Current through Register Vol. XLI, No. 50, December 13, 2024
Section 69-7-44 - Special Populations44.1. Behavioral Health Needs. 44.1.a. Each opioid treatment program shall ensure that patients with behavioral health needs are identified through the evaluation process and referred for appropriate treatment.44.1.b. At all phases of treatment, the opioid treatment program shall monitor patients during detoxification withdrawal and recovery for indications of symptoms of behavioral illness.44.1.c. Each opioid treatment program shall establish linkages with behavioral health providers in the community.44.1.d. Each opioid treatment program may provide psychotropic medication management onsite by appropriately trained medical professionals. Individualized treatment plans of care shall describe the goals of psychotropic medication management, which shall be reviewed regularly. The patient's chart and individualized treatment plan of care shall document regular contact with the prescribing physician and/or physician extender for the distinct purpose of monitoring prescribed psychotropic medications.44.2. HIV Patients. 44.2.a. The opioid treatment program shall educate all patients regarding HIV/AIDS, testing procedures, confidentiality, reporting, follow-up care, safer sex, social responsibilities and sharing of intravenous equipment.44.2.b. The program shall establish linkages with HIV/AIDS treatment programs in the community.44.3. Pain Patients. 44.3.a. Each opioid treatment program shall ensure that physicians practicing at the facility are knowledgeable in the management of opioid dependence in a context of chronic pain and pain management. The program may not prohibit a patient diagnosed with chronic pain from receiving medication for either maintenance or withdrawal in a program setting.44.3.b. Each opioid treatment program shall ensure continuity of care and communication between programs or physicians regarding patients receiving treatment in both an opioid treatment program and a facility or physician's office for purposes of pain management, with the patient's written permission. If a patient refuses permission for the two entities to communicate and coordinate care, the program shall document refusal and may make clinically appropriate decisions regarding take-home medication privileges and continuation in treatment.44.4. Criminal Justice. 44.4.a. Each opioid treatment program shall establish agreements and develop procedures to coordinate with agents of the criminal justice system on behalf of patients insofar as permitted by patient confidentiality requirements.44.5. Pregnant Patients. 44.5.a. Pregnant women seeking and needing treatment shall be enrolled in the opioid treatment program and provided treatment in accordance with guidelines and protocols from approved authorities.44.5.b. The opioid treatment program shall ensure that every pregnant patient has the opportunity for prenatal care, either onsite or by referral. If the arrangement is by referral, the program shall have agreements in place, including informed consent procedures, which ensure exchange of pertinent clinical information regarding compliance with the recommended plan of medical care.44.5.c. If not available elsewhere, the program shall offer a basic instruction on maternal, physical and dietary care as part of its counseling services and document the provision of the services in the clinical record.44.5.d. With respect to pharmacotherapy for opioid-addicted pregnant women in medication-assisted therapy, the program shall: 44.5.d.1. Maintenance treatment dosage levels of pregnant clients shall be maintained at the lowest possible dosage level that is a medically appropriate therapeutic dose as determined by the medical director or clinic physician taking the pregnancy into account.44.5.d.2. Ensure that the initial methadone dose for a newly admitted pregnant patient and the subsequent induction and maintenance dosing strategy reflect the same effective dosing protocols used for all other patients;44.5.d.3. Monitor the dose carefully, moving rapidly to supply increased or split dose if it becomes necessary; and44.5.d.4. If a pregnant patient elects to withdraw from methadone, ensure that withdrawal is not initiated by the clinic before fourteen weeks and after thirty-two weeks gestation; perform regular fetal assessments as appropriate for fetal age, and require that withdrawal is supervised by a physician experienced in addiction medicine.44.5.e. The opioid treatment program shall ensure appropriate referral for follow-up and primary care for the mother and infant.44.5.f. If a pregnant patient is discharged, the opioid treatment program shall identify the physician to whom the patient is being discharged and this information shall be retained in the clinical record.44.5.g. The program shall offer onsite parenting education and training to all male and female patients who are parents or shall refer interested patients to appropriate alternative services for the training.44.5.h. The program shall offer reproductive health education to all patients and appropriate referrals for contraceptive services as necessary.