N.M. Admin. Code § 8.325.12.9

Current through Register Vol. 35, No. 21, November 5, 2024

Section 8.325.12.9 - PROGRAM REQUIRED ELEMENTS

A. Identification of the type of treatment service delivery model(s) to be used by the correctional facility's treatment programs:

(1) Facility becomes an accredited/certified and DEA-registered opioid treatment program/narcotic treatment program (OTP/NTP).

(2) Facility contracts with medical service provider (to include onsite or telemedicine resources).

(3) Facility transport to OTP/NTP.

(4) Facility arranges for MOUD provider to come to the facility to provide services.

B. Screening and referral to assessment:

(1) A preliminary SUD screening shall be administered during the correctional facility's in-take process. The screening instrument shall:

(a) follow evidence-based practices consistent with current scientifically-based and validated tools, protocols, or guidance for SUD treatment and services to identify all individuals who may have a SUD as well as individuals in need of withdrawal management services; and

(b) assure identification of individuals who are receiving continuation of SUD treatment (to include MAT and MOUD) in the community or in a county detention facility prior to placement to inform continuation of those services during the individual's incarceration.

(2) Individuals screened and referred for assessment, shall receive a comprehensive assessment and diagnostic evaluation for SUD. The clinical assessment and diagnostic evaluation shall:

(a) follow best practice and accepted general SUD guidelines; and

(b) serve as basis for provision of treatment services for those individuals diagnosed with a SUD for which there are federal food and drug administration (FDA) approved medications. For persons specifically identified with OUD, FDA-approved MAT/MOUD shall be offered.

(3) Beginning on July 1, 2026, current inmates and detainees may request SUD screening at any time during their incarceration, including prior to release, and this shall result in a referral for screening and assessment, if indicated.

C.MAT/MOUD Medications:

(1) The program shall include provision of all medications approved by the FDA for the treatment of SUD and withdrawal management to ensure that each program participant receives the medication identified to be the most effective at treating and meeting individual needs.

(2) The program shall provide existing or prospective program participants education regarding the FDA-approved medications for the treatment of SUD, including the benefits and risks.

(3) The decision as to which FDA-approved medication is prescribed, dispensed and administered shall be made by the healthcare practitioner in consultation with the program participant, taking into consideration security, health and safety level, and community resource availability. Transferring from one OUD medication to another to another may commence, if:

(a) the new medication is deemed medically necessary by a healthcare practitioner authorized to prescribe that new medication and the program participant consents to the change; or

(b) the program participant elects to commence the new medication, the new medication is FDA-approved to treat the program participant's SUD, and a qualified healthcare practitioner does not identify any absolute contraindication to the change.

(4) Program participants who are receiving MOUD during incarceration and who elect to discontinue MOUD shall receive education on the risks of MOUD discontinuation and supervised clinical taper from MOUD to avoid abrupt discontinuation of the medication.

(5) Program healthcare practitioners will assess program participants on an annual basis at a minimum but can choose to assess a program participant more frequently in order to determine their response to a given medication. Following the assessment (whether annual or interim), the healthcare practitioner may, in consultation with the program participant, recommend that the medication be continued, titrated or tapered. Education must be provided to the program participant regarding the benefits and risks of the clinical options and decision making.

D.Therapeutic services:

(1) An individualized treatment plan shall be created for each program participant.

(2) Group or individual counseling services with clinical support and supervision shall be provided where available. Treatment services, to include medication, shall not be withheld in the event of the lack of availability of counseling services.

(3) Service delivery shall offer engagement with qualified peer support workers or certified peer support workers.

E.Reentry services:

(1) Reentry planning for the program participant shall begin upon entry to the treatment program.

(2) Qualified peer support workers or certified peer support workers shall be engaged with the reentry process from the onset of the program participant's enrollment in the treatment program.

(3) Facilities shall ensure referral to a community-based provider if MAT/MOUD is indicated for a program participant and, despite best efforts, treatment initiation is not possible prior to release.

(4) Reentry planning shall occur to assure continuity of care in the community for program participants who received MAT/MOUD services for their SUD during incarceration and are exiting facilities.

(5) Reentry services for program participants receiving MAT/MOUD during incarceration, in order to promote success and safeguard from poor outcomes, shall include, but not be limited to:

(a) providing information and referral to available SUD treatment facilities and primary care clinical facilities in the program participant's area of release;

(b) referring program participants who are receiving treatment with methadone, to OTPs under medical order and in compliance with current federal and state requirements and regulations regarding services' transfer;

(c) assisting program participants with information and resources for housing and regional resources that include job employment assistance, healthcare, transportation, and other safety-net services in community of release, including tribal programs and services;

(d) assisting program participants with information on and reactivation of medicaid/medicare enrollment and affiliation with a managed care organization (MCO) or fee for service for eligible participants; and

(e) assuring program participant access to naloxone rescue kits, or a prescription for a naloxone rescue kit as indicated in 33-2-51 NMSA 1978.

F.Transitional services (to include discharge):

(1) Transitional services shall include a warm handoff with a transition of care plan from sending entity (correctional facility medical provider) to receiving entity. This includes transition from county detention facility to state correctional facility and vice versa.

(2) Discharge planning shall include:

(a) linking to MAT/MOUD and other SUD services in the program participant's geographic area of residence;

(b) providing behavioral and medical health referrals;

(c) ensuring discharge prescription for naltrexone or buprenorphine products; and

(d) referring program participants who are receiving treatment with methadone, to OTPs under medical order and in compliance with current federal and state requirements and regulations to ensure continuity of care and access to MAT/MOUD.

(3) Program participants who are receiving MOUD during incarceration and who elect to discontinue MOUD upon their release shall receive education on the risks of MOUD discontinuation and supervised clinical taper from MOUD to avoid abrupt discontinuation of the medication.

(4) Program participants who are transitioning to a community or region that does not have resources available to continue treatment may receive supervised clinical taper from MOUD to avoid abrupt discontinuation of the medication.

G.Program participant safeguards: Correctional facilities shall assure that:

(1) treatment services, once initiated, are available for the duration of a program participant's period of incarceration;

(2) placement in the medication-assisted treatment program shall be offered to all qualified individuals, but participation shall not be mandatory;

(3) the program participant provides written consent to receive treatment services or to discontinue treatment services;

(4) no program participant shall be charged fees for SUD treatment services;

(5) MAT/MOUD services shall not be denied to any eligible program participant as a form of disciplinary action unless that action is related to the diversion, abuse or misuse of the program's prescribed medication; and

(6) program participants are provided the option to discontinue treatment services, should they choose to do so. (In such cases, discontinuation shall adhere to medically appropriate tapering guidelines and educational practices.)

N.M. Admin. Code § 8.325.12.9

Adopted by New Mexico Register, Volume XXXV, Issue 16, August 27, 2024, eff. 9/1/2024