Jail-based Medication-assisted Treatment (MAT) Mentor Initiative Sites

The Hampden County Sheriff’s Department has been operating an opioid treatment program (OTP) in its jail for more than a year. The department contracts with CODAC Behavioral Health, a community provider of specialty care for mental illness, addiction, and trauma, to provide comprehensive MAT services, including all three U.S. Food and Drug Administration-approved medications to treat opioid use disorder (OUD), individual and group counseling, and discharge planning and reentry services via a partnership with the Behavioral Health Network. Through the OTP, the department’s House of Corrections and the Stonybrook Stabilization and Treatment Centers treat patients with OUDs in three categories: continuation, new induction, and pre-release induction.

As of July 2018, based on Vermont Act 176, MAT is recognized as a medically necessary component of treatment for all Vermont citizens who are diagnosed with OUDs, including inmates. The Vermont Department of Corrections (DOC) has offered MAT to inmates since 2013. In 2018 this program was expanded to include MAT and counseling for all inmates with OUDs who meet the medical necessity threshold for MAT for as long as medically necessary, in accordance with Act 176 and existing Vermont Department of Health rules and regulations governing treatment and evidence-based best practices. The DOC delivers integrated, patient-centered, whole health care that meets the Vermont community standard of care through its medical contractor, VitalCore Health Strategies. DOC offers buprenorphine, methadone, naltrexone, evidence-based counseling, behavioral health services, and recovery supports, as well as a medication-first approach to the treatment of OUD. To meet these standards, DOC collaborates with many community-based and state partners to provide safe and effective health care and ensure high-quality care coordination upon release.

Under the leadership of Sheriff Christopher J. Donelan, the Franklin County Sheriff’s Office (FCSO) operates a fully trauma-informed treatment program for incarcerated persons. The FCSO also operates its own federal- and state-certified opioid treatment program. Methadone, buprenorphine, and naltrexone induction and maintenance are offered to all incarcerated patients who meet clinical criteria. The FCSO serves an average daily population of approximately 175 men and 25 women who are in the pre-trial and sentenced stages. A licensed behavioral health team offers mindfulness therapies based on clinical treatment modalities, such as Dialectical Behavior Therapy and other cognitive behavioral treatments targeting criminogenic need areas. Post-release case management is offered for all sentenced individuals, as well as to pre-trial detainees with an OUD who leave on medication.

The MAT program at Albany County Corrections and Rehabilitative Services Center (ACCRSC) was established in January 2019. The program offers suboxone in film form, buprenorphine in tablet form, methadone (via surrounding clinics), and naltrexone. The program was initiated through a three-phase approach. The first phase allowed patients enrolled in the MAT program and entering the jail to continue receiving medication while in custody of the jail. The second phase involved offering sentenced inmates with OUDs the opportunity to be induced to receive MAT. In the third phase, any inmate coming into the jail reporting opiate use was offered induction into the MAT program. Group and individual counseling are offered to all MAT program inmates. ACCRSC’s partner, Project Safe Point, assists with discharge planning and ensures that every inmate is connected to needed assistance in the community when released. Each inmate is given a Narcan kit, as well as a prescription (covered by the facility), upon release. The county’s medical department, addiction counselors, corrections staff, mental health providers, and outside entities such as Project Safe Point are all involved in making the program flow properly and efficiently. These efforts help ensure inmates’ smooth transition from incarceration to the community. Communication among all program team members is an integral part of the program, which includes inmate feedback. Data collection is essential for measuring the impact of the program and its success.

The South Correctional Entity (SCORE) Jail is a regionally owned jail in Des Moines, Washington, that serves the confinement needs of six member cities and surrounding cities, with a total capacity of 802 inmates. SCORE has had a MAT program since 2016 and offers methadone, buprenorphine, and naltrexone. Its program is client-centered and focuses on whole-person care by providing case management, job skills training, MAT with cognitive behavioral therapy, and comprehensive wraparound services to inmates prior to their release from jail and upon reentry. SCORE’s innovative efforts include telehealth services, peer recovery supports, linkages to reentry services, and treatment of co-occurring disorders. SCORE partners with various agencies to serve individuals from multiple communities.