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First Responders – Comprehensive Addiction and Recovery Act (FR-CARA)


Additional Links

Notice of Funding Opportunity (


Application Deadline: Apr 15, 2024


Substance Abuse and Mental Health Services Administration (SAMHSA)


Awards funding to support the use of naloxone and other drugs or devices approved by the Food and Drug Administration (FDA) for emergency reversal of known or suspected opioid overdose by first responders, including firefighters, law enforcement officers, paramedics, emergency medical technicians, mobile crisis providers, or other organizations that respond to overdose related incidents, and members of other key community sectors. Provides training and resources at the state, tribal, and local levels to first responders on carrying and administering drugs or devices approved for emergency treatment of known or suspected opioid overdose. Establishes processes and protocols for referral to appropriate treatment, recovery, harm reduction, and other psychosocial support services. Offers safety education around fentanyl, synthetic opioids, and other drug trends associated with overdoses.

The target population includes underserved communities, as defined by Executive Order 13985, communities disproportionately impacted by overdose, and individuals residing in counties with a Social Vulnerability Index (SVI) score between 0.75 and 1.0. Rural communities are a priority.

Required program activities include:

  • Support the availability and use of FD&C Act approved or cleared devices, including naloxone, for emergency reversal of known or suspected opioid overdose by first responders and other key community sectors
  • Train and provide resources for first responders and members of other key community sectors on carrying and administering drugs or devices for emergency reversal of known or suspected opioid overdose, overdose awareness education, and related safety measures, policies, and procedures
  • Establish culturally and linguistically appropriate processes, protocols, and mechanisms for referral to treatment, recovery, harm reduction, and other psychosocial support services including the use of outreach coordinators, peer support specialists to provide follow-up support and referrals
  • Form or join an advisory committee to provide guidance, monitor progress, and ensure that goals are being met
  • Conduct and submit the results of resource mapping within 4 months of the award to identify existing community assets, strengths, needs, and gaps related to overdose prevention
  • Establish organizational policies and procedures for the implementation of evidence-based, trauma-informed care practices
  • Develop strategies to increase access to services for people of all underserved groups in the community
  • Hire staff that represent the population of the community, and translate tools and resources available to recipients
  • Develop culturally and linguistically appropriate conflict and grievance resolutions processes

Amount of Funding

Award ceiling: $800,000 per year
Award floor: $300,000 per year
Project period: Up to 4 years
Estimated number of awards: 15
Estimated total program funding: $ 6,200,000

Approximately $6,200,000 of the total funding will be awarded to applicants serving rural communities, and at least 3 awards will be made to tribes and tribal organizations, pending adequate application volume.

Who Can Apply

Applications may be submitted by:

  • State and territorial governments
  • Federally recognized American Indian/Alaska Native (AI/AN) tribes, tribal organizations, Urban Indian Organizations, and consortia of tribes or tribal organizations
  • Local governmental entities including, but not limited to, municipal corporations, counties, cities, boroughs, incorporated towns, and townships

Applicants proposing to serve rural communities must identify a catchment area defined as 1 of the following:

  • A nonmetropolitan statistical area (MSA)
  • An area designated as a rural area by any law or regulation of a state
  • A rural census tract of a MSA

To determine whether a county or specific address is designated as rural for this funding opportunity, use the 2010 rural-urban commuting area (RUCA) codes.

Current First Responders-Comprehensive Addiction and Recovery Act (FR-CARA) are eligible for this opportunity if the population of focus and geographic/catchment area are different from their current funded application.

Additional provision of service requirements include:

  • Each primary applicant SUD prevention, treatment, or recovery support provider organization must have at least 2 years of experience as of the due date of the application providing relevant services. Official documents must establish that the organization has provided relevant services for the last 2 years.
  • Each SUD prevention, treatment, or recovery support treatment provider organization must comply with all applicable local, city, county, and state licensing, accreditation, and certification requirements, as of the due date of the application.

Geographic Coverage


What This Program Funds

Training Providers

Application Process

Application instructions, requirements, and other information about the online application process can be found in the funding announcement.

Applicant webinar recording and slides


For programmatic or technical questions:
Shannon Hastings

For grants management or budget questions:

For grant review process and application status questions:
Toni Davidson

Rural Awards

Past awards communities received in fiscal year 2023 can be found on the program website.

One rural community who received funding is the Cherokee County Health Services Council in Tahlequah, Oklahoma for the Opioid Response Initiative that will serve law enforcement and first responder organizations in 4 rural counties in northeastern Oklahoma. The project will provide resources, training, and support to 2,200 first responders for the purchase, distribution, and use of naloxone for the emergency reversal of known or suspected opioid overdoses.

Topics This Program Addresses

Emergency Medical Services • Harm Reduction • Health Education for Community and Patients • Naloxone • Opioids • Overdose Prevention • Recovery • Substance Use Disorder • Treatment