1. Short title This Act may be cited as the Alternatives to Opioids (ALTO) in the Emergency Department Act . 2. Findings The Congress finds as follows: (1) Opioids contributed to the deaths of more than 42,000 people in 2016, more than any year on official record. Forty percent of all opioid overdose deaths involve a prescription opioid. (2) The economic burden of prescription opioid misuse in the United States is estimated to be $78,500,000,000 per year. This includes costs stemming from health care, including addiction treatment, lost productivity, and criminal justice involvement. (3) Over 200 million opioid prescriptions are written in the United States each year, and 2,000,000 Americans have the symptoms of substance use disorder. (4) Approximately 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. (5) Emergency departments in several States, including in New Jersey and Colorado, have developed innovative programs to more widely utilize non-opioid pain treatments to reduce the use of opioids. 3. Emergency department alternatives to opioids demonstration program (a) Demonstration program grants The Secretary of Health and Human Services acting through the Assistant Secretary for Mental Health and Substance Use (in this section referred to as the Secretary ) shall carry out a 3-year demonstration program under which the Secretary shall award grants to eligible hospitals and emergency departments, including freestanding emergency departments, to develop, implement, enhance, or study alternative pain management protocols and treatments that promote the appropriate limited use of opioids in emergency departments. (b) Eligibility To be eligible to receive a grant under subsection (a), a hospital or emergency department shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require. (c) Geographic diversity In awarding grants under this section, the Secretary shall seek to ensure geographical diversity among grant