,,ii  #aae? ,,congress  #b;d ,session   
,s4 #cchc  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,augu/ #bc1 #bjah,mr4  
,c>d9 introduc$ ! foll[+ bill2 :i* 0    
read twice & ref]r$ to ! ,committee on  
,f9ance  ,a ,,bill  ,to am5d title ,,xix
 ( ! ,social ,security ,act to provide =
 a demon/ration project to increase     
sub/ance use provid] capacity "u !      
,m$icaid program4  #a4 ,%ort title ,?is 
,act may be cit$ z ! ,rural ,developm5t 
( ,opioid ,capacity ,s]vices ,act or !  
,rural ,,docs ,act4  #b4 ,demon/ration  
project to increase sub/ance use provid]
 capacity "u ! ,m$icaid program ,section
 #aijc ( ! ,social ,security ,act 7#db  
,u4,s4,c4 #acif;b7 is am5d$ by add+ at !
 end ! foll[+ new subsection3  7aa7     
,demon/ration project ,to increase      
sub/ance use provid] capacity  7#a7 ,9  
g5]al ,n lat] ?an ! date t is #ahj days 
aft] ! date ( ! enactm5t ( ?is section1 
! ,secret>y %all conduct a #e-ye>       
demon/ration project = ! purpose        
describ$ 9 p>agraph 7#b7 "u :i* !       

,secret>y %all--  7,a7 = ! fir/ #ah-mon?
 p]iod ( su* project1 aw>d plann+ grants
 describ$ 9 p>agraph 7#c72 &  7,b7 = !  
rema9+ #db-mon? p]iod ( su* project1    
provide to ea* ,/ate select$ "u p>agraph
 7#d7 paym5ts 9 accordance ) p>agraph   
7#e74  7#b7 ,purpose ,! purpose describ$
 9 ?is p>agraph is = ea* ,/ate select$  
"u p>agraph 7#d7 to increase ! treatm5t 
capacity ( provid]s p>ticipat+ "u !     
,/ate plan 7or a waiv] ( su* plan7 to   
provide sub/ance use disord] treatm5t or
 recov]y s]vices "u su* plan 7or waiv]7 
?r\gh ! foll[+ activities3  7,a7 ,= !   
purpose describ$ 9 p>agraph             
7#c77;,c77i71 activities t support an   
ongo+ assessm5t ( ! behavioral heal?    
treatm5t ne$s ( ! ,/ate1 tak+ into      
acc\nt ! matt]s describ$ 9 subclauses   
7,i7 ?r\gh 7,,iv7 ( su* p>agraph4  7,b7 
,activities t1 tak+ into acc\nt !       
results ( ! assessm5t describ$ 9        
subp>agraph 7,a71 support ! recruitm5t1 
tra9+1 & provision ( te*nical assi/ance 
= provid]s p>ticipat+ "u ! ,/ate plan   

7or a waiv] ( su* plan7 t (f] sub/ance  
use disord] treatm5t or recov]y s]vices4
  7,c7 ,improv$ reimbursem5t = &        
expansion (1 ?r\gh ! provision (        
education1 tra9+1 & te*nical assi/ance1 
! numb] or treatm5t capacity ( provid]s 
p>ticipat+ "u ! ,/ate plan 7or waiv]7   
t--  7i7 are au?oriz$ to disp5se drugs  
approv$ by ! ,food & ,drug ,adm9i/ration
 = individuals ) a sub/ance use disord] 
:o ne$ )drawal managem5t or ma9t5ance   
treatm5t = su* disord]2  7ii7 h 9 effect
 a regi/ration or waiv] "u section      
#cjc7;g7 ( ! ,controll$ ,sub/ances ,act 
= purposes ( disp5s+ n>cotic drugs to   
individuals = ma9t5ance treatm5t or     
detoxification treatm5t & are 9         
compliance ) any regulation promulgat$  
by ! ,assi/ant ,secret>y = ,m5tal ,heal?
 & ,sub/ance ,use = purposes ( c>ry+ out
 ! requirem5ts ( su* section #cjc7;g72  
or  7iii7 are qualifi$ "u applicable    
,/ate law to provide sub/ance use       
disord] treatm5t or recov]y s]vices4    
7,d7 ,improv$ reimbursem5t = & expansion

 (1 ?r\gh ! provision ( education1      
tra9+1 & te*nical assi/ance1 ! numb] or 
treatm5t capacity ( provid]s ( sub/ance 
use disord] treatm5t or recov]y s]vices 
p>ticipat+ "u ! ,/ate plan 7or waiv]71  
includ+ provid]s t h ! qualifications to
 address ! treatm5t or recov]y ne$s (-- 
7i7 individuals enroll$ "u ! ,/ate plan 
7or a waiv] ( su* plan7 :o h neonatal   
ab/95ce syndrome1 9 accordance )        
guidel9es issu$ by ! ,am]ican ,academy (
 ,p$iatrics & ,am]ican ,college (       
,ob/etricians & ,gynecologi/s relat+ to 
mat]nal c>e & infant c>e ) respect to   
neonatal ab/95ce syndrome2  7ii7        
pregnant wom51 po/p>tum wom51 & infants1
 p>ticul>ly ! concurr5t treatm5t1 z     
appropriate1 & compreh5sive case        
managem5t ( pregnant wom51 po/p>tum wom5
 & infants1 enroll$ "u ! ,/ate plan 7or 
a waiv] ( su* plan72  7iii7 adolesc5ts &
 "y adults betwe5 ! ages ( #ab & #ba    
enroll$ "u ! ,/ate plan 7or a waiv] (   
su* plan72 or  7iv7 ,am]ican ,indian &  
,alaska ,native individuals enroll$ "u !

 ,/ate plan 7or a waiv] ( su* plan74    
7#c7 ,plann+ grants  7,a7 ,9 g5]al ,!   
,secret>y %all1 ) respect to ! fir/     
#ah-mon? p]iod ( ! demon/ration project 
conduct$ "u p>agraph 7#a71 aw>d plann+  
grants to at lea/ #aj ,/ates select$ 9  
accordance ) subp>agraph 7,b7 = purposes
 ( prep>+ an application describ$ 9     
p>agraph 7#d77;,c7 & c>ry+ out !        
activities describ$ 9 subp>agraph 7,c74 
7,b7 ,selection ,9 select+ ,/ates =     
purposes ( ?is p>agraph1 ! ,secret>y    
%all-- 7i7 select ,/ates t h a ,/ate    
plan 7or waiv] ( ! ,/ate plan7 approv$  
"u ?is title2  7ii7 select ,/ates 9 a   
mann] t ensures geographic div]sity2 &  
7iii7 give pref]5ce to ,/ates ) a       
preval5ce ( sub/ance use disord]s 79    
p>ticul> opioid use disord]s7 t is      
comp>able to or high] ?an ! national    
av]age preval5ce1 z measur$ by aggregate
 p] capita drug ov]doses1 or any o!r    
measure t ! ,secret>y deems appropriate4
  7,c7 ,activities describ$ ,activities 
describ$ 9 ?is subp>agraph are1 )       

respect to a ,/ate1 ea* ( ! foll[+3 7i7 
,activities t support ! developm5t ( an 
initial assessm5t ( ! behavioral heal?  
treatm5t ne$s ( ! ,/ate to det]m9e !    
ext5t to :i* provid]s are ne$$ 7includ+ 
! types ( su* provid]s & geographic area
 ( ne$7 to improve ! network ( provid]s 
t treat sub/ance use disord]s "u ! ,/ate
 plan 7or waiv]71 includ+ ! foll[+3     
7,i7 ,an e/imate ( ! numb] ( individuals
 enroll$ "u ! ,/ate plan 7or a waiv] (  
su* plan7 :o h a sub/ance use disord]4  
7,,ii7 ,in=mation on ! capacity (       
provid]s to provide sub/ance use disord]
 treatm5t or recov]y s]vices to         
individuals enroll$ "u ! ,/ate plan 7or 
waiv]71 includ+ in=mation on provid]s :o
 provide su* s]vices & _! p>ticipation  
"u ! ,/ate plan 7or waiv]74  7,,iii7    
,in=mation on ! gap 9 sub/ance use      
disord] treatm5t or recov]y s]vices "u !
 ,/ate plan 7or waiv]7 bas$ on !        
in=mation describ$ 9 subclauses 7,i7 &  
7,,ii74  7,,iv7 ,projections reg>d+ !   
ext5t to :i* ! ,/ate p>ticipat+ "u !    

demon/ration project w\ld increase !    
numb] ( provid]s (f]+ sub/ance use      
disord] treatm5t or recov]y s]vices "u !
 ,/ate plan 7or waiv]7 dur+ ! p]iod ( ! 
demon/ration project4  7ii7 ,activities 
t1 tak+ into acc\nt ! results ( !       
assessm5t describ$ 9 clause 7i71 support
 ! developm5t ( ,/ate infra/ructure to1 
) respect to ! provision ( sub/ance use 
disord] treatm5t or recov]y s]vices "u !
 ,/ate plan 7or a waiv] ( su* plan71    
recruit prospective provid]s & provide  
tra9+ & te*nical assi/ance to su*       
provid]s4  7,d7 ,fund+ ,= purposes (    
subp>agraph 7,a71 !re is appropriat$1   
out ( any funds 9 ! ,treasury n o!rwise 
appropriat$1 #ej1jjj1jjj1 to rema9      
available until exp5d$4  7#d7           
,po/-plann+ ,/ates  7,a7 ,9 g5]al ,!    
,secret>y %all1 ) respect to ! rema9+   
#db-mon? p]iod ( ! demon/ration project 
conduct$ "u p>agraph 7#a71 select n m   
?an #e ,/ates 9 accordance ) subp>agraph
 7,b7 = purposes ( c>ry+ out !          
activities describ$ 9 p>agraph 7#b7 &   

receiv+ paym5ts 9 accordance ) p>agraph 
7#e74  7,b7 ,selection ,9 select+ ,/ates
 = purposes ( ?is p>agraph1 ! ,secret>y 
%all-- 7i7 select ,/ates t receiv$ a    
plann+ grant "u p>agraph 7#c72  7ii7    
select ,/ates t submit to ! ,secret>y an
 application 9 accordance ) !           
requirem5ts 9 subp>agraph 7,c71 tak+    
into consid]ation ! quality ( ea* su*   
application2  7iii7 select ,/ates 9 a   
mann] t ensures geographic div]sity2 &  
7iv7 give pref]5ce to ,/ates ) a        
preval5ce ( sub/ance use disord]s 79    
p>ticul> opioid use disord]s7 t is      
comp>able to or high] ?an ! national    
av]age preval5ce1 z measur$ by aggregate
 p] capita drug ov]doses1 or any o!r    
measure t ! ,secret>y deems appropriate4
  7,c7 ,applications  7i7 ,9 g5]al ,a   
,/ate seek+ to be select$ = purposes (  
?is p>agraph %all submit to ! ,secret>y1
 at su* "t & 9 su* =m & mann] z !       
,secret>y requires1 an application t    
includes su* in=mation1 provisions1 &   
assurances1 z ! ,secret>y may require1 9

 addition to ! foll[+3  7,i7 ,a propos$ 
process = c>ry+ out ! ongo+ assessm5t   
describ$ 9 p>agraph 7#b77;,a71 tak+ into
 acc\nt ! results ( ! initial assessm5t 
describ$ 9 p>agraph 7#c77;,c77i74       
7,,ii7 ,a review ( reimbursem5t         
me?odologies & o!r policies relat$ to   
sub/ance use disord] treatm5t or recov]y
 s]vices "u ! ,/ate plan 7or waiv]7 t   
may create b>ri]s to increas+ ! numb] ( 
provid]s deliv]+ su* s]vices4  7,,iii7  
,! developm5t ( a plan1 tak+ into acc\nt
 activities c>ri$ out "u p>agraph       
7#c77;,c77ii71 t w result 9 long-t]m &  
su/a9able provid] networks "u ! ,/ate   
plan 7or waiv]7 t w (f] a cont9uum ( c>e
 = sub/ance use disord]s4 ,su* plan %all
 include ! foll[+3  7aa7 ,specific      
activities to increase ! numb] (        
provid]s 7includ+ provid]s t specialize 
9 provid+ sub/ance use disord] treatm5t 
or recov]y s]vices1 hospitals1 heal? c>e
 sy/ems1 f$]ally qualifi$ heal? c5t]s1  
&1 z applicable1 c]tifi$ community      
behavioral heal? cl9ics7 t (f] sub/ance 

use disord] treatm5t1 recov]y1 or       
support s]vices1 includ+ %ort-t]m       
detoxification s]vices1 outpati5t       
sub/ance use disord] s]vices1 &         
evid5ce-bas$ pe] recov]y s]vices4  7bb7 
,/rategies t w inc5tivize provid]s      
describ$ 9 subp>agraphs 7,c7 & 7,d7 (   
p>agraph 7#b7 to obta9 ! necess>y tra9+1
 education1 & support to deliv] sub/ance
 use disord] treatm5t or recov]y s]vices
 9 ! ,/ate4  7cc7 ,mile/ones & timel9ess
 = implem5t+ activities set =? 9 ! plan4
  7dd7 ,specific measurable t>gets =    
increas+ ! sub/ance use disord] treatm5t
 & recov]y provid] network "u ! ,/ate   
plan 7or a waiv] ( su* plan74  7,,iv7 ,a
 propos$ process = report+ ! in=mation  
requir$ "u p>agraph 7#f77;,a71 includ+  
in=mation to assess ! effectiv5ess ( !  
ef=ts ( ! ,/ate to exp& ! capacity (    
provid]s to deliv] sub/ance use disord] 
treatm5t or recov]y s]vices dur+ ! p]iod
 ( ! demon/ration project "u ?is        
subsection4  7,v7 ,! expect$ f9ancial   
impact ( ! demon/ration project "u ?is  

subsection on ! ,/ate4  7,,vi7 ,a       
description ( all fund+ s\rces available
 to ! ,/ate to provide sub/ance use     
disord] treatm5t or recov]y s]vices 9 ! 
,/ate4  7,,vii7 ,a prelim9>y plan = h[ !
 ,/ate w su/a9 any increase 9 ! capacity
 ( provid]s to deliv] sub/ance use      
disord] treatm5t or recov]y s]vices     
result+ f ! demon/ration project "u ?is 
subsection aft] ! t]m9ation ( su*       
demon/ration project4  7,,viii7 ,a      
description ( h[ ! ,/ate w coord9ate !  
goals ( ! demon/ration project ) any    
waiv] t ! ,/ate has appli$ = "u1 or     
receiv$ pursuant to1 section #aaae = !  
deliv]y ( sub/ance use s]vices "u !     
,/ate plan1 z applicable4  7ii7         
,consultation ,9 complet+ an application
 "u clause 7i71 a ,/ate %all consult )  
relevant /akehold]s1 includ+ ,m$icaid   
manag$ c>e plans1 heal? c>e provid]s1 & 
,m$icaid b5efici>y advocates1 & include 
9 su* application a description ( su*   
consultation4  7#e7 ,paym5t  7,a7 ,9    
g5]al ,= ea* qu>t] occurr+ dur+ ! p]iod 

= :i* ! demon/ration project is conduct$
 7aft] ! fir/ #ah mon?s ( su* p]iod71 ! 
,secret>y %all pay "u ?is subsection1   
subject to subp>agraph 7,c71 to ea*     
,/ate select$ "u p>agraph 7#d7 an am\nt 
equal to #ij p]c5t ( s mu* ( ! qualifi$ 
sums exp5d$ dur+ su* qu>t]4  7,b7       
,qualifi$ sums def9$ ,= purposes (      
subp>agraph 7,a71 ! t]m qualifi$ sums   
means1 ) respect to a ,/ate & a qu>t]1 !
 am\nt equal to ! am\nt 7if any7 by :i* 
! sums exp5d$ by ! ,/ate dur+ su* qu>t] 
attributable to sub/ance use treatm5t or
 recov]y s]vices furni%$ by provid]s    
p>ticipat+ "u ! ,/ate plan 7or a waiv] (
 su* plan7 exce$s #a_/d ( su* sums      
exp5d$ by ! ,/ate dur+ fiscal ye> #bjah 
attributable to sub/ance use treatm5t or
 recov]y s]vices4  7,c7 ,non-duplication
 ( paym5t ,9 ! case t paym5t is made "u 
subp>agraph 7,a7 ) respect to           
exp5ditures = sub/ance use treatm5t or  
recov]y s]vices furni%$ by provid]s     
p>ticipat+ "u ! ,/ate plan 7or a waiv] (
 su* plan71 paym5t may n also be made "u

 subsection 7a7 ) respect to exp5ditures
 = ! same s]vices s furni%$4  7#f7      
,reports  7,a7 ,/ate reports ,a ,/ate   
receiv+ paym5ts "u p>agraph 7#e7 %all1 =
 ! p]iod ( ! demon/ration project "u ?is
 subsection1 submit to ! ,secret>y a    
qu>t]ly report1 ) respect to exp5ditures
 = sub/ance use treatm5t or recov]y     
s]vices = :i* paym5t is made to ! ,/ate 
"u ?is subsection1 on ! foll[+3  7i7 ,! 
specific activities ) respect to :i*    
paym5t "u ?is subsection 0 provid$4     
7ii7 ,! numb] ( provid]s t deliv]$      
sub/ance use disord] treatm5t or recov]y
 s]vices 9 ! ,/ate "u ! demon/ration    
project comp>$ to ! e/imat$ numb] (     
provid]s t w\ld h o!rwise deliv]$ su*   
s]vices 9 ! abs5ce ( su* demon/ration   
project4  7iii7 ,! numb] ( individuals  
enroll$ "u ! ,/ate plan 7or a waiv] (   
su* plan7 :o receiv$ sub/ance use       
disord] treatm5t or recov]y s]vices "u !
 demon/ration project comp>$ to !       
e/imat$ numb] ( su* individuals :o w\ld 
h o!rwise receiv$ su* s]vices 9 ! abs5ce

 ( su* demon/ration project4  7iv7 ,o!r 
matt]s z det]m9$ by ! ,secret>y4  7,b7  
,,cms reports  7i7 ,initial report ,n   
lat] ?an ,octob] #a1 #bjbj1 ! ,secret>y 
%all submit to ,congress an initial     
report on--  7,i7 ! ,/ates aw>d$ plann+ 
grants "u p>agraph 7#c72  7,,ii7 !      
crit]ia us$ 9 su* selection2 &  7,,iii7 
! activities c>ri$ out by su* ,/ates "u 
su* plann+ grants4  7ii7 ,int]im report 
,n lat] ?an ,octob] #a1 #bjbb1 !        
,secret>y %all submit to ,congress an   
int]im report--  7,i7 on activities     
c>ri$ out "u ! demon/ration project "u  
?is subsection2  7,,ii7 on ! ext5t to   
:i* ,/ates select$ "u p>agraph 7#d7 h   
a*iev$ ! /at$ goals submitt$ 9 _!       
applications "u subp>agraph 7,c7 ( su*  
p>agraph2  7,,iii7 ) a description ( !  
/r5g?s & limitations ( su* demon/ration 
project2 &  7,,iv7 ) a plan = !         
su/a9ability ( su* project4  7iii7 ,f9al
 report ,n lat] ?an ,octob] #a1 #bjbd1 !
 ,secret>y %all submit to ,congress a   
f9al report-- 7,i7 provid+ updates on ! 

matt]s report$ 9 ! int]im report "u     
clause 7ii72  7,,ii7 includ+ a          
description ( any *anges made ) respect 
to ! demon/ration project "u ?is        
subsection aft] ! submission ( su*      
int]im report2 &  7,,iii7 evaluat+ su*  
demon/ration project4  7#g7 ,data %>+ & 
be/ practices ,dur+ ! p]iod ( !         
demon/ration project "u ?is subsection1 
! ,secret>y %all1 9 collaboration )     
,/ates select$ "u p>agraph 7#d71        
facilitate data %>+ & ! developm5t ( be/
 practices betwe5 su* ,/ates & ,/ates t 
7 n s select$4  7#h7 ,,cms fund+ ,!re is
 appropriat$1 out ( any funds 9 !       
,treasury n o!rwise appropriat$1        
#e1jjj1jjj to ! ,c5t]s = ,m$ic>e        
,m$icaid ,s]vices = purposes ( implem5t+
 ?is subsection4 ,su* am\nt %all rema9  
available until exp5d$4  4