Current through Register Vol. 56, No. 6, March 18, 2024
(a) Every residential substance use disorders facility shall provide for the rendering of medical services to clients. All residential substance use disorders treatment facilities governed by this chapter shall comply with all guidelines issued from CSAT that mandate any Federal Food and Drug Administration-approved medications for detoxification and maintenance. All facilities shall also comply with the Buprenorphine Guidelines, incorporated herein by reference as chapter Appendix B and with the Vivitrol<(R)> Injectable Guidelines, incorporated herein by reference, as chapter Appendix C.
1. Hospital-based (medical) detoxification facilities, non-hospital-based (medical) detoxification facilities, short-term residential facilities and long-term residential facilities shall designate a medical director who shall supervise the medical services provided, or supervise the coordination of the medical services provided.
i. Hospital-based (medical) detoxification facilities, non-hospital-based (medical) detoxification facilities and short-term residential facilities shall provide for the rendering of medical services on site.
ii. Long-term residential facilities may provide for the rendering of medical services on site or through written agreements with one or more physicians who provide services outside of the facility.
2. Extended care facilities and halfway houses are not required to designate a medical director, but shall incorporate information regarding medical services rendered to a client in the client's treatment plan.
i. Extended care facilities and halfway houses shall establish agreements/contracts with licensed physicians to provide medical services on site or outside the facility.
ii. Extended care facilities and halfway houses shall designate qualified facility staff as identified by a licensed physician to serve as the facility medical liaison. Such an individual shall possess at least a B.A. with at least one year of experience in a substance abuse treatment facility.
iii. The medical liaison shall be responsible for:
(1) Incorporating medical information in client treatment plans;
(2) Documenting all medical contacts in the clinical record;
(3) Coordinating all medical and dental appointments and arranging transportation as necessary;
(4) Monitoring compliance with self-administrated medications and treatments; and
(5) Participating as a full member of the multi-disciplinary treatment team representing medical issues.
iv. Extended care facilities and halfway houses shall obtain written consent from each client for the release of information from the physician to the medical liaison. Such written consents shall comply with the Federal statutes and rules for the Confidentiality of Alcohol and Drug Abuse Client Records at 42 U.S.C. §§
290dd-2 and 290ee-2, and 42 CFR Part 2 and the provisions of HIPAA.
(b) Prior to a client's admission, facilities shall perform or have performed:
1. A physical examination of the client upon admission that meets the standards of N.J.A.C. 8:111-9.1(b).
i. The physical examination requirements for a client at admission may be waived if the facility verifies and documents that a physical examination meeting those requirements at N.J.A.C. 8:111-9.1(b)were performed within 30 days prior to admission;
2. A physical examination within 72 hours of admission to the facility, provided that the client has been assessed by a registered professional nurse for symptoms of communicable disease. The physical examination requirements may be waived when there is written documentation verifying that such an examination and/or laboratory tests were performed within 30 days prior to the date or anticipated date of admission of the client in the facility; and
3. An assessment of the client for communicable disease prior to the admission of the client to the facility.
i. A client suspected of having a communicable disease shall not be admitted to the facility until the client is determined to be free of communicable disease as based upon a complete physical examination of the client.
(c) The physical exam may be waived by the receiving facility if a client in treatment at another residential treatment facility is transferred directly to a direct treatment facility, had a physical examination within 12 months and is medically stable. This information shall be verified by the facility and such verification documented in the client's record.
(d) Along with providing the medical services in accordance with (a) above, the facility may refer clients to licensed physicians outside of the facility for additional medical services as necessary to provide a continuum of care for the client.
1. Facilities with adolescent clients shall provide notice to and obtain the written consent for the rendering of medical services from the adolescent's parent, guardian or legally authorized representative as the services require.
(e) Facilities not required to designate a medical director shall have a written policy and procedure regarding the provision or coordination of medical services, including detailed descriptions of how the facility shall ensure performance of the responsibilities set forth in (a) above.
(f) Facilities serving women and dependent children shall ensure and document that the children are immunized at admission, show no signs of illness and have been receiving regular primary medical care prior to admission and continue to receive primary medical care as needed during their stay at the facility.
