West Virginia Code of State Rules
Agency 69 - Health And Human Resources
Title 69 - LEGISLATIVE RULE DEPARTMENT OF HEALTH AND HUMAN RESOURCES
Series 69-07 - Regulations of Opioid Treatment Programs
Section 69-7-18 - Staffing
Universal Citation: 69 WV Code of State Rules 69-7-18
Current through Register Vol. XLI, No. 38, September 20, 2024
18.1. Medical Director.
18.1.a. Each opioid treatment
program shall have a designated medical director. The medical director shall be
a physician licensed to practice medicine or osteopathy in the state of West
Virginia and shall have either:
18.1.a.1.
Demonstrated experience in opioid treatment; or
18.1.a.2. A written plan to attain competence
in opioid treatment within a probationary time period as provided in
§18.1.b herein.
18.1.b. The medical director may submit a
written plan to attain competence in opioid treatment to the state authority
for approval at least two weeks prior to employment at an opioid treatment
program.
18.1.b.1. The time frame for
completion of the plan may not exceed twelve months from the date of the
appointment as medical director. The physician may work as a medical director
during this probationary time period, subject to the supervision and reporting
requirements of this rule.
18.1.b.2. During the probationary time
period, the medical director shall be supervised on a regular basis by a
physician licensed in this state with demonstrated competence in the field of
opioid treatment.
18.1.b.3.
Consultation with and supervision of a medical director during the probationary
time period may be provided by telephone or video conferencing and shall be
documented, initialed or verified (either in ink or electronically) and dated
by both the supervising physician and the supervised physician.
18.1.b.4. The administrator of the opioid
treatment program is responsible for maintaining documentation regarding the
medical director's training and experience in a file which is current and
readily available at all times. The administrator is also responsible for
ensuring that the plan of development is completed within the approved time
lines.
18.1.b.5. The state
authority may request periodic documentation of continuing education during the
initial probationary period and afterward if the documentation provided at the
end of that period is not satisfactory.
18.1.c. The medical director shall maintain
authority over the medical aspects of treatment offered by the opioid treatment
program. The medical director is responsible for:
18.1.c.1. All opioid treatment
decisions;
18.1.c.2. Operation of
all medical aspects of the treatment program;
18.1.c.3. Administration and supervision of
all medical services;
18.1.c.4.
Ensuring that the opioid treatment program is in compliance with all applicable
federal, state and local laws, rules and regulations;
18.1.c.5. Obtaining and maintaining his or
her continuing medical education in the field of addiction on a documented and
ongoing basis;
18.1.c.6. Approving
the basic and continuing educational programs of all staff employed by or
volunteering at the opioid treatment program; and
18.1.c.7. Determining the ability of the
program physicians or physician extenders to work independently within the
applicable scope of practice.
18.2. Professional Medical Staff.
18.2.a. The opioid treatment program may
employ and use program physicians, physician extenders and other health care
professionals working within their scope of practice who have received
sufficient education, training and experience, or any combination thereof, to
enable that person to perform the assigned functions. All physicians, nurses
and other licensed professional care providers must comply with the
credentialing requirements of their respective professions. The opioid
treatment program may only employ advanced practice registered nurses and
physician's assistants as physician extenders.
18.2.b. All physicians and physician
extenders employed by the opioid treatment program shall be actively licensed
in West Virginia and shall have:
18.2.b.1. A
minimum of one year's experience in opioid treatment settings; or
18.2.b.2. Active enrollment in a plan of
education for obtaining competence in opioid treatment methods and addiction
that is approved by the medical director. The medical director shall certify
the individual's completion of the plan of education when, in the discretion of
the medical director, it is satisfactorily accomplished.
18.2.c. During all hours of operation, every
opioid treatment program shall have an actively licensed physician on call and
available for consultation with other staff members at any time.
18.2.d. During all hours of operation when
medication is being administered, every opioid treatment program shall have
present and on duty at the facility at least one of the following
actively-licensed health care professionals
18.2.d.1. Physician assistant; or
18.2.d.2. Advanced practice registered nurse;
or
18.2.d.3. Registered nurse;
or
18.2.d.4. Licensed practical
nurse operating within his or her scope of practice.
18.2.e. Plans of Education.
18.2.e.1. Program physicians and physician
extenders operating under a plan of education shall be supervised by the
medical director at a frequency appropriate for the qualifications and
experience of the employee.
18.2.e.2. The program sponsor or the
administrator of the opioid treatment program shall document when an employee
undertakes a plan of education; maintain all records regarding plans of
education for the professional medical staff; ensure that completion of any
plan of education is documented and maintained in the personnel files; and
ensure that the medical director monitors and certifies satisfactory completion
of each plan of education.
18.2.e.3. The medical director shall approve
each plan of education and the ability of a program physician or physician
extender to work independently within his or her scope of practice. The medical
director shall sign an affidavit that verifies and documents an employee's
successful completion of a plan of education and the medical director's
approval for that person to provide services on an independent basis within his
or her scope of practice. The affidavit shall be maintained in the personnel
file of each professional medical staff person who has completed a plan of
education.
18.3. Counseling Staff.
18.3.a. Counseling through an opioid
treatment program shall be provided by a program counselor, qualified by
education, training or experience to assess the psychological and sociological
background of patients, to contribute to the appropriate treatment plan for the
patient and to monitor patient progress.
18.3.b. A mental health professional or a
health care professional as identified in section 18.2.d. shall be present and
on duty at the opioid treatment center during all hours of operation when
medication is not being administered. The opioid treatment program shall assign
a primary counselor to each patient.
18.3.c. Any counselor employed by an opioid
treatment program shall have one or more of the following qualifications:
18.3.c.1. A bachelor's degree and either
licensure or certification as a social worker, or certification as an addiction
counselor; or
18.3.c.2. A graduate
degree with either licensure and certification in the individual's chosen field
or as an addiction counselor; or
18.3.c.3. Certification as an addiction
counselor; or
18.3.c.4. A
bachelor's degree in a relevant human services field, practicing under the
supervision of an advanced alcohol and drug counselor (AADC); Provided, that
the individual practicing with a bachelor's degree under supervision applies
for certification as an alcohol and drug counselor within three years of the
date of employment as a counselor; or
18.3.c.5. An advanced degree and actively
working towards licensure or certification in a chosen field under the
supervision of a licensed or certified professional in that field and/or under
the supervision of an AADC.
18.3.d. Each opioid treatment program's
policy and procedures shall establish ratios of primary counselors to persons
served that are adequate to allow sessions to occur as mandated and will allow
persons served access to a primary counselor.
18.3.e. An opioid treatment program shall
employ or retain an AADC to supervise unlicensed and/or uncertified counselors
in the core competencies required by an applicable certification board. At a
minimum, the supervisor shall provide at least one hour of supervision per
twenty hours of direct service. Supervision may be group in nature, but must
consist of case consultation and discussion and/or clinical training rather
than administrative oversight.
18.3.f. The administrator of the opioid
treatment program is responsible for documentation of supervision, which shall
be available for review at all times.
18.3.g. Newly employed counselors and other
non-physician clinical staff without experience in a recovery-based opioid
treatment program shall receive initial training lasting at least twenty hours
and consisting of, at a minimum, the following:
18.3.g.1. Addiction overview;
18.3.g.2. Opioid treatment, detoxification
protocols, recovery models and basic pharmacology and dosing;
18.3.g.3. Characteristics of the opioid
dependent population;
18.3.g.4.
Toxicology screening and observation of sample collection;
18.3.g.5. Program policy and
procedure;
18.3.g.6. Confrontation,
de-escalation and anger management;
18.3.g.7. Cultural sensitivity as necessary
and appropriate;
18.3.g.8. Current
strategies for identifying and treating alcohol, cocaine and other drug
abuse;
18.3.g.9. Identification of
co-occurring behavioral health or developmental disorders; and
18.3.g.10. Other clinical issues as
appropriate for the population served.
18.3.h. An experienced counselor newly
employed from another opioid treatment program may request an exemption from
the mandatory initial training required by this rule. The administrator of the
opioid treatment program shall document in the personnel file any exemption
granted and the basis for the exemption.
18.3.i. Counselors with less than one year of
full time experience in the field of opioid treatment shall accompany an
experienced counselor at all times for a minimum of two weeks before seeing
persons served without immediate and constant supervision.
18.3.j. There shall be one (1) counselor for
every fifty (50) clients in the program.
18.4. Unlicensed Clinical Staff and Volunteers.
18.4.a. An opioid treatment
program may employ unlicensed clinical staff and utilize volunteers to assist
in the operation of the program and facility. The program shall develop
policies and procedures which specify the roles and responsibilities of each
unlicensed employee and volunteers. Documentation of the responsibilities,
training and other obligations of an unlicensed clinical staff employee or
volunteer shall be included in the personnel file of the employee or volunteer.
18.4.a.1. All employees and volunteers shall
be screened through criminal and protective services background checks prior to
being hired or permitted on the premises of an opioid treatment program
facility. No person who has a history of one or more convictions for a felony
crime may be an employee or volunteer of an opioid treatment program.
18.4.a.2. An opioid treatment program may
apply to the secretary for a written waiver of employment restrictions on a
case-by-case basis. The secretary, in his or her sole discretion, may waive any
employment restriction if the circumstances appear reasonable and
just.
18.4.b. An opioid
treatment program shall designate a supervisor for each separate service or
program. A supervisor may be responsible for more than one program. All
unlicensed clinical staff and volunteers shall receive regular supervision and
be provided with assistance, directions for activity and support.
Disclaimer: These regulations may not be the most recent version. West Virginia 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.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
