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HCA Contract No. K5885-05 Page 6 of 13 <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. Contractor shall not use alternate-day or “balloon” dosing of buprenorphine (i.e., administering a <br />dose of medication on one (1) day which is intended to last for two (2) or more days). <br />3.3.4. Administer methadone and buprenorphine more often than one dose daily if clinically <br />necessary, e.g., in some pregnant or post-partum individuals, those who metabolize the <br />medication faster, and individuals who have side effects from large single doses. <br />3.3.5. Offer counseling to individuals for their OUD/AUD if they are expected to remain in jail for longer <br />than one (1) month. Provide MOUD/MAUD regardless of the individual’s willingness to <br />participate in counseling. <br />3.3.6. There may be reasons an individual will not continue MOUD/MAUD in the community, such as <br />no available treatment provider in the community to which the individual is released. If the <br />individual will not continue MOUD/MAUD in the community, the decision when or if to <br />discontinue MOUD/MAUD prior to release must be based on a mutually agreed-upon decision <br />between the individual and the prescriber and must consider factors, including but not limited to, <br />the risks of opioid misuse or overdose during incarceration, and the individual's willingness to <br />receive a four-week (4-week) dose of an extended-release injectable buprenorphine just prior to <br />release which will provide a safe, tapered withdrawal. <br />3.4. Release <br />Contractor must accomplish the following prior to each individual’s release from jail: <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, including in the event of an unexpected <br />release of an individual who needs continued treatment and services. <br />3.4.2. Provide at least two (2) doses of an opioid reversal agent (e.g., naloxone or Narcan®) and <br />training on how to administer the medication to all individuals with OUD. <br />3.4.3. Schedule the first community appointment with a treatment facility for continuation of MOUD or <br />MAUD. <br />3.4.4. Provide in hand, upon release, and at no cost to the individual, a sufficient number of doses of <br />MOUD and/or MAUD to bridge the individual until the scheduled MOUD/MAUD follow-up <br />appointment at the selected community treatment facility. <br />3.4.4.1. If an individual is on a long-acting injectable medication, the Contractor will ensure the <br />timing of the injectable medication ensures sustained treatment effect to bridge the <br />individual to the scheduled MOUD/MAUD follow-up appointment at the selected <br />community treatment facility. <br />3.4.4.2. If an individual is at risk of being released directly from court, inform them prior to <br />going to court that they may request to be transported back to jail by staff to receive <br />these medications prior to going home. <br />Docusign Envelope ID: 700826AD-3CE3-815C-8194-013EF364AA04