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DocuSign Envelope ID: 666BF09F-322B-4BB0-BCBD-40579A7ED52C <br />3.3 During Incarceration. <br />3.3.1 Offer initiation of MOUD/MAUD to individuals with OUD/AUD not already identified and/or <br />offered treatment at intake (e.g., individuals with OUD but without physical dependence; <br />individuals with AUD who underwent withdrawal). <br />3.3.2 Educate individuals on treatment choices and the process for continuation of access to <br />MOUD/MAUD, during incarceration, and upon release. <br />3.3.3 Administer methadone and buprenorphine daily or more frequently. <br />3.3.4 Contractor will not use alternate -day ("Balloon") dosing of buprenorphine. <br />3.3.5 Offer counseling to individuals for their OUD and/or AUD disorder who are expected to remain <br />in jail for longer than one month. <br />3.3.6 Provide MOUD/MAUD not contingent on the individual's willingness to participate in <br />counseling. <br />3.4 Release. The Jail must accomplish the following prior to release: <br />3.4.1 Complete release planning and reentry coordination as soon as possible after admission to <br />ensure an effective plan is in place prior to release or in the event of an unexpected release of <br />an individual who needs continued treatment and services. <br />3.4.2 Provide at least two (2) doses of naloxone (e.g., Narcan®) or nalmefene (Opvee(D) and <br />training on how to administer the medications to all individuals with OUD. <br />3.4.3 Schedule the first community appointment with a treatment facility for continuation of MOUD <br />or MAUD. <br />3.4.4 Provide - in hand, upon release, and at no cost to the individual - sufficient doses of MOUD <br />and/or MAUD to bridge individual until scheduled MOUD/MAUD follow-up appointment at <br />community treatment facility (does not apply to individuals treated with injectable <br />MOUD/MAUD). <br />3.4.4.1 Inform individuals who are at risk of being released directly from court, prior to going <br />to court, that they may request to be transported back to the jail by staff to receive <br />these medications prior to going home. <br />3.4.4.2 In situations where an appointment cannot be made, e.g., after-hours bail -out, give <br />the individual enough medication to last until the next available appointment at the <br />community treatment facility. If the appointment date is unknown, give individual a <br />minimum of a 30-day supply. <br />3.4.4.3 <br />In situations where medications cannot be provided upon release, e.g., <br />unscheduled release at a time when medical staff are not present in the jail: <br />3.4.4.3.1 Inform the individual that they may either return to the jail in the <br />morning to receive bridge medications; or <br />3.4.4.3.2 If no medical staff are present the following day, call in a prescription <br />for the same bridging medication to a local pharmacy, at no cost to the <br />individual. <br />Washington State Page 6 of 10 MOUD in Jails Services <br />Health Care Authority HCA Contract No. K5885-3 <br />Schedule A-3 <br />