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<section article="gcs" article_name="Correctional Services" number="9-603" title_number="9" title_name="State and Local Correctional System -- Incarcerated Individuals" subtitle_number="6" subtitle_name="Miscellaneous">
  <level label="a">
    <level label="1">
      <text>Subject to paragraph (2) of this subsection, the requirements under this section shall apply to:</text>
      <level label="i">
        <text>local detention centers in the following counties by January 1, 2020:</text>
        <level label="1">
          <text>Howard County;</text>
        </level>
        <level label="2">
          <text>Montgomery County;</text>
        </level>
        <level label="3">
          <text>Prince George’s County; and</text>
        </level>
        <level label="4">
          <text>St. Mary’s County; and</text>
        </level>
      </level>
      <level label="ii">
        <text>local detention centers in six additional counties by October 1, 2021.</text>
      </level>
    </level>
    <level label="2">
      <level label="i">
        <text>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.</text>
      </level>
      <level label="ii">
        <text>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.</text>
      </level>
      <level label="iii">
        <text>Funding for the program at the Baltimore Pre–trial Complex shall be as provided in the State budget.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <level label="1">
      <text>In this section the following words have the meanings indicated.</text>
    </level>
    <level label="2">
      <text>“Health care practitioner” means an individual who is licensed, certified, or otherwise authorized to practice under the Health Occupations Article.</text>
    </level>
    <level label="3">
      <text>“Incarcerated individual” means an individual confined within a local correctional facility.</text>
    </level>
    <level label="4">
      <text>“Medication” means a medication approved by the federal Food and Drug Administration for the treatment of opioid use disorder.</text>
    </level>
    <level label="5">
      <text>“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.</text>
    </level>
    <level label="6">
      <text>“Opioid use disorder” means a medically diagnosed problematic pattern of opioid use that causes significant impairment or distress.</text>
    </level>
    <level label="7">
      <text>“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.</text>
    </level>
  </level>
  <level label="c">
    <text>An incarcerated individual in a State or local correctional facility shall be placed on a properly supervised program of methadone detoxification if:</text>
    <level label="1">
      <text>a physician determines that the incarcerated individual is a person with an opioid use disorder;</text>
    </level>
    <level label="2">
      <text>the treatment is prescribed by a physician; and</text>
    </level>
    <level label="3">
      <text>the incarcerated individual consents in writing to the treatment.</text>
    </level>
  </level>
  <level label="d">
    <level label="1">
      <text>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:</text>
      <level label="i">
        <text>if the medical diagnosis of an opioid use disorder is appropriate; and</text>
      </level>
      <level label="ii">
        <text>if medication–assisted treatment is appropriate.</text>
      </level>
    </level>
    <level label="2">
      <text>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.</text>
    </level>
    <level label="3">
      <text>Information shall be provided to the incarcerated individual describing medication options used in medication–assisted treatment.</text>
    </level>
    <level label="4">
      <text>Medication–assisted treatment shall be available to an incarcerated individual for whom such treatment is determined to be appropriate under this subsection.</text>
    </level>
    <level label="5">
      <text>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.</text>
    </level>
    <level label="6">
      <text>Each pregnant woman identified with an opioid use disorder shall receive evaluation and be offered medication–assisted treatment as soon as practicable.</text>
    </level>
  </level>
  <level label="e">
    <text>Each local correctional facility shall:</text>
    <level label="1">
      <text>following an assessment using clinical guidelines for medication–assisted treatment:</text>
      <level label="i">
        <text>make medication available by a qualified provider to the incarcerated individual; or</text>
      </level>
      <level label="ii">
        <text>begin withdrawal management services prior to administration of medication;</text>
      </level>
    </level>
    <level label="2">
      <text>make available and administer medications for the treatment of opioid use disorder;</text>
    </level>
    <level label="3">
      <text>provide behavioral health counseling for incarcerated individuals diagnosed with opioid use disorder consistent with therapeutic standards for such therapies in a community setting;</text>
    </level>
    <level label="4">
      <text>provide access to a health care practitioner who can provide access to all FDA–approved medications for the treatment of opioid use disorders; and</text>
    </level>
    <level label="5">
      <text>provide on–premises access to peer recovery specialists.</text>
    </level>
  </level>
  <level label="f">
    <text>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:</text>
    <level label="1">
      <text>the incarcerated individual voluntarily discontinues the treatment, verified through a written agreement that includes a signature; or</text>
    </level>
    <level label="2">
      <text>a health care practitioner determines that the treatment is no longer medically appropriate.</text>
    </level>
  </level>
  <level label="g">
    <text>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:</text>
    <level label="1">
      <text>includes information regarding postincarceration access to medication continuity, peer recovery specialists, other supportive therapy, and enrollment in health insurance plans;</text>
    </level>
    <level label="2">
      <text>includes any recommended referrals by a health care practitioner to medication continuity, peer recovery specialists, and other supportive therapy; and</text>
    </level>
    <level label="3">
      <text>is reviewed and, if needed, revised by a health care practitioner or peer recovery specialist.</text>
    </level>
  </level>
  <level label="h">
    <text>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.</text>
  </level>
  <level label="i">
    <text>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.</text>
  </level>
  <level label="j">
    <text>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:</text>
    <level label="1">
      <text>the number of incarcerated individuals diagnosed with:</text>
      <level label="i">
        <text>a mental health disorder;</text>
      </level>
      <level label="ii">
        <text>an opioid use disorder;</text>
      </level>
      <level label="iii">
        <text>a non–opioid substance use disorder; and</text>
      </level>
      <level label="iv">
        <text>a dual diagnosis of mental health and substance use disorder;</text>
      </level>
    </level>
    <level label="2">
      <text>the number and cost of assessments for incarcerated individuals in local correctional facilities, including the number of unique incarcerated individuals examined;</text>
    </level>
    <level label="3">
      <text>the number of incarcerated individuals who were receiving medication or medication–assisted treatment for opioid use disorder immediately prior to incarceration;</text>
    </level>
    <level label="4">
      <text>the type and prevalence of medication or medication–assisted treatments for opioid use disorder provided;</text>
    </level>
    <level label="5">
      <text>the number of incarcerated individuals diagnosed with opioid use disorder;</text>
    </level>
    <level label="6">
      <text>the number of incarcerated individuals for whom medication and medication–assisted treatment for opioid use disorder was prescribed;</text>
    </level>
    <level label="7">
      <text>the number of incarcerated individuals for whom medication and medication–assisted treatment was prescribed and initiated for opioid use disorder;</text>
    </level>
    <level label="8">
      <text>the number of medications and medication–assisted treatments for opioid use disorder provided according to each type of medication and medication– assisted treatment options;</text>
    </level>
    <level label="9">
      <text>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;</text>
    </level>
    <level label="10">
      <text>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;</text>
    </level>
    <level label="11">
      <text>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;</text>
    </level>
    <level label="12">
      <text>the number of incarcerated individuals who discontinued medication or medication–assisted treatment for opioid use disorder during incarceration;</text>
    </level>
    <level label="13">
      <text>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;</text>
    </level>
    <level label="14">
      <text>the number of incarcerated individuals receiving medication or medication–assisted treatment for opioid use disorder prior to release;</text>
    </level>
    <level label="15">
      <text>the number of incarcerated individuals receiving medication or medication–assisted treatment prior to release for whom the facility had made a prerelease reentry plan;</text>
    </level>
    <level label="16">
      <text>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;</text>
    </level>
    <level label="17">
      <text>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</text>
    </level>
    <level label="18">
      <text>any other information requested by the Maryland Department of Health related to the administration of the provisions under this section.</text>
    </level>
  </level>
  <level label="k">
    <text>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.</text>
  </level>
</section>
