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DocuSign Envef ope lD'. 7 C237 4F6-A62'l -4812-836E-CgF03'l F54785 <br />Schedule A-2: Statement of Work <br />July 1, 2023-June 30, 2024 <br />1. Purpose. <br />To provide medication for opioid use disorder (MOUD) in jails to incarcerated individuals who are <br />identified with an opioid use disorder (OUD). To support a full MOUD program which includes the <br />following: an OUD screening, discussion of MOUD options between the incarcerated individual and <br />provider, initiation prior to the onset of withdrawal or continuation of MOUD, release and reentry planning <br />to include connection with continued treatment, same day release appointment when possible or MOUD <br />to bridge patient until next appointment and naloxone upon release. Reentry planning may also include <br />assisting the incarcerated individualwith sign-up of Medicaid, reestablishing Medicaid and connection <br />with the Managed Care Organizations (MCOs). <br />Health Equity - This project also intends to address inequities in OUD treatment and recovery services by <br />providing medically necessary treatment for opioid use disorderto incarcerated individuals. MOUD in jaili <br />programs should understand cultural barriers and provide culturally appropriate services and recognize <br />the need for inclusion of people with lived experiences in the development of the MOUD in jails programs. <br />Additionally, this project intends to identify stigma and educate staff to ensure ongoing colliboration and <br />openness to change. <br />2. Performance Work Statement. <br />The Contractor shall ensure funds are responsibly used towards the MOUD program in the jail/jails and <br />provide the standard of care core components which include: <br />a. FDA approved medication for opioid use disorder (MOUD) must be available and offered to all <br />incarcerated individuals who are identified with OUD at intake. lndividuals with OUD may decline <br />MOUD at any time, but ongoing discussions on MOUD may be offered. <br />b. Methadone, buprenorphine, naltrexone should all be offered unless: (a) an opioid treatment <br />program (OTP) is not within reasonable driving distance from the jail, in which case the jail is not <br />required to offer methadone as an option; or (b) there is no available buprenorphine provider in <br />the community to which the patient will likely release, in which case the jail is not required to offer <br />buprenorphine as an option. Naltrexone may be provided in oralformulation while the patient is <br />incarcerated, but injectable long-acting naltrexone must be offered as an option prior to release. <br />Long-acting injectable buprenorphine can also be offered. <br />c.MOUD must be continued for those who are already taking MOUD upon entering the facility. <br />MOUD is continued using the same medication, at the same dose unless ordered otherwise by <br />the prescriber based on clinical need (documented in the patient's medical record) with the <br />exception of injectable long-acting naltrexone which may be converted to an equivalent oral dose <br />until just prior to release and the injectable form is restarted. Methadone may be transitioned to <br />buprenorphine if the jail is not a licensed opioid treatment program (OTP) and the nearest OTp is <br />not within reasonable driving distance from the jail. The presence of other illicit or controlled <br />substances should not result in discontinuation of MOUD (consistent with the 2O2O ASAM <br />National Practice Guideline for the Treatment of Opioid lJse Disordef) Please also review and <br />impfement the newly released (June 2023), Bureau of Justice Assistance , Guidelines for <br />Managinq Substance Withdrawal in Jails . <br />d. Screening for risk of acute withdrawal must be done upon intake. Screening for opioid use <br />disorder (OUD) absent a risk of acute withdrawal must also be done, but it may be done after <br />HCA Contract No. K5885-02 Page 3 of 7