Witnesses at House Corrections hearing urge continuous MOUD treatment for detainees, back H.32 changes

Members of the House Corrections and Institutions Committee heard detailed accounts Thursday about gaps in continuity of medication for opioid use disorder (MOUD) when people leave Vermont correctional facilities, and testimony supporting changes in the bill H.32 to expand reentry planning to cover detainees.

The testimony focused on how treatment started inside facilities can be disrupted at release. Jason Brosh, a resident of Calais who participated in the committee hearing, said he was taken off continuity planning when contractors changed and “there was no arrangements made for me to continue with treatment when I left the facility.” Brosh told the committee he was released from court wearing “gray sweatpants,” with no identification and without immediate access to MOUD.

The gap between in‑custody induction onto MOUD and community follow‑up has real consequences, witnesses said. Joshua Tripp, a former detainee now in treatment court, told the panel he was released in June 2024 without medication and “went back to using from June till September,” until treatment court connected him to care.

Why it matters: committee members and witnesses said incarceration is often a window of opportunity to start or stabilize MOUD because people are sober and accessible for care; losing access at release, they said, increases the risk of overdose and return to illicit use.

Clinical and programmatic concerns emerged in testimony. Registered nurse Leslie Thorson, who reviewed DOC medical records for an outside agency, summarized evidence and standards she said the committee should use when assessing corrections MOUD practice: “Medication treatment for opioid use disorder has been proven to decrease IV and other illicit drug use” and to reduce overdose and all‑cause mortality, she said. Thorson recommended adherence to national induction and treatment standards (including SAMHSA guidance and the National Commission on Correctional Health Care standards) and expanded psychosocial counseling alongside medication.

Witnesses described operational problems that interrupt care: delays in induction when people transfer between facilities; telehealth‑only appointments that limit continuity; inconsistent dosing or reductions on intake that can prompt diversion; and limited counseling and case management capacity. Thorson cited chart reviews that, she said, showed inconsistent induction procedures and sparse counseling availability across facilities.

Committee members walked through how H.32 currently reads and the change under consideration. Committee staff and witnesses explained that current law requires the department or its contractor to identify a health‑care practitioner or opioid treatment program and schedule an intake appointment for an offender before release; the version of H.32 before the committee would extend that scheduling ability to detainees (language in the draft uses “may provide” for detainees, while the scheduling requirement for offenders is mandatory).

Several witnesses urged stronger language and operational detail. Thorson told the committee that where H.32 uses “may provide” for detainees, that creates unequal access: “It should be shall provide,” she said, arguing detainees released after short stays face the same risk post‑release as sentenced people. Jason Brosh and Joshua Tripp described how, in their cases, caseworkers and contractors did not complete reentry appointments or provide a bridge prescription that would have covered the time until community intake.

On specific clinical options, several witnesses described monthly injectable buprenorphine (referred to in testimony as an injectable that reduced diversion and daily‑medication burden). Brosh said switching to a monthly injectable “changed my life” because it removed daily dosing and diversion risk; witnesses and members discussed cost and access questions for that formulation.

Committee members asked about measurement of success. Tripp and others said success should be measured by a mix of clinical markers and social outcomes — continued receipt of MOUD, engagement in counseling, employment or housing stability and absence of new arrests — and suggested data sharing agreements and post‑release follow‑up (with consent) as ways to measure outcomes.

Discussion vs. decision: the hearing produced no committee vote or change in text. Committee members signaled interest in H.32’s amendment to include detainees but did not adopt new language in the hearing. Several members asked DOC and its contractor about operationalizing scheduling, bridge doses, caseworker workload and how the 1115 Medicaid waiver might help cover short‑term prescriptions at release.

What’s next: witnesses recommended DOC rely on national correctional health standards, include clear operational steps in H.32 for detainee scheduling and bridge medication, increase counseling capacity in the WellPath contract or DOC staffing, and use third‑party health‑services monitoring to audit practice.

“I was released with no medication,” Joshua Tripp told the committee. “That did not continue,” he said of his in‑custody MOUD, a gap witnesses identified repeatedly as the core problem H.32 aims to address.