National Telehealth Medication Assisted Treatment (MAT) and Psychiatric Services

The Federal Bureau of Prisons (Bureau) is an agency of the Department of Justice (DOJ). It consists of 122 institutions throughout the United States, including Hawaii and Puerto Rico; 6 regional offices, a Central Office (headquarters), 2 staff training centers, 22 Residential Reentry Management Offices, and 6 Community Treatment Services (CTS) field offices. The Bureau is responsible for the custody and care of approximately 157,000 Federal offenders. Around 14,000 of those offenders are residing in Residential Reentry Centers (RRCs), on home confinement, or on Federal Location Monitoring (FLM) throughout the United States of America and various territories (i.e., Guam, and Puerto Rico). The Bureau is committed to providing high-quality, evidenced-based programs and services for all federal offenders residing in the community. The CTS Contracting Section is responsible for procuring community based mental health and substance use disorder, including medication assisted treatment (MAT), services by utilizing community treatment providers in areas where offenders are located. There are approximately 4,000 offenders in community placement receiving treatment through CTS. Treatment services are predominantly utilized for substance use disorders (58%), followed by for mental health disorders (51%). There has been an increase in the utilization of MAT services over the past year, which is nearly 10% of the offenders in community placement. Although the Bureau has a dedicated network of community treatment providers contracted to provide these services, there are still gaps in service for the provision of MAT for offenders with an Opioid Use Disorder (OUD). Many of the current CTS contracts do not have the capability to provide MAT services in addition to delivering mental health and substance use disorder treatment. And MAT services may be difficult to obtain in certain geographical areas where offenders are placed as well as access to the medications for OUD (MOUD). Lastly, the ability to procure opioid treatment program (OTP) services has presented challenges for CTS in ensuring continuity of care for offenders returning to the community who require these types of services. Mental health treatment provided by CTS contractors, in addition to counseling, may include psychiatric services. These services must be provided by qualified practitioners with prescriptive authority, who meet the standards of practice established by the applicable state’s professional regulatory board to conduct psychiatric evaluations, prescribe and administer psychotropic medications, and provide medication monitoring services in the state where services will be rendered. As with MAT, accessing practitioners who will provide psychiatric services to offenders can be challenging, particularly with the administration of intramuscular injections.