Ohio Administrative Code|Rule 5122-40-07 | Program policies and patient records.

                                                
(A) Each opioid treatment program shall
		  have written policies or procedures that include, but are not limited to, the
		  following: 
(1) Admission criteria
			 for adolescents and adults for medication maintenance and detoxification,
			 including at a minimum:
(a) Determination by an individual qualified to diagnose by their
				scope of practice that the patient is currently dependent on an opioid drug
				according to the current diagnostic and statistical manual for mental disorders
				or the international statistical classification of diseases and related health
				problems;
(b) The patient became dependent on an opioid drug at least one
				year before admission to the opioid program. This requirement may be waived by
				the medical director or other authorized program physician if the patient has
				been released from a penal institution within the past six months, is pregnant
				(as verified by the medical director or other authorized program physician) or
				has been discharged from an opioid treatment program within the last two years;
				and, 
(c) A patient under eighteen years of age shall have two
				documented unsuccessful attempts at short-term detoxification or alcohol and
				other drug treatment within a twelve-month period and must have written consent
				for maintenance from a parent or legal guardian. 
(2) Admission procedures
			 for medication maintenance and detoxification;
(3) Procedures for
			 providing counseling on preventing exposure to and the transmission of
			 tuberculosis, hepatitis type B and C, and human immunodeficiency virus (HIV)
			 disease for each patient admitted or readmitted to maintenance or
			 detoxification treatment;
(4) Policies and
			 procedures for the frequency of testing someone with new or increased risk
			 factors for tuberculosis, sexually transmitted diseases, hepatitis type B and
			 C, and HIV disease.
(5) Policy or procedure that establish
			 ratios of primary counselors to patients that are in accordance with the
			 requirements for counselors in rule 5122-40-09 of the Administrative
			 Code.
(6) Policies and procedures that
			 treatment will meet the standards of medical care for opioid treatment services
			 established by the American society of addiction medicine, 2015 edition, or
			 other nationally recognized standards organization selected by the
			 director.
(7) Procedures for the ordering,
			 delivery, receipt and storage of any medication used for medication assisted
			 treatment;
(8) Policy or procedure for the security
			 alarm system that includes, but is not limited to, the following: 
(a) Provisions for testing the alarm system; and,
(b) Provisions for documenting the testing of the alarm system.
				
(9) Policy or procedure which specifies
			 which staff will have access to the program's medication assisted
			 treatment supply;
(10) Procedures for administering
			 medication assisted treatment in accordance with the requirements of rule
			 5122-40-06 of the Administrative Code;
(11) Procedures for dispensing medication
			 assisted treatment, including days and hours, in accordance with the
			 requirements of rule 5122-40-06 of the Administrative Code;
(12) Policy or procedure for days and
			 hours for non-medication dispensing program services;
(13) Policies and procedures for the
			 involuntary termination of patients in accordance with the requirements of rule
			 5122-40-14 of the Administrative Code;
(14) Procedures for referring or providing
			 prenatal services to pregnant patients in accordance with the requirements of
			 rule 5122-40-06 of the Administrative Code;
(15) Policies and procedures for take-home
			 doses of medication assisted treatment in accordance with the requirements of
			 rule 5122-40-06 of the Administrative Code;
(16) Policy or procedure for urinalysis
			 for patients in accordance with the requirements of rule 5122-40-11 of the
			 Administrative Code;
(17) Policies and procedures for
			 urinalysis for employees of the opioid treatment program;
(18) Procedure for cleaning the medication
			 areas;
(19) Policies and procedures for missed
			 medication administration appointments;
(20) Policies and procedures stating that
			 medication assisted treatment shall not be provided to a patient who is known
			 to be currently receiving medication assisted treatment from another opioid
			 treatment program with the exception of guest dosing patients whose need for
			 medication maintenance has been verified by the medical director or other
			 authorized program physician of both the opioid treatment program where the
			 patient is currently enrolled and at the program where the patient is
			 requesting to receive services;
(21) Policies and procedures related to
			 disaster planning, pursuant to rule 5122-40-12 of the Administrative
			 Code;
(22) Policies and procedures relating to a
			 diversion control plan, pursuant to rule 5122-40-10 of the Administrative Code;
			 and,
(23) Policies and procedures for accessing
			 the states drug database pursuant to section 4729.75 of the Revised
			 Code, pursuant to rule 5122-40-08 of the Administrative Code.
(24) Policies and procedures relating to
			 permanent patient transfer, pursuant to rule 5122-40-08 of the Administrative
			 Code. 
(B) An individual client record shall be
		  maintained for each client, and contain the following: 
(1) Date of each visit
			 that the patient makes to the program;
(2) Date, time, and
			 amount of medication administered or dispensed along with the printed name and
			 original signature of the service provider;
(3) Medical
			 history;
(4) Documentation of
			 physical examination and results;
(5) Results for
			 serological tests for hepatitis type B and C performed by the program or a copy
			 of results when performed by another entity. The program may accept results
			 from tests performed within the past six months;
(6) Result of a
			 serological test for HIV performed by the program or a copy of results when
			 performed by another entity within the past six months. The program may accept
			 results from tests performed within the past six months;
(7) Results of a serological test for
			 syphilis performed by the program or a copy of results when performed by
			 another entity within the past six months. The program may accept results from
			 tests performed within the past six months;
(8) Results of tubercular skin test or
			 interferon gamma release assay (IGRA) blood test performed by the program or a
			 copy of results when performed by another entity within the past six months.
			 The program may accept results from tests performed within the past six
			 months;
(9) Results of a urinalysis for drug
			 determination at the time of admission and the results of each subsequent
			 urinalysis;
(10) Assessment in accordance with Chapter
			 5122-29 of the Administrative Code;
(11) Individualized treatment plan in
			 accordance with Chapter 5122-27 of the Administrative Code;
(12) Progress notes in accordance with
			 Chapter 5122-27 of the Administrative Code;
(13) Documentation of counseling on
			 preventing exposure to tuberculosis, hepatitis type B and C, and the
			 transmission of human immunodeficiency virus (HIV) disease;
(14) Documentation of provision of the
			 following when the individual has been assessed as in need of these services,
			 either directly or through referral to adequate and reasonably accessible
			 community resources: 
(a) Vocational rehabilitation services; 
(b) Employment services; and.
(c) Education services. 
(15) Documentation to reflect that the
			 program has attempted to determine whether or not the patient is enrolled in
			 any other opioid treatment program. This documentation may be stored in either
			 the client record or the central registry system;
(16) Documentation to reflect verification
			 by the medical director or other authorized program physician of the need for
			 medication assisted treatment for guest dosing patients;
(17) Information required by Chapter
			 5122-27 of the Administrative Code; and,
(18) Documentation of any check of the
			 prescription drug monitoring program data pursuant to rule 5122-40-08 of the
			 Administrative Code.
(C) Patient records shall be maintained
		  for at least seven years from the last date of administering or dispensing a
		  controlled substance.
(D) Opioid treatment programs may during the COVID-19 state
		  of emergency declared by the governor of Ohio, substitute cheek swabs for
		  toxicology testing for cheek swabs, urine screens, urine drug screens or
		  urinalysis wherever required by rule in this chapter.
(E) Tests for hepatitis type B and C, HIV, syphilis, or
		  tuberculosis may be delayed if PPE is not available during the COVID-19 state
		  of emergency declared by the governor of Ohio. Monthly toxicology screenings
		  may also be delayed if personal protective equipment is not
		  available.


Last updated June 11, 2021 at 10:42 AM