The House Corrections and Institutions Committee on Friday, Feb. 4, continued its review of H.32, a bill that would update Vermont statutes governing delivery of medication for opioid use disorder (MOUD) in correctional facilities and the reentry process for people leaving custody.

Committee counsel Katie McGlenn reviewed changes in a new draft that (among other edits) replaces older terms such as ‘‘medically assisted treatment’’ with ‘‘medication for opioid use disorder’’ (MOUD), adds a definition for ‘‘health care practitioner,’’ and relocates reentry provisions to a consolidated reentry subsection. The draft also cross-references Department of Health rules for opioid treatment programs and office-based opioid treatment providers.

Why it matters: Committee members said the provisions affect continuity of care after release and could influence post-release overdose risk. Tony (Division of Substance Use, Vermont Department of Health) told the committee that people released from incarceration who are not on MOUD face markedly higher overdose mortality, and the committee repeatedly flagged the need to ensure the statute matches how reentry coordination is delivered in practice.

Key points from the discussion

- Reentry coordination and who is responsible. The draft requires that, prior to community reentry, the Department shall provide information and offer care coordination and shall ‘‘identify a health care practitioner licensed to prescribe medication for opioid use disorder or an opioid treatment program or both, and schedule an intake appointment for the offender’’ so that community treatment can continue. Members pressed whether that language should say ‘‘the Department,’’ ‘‘the Department or its contractor,’’ or use neutral phrasing such as ‘‘provide or cause to be provided’’ because DOC currently contracts with a vendor (WellPath) to deliver many health services. Committee counsel and members agreed the committee should ask DOC and its counsel to clarify how the language would operate in practice and how liability would be allocated between the state and any contractor.

- Clarifying who is covered. The draft distinguishes ‘‘offenders’’ (people serving a sentence) from ‘‘detainees’’ (people held pretrial) and places the reentry requirements explicitly in the offender/reentry subsection. Committee members asked DOC to confirm operational differences and edge cases (for example, a person who ‘‘maxes out’’ and moves out of state) so the statute’s reach is clear.

- Supplies on release. The bill would authorize the Department to provide a legally permissible supply of medication at discharge when the medication prescribed in custody is available at the facility and clinically appropriate, to cover the person until they can obtain medication in the community. Committee members asked whether the draft should articulate criteria that trigger a permissive ‘‘may provide’’ for certain categories of detainees; they agreed that DOC testimony would help set such criteria.

- Contractor language and legal exposure. Several members raised legal and practical concerns about inconsistent references to the ‘‘department’’ versus ‘‘contractor’’ elsewhere in the draft. One committee member urged consistent wording across medical and MOUD provisions so responsibility and potential legal exposure are clear. Counsel proposed adding explicit contracting language (for example, saying the Department ‘‘may contract for’’ services) or a clause such as ‘‘the Department shall provide or cause to be provided’’ to preserve flexibility.

- Staff training. The draft flags a possible provision that DOC staff receive MOUD-related training (why people are on MOUD, signs and symptoms, and related procedures). Members and witnesses discussed trade-offs: several lawmakers expressed support for training frontline correctional staff so staff better understand medical decisions and reduce conflicts or misconceptions; others cautioned about unit-level staffing and collective-bargaining implications and recommended careful drafting and testimony from VSEA and DOC training staff.

- Injectables and diversion. Committee members discussed whether to encourage or authorize long‑acting injectable MOUD in custody to reduce diversion and administrative burden. Tony said injectable uptake in the broader community remains low and that injectable patients are a small portion of all people on MOUD (he estimated roughly 9,500 people on MOUD statewide and roughly 150 receiving injectables, numbers he described as approximate). He and others cautioned that if correctional facilities shift to injectables there may be few community providers able to continue injectable treatment after release.

- Reporting and timing. Counsel proposed an annual report (draft text in the bill) requiring an agency identified in the draft (labeled there as ‘‘DIVA’’) to report aggregated counts of people released on MOUD and the subset still refilling prescriptions six months after reentry. The committee asked for follow-up with the agency and DOC about data capacity. The draft includes proposed effective dates: most provisions effective July 1, 2026, with one section (section 3 in the draft) effective July 1, 2027, to allow time for data and operational changes.

Who the committee asked to testify next

Committee members and staff agreed the bill would benefit from additional testimony and recommended inviting representatives from: the Department of Corrections (DOC) and DOC legal counsel; the contractor that provides DOC health services (WellPath); the Vermont State Employees Association (VSEA) about training impacts; hub-and-spoke or opioid treatment program providers (Katie and Tony specifically recommended Dr. John Brooklyn and Dr. Fred Lord as clinical witnesses); and the agency listed in the draft report provision (labeled ‘‘DIVA’’ in the bill text) to confirm data availability.

Next steps

Committee counsel said she will revise the draft based on the committee’s feedback and return with updated language and that DOC and the other parties should be asked to provide testimony on the contractor/department language, training scope, discharge-supply criteria, and reporting feasibility. The committee did not take a formal vote on H.32 during the Feb. 4 meeting.

Tony provided direct testimony on overdose risk, telling the committee that people who leave custody and are not on MOUD have ‘‘a death rate [that is] a hundred and 29 times the general public’’ and that post-release mortality risk is concentrated in the weeks after release. Katie McGlenn summarized drafting options to address contractor responsibilities and to preserve flexibility if DOC later changes how services are provided.