W. Va. Code R. § 69-11-26

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 69-11-26 - Counseling

26.1. Each MAT program shall provide substance use disorder counseling to every patient as is clinically appropriate. Counseling sessions should encourage and guide the patient to a lifestyle that does not include abuse or misuse of prescribed and illicit medications, drugs or other substances. Counseling sessions are essential to promote and guide the patient to a more productive lifestyle of abstinence from illicit medications or drugs.

26.2. The counseling shall be provided by a counselor or other professional as described in this rule, qualified by education or training to assess the psychological and sociological background of patients, to contribute to the appropriate individualized treatment plan for the patient, and to monitor patient progress. The primary counselor shall develop and implement the psychological and social portions of the patient's individualized treatment plan of care, in coordination with the medical staff and program physician. The individualized treatment plan of care shall address the social, environmental, psychological, social and familial issues relative to recognizing, correcting and eliminating the individual's maladaptive patterns of drug consumption and other high risk or destructive behaviors.

26.3. The primary counselor is responsible for assisting the patient in altering lifestyles and patterns of behavior in order to improve the individual's ability to function adaptively in his or her family and community. Counseling shall address the social, environmental, psychological and familial issues that contribute to the individual's maladaptive patterns of drug consumption and other high risk or destructive behaviors.

26.4. Each MAT program shall provide counseling on matters indirectly related to substance use disorder, including, but not limited to:

26.4.a. Preventing exposure to, and the transmission of, HIV and hepatitis C for each patient admitted or readmitted to maintenance or detoxification treatment; and

26.4.b. Domestic violence, sexual abuse and anger management.

26.5. Each MAT program shall develop and implement policies and procedures which ensure that single sex groups or same sex counselors will be available to all patients, as needed and clinically indicated.

26.6. Each MAT program must provide directly, or through referral to adequate and reasonably accessible community resources, vocational rehabilitation, education and employment services for patients who either request such services or who have been determined by the program staff to be in need of such services.

26.7. The clinical staff caseload ratio, as prescribed in subdivision 8.6.c., shall:

26.7.a. Reflect an appropriate clinical mix of gender, race and ethnicity representative of the population served;

26.7.b. Allow the program to provide adequate psychosocial assessments, treatment planning and individualized counseling;

26.7.c. Allow for regularly scheduled, documented individual counseling sessions, as clinically indicated; and

26.7.d. Allow patients access to their primary counselor if more frequent contact is merited by need or is requested by the patient.

26.8. Counseling sessions, which may be accomplished via telehealth, shall be provided according to generally accepted best practices and shall be offered:

26.8.a. At least twice weekly during the first 30 days of treatment;

26.8.b. At least weekly during the next 90 days of treatment;

26.8.c. At least twice per month during the remainder of the first year of treatment; and

26.8.d. Thereafter, for subsequent 90-day periods of treatment, counseling sessions shall take place as needed or indicated in the patient's individualized treatment plan of care, but not less frequently than monthly as long as the patient is compliant.

26.9. The counseling program shall provide for mandatory and documented weekly counseling of any patient who has a positive drug test and is required by this rule to undergo additional counseling. The counseling sessions shall be no less than 30 minutes to a patient with a counselor or other professional as described in subdivision 8.6.a., whichever is applicable, of this rule who is licensed, certified or enrolled in the process of obtaining licensure, registration or certification. The mandatory counseling sessions may consist of group counseling sessions. However, the patient must attend at least one individual, private session per month.

26.10. Exceptions to frequency of counselor-to-patient contact shall be clearly justified by program documentation. The program physician evaluating the patient's eligibility for take-home doses shall carefully consider the patient's participation in the counseling sessions and the patient's current phase in treatment as factors in the decision. A justified lack of participation, such as for reasons of employment, shall not be held against the patient in the take-home decision.

26.11. All counseling sessions shall be contained in the MAT program's patient record and shall include documentation of the following:

26.11.a. The reason for or nature of the contact;

26.11.b. The patient's current condition;

26.11.c. Significant events occurring since the prior contact;

26.11.d. The assessment of the patient's status; and

26.11.e. A plan for action or further treatment that addresses the goals of the individualized treatment plan of care.

26.12. Upon completion of each counseling session, documentation shall be made within 72 hours of the contact and shall be clearly dated and initialed or signed the counselor providing the counseling session.

26.13. Counseling session opportunities for family or significant other involvement in counseling shall be provided and documented.

26.14. If counseling is not directly provided through the MAT program, the counselors shall still meet the credentialing requirements pursuant to this rule and verification of all sessions must be documented in the MAT patient record.

W. Va. Code R. § 69-11-26