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Docu S ig n Envelope lD: 7 C237 4F 6-A621 -481 2-836E-Cg F03 1 F54785 <br />intake, as long as the delay does not impair the ability to begin treatment prior to release. The <br />incarcerated individual must be educated on treatment choices and the process for continuation <br />of access to MOUD, during incarceration, and upon release. (See resources for vatidated tool <br />suggestions.) <br />Individuals entering the facility who are physically dependent on opioids, must be offered MOUD <br />treatment; withdrawal (including withdrawal using buprenorphine or methadone) is not <br />acceptable unless the patient provides an informed refusal of treatment or the patient elects <br />MOUD treatment with naltrexone, in which case withdrawal is clinically required. Use of other <br />medications (clonidine, anti-emetics, anti-diarrheals, analgesics) may be used as adjuncts or <br />may be used in place of opioid agonist or partial agonist if the individual so chooses, but they <br />may not be the only withdrawaltreatment available. <br />f Methadone and buprenorphine must be administered daily or more frequently. Alternate-day <br />("Balloon") dosing of buprenorphine may be used in rare cases based on a clinical need, the <br />decision for which is arrived at jointly between the healthcare provider and patient and is well- <br />documented in the patient's medical record. <br />g' Release planning and reentry coordination completed as soon as possible to ensure an effective <br />plan is in place prior to release or in the event of an unexpected release of an incarcerated <br />individualwho needs continued treatment and services. <br />h. Provide at least 2 doses of naloxone and naloxone administration training to all incarcerated <br />individuals with OUD upon release. <br />i, schedule the first community appointment with a treatment facility <br />Provide - in hand upon release and at no cost to the individual - sufficient doses of MOUD to <br />bridge patient until scheduled MOUD follow-up appointment at community treatment facility <br />(does not apply to patients treated with injectable MOUD). <br />lndividuals who are at risk of being released directly from court are informed, prior to going <br />to court, that they may request to be transported back to the jail by staff to receive these <br />medications prior to going home. <br />[.ln situations where an appointment cannot be made, e.g., after-hours bail-out, resident is <br />given enough medication to last until the next available appointment at the community <br />treatment facility. lf that date is unknown, the individual is given a minimum ol a7-day <br />supply. <br />iii. ln situations where medications cannot be provided upon release, e.g., unscheduled <br />release at a time when medical staff are not present in the jail, the individual is informed <br />that he/she may either return to the jail in the morning to receive bridge medications or, if <br />no medical staff are present the following day, will have a prescription for the same <br />bridging medication called to a local pharmacy, at no cost to the individual. <br />k. Ensure policies and procedures are in place to mitigate medication diversion. <br />3. Allowable Expenses. <br />e <br />HCA Contract No. K5885-02 Page 4 of7