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 At-
torney 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 orga-
nization that is capable of conducting 
that training and making that deter-
mination; and 
(ii) meets the criteria specified by the 
Attorney General, in consultation with the 
Secretary of Health and Human Services, 
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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 pro-
gram— 
(A) to provide medication-assisted treat-
ment to individuals who have opioid use dis-
order and are incarcerated within the jurisdic-
tion of the State or unit of local government 
carrying out the program; and 
(B) that is developed, implemented, or ex-
panded 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 treat-
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ment 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 ap-
proach 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-as-
sisted Treatment Corrections and Community Re-
entry 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 Medica-
tion-Assisted Treatment Corrections and Community 
Reentry Program established under subsection (b); 
(12) the term ‘‘psychosocial’’ means the inter-
relation of social factors and individual thought and 
behavior; 
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(13) the term ‘‘recovery community organiza-
tion’’ 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 Serv-
ice 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 pos-
session 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, 
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in consultation with the Secretary of Health and Human 
Services, shall establish a program— 
(1) that shall be known as the ‘‘Medication-As-
sisted Treatment Corrections and Community Re-
entry Program’’; and 
(2) under which the Attorney General— 
(A) may make grants to, and enter into co-
operative agreements with, States or units of 
local government to develop, implement, or ex-
pand one or more programs to provide medica-
tion-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 or-
ganizations with expertise in security, medical 
health, mental health, and addiction care to 
oversee and support implementation of the pro-
gram, including through the use of evidence- 
based clinical practices. 
(c) PURPOSES.—The purposes of the Program are 
to— 
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(1) develop medication-assisted treatment pro-
grams 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 incarcer-
ation; 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 reli-
ability and validity that provide useful clinical 
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data to guide the long-term treatment of par-
ticipants 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 At-
torney General in light of the number of indi-
viduals 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 
dem-
onstrating, 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 re-
quired under paragraph (1); and 
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(II) naloxone or any other emer-
gency 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 par-
tial 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 par-
ticipants, shall work with participants who are 
recovering from opioid use disorder. 
(e) APPLICATION.— 
(1) IN GENERAL.—A State or unit of local gov-
ernment 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 medica-
tion-assisted treatment program that 
the applicant will develop, implement, 
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or expand under the covered grant or 
cooperative agreement; 
(II) the activities that the appli-
cant 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 partici-
pation 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 antago-
nist, not less than 1 drug that uses an 
opioid agonist, and not less than 1 drug 
that uses an opioid partial agonist, an ex-
planation of why the applicant is unable to 
or chooses not to offer a drug that uses an 
opioid antagonist, a drug that uses an 
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opioid agonist, or a drug that uses an 
opioid partial agonist, as applicable; 
(iii) a plan for— 
(I) measuring progress in achiev-
ing 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 incarcer-
ation with respect to the form of 
medication-assisted treatment the 
participants received during in-
carceration, including— 
(AA) by working with 
community service providers 
to assist eligible partici-
pants, before release from 
incarceration in registering 
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for the Medicaid program 
under title XIX of the Social 
Security Act (42 U.S.C. 
1396 et seq.) or other min-
imum 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 
treat-
ment program, and if the 
participant cannot pay the 
cost of enrolling in a medi-
cation-assisted 
treatment 
program, by working with 
units of local government, 
nonprofit 
organizations, 
opioid use disorder treat-
ment providers, and entities 
carrying out programs under 
substance 
use 
disorder 
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grants to, before the partici-
pant is released from incar-
ceration, 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 partici-
pant in a medication-as-
sisted treatment program; 
(bb) medications are se-
curely stored; and 
(cc) protocols relating to di-
version are maintained; and 
(III) with respect to each com-
munity 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 sub-
stance use disorder and local public 
health officials and nonprofit organi-
zations in the community to help en-
sure that medication-assisted treat-
ment provided at each correctional fa-
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cility at which the covered program 
will be carried out is also available at 
locations that are not correctional fa-
cilities 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 treat-
ment of opioid use disorder required 
to be offered under subsection (d)(1), 
which may include clinicians who use 
telemedicine, in accordance with regu-
lations issued by the Administrator of 
the Drug Enforcement Administra-
tion, to provide services under the cov-
ered program; and 
(II) the covered program will 
provide evidence-based counseling and 
behavioral therapies, which may in-
clude counseling and therapy adminis-
tered through the use of telemedicine, 
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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 ex-
pects to serve through the covered program. 
(2) MEDICATION-ASSISTED
TREATMENT
COR-
RECTIONS AND COMMUNITY REENTRY APPLICATION 
REVIEW PANEL.— 
(A) IN GENERAL.—Not later than 60 days 
after the date of enactment of this Act, the At-
torney General shall establish a Medication-As-
sisted Treatment Corrections and Community 
Reentry Application Review Panel that shall— 
(i) be composed of not fewer than 10 
individuals and not more than 15 individ-
uals; and 
(ii) include— 
(I) one or more employees, who 
are not political appointees, of— 
(aa) the Department of Jus-
tice; 
(bb) the Drug Enforcement 
Administration; 
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(cc) the Substance Abuse 
and Mental Health Service Ad-
ministration; 
(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 enforce-
ment organizations and public 
health entities. 
(B) DUTIES.— 
(i) IN GENERAL.—The Panel shall— 
(I) review and evaluate applica-
tions for covered grants and coopera-
tive agreements; and 
(II) make recommendations to 
the Attorney General relating to the 
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awarding of covered grants and coop-
erative agreements. 
(ii) RURAL COMMUNITIES.—In review-
ing and evaluating applications under 
clause (i), the Panel shall take into consid-
eration the unique circumstances, including 
the lack of resources relating to the treat-
ment of opioid use disorder, faced by rural 
States and units of local government. 
(C) TERMINATION.—The Panel shall ter-
minate 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 con-
sultation with the Panel, shall publish in the Federal 
Register— 
(A) the process through which applications 
submitted under paragraph (1) shall be sub-
mitted 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 out-
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come 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 govern-
ment 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 re-
port to the Attorney General that includes informa-
tion relating to the covered program carried out by 
the State or unit of local government, including in-
formation relating to— 
(A) the goals of the covered program; 
(B) any evidence-based interventions car-
ried out under the covered program; 
(C) outcomes of the covered program, 
which shall— 
(i) be reported in a manner that dis-
tinguishes the outcomes based on the cat-
egories of, with respect to the participants 
in the covered program— 
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(I) the race of the participants; 
and 
(II) the gender of the partici-
pants; and 
(ii) include information relating to the 
rate of reincarceration among participants 
in the covered program; and 
(D) expenditures under the covered pro-
gram. 
(2) PUBLICATION.— 
(A) AWARDEE.—A State or unit of local 
government that submits a report under para-
graph (1) shall make the report publicly avail-
able on— 
(i) the website of each correctional fa-
cility 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 car-
ried 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 
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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 Gen-
eral awards the first covered grant or cooperative 
agreement, and each year thereafter, the Attorney 
General shall submit to the Committee on the Judi-
ciary of the Senate and the Committee on the Judi-
ciary 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 Gen-
eral 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. 
Æ 
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