A prisoner-rights group has challenged the Vermont Department of Corrections about the way substance-abuse treatment is provided to inmates, but changes were made last week to get more people into medication-assisted treatment.
In May, Gov. Phil Scott signed into law a bill stating that “medication-assisted treatment offered at or facilitated by a correctional facility is a medically necessary component of treatment for inmates diagnosed with opioid-use disorder.”
The law says that within 24 hours of admission to a correctional facility, an inmate will be screened for substance abuse.
“If at any time an inmate screens positive as having an opioid-use disorder, the inmate may elect to commence buprenorphine-specific, medication-assisted treatment if it is deemed medically necessary ... The inmate shall be authorized to receive the medication as soon as possible and for as long as medically necessary,” the law reads.
However, in a complaint filed in September with the Vermont Department of Health’s Board of Medical Practice, Tom Dalton, executive director of Vermonters for Criminal Justice Reform, said tat Centurion Medical Products, the contractor hired by the state, has failed to provide screening or to induct inmates into treatment.
According to the complaint, about two months after the law took effect, about 500 inmates requested treatment, but only about 170 were screened and fewer than 50 were inducted into treatment.
Dalton said he has been working on the issue for many years. He said he had an experience with someone who was receiving the medication but who lost access after spending a few weeks in jail.
Later, the person died of an overdose while waiting to get back into treatment, he said.
“That was really a galvanizing event for me to say, ‘We need to make sure people can have access to their medication during periods of incarceration,’” Dalton said.
Dalton said having inmates treated for substance abuse is important for everyone.
“I would say Vermont communities are safer when Vermont correctional facilities treat addiction. It seems really obvious, but we’re 15 to 20 years into an opioid disaster, and it’s still not happening in a lot of cases,” he said.
One of the foremost concerns Dalton raised was what seemed to be a tie established by Centurion between an inmate’s release date and induction into treatment. Dalton said many inmates were not treated until they had a release date. However, some inmates don’t have a release date because they haven’t established housing or have other charges pending.
Annie Ramniceanu, director of addiction and mental health services for the Vermont Department of Corrections, said Centurion wanted to be sure inmates got treatment at a time when they were most vulnerable, going from the mostly-controlled environment of a correctional facility and back to the inmate’s home environment.
However, since Dalton filed his complaint, there have been changes.
Last week, Ramniceanu said DOC and Centurion officials had been working since early October to define the populations that are closest to release. She said the population that will have access to treatment, if medical necessity has been established, includes people who are detained, being held because of lack of housing, have served their minimum sentence or are being held because new charges are pending.
“(They) should all be considered for induction (into treatment) without regard to specific release date because we know they could be released at any point in time,” she said.
Because of the changes, about 320 people had been inducted into into the treatment program as of Friday, Ramniceanu said. About 30 are being treated with methadone and the rest with buprenorphine.
She said the change to the guidelines resulted in about 225 new inductions last week.
Lisa Menard, commissioner of the Department of Corrections, said the changes were “in the works for some time” and not a direct result of the complaint.
Menard said Centurion had determined the medical necessity for treating patients was within the last 30 days of their time in prison.
“We, the department, decided simply to tell the contractor, consider them within 30 days of release because their (the inmates) residence could come up in a day, it could come up in 30 days. We don’t want people leaving, missing the opportunity to have been inducted (into treatment),” Menard said.
Not everyone has gotten the treatment they need.
Greg Shaw, of Rutland, who said in early October that he was in prison because he had relapsed and used cocaine, said he was not admitted to a treatment program.
“I can’t even get counseling. I can’t even get treatment, let alone MAT,” he said.
Shaw said he has to “hustle” every day in prison.
“My best explanation for it is, in here, having to seek out (medication) myself. I literally feel like I’m chasing heroin and cocaine on the street but only chasing Suboxone in here,” he said.
Dalton said as of Tuesday, Shaw had not gotten treatment yet.