this section shall be on a voluntary basis. (4) Applications (A) In general To participate in the demonstration project, a hospital with an emergency department shall submit to the Secretary an application at such time, in such manner, and containing such information (in addition to the written commitment described in subparagraph (B)) as specified by the Secretary. The Secretary shall take such measures as is necessary to make available such application form to potential participants no later than 180 days after the date of the enactment of this Act. (B) Information required Each application submitted by a hospital under subparagraph (A) shall include a binding written commitment to participate in the demonstration project for the duration of the project signed by the Chief Executive Officer of the hospital, the physician medical director of the emergency department of the hospital, the nursing director of the emergency department of the hospital, and the pharmacy director of the emergency department of the hospital. (c) Elements of demonstration project Under the demonstration project, the following shall apply: (1) The Secretary shall designate no fewer than five conditions or sets of symptoms that will be monitored during the demonstration project. (2) The performance during each year of the demonstration project, with respect to such conditions designated under paragraph (1), of all emergency departments of hospitals participating in the demonstration project will be measured against the performance of such emergency departments during a base year, which shall represent the most recent set of full year data available before the first date of the demonstration project. (3) The Secretary shall provide hospitals participating in the demonstration project with a description of clearly defined treatments that are considered alternatives to opioids to be applied for purposes of subsection (a). (d) Incentive payment Under the demonstration project, the Secretary shall create a payment structure under which