Current through Bulletin 2024-06, March 15, 2024
(1) Each substance use disorder treatment
program shall:
(a) develop and implement a
plan on how to support opioid overdose reversal;
(b) maintain proof of completion of the
National Survey of Substance Abuse Treatment Services annually; and
(c) ensure medical cannabis is not an
enticement or offered, referred, or recommended as treatment for substance use
disorder.
(2) A program
providing medication for opioid use disorder (MOUD) shall:
(a) maintain a program-wide counselor to
client ratio of: 1:65 to provide adequate substance use counseling to each
client as clinically necessary; and
(b) assure each client sees a licensed
practitioner that may prescribe controlled substances at least once
yearly.
(3) Each MOUD
provider that prescribes, administers or dispenses methadone shall:
(a) admit a client to the program only after
the completion of a face-to-face visit with a licensed practitioner authorized
to prescribe controlled substances who confirms opioid dependence;
(b) ensure that a licensed practitioner
authorized to prescribe controlled substances approves every subsequent dose
increase before the change;
(c)
require each client admitted to the program to participate in random drug
testing performed randomly at least eight times per year, per patient in
maintenance treatment, in accordance with generally accepted clinical practice
and in accordance with 42CFR part 8; and
(d) require one hour of prescribing
practitioner time at the program site each month for every ten MOUD clients
enrolled.
(4) Each MOUD
program that prescribes, administers or dispenses methadone shall:
(a) maintain Substance Abuse and Mental
Health Services Administration certification and accreditation as an opioid
treatment program;
(b) employ the
following:
(i) a licensed physician who is an
ASAM-certified physician;
(ii) a
prescribing licensed practitioner who can document specific training in current
industry standards regarding methadone treatment for opioid addictions;
or
(iii) a prescribing licensed
practitioner who can document specific training or experience in methadone
treatment for opioid addictions; and
(c) provide one qualified provider as defined
in Section
58-17b-309.7 to dispense or
administer medications for every 150 methadone clients dosing on an average
daily basis.
(5) An
outpatient treatment program may offer mobile MOUD services under their
physical site license if:
(a) the existing
licensed site provides MOUD services;
(b) the licensee maintains policy and
procedures addressing the agency policies as they apply to the mobile unit;
and
(c) registration requirements
of the Drug Enforcement Administration Code of Federal Regulations, Title 21,
Parts 1300, 1301 and 1304, 2021 edition are met.
(6) An alcohol and drug education provider
shall provide court ordered education only if certified to do so through the
OSUMH in accordance with Rule R523-11.
(7) A licensed substance use disorder
counselor (SUDC) in a substance use disorder outpatient treatment program may:
(a) collect client information;
(b) conduct the screening portion of an
assessment;
(c) make level of care
recommendations; and
(d) identify a
substance use disorder.
(8) A SUDC may not diagnose a
client.
(9) A OSUMH certified
alcohol and drug education provider shall:
(a)
complete and maintain a substance use screening, that may be shared between
providers with written client consent, for each client before providing the
education course;
(b) provide a
workbook to each participant to keep upon completion of the course;
(c) ensure at least 16 hours of course
education; and
(d) provide separate
classes for adults and youth.
(10) A provider offering services to
justice-involved clients shall:
(a) operate in
compliance with Rules R523-3 and R523-4;
(b) maintain a validated criminogenic screen
or risk assessment for each justice-involved client that is conducted with an
accepted tool including:
(i) Level of Service
Inventory-Revised (LSI-R);
(ii)
Risk and Needs Triage (RANT);
(iii)
Ohio Risk Assessment System (ORAS): or
(iv) any other screen that the provider can
demonstrate their validation to the OSUMH:
(c) separate clients into treatment groups
according to level of risk assessed;
(d) complete screenings that assess both
substance abuse and mental health comorbidity; and
(e) treat, or refer to other licensed
Department of Health and Human Services programs that serve justice-involved
clients to treat the array of disorders noted in the screening.