(a) (1) Subject to paragraph (2) of this subsection, the requirements under this section shall apply to: (i) local detention centers in the following counties by January 1, 2020: 1. Howard County; 2. Montgomery County; 3. Prince George's County; and 4. St. Mary's County; and (ii) local detention centers in six additional counties by October 1, 2021. (2) (i) The Governor's Office of Crime Prevention and Policy, the Maryland Department of Health, and the Maryland Correctional Administrators Association shall evaluate the implementation of the requirements of this section and determine a schedule to add additional counties, provided that the provisions of this section shall apply to all local detention centers and the Baltimore Pre-trial Complex by January 2023. (ii) If the Baltimore Pre-trial Complex has not fully implemented the provisions of this section by January 2023, the Department of Public Safety and Correctional Services shall report to the Senate Finance Committee and the House Judiciary Committee, in accordance with § 2-1257 of the State Government Article, on the status and timeline of implementation. (iii) Funding for the program at the Baltimore Pre-trial Complex shall be as provided in the State budget. (b) (1) In this section the following words have the meanings indicated. (2) "Health care practitioner" means an individual who is licensed, certified, or otherwise authorized to practice under the Health Occupations Article. (3) "Incarcerated individual" means an individual confined within a local correctional facility. (4) "Medication" means a medication approved by the federal Food and Drug Administration for the treatment of opioid use disorder. (5) "Medication-assisted treatment" means the use of medication, in combination with counseling and behavioral health therapies, to provide a holistic approach to the treatment of opioid use disorder. (6) "Opioid use disorder" means a medically diagnosed problematic pattern of opioid use that causes significant impairment or distress. (7) "Peer recovery specialist" means an individual who has been certified by an entity approved by the Maryland Department of Health for the purpose of providing peer support services, as defined under § 7.5-101(n) of the Health - General Article. (c) An incarcerated individual in a State or local correctional facility shall be placed on a properly supervised program of methadone detoxification if: (1) a physician determines that the incarcerated individual is a person with an opioid use disorder; (2) the treatment is prescribed by a physician; and (3) the incarcerated individual consents in writing to the treatment. (d) (1) Each local correctional facility shall conduct an assessment of the mental health and substance use status of each incarcerated individual using evidence-based screenings and assessments, to determine: (i) if the medical diagnosis of an opioid use disorder is appropriate; and (ii) if medication-assisted treatment is appropriate. (2) If an assessment conducted under paragraph (1) of this subsection indicates opioid use disorder, an evaluation of the incarcerated individual shall be conducted by a health care practitioner with prescriptive authority authorized under Title 8, Title 14, or Title 15 of the Health Occupations Article. (3) Information shall be provided to the incarcerated individual describing medication options used in medication-assisted treatment. (4) Medication-assisted treatment shall be available to an incarcerated individual for whom such treatment is determined to be appropriate under this subsection. (5) Each local correctional facility shall make available at least one formulation of each FDA-approved full opioid agonist, partial opioid agonist, and long-acting opioid antagonist used for the treatment of opioid use disorders. (6) Each pregnant woman identified with an opioid use disorder shall receive evaluation and be offered medication-assisted treatment as soon as practicable. (e) Each local correctional facility shall: (1) following an assessment using clinical guidelines for medication- assisted treatment: (i) make medication available by a qualified provider to the incarcerated individual; or (ii) begin withdrawal management services prior to administration of medication; (2) make available and administer medications for the treatment of opioid use disorder; (3) provide behavioral health counseling for incarcerated individuals diagnosed with opioid use disorder consistent with therapeutic standards for such therapies in a community setting; (4) provide access to a health care practitioner who can provide access to all FDA-approved medications for the treatment of opioid use disorders; and (5) provide on-premises access to peer recovery specialists. (f) If an incarcerated individual received medication or medication- assisted treatment for opioid use disorder immediately preceding or during the incarcerated individual's incarceration, a local correctional facility shall continue the treatment after incarceration or transfer unless: (1) the incarcerated individual voluntarily discontinues the treatment, verified through a written agreement that includes a signature; or (2) a health care practitioner determines that the treatment is no longer medically appropriate. (g) Before the release of an incarcerated individual diagnosed with opioid use disorder under subsection (d) of this section, a local correctional facility shall develop a plan of reentry that: (1) includes information regarding postincarceration access to medication continuity, peer recovery specialists, other supportive therapy, and enrollment in health insurance plans; (2) includes any recommended referrals by a health care practitioner to medication continuity, peer recovery specialists, and other supportive therapy; and (3) is reviewed and, if needed, revised by a health care practitioner or peer recovery specialist. (h) The procedures and standards used to determine substance use disorder diagnosis and treatment of incarcerated individuals are subject to the guidelines and regulations adopted by the Maryland Department of Health. (i) As provided in the State budget, the State shall fund the program of opioid use disorder screening, evaluation, and treatment of incarcerated individuals as provided under this section. (j) On or before November 1, 2020, and annually thereafter, the Governor's Office of Crime Prevention and Policy shall report data from individual local correctional facilities to the General Assembly, in accordance with § 2-1257 of the State Government Article, on: (1) the number of incarcerated individuals diagnosed with: (i) a mental health disorder; (ii) an opioid use disorder; (iii) a non-opioid substance use disorder; and (iv) a dual diagnosis of mental health and substance use disorder; (2) the number and cost of assessments for incarcerated individuals in local correctional facilities, including the number of unique incarcerated individuals examined; (3) the number of incarcerated individuals who were receiving medication or medication-assisted treatment for opioid use disorder immediately prior to incarceration; (4) the type and prevalence of medication or medication-assisted treatments for opioid use disorder provided; (5) the number of incarcerated individuals diagnosed with opioid use disorder; (6) the number of incarcerated individuals for whom medication and medication-assisted treatment for opioid use disorder was prescribed; (7) the number of incarcerated individuals for whom medication and medication-assisted treatment was prescribed and initiated for opioid use disorder; (8) the number of medications and medication-assisted treatments for opioid use disorder provided according to each type of medication and medication- assisted treatment options; (9) the number of incarcerated individuals who continued to receive the same medication or medication-assisted treatment for opioid use disorder as the incarcerated individual received prior to incarceration; (10) the number of incarcerated individuals who received a different medication or medication-assisted treatment for opioid use disorder compared to what the incarcerated individual received prior to incarceration; (11) the number of incarcerated individuals who initiated treatment with medication or medication-assisted treatment for opioid use disorder who were not being treated for opioid use disorder prior to incarceration; (12) the number of incarcerated individuals who discontinued medication or medication-assisted treatment for opioid use disorder during incarceration; (13) a review and summary of the percent of days, including the average percent, median percent, mode percent, and interquartile range of percent, for incarcerated individuals with opioid use disorder receiving medication or medication-assisted treatment for opioid use disorder as calculated overall and stratified by other factors, such as type of treatment received; (14) the number of incarcerated individuals receiving medication or medication-assisted treatment for opioid use disorder prior to release; (15) the number of incarcerated individuals receiving medication or medication-assisted treatment prior to release for whom the facility had made a prerelease reentry plan; (16) a review and summary of practices related to medication and medication-assisted treatment for opioid use disorder for incarcerated individuals with opioid use disorder before October 1, 2019; (17) a review and summary of prerelease planning practices relative to incarcerated individuals diagnosed with opioid use disorder prior to, and following, October 1, 2019; and (18) any other information requested by the Maryland Department of Health related to the administration of the provisions under this section. (k) Any behavioral health assessment, evaluation, treatment recommendation, or course of treatment shall be reported to the Governor's Office of Crime Prevention and Policy and also include any other data necessary to meet reporting requirements under this section.
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