Committee advances draft language to require MOUD reentry planning in corrections bill

House Corrections and Institutions members spent the April 23 meeting reviewing draft 2.1 of House Bill 32, concentrating on provisions that would require the Department of Corrections or its contractor to begin medication for opioid use disorder (MOUD) before a sentenced person’s release and to coordinate continued treatment in the community.

The committee’s legal counsel, Katie McGlenn of the Office of Legislative Council, summarized the bill’s proposed MOUD language and stressed the way clinical decisions are framed: “The inmate may elect to commence MOUD if it is deemed medically necessary by a health care practitioner,” McGlenn said, emphasizing that desire alone would not override a clinical judgment.

The differences between sentenced offenders and detainees were a focal point. The draft would require the department or its contractor to provide reentry planning and commence MOUD for an offender prior to release; for detainees, the bill uses permissive language that would allow — but not require — the department or contractor to provide the same services. Committee members asked whether the permissive treatment of detainees could create a gap for people held for short periods or for long pretrial detentions that later result in sentencing.

Committee discussion also covered operational details: the draft says a person who starts MOUD in custody shall be authorized to receive the medication “as soon as possible and for as long as medically necessary,” and allows switching between MOUD medications if a clinician deems the change medically necessary and the person elects to commence the new medication.

Tony, representing the Department of Health’s Division of Substance Use, described limits on how the statute can specify supply amounts and the practical goal behind the provision: “We’re really trying to make sure that we write bridge prescriptions from when somebody leaves to when they get to their next appointment so that folks don't have extra medications that would be difficult to reconcile,” Tony said, adding that insurer coverage often dictates how many days’ supply is feasible.

The draft also requires the health care practitioner who discontinues a MOUD medication to record the reason in the medical record and to offer the person an opportunity to authorize notification of their community-based prescriber. Committee members discussed risks when notifications do not occur and whether community providers would reassess a returning patient.

Committee members reviewed reentry-planning specifics: the department or its contractor would be required to schedule an intake appointment with a community health care practitioner or opioid treatment program for an offender; the same scheduling is permissive for a detainee. The draft states that if induction is not possible before release, the department or contractor “shall ensure comprehensive care coordination with a community based provider.”

Members discussed measurement and reporting. The draft includes a requirement for an annual, aggregated report — prepared by a state data entity in consultation with DOC — giving the count of previously incarcerated individuals released on MOUD and the aggregated number who continued to refill a MOUD prescription six months after reentry. Members referenced a 2022 study that used Medicaid claims and DOC data to measure follow-through; committee participants highlighted that Medicaid-based reporting would capture a majority payer but would not include privately insured people and that matching incarceration records to claims data is administratively challenging.

No formal votes were taken. The committee asked staff to draft permissive legislative intent language encouraging department training for DOC staff about MOUD, and members requested that Department of Corrections and relevant data partners (identified in the meeting as DOC and the state Medicaid data entity, referenced in the transcript as "DIVA") work with counsel to refine the reporting language and feasible metrics such as first refill or first community appointment within a set period after release.

The committee scheduled follow-up work: counsel will circulate a revised draft and coordinate with DOC and the data partners; members set a working session for Friday at 11:00 and requested DOC participation in person or by Zoom.

The discussion closed with members expressing a shared goal of improving continuity of care on release while acknowledging data and operational constraints around measuring long-term outcomes such as recidivism or emergency department utilization.