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-11.8 - Counseling services

Universal Citation: NJ Admin Code 10:161B-11.8

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

(a) As part of a multidisciplinary team approach, an opioid treatment program shall provide counseling services in accordance with 10:161B-10.1.

(b) All opioid treatment programs shall provide counseling services, at a minimum, in accordance with the Phase schedule set forth below. Clients shall be considered for movement from one phase to another when the multidisciplinary team review has determined that the client has progressed in treatment and meets the following criteria:

1. For Phase I: Upon admission.
i. The client shall receive at least one counseling session per week with at least one individual counseling session per month, a total of four counseling sessions per month;

ii. A client shall be considered for Phase II based upon the review, recommendation and documentation of the multidisciplinary team after three consecutive months of negative drug screenings and compliance with other criteria established by the program; and

iii. Minimum duration of Phase I shall be three months if all drug screening results are negative; re-assessment shall take place at this time.

2. For Phase II:
i. The client shall receive at least two counseling sessions per month, including at least one individual counseling session;

ii. A positive drug screening shall result in an immediate clinical intervention, which shall be recorded in the client record;

iii. A second positive drug screening within a 90-day period shall result in a return to weekly counseling until at least one month of negative drug screenings, at which point the multidisciplinary team would determine the frequency of the counseling and the take home schedule based on the stability of the client;

iv. A client shall be considered for Phase III based upon the review, recommendation and documentation of the multidisciplinary team when he/she has had a total of six consecutive months of negative drug screening results in Phase II and is in compliance with other criteria established by the program; and

v. Minimum time in Phase II is six months if all drug screening results are negative.

3. For Phase III:
i. The client shall receive at least one individual counseling session per month;

ii. A positive drug screening shall result in an immediate clinical intervention, which shall be recorded in the client record;

iii. A second positive drug screening within a 90-day period shall result in a return to weekly counseling until at least one month of negative drug screenings, at which point the multidisciplinary team would determine the frequency of the counseling and the take home schedule based on the stability of the client;

iv. A client shall be considered for Phase IV based upon the review, recommendation and documentation of the multidisciplinary team when he/she has had nine consecutive months of negative drug screening results in Phase III and is in compliance with other criteria established by the program; and

v. Minimum time in Phase III is nine months if all drug screening results are negative.

4. For Phase IV:
i. Based upon the review, recommendation and documentation of the multidisciplinary team, the client shall receive a minimum of one individual counseling session every three months;

ii. A positive drug screening shall result in an immediate clinical intervention, which shall be recorded in the client record;

iii. A second positive drug screening within a 90-day period shall result in a return to weekly counseling until at least one month of negative drug screenings, at which point the multidisciplinary team would determine the frequency of the counseling and the take home schedule based on the stability of the client;

iv. A client shall be considered for Phase V based upon the review and recommendation of the multidisciplinary team when he or she has had six months of negative drug screening results in Phase IV and the multidisciplinary team has determined that the client has progressed in treatment and meets program criteria for promotion; and

v. Minimum time in Phase IV is six months if all drug screening results are negative.

5. For Phase V:
i. Clients who have had 24 consecutive months of negative drug screening results and meet other program criteria for treatment progress shall receive counseling services at a frequency determined by the multidisciplinary team and program policy;

ii. A positive drug screening shall result in an immediate clinical intervention, which shall be recorded in the client record; and

iii. A second positive drug screening within one year shall result in a return to weekly counseling until at least one month of negative drug screenings, at which point the multidisciplinary team would determine the frequency of the counseling based and the take home schedule on the stability of the client.

6. For Phase VI:
i. Clients who have had 36 consecutive months of negative drug screening results and meet other program criteria for treatment progress shall receive counseling services consistent with the clinical needs of the client and the documented recommendation of the multidisciplinary team;

ii. A positive drug screening shall result in an immediate clinical intervention, which shall be recorded in the client record;

iii. A second positive drug screening within one year shall result in a return to weekly counseling until at least one month of negative drug screenings, at which point the multidisciplinary team would determine the frequency of the counseling and the take home schedule based on the stability of the client; and

iv. Clients in this phase may be eligible for clinic based medical maintenance and may be provided up to 30 take home doses of medication based upon the documented recommendation of the multidisciplinary team. Opioid treatment programs electing to provide clinic based medical maintenance shall comply with the provisions of this rule, 10:161B-11.15.

7. For Phase I-A:
i. Clients in Phase I, for a period of at least 12 months, who have failed to progress in treatment despite documented efforts by the opioid treatment program to intensify treatment services and where referral to supplemental treatment services or a residential program is not available, may be retained in treatment at a lesser level of service designated as Phase I-A in accordance with the following:
(1) The opioid treatment program can document a multidisciplinary team case conference that determines a substantial identifiable benefit exists to the client and/or the general public that supports retaining the client in treatment despite the client's continued lack of progress in treatment;

(2) An opioid treatment program's decision to retain a client in Phase I-A shall be based on a benefit to the client and/or general public which is documented in the client record and supported in writing by the counselor, director of substance abuse counseling, director of nursing services and medical director; and

(3) Written documentation of alternative treatment (that is, IOP, residential, hospitalization, etc.) options explored by the program shall be included, along with reasons why these options are inappropriate (that is, not available in area, etc.).

ii. Clients designated as Phase I-A shall receive at least two counseling sessions per month, including one individual counseling session, and shall receive at least one monthly drug screening; and

iii. The multidisciplinary team shall review and document the status of clients designated in Phase I-A on a quarterly basis.

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