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Docusign Envelope lD: 97E7029C-8CD5-4FBF-9DC4-1837DD269189 2.2.5. 2.2.6. 2.2.7 2.2.8 2.2.9 Continue MOUD and MAUD for individuals who are already taking these medications upon entering the facility. Continue the individual on the same medication at the same dose unless ordered otherwise by the prescriber based on clinical need, and as documented in the individual's medical record, unless one of the following exceptions is applicable: 2.2.6.1. lnjectable long-acting naltrexone may be converted to an equivalent oral dose untiljust prior to release at which time the injectable form shall be restarted. 2.2.6.2.lnjectable long-acting buprenorphine may be converted to an equivalent oral dose until just prior to release at which time the injectable form shall be restarted. 2.2.6.3 Oral buprenorphine may be converted to any of the three formulations available; film, tablet with naloxone, or tablet without naloxone. 2.2.6.4 lf the individual is not pregnant, methadone may be transitioned to buprenorphine if the Contractor is not a licensed Opioid Treatment Program (OTP) and the nearest OTP is not within reasonable driving distance from the jail or there is no OTP within reasonable distance of the individual's release residence. 2.2.6.5.Though MOUD/MAUD may not be discontinued on a policy or administrative basis because of the presence of other illicit or controlled substances, administration of the community-based MOUD or MAUD may be adjusted if clinically necessary due to pharmacologic risks of d rug-to-drug interaction. Screen for OUD and AUD without physical dependence (i.e. without a risk of acute withdrawal) after intake, as long as the delay does not impair the ability to begin treatment prior to release. Educate individuals on treatment choices and the process for continuation of access to MOUD during incarceration and upon release. Make available and offer treatment using some formulation of methadone, buprenorphine, and naltrexone based on a mutually agreed-upon plan between the prescriber and the individual, with the following exceptions or caveats: 2.2.9.1. The Contractor may decline to offer methadone if the Contractor is not a licensed OTP, and the nearest OTP is not within reasonable driving distance from the jail or there is no OTP within reasonable distance of the individual's release residence. 2.2.9.2 lf there is no available buprenorphine provider in the community to which the individualwill release, the Contractor must still offer buprenorphine (tapered over several days) if opioid withdrawal is clinically indicated. HCA Contract No. K5885-04 Page5of13