CREATE Opportunities Act

I 116TH CONGRESS 1ST SESSION H. R. 3496 To authorize the Attorney General to make grants to, and enter into coopera- tive 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 govern- ment. IN THE HOUSE OF REPRESENTATIVES JUNE 26, 2019 Ms. KUSTER of New Hampshire (for herself, Mr. TURNER, Ms. BLUNT ROCH- ESTER, and Mrs. WALORSKI) introduced the following bill; which was re- ferred 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 Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 2 •HR 3496 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Community Re-Entry 2 through Addiction Treatment to Enhance Opportunities 3 Act’’ or as the ‘‘CREATE Opportunities Act’’. 4 SEC. 2. MEDICATION-ASSISTED TREATMENT CORRECTIONS 5 AND COMMUNITY REENTRY PROGRAM. 6 (a) DEFINITIONS.—In this section— 7 (1) the term ‘‘Attorney General’’ means the At- 8 torney General, acting through the Director of the 9 National Institute of Corrections; 10 (2) the term ‘‘certified recovery coach’’ means 11 an individual— 12 (A) with knowledge of, or experience with, 13 recovery from a substance use disorder; and 14 (B) who— 15 (i) has completed training through, 16 and is determined to be in good standing 17 by— 18 (I) a single State agency; or 19 (II) a recovery community orga- 20 nization that is capable of conducting 21 that training and making that deter- 22 mination; and 23 (ii) meets the criteria specified by the 24 Attorney General, in consultation with the 25 Secretary of Health and Human Services, 26 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 3 •HR 3496 IH for qualifying as a certified recovery coach 1 for the purposes of this Act; 2 (3) the term ‘‘correctional facility’’ has the 3 meaning given the term in section 901 of title I of 4 the Omnibus Crime Control and Safe Streets Act of 5 1968 (34 U.S.C. 10251); 6 (4) the term ‘‘covered grant or cooperative 7 agreement’’ means a grant received, or cooperative 8 agreement entered into, under the Program; 9 (5) the term ‘‘covered program’’ means a pro- 10 gram— 11 (A) to provide medication-assisted treat- 12 ment to individuals who have opioid use dis- 13 order and are incarcerated within the jurisdic- 14 tion of the State or unit of local government 15 carrying out the program; and 16 (B) that is developed, implemented, or ex- 17 panded through a covered grant or cooperative 18 agreement; 19 (6) the term ‘‘medication-assisted treatment’’ 20 means the use of one or more drugs, or one or more 21 combinations of drugs, that have been approved 22 under the Federal Food, Drug, and Cosmetic Act 23 (21 U.S.C. 301 et seq.) or section 351 of the Public 24 Health Service Act (42 U.S.C. 262) for the treat- 25 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 4 •HR 3496 IH ment of an opioid use disorder, in combination with 1 evidence-based counseling and behavioral therapies, 2 such as psychosocial counseling, overseen by one or 3 more social work professionals and one or more 4 qualified clinicians, to provide a comprehensive ap- 5 proach to the treatment of substance use disorders; 6 (7) the term ‘‘nonprofit organization’’ means an 7 organization that is described in section 501(c)(3) of 8 the Internal Revenue Code of 1986 and is exempt 9 from taxation under section 501(a) of such Code; 10 (8) the term ‘‘Panel’’ means the Medication-as- 11 sisted Treatment Corrections and Community Re- 12 entry Application Review Panel established under 13 subsection (e)(2); 14 (9) the term ‘‘participant’’ means an individual 15 who participates in a covered program; 16 (10) the term ‘‘political appointee’’ has the 17 meaning given the term in section 714(h) of title 38, 18 United States Code; 19 (11) the term ‘‘Program’’ means the Medica- 20 tion-Assisted Treatment Corrections and Community 21 Reentry Program established under subsection (b); 22 (12) the term ‘‘psychosocial’’ means the inter- 23 relation of social factors and individual thought and 24 behavior; 25 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 5 •HR 3496 IH (13) the term ‘‘recovery community organiza- 1 tion’’ has the meaning given the term in section 547 2 of the Public Health Service Act (42 U.S.C. 290ee– 3 2); 4 (14) the term ‘‘single State agency’’ means, 5 with respect to a State or unit of local government, 6 the single State agency identified by the State, or 7 the State in which the unit of local government is 8 located, in the plan submitted by that State under 9 section 1932(b)(1)(A)(i) of the Public Health Serv- 10 ice Act (42 U.S.C. 300x–32(b)(1)(A)(i)); 11 (15) the term ‘‘State’’ means— 12 (A) each State of the United States; 13 (B) the District of Columbia; and 14 (C) each commonwealth, territory, or pos- 15 session of the United States; and 16 (16) the term ‘‘unit of local government’’ has 17 the meaning given the term in section 901 of title 18 I of the Omnibus Crime Control and Safe Streets 19 Act of 1968 (34 U.S.C. 10251), except that such 20 term also includes a tribal organization, as defined 21 in section 4 of the Indian Self-Determination and 22 Education Assistance Act (25 U.S.C. 5304). 23 (b) AUTHORIZATION.—Not later than 90 days after 24 the date of enactment of this Act, the Attorney General, 25 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 6 •HR 3496 IH in consultation with the Secretary of Health and Human 1 Services, shall establish a program— 2 (1) that shall be known as the ‘‘Medication-As- 3 sisted Treatment Corrections and Community Re- 4 entry Program’’; and 5 (2) under which the Attorney General— 6 (A) may make grants to, and enter into co- 7 operative agreements with, States or units of 8 local government to develop, implement, or ex- 9 pand one or more programs to provide medica- 10 tion-assisted treatment that meets the standard 11 of care generally accepted for the treatment of 12 opioid use disorder to individuals who have 13 opioid use disorder and are incarcerated within 14 the jurisdictions of the States or units of local 15 government; and 16 (B) shall establish a working relationship 17 with one or more knowledgeable corrections or- 18 ganizations with expertise in security, medical 19 health, mental health, and addiction care to 20 oversee and support implementation of the pro- 21 gram, including through the use of evidence- 22 based clinical practices. 23 (c) PURPOSES.—The purposes of the Program are 24 to— 25 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 7 •HR 3496 IH (1) develop medication-assisted treatment pro- 1 grams in consultation with nonprofit organizations 2 and community organizations that are qualified to 3 provide technical support for the programs; 4 (2) reduce the risk of overdose to participants 5 after the participants are released from incarcer- 6 ation; and 7 (3) reduce the rate of reincarceration. 8 (d) PROGRAM REQUIREMENTS.—In carrying out a 9 covered program, a State or unit of local government 10 shall— 11 (1) in providing medication-assisted treatment 12 under the covered program, offer to participants 2 13 or more drugs that— 14 (A) have been approved under the Federal 15 Food, Drug, and Cosmetic Act (21 U.S.C. 301 16 et seq.) or section 351 of the Public Health 17 Service Act (42 U.S.C. 262) for the treatment 18 of an opioid use disorder; and 19 (B) do not contain the same active moiety; 20 and 21 (2) use— 22 (A) screening tools with psychometric reli- 23 ability and validity that provide useful clinical 24 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 8 •HR 3496 IH data to guide the long-term treatment of par- 1 ticipants who have— 2 (i) opioid use disorder; or 3 (ii) co-occurring opioid use disorder 4 and mental disorders; 5 (B) at each correctional facility at which 6 the covered program is carried out, a sufficient 7 number of personnel, as determined by the At- 8 torney General in light of the number of indi- 9 viduals incarcerated at the correctional facility 10 and the number of those individuals who the 11 correctional facility has screened and identified 12 as having opioid use disorder, to— 13 (i) monitor participants with active 14 opioid use disorder who begin participation 15 in the covered program while dem- 16 onstrating, or develop, signs and symptoms 17 of opioid withdrawal; 18 (ii) provide evidence-based medically 19 managed withdrawal care or assistance to 20 the participants described in clause (i); 21 (iii) prescribe or otherwise dispense— 22 (I) the drugs that are offered 23 under the covered program, as re- 24 quired under paragraph (1); and 25 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 9 •HR 3496 IH (II) naloxone or any other emer- 1 gency opioid antagonist approved by 2 the Commissioner of Food and Drugs 3 to treat opioid overdose; and 4 (iv) discuss with participants the risks 5 and benefits of, and differences among, the 6 opioid antagonist, opioid agonist, and par- 7 tial agonist drugs used to treat opioid use 8 disorder; and 9 (C) a certified recovery coach, social work 10 professional, or other qualified clinician who, in 11 order to support the sustained recovery of par- 12 ticipants, shall work with participants who are 13 recovering from opioid use disorder. 14 (e) APPLICATION.— 15 (1) IN GENERAL.—A State or unit of local gov- 16 ernment desiring a covered grant or cooperative 17 agreement shall submit to the Attorney General an 18 application that— 19 (A) shall include— 20 (i) a description of— 21 (I) the objectives of the medica- 22 tion-assisted treatment program that 23 the applicant will develop, implement, 24 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 10 •HR 3496 IH or expand under the covered grant or 1 cooperative agreement; 2 (II) the activities that the appli- 3 cant will carry out under the covered 4 program; 5 (III) how the activities described 6 under subclause (II) will achieve the 7 objectives described in subclause (I); 8 and 9 (IV) the outreach and education 10 component of the covered program 11 that the applicant will carry out in 12 order to encourage maximum partici- 13 pation in the covered program; 14 (ii) if, under the covered program that 15 the applicant will carry out, the applicant 16 will not, in providing medication-assisted 17 treatment, offer to participants not less 18 than 1 drug that uses an opioid antago- 19 nist, not less than 1 drug that uses an 20 opioid agonist, and not less than 1 drug 21 that uses an opioid partial agonist, an ex- 22 planation of why the applicant is unable to 23 or chooses not to offer a drug that uses an 24 opioid antagonist, a drug that uses an 25 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 11 •HR 3496 IH opioid agonist, or a drug that uses an 1 opioid partial agonist, as applicable; 2 (iii) a plan for— 3 (I) measuring progress in achiev- 4 ing the objectives described in clause 5 (i)(I), including a strategy to collect 6 data that can be used to measure that 7 progress; 8 (II) collaborating with the single 9 State agency for the applicant or one 10 or more nonprofit organizations in the 11 community of the applicant to help 12 ensure that— 13 (aa) if participants so desire, 14 participants have continuity of 15 care after release from incarcer- 16 ation with respect to the form of 17 medication-assisted treatment the 18 participants received during in- 19 carceration, including— 20 (AA) by working with 21 community service providers 22 to assist eligible partici- 23 pants, before release from 24 incarceration in registering 25 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 12 •HR 3496 IH for the Medicaid program 1 under title XIX of the Social 2 Security Act (42 U.S.C. 3 1396 et seq.) or other min- 4 imum essential coverage, as 5 defined in section 5000A(f) 6 of the Internal Revenue 7 Code of 1986; and 8 (BB) if a participant 9 cannot afford, or does not 10 qualify for, health insurance 11 that provides coverage with 12 respect to enrollment in a 13 medication-assisted treat- 14 ment program, and if the 15 participant cannot pay the 16 cost of enrolling in a medi- 17 cation-assisted treatment 18 program, by working with 19 units of local government, 20 nonprofit organizations, 21 opioid use disorder treat- 22 ment providers, and entities 23 carrying out programs under 24 substance use disorder 25 VerDate Sep 11 2014 03:03 Jul 10, 2019 Jkt 089200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H3496.IH H3496 SSpencer on DSKBBXCHB2PROD with BILLS 13 •HR 3496 IH grants to, before the partici- 1 pant is released from incar- 2 ceration, identify a resource, 3 other than the applicant or 4 the covered program to be 5 carried out by the applicant, 6 that may be used to pay the 7 cost of enrolling the partici- 8 pant in a medication-as- 9 sisted treatment program; 10 (bb) medications are se- 11 curely stored; and 12 (cc) protocols relating to di- 13 version are maintained; and 14 (III) with respect to each com- 15 munity in which a correctional facility 16 at which a covered program will be 17 carried [Text truncated for display. 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