New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 161B - STANDARDS FOR LICENSURE OF OUTPATIENT SUBSTANCE USE DISORDER TREATMENT FACILITIES
Subchapter 11 - OPIOID TREATMENT SERVICES
Section 10:161B-11.4 - Policies and procedures

Universal Citation: NJ Admin Code 10:161B-11.4

Current through Register Vol. 56, No. 18, September 16, 2024

(a) Opioid treatment programs shall develop and implement written policies and procedures to include the following:

1. Medication management, including:
i. The responsibilities of the medical director, other physicians, and other health care professionals;

ii. The role of physicians regarding admission, dosage, and discharge;

iii. Establishing the initial and maintenance dose;

iv. Unsupervised dosing;

v. Emergency administration of medications;

vi. Diversion control plan;

vii. Medicating traveling clients; and

viii. Safe storage practices for unsupervised medications to include the use of child-proof or child-resistant containers;

2. Drug-screening procedures including, but not limited to:
i. Frequency of drug screening;

ii. Ensuring respect for the clients during drug screening sample collection;

iii. Testing, at a minimum, for opioids, methadone, amphetamines, cocaine, and benzodiazepines, and as appropriate, testing for drugs of choice as evidenced in evaluation and/or intake assessment;

iv. Documentation of interpretation of the results, action taken, and treatment planning for positive results;

v. Minimizing falsification during urine sample collection;

vi. Medically oriented specimen-handling procedures; and

vii. A procedure for addressing positive drug screening through the treatment planning process;

3. Other laboratory procedures;

4. Withdrawal procedures which shall address:
i. Voluntary, medical withdrawal;

ii. Withdrawal against medical advice;

iii. Involuntary administrative withdrawal;

iv. Referral and discharge;
(1) Policies for voluntary and involuntary discharge, which shall address the criteria for discharge, including the provision of assistance in transferring the client to another opioid treatment program or withdrawing the client from methadone or other approved medication prior to discharge;
(A) Program discharge policies shall be shared with the client at admission and shall be part of the client's rights statement provided to and signed by the client at admission;

(2) The discharge policy shall address the discharge of non-compliant clients based on failure to attend counseling sessions, repeated positive urines, missed days or behavior jeopardizing the health, safety or welfare of other clients and/or staff;

(3) Except as provided for by the provisions of Phase I-A (see 10:161B-11.8(b)7 ) , the discharge policy shall address the discharge of clients who are not progressing in treatment despite documented efforts by the opioid treatment programs to intensify treatment services and refer the client to supplemental treatment services or other outpatient or residential opioid treatment programs; and

(4) Policies shall provide that no client maintained on methadone or other approved medications shall be discharged from an opioid treatment program without facilitating admission to another opioid treatment program or being withdrawn from the opioid agonist medication prior to discharge;

v. Policies for withdrawal of clients from methadone, which shall include the following:
(1) The dosage of methadone may not be reduced faster than 10 milligrams (mg) every two days, except a client receiving more than 100 mg per day may be reduced up to 20 percent of the starting dose every two days until the client is at 100 mg or less: thereafter, the dosage may be reduced no more than 10 mg every two days.

(2) Pregnant women shall not be voluntarily or involuntarily withdrawn from methadone during the duration of the pregnancy except for medical necessity as determined by the medical director.

(3) If determined to be medically necessary by the medical director or facility's physician, clients continuing to use illicit drugs may be reduced at a rate faster than described above in (a)4v(1) above.

(4) Clients who must be removed from the program in response to threats or acts of violence against staff or other clients shall be transferred to another opioid treatment program if considered appropriate, or provisions shall be made to withdraw the client from the opioid agonist medication either at the opioid treatment program or at another facility. If the client does not appear at the opioid treatment program or alternate medication site or creates a security disturbance at the opioid treatment program or alternate site, the program shall document the incident in the client's record and the program's responsibility for providing medically supervised withdrawal services shall be considered fulfilled;

5. Emergency medical procedures;

6. Program contingency procedures; and

7. Critical incidents and threats.

Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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