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<br />HCA Contract No. K5885-04 Page 7 of 13 <br />2.2.11.1. If they do not, they must be transported to a community hospital and <br />may not return to the jail until they are clinically safe to return to the jails <br />AND have regained decision-making capacity. <br />2.3. During Incarceration <br />2.3.1. Offer initiation of MOUD/MAUD to individuals with unidentified OUD/AUD and/or if <br />treatment was not offered at intake. E.g., individuals with OUD but without physical <br />dependence, individuals with AUD who underwent withdrawal, etc. <br />2.3.2. Educate individuals on treatment choices and the process for continuation of <br />access to MOUD/MAUD during incarceration and upon release. <br />2.3.3. Administer methadone and buprenorphine daily or more frequently. <br />2.3.4. Contractor shall not use alternate-day or “balloon” dosing of buprenorphine. <br />2.3.5. Offer counseling to individuals for their OUD/AUD if they are expected to remain in <br />jail for longer than one month. <br />2.3.6. Provide MOUD/MAUD regardless of the individual’s willingness to participate in <br />counseling. <br />2.4. Release <br />Contractor must accomplish the following prior to each individual’s release from jail: <br />2.4.1. Complete release planning and reentry coordination as soon as possible after <br />admission to ensure an effective plan is in place prior to release or in the event of <br />an unexpected release of an individual who needs continued treatment and <br />services. <br />2.4.2. Provide at least two (2) doses of naloxone (e.g., Narcan®) and training on how to <br />administer the medication to all individuals with OUD. <br />2.4.3. Schedule the first community appointment with a treatment facility for continuation <br />of MOUD or MAUD. <br />2.4.4. Provide in hand, upon release, and at no cost to the individual, sufficient doses of <br />MOUD and/or MAUD to bridge, or sustain treatment for, the individual until the <br />scheduled MOUD/MAUD follow-up appointment at the selected community <br />treatment facility. This does not apply to individuals treated with injectable <br />MOUD/MAUD. <br />2.4.4.1. If an individual is at risk of being released directly from court, inform <br />them prior to going to court that they may request to be transported <br />back to the jail by staff to receive these medications prior to going home. <br />2.4.4.2. In situations where a follow-up appointment upon release cannot be <br />made, e.g., after-hours bail-out, give the individual enough medication to <br />last until the next available appointment at the community treatment <br />facility. If the appointment date is unknown, give the individual a 30-day <br />supply at minimum.