County jails need medication for drug addiction too, lawmakers say

By Anthony Hennen | The Center Square

HARRISBURG, PA – Since significant numbers of inmates in Pennsylvania’s jails and prisons live with addiction, the legislature wants to expand treatment in the hopes of lowering recidivism rates – and costs.

On Friday, the House passed a bill that would expand a grant program for medication-assisted treatment, or MAT, in county jails. House Bill 1515 –introduced by Rep. Maureen Madden, D-Tobyhanna – lets county jails use all FDA-approved medications for MAT, instead of limiting it to naltrexone (also known as Vivitrol).

“My bill opens the grant program so that county jails, if they choose to do so, have greater flexibility in terms of medication options for individuals who are overcoming addiction while incarcerated and before release,” Madden said in a press release. “There are also more provably successful medications soon expected to become available that can be even more effective.”

Advocates have argued for more MAT in county jails to treat opiate addictions — both to improve inmate health and to save taxpayer money, as The Center Square previously reported. The idea is that better treatment during time in jail or prison lowers recidivism rates and avoids a costly return to prison.

Inmates in county jails — which are separate from state prisons — have limited access to medication-assisted treatment. A 2022 report from the Vera Institute of Justice, a criminal justice reform group, found that only three of 62 jails allow inmates to start treatment for an opiate addiction in jail. If an inmate already has a prescription when they enter, only 18 jails allow treatment to continue.

HB 1515 expands an existing law, Act 80 of 2015, to make jail programs similar to what’s offered in state prisons. State prisons already offer more forms of MAT than county jails. If approved by the Senate, the bill does not give inmates the right to access MAT, but gives jails more flexibility in the type of drug used for treatment.

Treatment costs would get picked up by Medicaid. The bill would require Medicaid managed care plans to approve treatment. It would also require a report that lists how many inmates received medication-assisted treatment, how many completed the program, recidivism rates of inmates, a list of the grants awarded to counties, and the impact on treatment outcomes — along with any potential cost savings.

Grant money comes from existing funding for Act 80, which currently has a $6 million surplus.

The success of the bill in the House will spur other proposals for addiction treatment.

Rep. Jim Gregory, R-Hollidaysburg, pulled an amendment to HB1515 and will instead offer it as a stand-alone bill.
“My amendment includes grants and services that would help the continuum of care supporting long term recovery,” Gregory said. “Money spent in this program needs to help return what is now a crumbled and devastated infrastructure of treatment and recovery in Pennsylvania.”

Gregory, who spoke of his own issues with addiction and has been sober for 13 years, warned of the importance of treatment and programs outside prison to support long-term recovery.

“Once out of prison, too many return to that prison that I know of that has no walls — it is the prison of addiction,” Gregory said. “I know what that prison feels like: it’s a prison of no hope, it’s a prison of no faith, it’s a prison with no future. It has only one thing: a return to prison, or death.”