Community Re-Entry through Addiction Treatment to Enhance Opportunities Act or the CREATE Opportunities Act
This bill establishes the Medication-Assisted Treatment Corrections and Community Reentry Program in the Department of Justice. Under the program, the National Institute of Corrections may award grants to support state or local programs that provide medication-assisted treatment for incarcerated individuals who have opioid-use disorders.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5697 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 5697
To authorize the Attorney General to make grants to, and enter into
cooperative agreements with, States and units of local government to
develop, implement, or expand one or more programs to provide
medication-assisted treatment to individuals who have opioid use
disorder and are incarcerated within the jurisdictions of the States or
units of local government.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 22, 2021
Ms. Kuster (for herself, Mrs. Walorski, Ms. Blunt Rochester, and Mr.
Turner) introduced the following bill; which was referred to the
Committee on the Judiciary
_______________________________________________________________________
A BILL
To authorize the Attorney General to make grants to, and enter into
cooperative agreements with, States and units of local government to
develop, implement, or expand one or more programs to provide
medication-assisted treatment to individuals who have opioid use
disorder and are incarcerated within the jurisdictions of the States or
units of local government.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Community Re-Entry through Addiction
Treatment to Enhance Opportunities Act'' or as the ``CREATE
Opportunities Act''.
SEC. 2. MEDICATION-ASSISTED TREATMENT CORRECTIONS AND COMMUNITY REENTRY
PROGRAM.
(a) Definitions.--In this section--
(1) the term ``Attorney General'' means the Attorney
General, acting through the Director of the National Institute
of Corrections;
(2) the term ``certified recovery coach'' means an
individual--
(A) with knowledge of, or experience with, recovery
from a substance use disorder; and
(B) who--
(i) has completed training through, and is
determined to be in good standing by--
(I) a single State agency; or
(II) a recovery community
organization that is capable of
conducting that training and making
that determination; and
(ii) meets the criteria specified by the
Attorney General, in consultation with the
Secretary of Health and Human Services, for
qualifying as a certified recovery coach for
the purposes of this Act;
(3) the term ``correctional facility'' has the meaning
given the term in section 901 of title I of the Omnibus Crime
Control and Safe Streets Act of 1968 (34 U.S.C. 10251);
(4) the term ``covered grant or cooperative agreement''
means a grant received, or cooperative agreement entered into,
under the Program;
(5) the term ``covered program'' means a program--
(A) to provide medication-assisted treatment to
individuals who have opioid use disorder and are
incarcerated within the jurisdiction of the State or
unit of local government carrying out the program; and
(B) that is developed, implemented, or expanded
through a covered grant or cooperative agreement;
(6) the term ``medication-assisted treatment'' means the
use of one or more drugs, or one or more combinations of drugs,
that have been approved under the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 301 et seq.) or section 351 of the
Public Health Service Act (42 U.S.C. 262) for the treatment of
an opioid use disorder, in combination with evidence-based
counseling and behavioral therapies, such as psychosocial
counseling, overseen by one or more social work professionals
and one or more qualified clinicians, to provide a
comprehensive approach to the treatment of substance use
disorders;
(7) the term ``nonprofit organization'' means an
organization that is described in section 501(c)(3) of the
Internal Revenue Code of 1986 and is exempt from taxation under
section 501(a) of such Code;
(8) the term ``Panel'' means the Medication-assisted
Treatment Corrections and Community Reentry Application Review
Panel established under subsection (e)(2);
(9) the term ``participant'' means an individual who
participates in a covered program;
(10) the term ``political appointee'' has the meaning given
the term in section 714(h) of title 38, United States Code;
(11) the term ``Program'' means the Medication-Assisted
Treatment Corrections and Community Reentry Program established
under subsection (b);
(12) the term ``psychosocial'' means the interrelation of
social factors and individual thought and behavior;
(13) the term ``recovery community organization'' has the
meaning given the term in section 547 of the Public Health
Service Act (42 U.S.C. 290ee-2);
(14) the term ``single State agency'' means, with respect
to a State or unit of local government, the single State agency
identified by the State, or the State in which the unit of
local government is located, in the plan submitted by that
State under section 1932(b)(1)(A)(i) of the Public Health
Service Act (42 U.S.C. 300x-32(b)(1)(A)(i));
(15) the term ``State'' means--
(A) each State of the United States;
(B) the District of Columbia; and
(C) each commonwealth, territory, or possession of
the United States; and
(16) the term ``unit of local government'' has the meaning
given the term in section 901 of title I of the Omnibus Crime
Control and Safe Streets Act of 1968 (34 U.S.C. 10251), except
that such term also includes a tribal organization, as defined
in section 4 of the Indian Self-Determination and Education
Assistance Act (25 U.S.C. 5304).
(b) Authorization.--Not later than 90 days after the date of
enactment of this Act, the Attorney General, in consultation with the
Secretary of Health and Human Services, shall establish a program--
(1) that shall be known as the ``Medication-Assisted
Treatment Corrections and Community Reentry Program''; and
(2) under which the Attorney General--
(A) may make grants to, and enter into cooperative
agreements with, States or units of local government to
develop, implement, or expand one or more programs to
provide medication-assisted treatment that meets the
standard of care generally accepted for the treatment
of opioid use disorder to individuals who have opioid
use disorder and are incarcerated within the
jurisdictions of the States or units of local
government; and
(B) shall establish a working relationship with one
or more knowledgeable corrections organizations with
expertise in security, medical health, mental health,
and addiction care to oversee and support
implementation of the program, including through the
use of evidence-based clinical practices.
(c) Purposes.--The purposes of the Program are to--
(1) develop medication-assisted treatment programs in
consultation with nonprofit organizations and community
organizations that are qualified to provide technical support
for the programs;
(2) reduce the risk of overdose to participants after the
participants are released from incarceration; and
(3) reduce the rate of reincarceration.
(d) Program Requirements.--In carrying out a covered program, a
State or unit of local government shall--
(1) in providing medication-assisted treatment under the
covered program, offer to participants 2 or more drugs that--
(A) have been approved under the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 301 et seq.) or
section 351 of the Public Health Service Act (42 U.S.C.
262) for the treatment of an opioid use disorder; and
(B) do not contain the same active moiety; and
(2) use--
(A) screening tools with psychometric reliability
and validity that provide useful clinical data to guide
the long-term treatment of participants who have--
(i) opioid use disorder; or
(ii) co-occurring opioid use disorder and
mental disorders;
(B) at each correctional facility at which the
covered program is carried out, a sufficient number of
personnel, as determined by the Attorney General in
light of the number of individuals incarcerated at the
correctional facility and the number of those
individuals who the correctional facility has screened
and identified as having opioid use disorder, to--
(i) monitor participants with active opioid
use disorder who begin participation in the
covered program while demonstrating, or
develop, signs and symptoms of opioid
withdrawal;
(ii) provide evidence-based medically
managed withdrawal care or assistance to the
participants described in clause (i);
(iii) prescribe or otherwise dispense--
(I) the drugs that are offered
under the covered program, as required
under paragraph (1); and
(II) naloxone or any other
emergency opioid antagonist approved by
the Commissioner of Food and Drugs to
treat opioid overdose; and
(iv) discuss with participants the risks
and benefits of, and differences among, the
opioid antagonist, opioid agonist, and partial
agonist drugs used to treat opioid use
disorder; and
(C) a certified recovery coach, social work
professional, or other qualified clinician who, in
order to support the sustained recovery of
participants, shall work with participants who are
recovering from opioid use disorder.
(e) Application.--
(1) In general.--A State or unit of local government
desiring a covered grant or cooperative agreement shall submit
to the Attorney General an application that--
(A) shall include--
(i) a description of--
(I) the objectives of the
medication-assisted treatment program
that the applicant will develop,
implement, or expand under the covered
grant or cooperative agreement;
(II) the activities that the
applicant will carry out under the
covered program;
(III) how the activities described
under subclause (II) will achieve the
objectives described in subclause (I);
and
(IV) the outreach and education
component of the covered program that
the applicant will carry out in order
to encourage maximum participation in
the covered program;
(ii) if, under the covered program that the
applicant will carry out, the applicant will
not, in providing medication-assisted
treatment, offer to participants not less than
1 drug that uses an opioid antagonist, not less
than 1 drug that uses an opioid agonist, and
not less than 1 drug that uses an opioid
partial agonist, an explanation of why the
applicant is unable to or chooses not to offer
a drug that uses an opioid antagonist, a drug
that uses an opioid agonist, or a drug that
uses an opioid partial agonist, as applicable;
(iii) a plan for--
(I) measuring progress in achieving
the objectives described in clause
(i)(I), including a strategy to collect
data that can be used to measure that
progress;
(II) collaborating with the single
State agency for the applicant or one
or more nonprofit organizations in the
community of the applicant to help
ensure that--
(aa) if participants so
desire, participants have
continuity of care after
release from incarceration with
respect to the form of
medication-assisted treatment
the participants received
during incarceration,
including--
(AA) by working
with community service
providers to assist
eligible participants,
before release from
incarceration in
registering for the
Medicaid program under
title XIX of the Social
Security Act (42 U.S.C.
1396 et seq.) or other
minimum essential
coverage, as defined in
section 5000A(f) of the
Internal Revenue Code
of 1986; and
(BB) if a
participant cannot
afford, or does not
qualify for, health
insurance that provides
coverage with respect
to enrollment in a
medication-assisted
treatment program, and
if the participant
cannot pay the cost of
enrolling in a
medication-assisted
treatment program, by
working with units of
local government,
nonprofit
organizations, opioid
use disorder treatment
providers, and entities
carrying out programs
under substance use
disorder grants to,
before the participant
is released from
incarceration, identify
a resource, other than
the applicant or the
covered program to be
carried out by the
applicant, that may be
used to pay the cost of
enrolling the
participant in a
medication-assisted
treatment program;
(bb) medications are
securely stored; and
(cc) protocols relating to
diversion are maintained; and
(III) with respect to each
community in which a correctional
facility at which a covered program
will be carried out is located,
collaborating with State agencies
responsible for overseeing programs
relating to substance use disorder and
local public health officials and
nonprofit organizations in the
community to help ensure that
medication-assisted treatment provided
at each correctional facility at which
the covered program will be carried out
is also available at locations that are
not correctional facilities in those
communities, to the greatest extent
practicable; and
(iv) a certification that--
(I) each correctional facility at
which the covered program will be
carried out has access to a sufficient
number of clinicians who are licensed
to prescribe or otherwise dispense to
participants the drugs for the
treatment of opioid use disorder
required to be offered under subsection
(d)(1), which may include clinicians
who use telemedicine, in accordance
with regulations issued by the
Administrator of the Drug Enforcement
Administration, to provide services
under the covered program; and
(II) the covered program will
provide evidence-based counseling and
behavioral therapies, which may include
counseling and therapy administered
through the use of telemedicine, as
appropriate, to participants as part of
the medication-assisted treatment
provided under the covered program; and
(B) may include a statement indicating the number
of participants that the applicant expects to serve
through the covered program.
(2) Medication-assisted treatment corrections and community
reentry application review panel.--
(A) In general.--Not later than 60 days after the
date of enactment of this Act, the Attorney General
shall establish a Medication-Assisted Treatment
Corrections and Community Reentry Application Review
Panel that shall--
(i) be composed of not fewer than 10
individuals and not more than 15 individuals;
and
(ii) include--
(I) one or more employees, who are
not political appointees, of--
(aa) the Department of
Justice;
(bb) the Drug Enforcement
Administration;
(cc) the Substance Abuse
and Mental Health Service
Administration;
(dd) the National Center
for Injury Prevention and
Control at the Centers for
Disease Control and Prevention;
and
(ee) the Office of National
Drug Control Policy; and
(II) other stakeholders who--
(aa) have expert knowledge
relating to the opioid
epidemic, drug treatment, or
community addiction services;
and
(bb) represent law
enforcement organizations and
public health entities.
(B) Duties.--
(i) In general.--The Panel shall--
(I) review and evaluate
applications for covered grants and
cooperative agreements; and
(II) make recommendations to the
Attorney General relating to the
awarding of covered grants and
cooperative agreements.
(ii) Rural communities.--In reviewing and
evaluating applications under clause (i), the
Panel shall take into consideration the unique
circumstances, including the lack of resources
relating to the treatment of opioid use
disorder, faced by rural States and units of
local government.
(C) Termination.--The Panel shall terminate on the
last day of fiscal year 2025.
(3) Publication of criteria in federal register.--Not later
than 90 days after the date of enactment of this Act, the
Attorney General, in consultation with the Panel, shall publish
in the Federal Register--
(A) the process through which applications
submitted under paragraph (1) shall be submitted and
evaluated; and
(B) the criteria used in awarding covered grants
and cooperative agreements.
(f) Duration.--A covered grant or cooperative agreement shall be
for a period of not more than 4 years, except that the Attorney General
may extend the term of a covered grant or cooperative agreement based
on outcome data or extenuating circumstances relating to the covered
program carried out under the covered grant or cooperative agreement.
(g) Report.--
(1) In general.--Not later than 2 years after the date on
which a State or unit of local government is awarded a covered
grant or cooperative agreement, and each year thereafter until
the date that is 1 year after the date on which the period of
the covered grant or cooperative agreement ends, the State or
unit of local government shall submit a report to the Attorney
General that includes information relating to the covered
program carried out by the State or unit of local government,
including information relating to--
(A) the goals of the covered program;
(B) any evidence-based interventions carried out
under the covered program;
(C) outcomes of the covered program, which shall--
(i) be reported in a manner that
distinguishes the outcomes based on the
categories of, with respect to the participants
in the covered program--
(I) the race of the participants;
and
(II) the gender of the
participants; and
(ii) include information relating to the
rate of reincarceration among participants in
the covered program; and
(D) expenditures under the covered program.
(2) Publication.--
(A) Awardee.--A State or unit of local government
that submits a report under paragraph (1) shall make
the report publicly available on--
(i) the website of each correctional
facility at which the State or unit of local
government carried out the covered grant
program; and
(ii) if a correctional facility at which
the State or unit of local government carried
out the covered grant program does not operate
a website, the website of the State or unit of
local government.
(B) Attorney general.--The Attorney General shall
make each report received under paragraph (1) publicly
available on the website of the National Institute of
Corrections.
(3) Submission to congress.--Not later than 2 years after
the date on which the Attorney General awards the first covered
grant or cooperative agreement, and each year thereafter, the
Attorney General shall submit to the Committee on the Judiciary
of the Senate and the Committee on the Judiciary of the House
of Representatives a summary and compilation of the reports
that the Attorney General has received under paragraph (1)
during the year preceding the date on which the Attorney
General submits the summary and compilation.
(h) Authorization of Appropriations.--There is authorized to be
appropriated $50,000,000 to carry out this section for each of fiscal
years 2022 through 2025.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on the Judiciary.
Referred to the Subcommittee on Crime, Terrorism, and Homeland Security.
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