II 

117TH CONGRESS 

1ST SESSION S. 3028 

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 1 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 SENATE OF THE UNITED STATES 

OCTOBER 20, 2021 

Mr. MARKEY (for himself and Ms. MURKOWSKI) introduced the following bill; 

which was read twice and 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 

1 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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Community Re-Entry 

3 through Addiction Treatment to Enhance Opportunities 

4 Act’’ or as the ‘‘CREATE Opportunities Act’’. 

5 SEC. 2. MEDICATION-ASSISTED TREATMENT CORRECTIONS 

6 AND COMMUNITY REENTRY PROGRAM. 

7 (a) DEFINITIONS.—In this section— 

8 (1) the term ‘‘Attorney General’’ means the At9 torney General, acting through the Director of the 

10 National Institute of Corrections; 

11 (2) the term ‘‘certified recovery coach’’ means 

12 an individual— 

13 (A) with knowledge of, or experience with, 

14 recovery from a substance use disorder; and 

15 (B) who— 

16 (i) has completed training through, 

17 and is determined to be in good standing 

18 by— 

19 (I) a single State agency; or 

20 (II) a recovery community orga21 nization that is capable of conducting 

22 that training and making that deter23 mination; and 

24 (ii) meets the criteria specified by the 

25 Attorney General, in consultation with the 

26 Secretary of Health and Human Services, 


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1 for qualifying as a certified recovery coach 

2 for the purposes of this Act; 

3 (3) the term ‘‘correctional facility’’ has the 

4 meaning given the term in section 901 of title I of 

5 the Omnibus Crime Control and Safe Streets Act of 

6 1968 (34 U.S.C. 10251); 

7 (4) the term ‘‘covered grant or cooperative 

8 agreement’’ means a grant received, or cooperative 

9 agreement entered into, under the Program; 

10 (5) the term ‘‘covered program’’ means a pro11 gram— 

12 (A) to provide medication-assisted treat13 ment to individuals who have opioid use dis14 order and are incarcerated within the jurisdic15 tion of the State or unit of local government 

16 carrying out the program; and 

17 (B) that is developed, implemented, or ex18 panded through a covered grant or cooperative 

19 agreement; 

20 (6) the term ‘‘medication-assisted treatment’’ 

21 means the use of 1 or more drugs, or 1 or more 

22 combinations of drugs, that have been approved 

23 under the Federal Food, Drug, and Cosmetic Act 

24 (21 U.S.C. 301 et seq.) or section 351 of the Public 

25 Health Service Act (42 U.S.C. 262) for the treatVerDate Sep 11 2014 00:14 Oct 26, 2021 Jkt 029200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3028.IS S3028

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1 ment of an opioid use disorder, in combination with 

2 evidence-based counseling and behavioral therapies, 

3 such as psychosocial counseling, overseen by 1 or 

4 more social work professionals and 1 or more quali5 fied clinicians, to provide a comprehensive approach 

6 to the treatment of substance use disorders; 

7 (7) the term ‘‘nonprofit organization’’ means an 

8 organization that is described in section 501(c)(3) of 

9 the Internal Revenue Code of 1986 and is exempt 

10 from taxation under section 501(a) of such Code; 

11 (8) the term ‘‘Panel’’ means the Medication-as12 sisted Treatment Corrections and Community Re13 entry Application Review Panel established under 

14 subsection (e)(2); 

15 (9) the term ‘‘participant’’ means an individual 

16 who participates in a covered program; 

17 (10) the term ‘‘political appointee’’ has the 

18 meaning given the term in section 714(h) of title 38, 

19 United States Code; 

20 (11) the term ‘‘Program’’ means the Medica21 tion-assisted Treatment Corrections and Community 

22 Reentry Program established under subsection (b); 

23 (12) the term ‘‘psychosocial’’ means the inter24 relation of social factors and individual thought and 

25 behavior; 


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1 (13) the term ‘‘recovery community organiza2 tion’’ has the meaning given the term in section 547 

3 of the Public Health Service Act (42 U.S.C. 290ee– 

4 2); 

5 (14) the term ‘‘single State agency’’ means, 

6 with respect to a State or unit of local government, 

7 the single State agency identified by the State, or 

8 the State in which the unit of local government is 

9 located, in the plan submitted by that State under 

10 section 1932(b)(1)(A)(i) of the Public Health Serv11 ice Act (42 U.S.C. 300x–32(b)(1)(A)(i)); 

12 (15) the term ‘‘State’’ means— 

13 (A) each State of the United States; 

14 (B) the District of Columbia; and 

15 (C) each commonwealth, territory, or pos16 session of the United States; and 

17 (16) the term ‘‘unit of local government’’ has 

18 the meaning given the term in section 901 of title 

19 I of the Omnibus Crime Control and Safe Streets 

20 Act of 1968 (34 U.S.C. 10251), except that such 

21 term also includes a tribal organization, as defined 

22 in section 4 of the Indian Self-Determination and 

23 Education Assistance Act (25 U.S.C. 5304). 

24 (b) AUTHORIZATION.—Not later than 90 days after 

25 the date of enactment of this Act, the Attorney General, 


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1 in consultation with the Secretary of Health and Human 

2 Services, shall establish a program— 

3 (1) that shall be known as the ‘‘Medication-as4 sisted Treatment Corrections and Community Re5 entry Program’’; and 

6 (2) under which the Attorney General— 

7 (A) may make grants to, and enter into co8 operative agreements with, States or units of 

9 local government to develop, implement, or ex10 pand 1 or more programs to provide medica11 tion-assisted treatment that meets the standard 

12 of care generally accepted for the treatment of 

13 opioid use disorder to individuals who have 

14 opioid use disorder and are incarcerated within 

15 the jurisdictions of the States or units of local 

16 government; and 

17 (B) shall establish a working relationship 

18 with 1 or more knowledgeable corrections orga19 nizations with expertise in security, medical 

20 health, mental health, and addiction care to 

21 oversee and support implementation of the pro22 gram, including through the use of evidence23 based clinical practices. 

24 (c) PURPOSES.—The purposes of the Program are 

25 to— 


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1 (1) develop medication-assisted treatment pro2 grams in consultation with nonprofit organizations 

3 and community organizations that are qualified to 

4 provide technical support for the programs; 

5 (2) reduce the risk of overdose to participants 

6 after the participants are released from incarcer7 ation; and 

8 (3) reduce the rate of reincarceration. 

9 (d) PROGRAM REQUIREMENTS.—In carrying out a 

10 covered program, a State or unit of local government 

11 shall— 

12 (1) in providing medication-assisted treatment 

13 under the covered program, offer to participants 3 

14 or more drugs that— 

15 (A) have been approved under the Federal 

16 Food, Drug, and Cosmetic Act (21 U.S.C. 301 

17 et seq.) or section 351 of the Public Health 

18 Service Act (42 U.S.C. 262) for the treatment 

19 of an opioid use disorder; and 

20 (B) do not contain the same active moiety; 

21 and 

22 (2) use— 

23 (A) screening tools with psychometric reli24 ability and validity that provide useful clinical 


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1 data to guide the long-term treatment of par2 ticipants who have— 

3 (i) opioid use disorder; or 

4 (ii) co-occurring opioid use disorder 

5 and mental disorders; 

6 (B) at each correctional facility at which 

7 the covered program is carried out, a sufficient 

8 number of personnel, as determined by the At9 torney General in light of the number of indi10 viduals incarcerated at the correctional facility 

11 and the number of those individuals who the 

12 correctional facility has screened and identified 

13 as having opioid use disorder, to— 

14 (i) monitor participants with active 

15 opioid use disorder who begin participation 

16 in the covered program while demonstrat17 ing, or develop, signs and symptoms of 

18 opioid withdrawal; 

19 (ii) provide evidence-based medically 

20 managed withdrawal care or assistance to 

21 the participants described in clause (i); 

22 (iii) prescribe or otherwise dispense— 

23 (I) the drugs that are offered 

24 under the covered program, as re25 quired under paragraph (1); and 


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1 (II) naloxone or any other emer2 gency opioid antagonist approved by 

3 the Commissioner of Food and Drugs 

4 to treat opioid overdose; and 

5 (iv) discuss with participants the risks 

6 and benefits of, and differences among, the 

7 opioid antagonist, opioid agonist, and par8 tial agonist drugs used to treat opioid use 

9 disorder; and 

10 (C) a certified recovery coach, social work 

11 professional, or other qualified clinician who, in 

12 order to support the sustained recovery of par13 ticipants, shall work with participants who are 

14 recovering from opioid use disorder. 

15 (e) APPLICATION.— 

16 (1) IN GENERAL.—A State or unit of local gov17 ernment desiring a covered grant or cooperative 

18 agreement shall submit to the Attorney General an 

19 application that— 

20 (A) shall include— 

21 (i) a description of— 

22 (I) the objectives of the medica23 tion-assisted treatment program that 

24 the applicant will develop, implement, 


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1 or expand under the covered grant or 

2 cooperative agreement; 

3 (II) the activities that the appli4 cant will carry out under the covered 

5 program; 

6 (III) how the activities described 

7 under subclause (II) will achieve the 

8 objectives described in subclause (I); 

9 and 

10 (IV) the outreach and education 

11 component of the covered program 

12 that the applicant will carry out in 

13 order to encourage maximum partici14 pation in the covered program; 

15 (ii) a plan for— 

16 (I) measuring progress in achiev17 ing the objectives described in clause 

18 (i)(I), including a strategy to collect 

19 data that can be used to measure that 

20 progress; 

21 (II) collaborating with the single 

22 State agency for the applicant or 1 or 

23 more nonprofit organizations in the 

24 community of the applicant to help 

25 ensure that— 


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1 (aa) if participants so desire, 

2 participants have continuity of 

3 care after release from incarcer4 ation with respect to the form of 

5 medication-assisted treatment the 

6 participants received during in7 carceration, including— 

8 (AA) by working with 

9 community service providers 

10 to assist eligible partici11 pants, before release from 

12 incarceration in registering 

13 for the Medicaid program 

14 under title XIX of the Social 

15 Security Act (42 U.S.C. 

16 1396 et seq.) or other min17 imum essential coverage, as 

18 defined in section 5000A(f) 

19 of the Internal Revenue 

20 Code of 1986; and 

21 (BB) if a participant 

22 cannot afford, or does not 

23 qualify for, health insurance 

24 that provides coverage with 

25 respect to enrollment in a 


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1 medication-assisted treat2 ment program, and if the 

3 participant cannot pay the 

4 cost of enrolling in a medi5 cation-assisted treatment 

6 program, by working with 

7 units of local government, 

8 nonprofit organizations, 

9 opioid use disorder treat10 ment providers, and entities 

11 carrying out programs under 

12 substance use disorder 

13 grants to, before the partici14 pant is released from incar15 ceration, identify a resource, 

16 other than the applicant or 

17 the covered program to be 

18 carried out by the applicant, 

19 that may be used to pay the 

20 cost of enrolling the partici21 pant in a medication-as22 sisted treatment program; 

23 (bb) medications are se24 curely stored; and 


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1 (cc) protocols relating to di2 version are maintained; and 

3 (III) with respect to each com4 munity in which a correctional facility 

5 at which a covered program will be 

6 carried out is located, collaborating 

7 with State agencies responsible for 

8 overseeing programs relating to sub9 stance use disorder and local public 

10 health officials and nonprofit organi11 zations in the community to help en12 sure that medication-assisted treat13 ment provided at each correctional fa14 cility at which the covered program 

15 will be carried out is also available at 

16 locations that are not correctional fa17 cilities in those communities, to the 

18 greatest extent practicable; and 

19 (iii) a certification that— 

20 (I) each correctional facility at 

21 which the covered program will be 

22 carried out has access to a sufficient 

23 number of clinicians who are licensed 

24 to prescribe or otherwise dispense to 

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1 ment of opioid use disorder required 

2 to be offered under subsection (d)(1), 

3 which may include clinicians who use 

4 telemedicine, in accordance with regu5 lations issued by the Administrator of 

6 the Drug Enforcement Administra7 tion, to provide services under the cov8 ered program; and 

9 (II) the covered program will 

10 provide evidence-based counseling and 

11 behavioral therapies, which may in12 clude counseling and therapy adminis13 tered through the use of telemedicine, 

14 as appropriate, to participants as part 

15 of the medication-assisted treatment 

16 provided under the covered program; 

17 and 

18 (B) may include a statement indicating the 

19 number of participants that the applicant ex20 pects to serve through the covered program. 

21 (2) MEDICATION-ASSISTED TREATMENT COR22 RECTIONS AND COMMUNITY REENTRY APPLICATION

23 REVIEW PANEL.— 

24 (A) IN GENERAL.—Not later than 60 days 

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1 torney General shall establish a Medication-as2 sisted Treatment Corrections and Community 

3 Reentry Application Review Panel that shall— 

4 (i) be composed of not fewer than 10 

5 individuals and not more than 15 individ6 uals; and 

7 (ii) include— 

8 (I) 1 or more employees, who are 

9 not political appointees, of— 

10 (aa) the Department of Jus11 tice; 

12 (bb) the Drug Enforcement 

13 Administration; 

14 (cc) the Substance Abuse 

15 and Mental Health Service Ad16 ministration; 

17 (dd) the National Center for 

18 Injury Prevention and Control at 

19 the Centers for Disease Control 

20 and Prevention; and 

21 (ee) the Office of National 

22 Drug Control Policy; and 

23 (II) other stakeholders who— 

24 (aa) have expert knowledge 

25 relating to the opioid epidemic, 


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1 drug treatment, or community 

2 addiction services; and 

3 (bb) represent law enforce4 ment organizations and public 

5 health entities. 

6 (B) DUTIES.— 

7 (i) IN GENERAL.—The Panel shall— 

8 (I) review and evaluate applica9 tions for covered grants and coopera10 tive agreements; and 

11 (II) make recommendations to 

12 the Attorney General relating to the 

13 awarding of covered grants and coop14 erative agreements. 

15 (ii) RURAL COMMUNITIES.—In review16 ing and evaluating applications under 

17 clause (i), the Panel shall take into consid18 eration the unique circumstances, including 

19 the lack of resources relating to the treat20 ment of opioid use disorder, faced by rural 

21 States and units of local government. 

22 (C) TERMINATION.—The Panel shall ter23 minate on the last day of fiscal year 2025. 

24 (3) PUBLICATION OF CRITERIA IN FEDERAL

25 REGISTER.—Not later than 90 days after the date of 


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1 enactment of this Act, the Attorney General, in con2 sultation with the Panel, shall publish in the Federal 

3 Register— 

4 (A) the process through which applications 

5 submitted under paragraph (1) shall be sub6 mitted and evaluated; and 

7 (B) the criteria used in awarding covered 

8 grants and cooperative agreements. 

9 (f) DURATION.—A covered grant or cooperative 

10 agreement shall be for a period of not more than 4 years, 

11 except that the Attorney General may extend the term of 

12 a covered grant or cooperative agreement based on out13 come data or extenuating circumstances relating to the 

14 covered program carried out under the covered grant or 

15 cooperative agreement. 

16 (g) REPORT.— 

17 (1) IN GENERAL.—Not later than 2 years after 

18 the date on which a State or unit of local govern19 ment is awarded a covered grant or cooperative 

20 agreement, and each year thereafter until the date 

21 that is 1 year after the date on which the period of 

22 the covered grant or cooperative agreement ends, the 

23 State or unit of local government shall submit a re24 port to the Attorney General that includes informa25 tion relating to the covered program carried out by 


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1 the State or unit of local government, including in2 formation relating to— 

3 (A) the goals of the covered program; 

4 (B) any evidence-based interventions car5 ried out under the covered program; 

6 (C) outcomes of the covered program, 

7 which shall— 

8 (i) be reported in a manner that dis9 tinguishes the outcomes based on the cat10 egories of, with respect to the participants 

11 in the covered program— 

12 (I) the race of the participants; 

13 and 

14 (II) the gender of the partici15 pants; and 

16 (ii) include information relating to the 

17 rate of reincarceration among participants 

18 in the covered program; and 

19 (D) expenditures under the covered pro20 gram. 

21 (2) PUBLICATION.— 

22 (A) AWARDEE.—A State or unit of local 

23 government that submits a report under para24 graph (1) shall make the report publicly avail25 able on— 


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1 (i) the website of each correctional fa2 cility at which the State or unit of local 

3 government carried out the covered grant 

4 program; and 

5 (ii) if a correctional facility at which 

6 the State or unit of local government car7 ried out the covered grant program does 

8 not operate a website, the website of the 

9 State or unit of local government. 

10 (B) ATTORNEY GENERAL.—The Attorney 

11 General shall make each report received under 

12 paragraph (1) publicly available on the website 

13 of the National Institute of Corrections. 

14 (3) SUBMISSION TO CONGRESS.—Not later than 

15 2 years after the date on which the Attorney Gen16 eral awards the first covered grant or cooperative 

17 agreement, and each year thereafter, the Attorney 

18 General shall submit to the Committee on the Judi19 ciary of the Senate and the Committee on the Judi20 ciary of the House of Representatives a summary 

21 and compilation of the reports that the Attorney 

22 General has received under paragraph (1) during the 

23 year preceding the date on which the Attorney Gen24 eral submits the summary and compilation. 


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1 (h) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated $50,000,000 to carry out 

3 this section for each of fiscal years 2022 through 2025. 

Æ 


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