Compilation of Rules and Regulations of the State of Georgia › Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH › Chapter 111-8 - HEALTHCARE FACILITY REGULATION › Subject 111-8-53 - RULES AND REGULATIONS FOR NARCOTIC TREATMENT PROGRAMS › Rule 111-8-53-.10 - Staffing

Current through Rules and Regulations filed through June 27, 2024
(1) Staff Ratios
				and Responsibilities. The program shall have sufficient and appropriate types
				and numbers of staff to provide the treatment and services as required by
				applicable state law and regulation and as outlined in its program description.
				When the program is open to provide treatment, there shall be a minimum of one
				clinical staff member and at least one additional staff member on site at all
				times. Patient-staff ratios shall be adjusted to ensure reasonable and prompt
				access to medical staff and counselors by patients and to provide the frequency
				and intensity of medical and counseling services required by the patients.
(a) Administrator. The governing body of each
				program shall designate in writing an administrator. The administrator shall be
				responsible for the on-going and day-to-day operations of the program, for
				overall compliance with federal, state, and local laws and regulations
				regarding the operation of narcotic treatment programs, and for all program
				employees including practitioners, agents, or other persons providing services
				at the program. The administrator must be at least 21 years of age, must have
				at least one year of supervisory and administrative experience in the field of
				substance abuse treatment, and must have at least one year of experience
				working in a narcotic treatment program. Programs must notify the Department in
				writing within 10 calendar days whenever there is a change in administrator.
(i) Criminal History Background Check -
				Administrators. The program must obtain a satisfactory criminal history
				background check for the person being considered for employment as an
				administrator and must obtain a new background check for the employed
				administrator every three (3) years thereafter. The records check must be
				performed as prescribed in these rules. Programs licensed prior to May 4, 2017
				shall only be subject to the requirements of Rule
				111-8-53-.10(a)(i) -
				(iv) if there is a change in the
				administrator.
(ii) At the time of
				initial employment, in lieu of a records check application, the program may
				submit evidence, satisfactory to the Department, that within the immediately
				preceding 12 months the administrator has received a satisfactory narcotic
				treatment program criminal records check determination.
(iii) A person with an unsatisfactory
				criminal history background check determination must not serve as an
				administrator of a licensed narcotic treatment program. Failure to satisfy this
				requirement may result in enforcement action against the facility as prescribed
				in Chapter 111-8-25.
(iv) The
				administrator must immediately submit to an additional criminal history
				background check when the Department provides the administrator with written
				notice of any one of the following:
1. There
				is reason to believe that the administrator has acquired a criminal record as
				defined by these rules; or
2. The
				criminal history background check is required in connection with a complaint
				investigation being conducted by the Department.
(b) Clinical Director. The governing body of
				each program shall designate in writing a clinical director. The clinical
				director shall be responsible for the day-to-day and on-going clinical aspects
				of the program and of the treatment for those patients admitted to the program.
				Programs must notify the Department in writing within 10 calendar days whenever
				there is a change in clinical director.
(c) Medical Director. The governing body of
				each program shall designate in writing a medical director to be responsible
				for the administration of all medical services, including compliance with all
				federal, state, and local laws and regulations regarding the medical treatment
				of narcotic addiction. A physician may serve as medical director of no more
				than two narcotic treatment programs provided that all such programs are in
				substantial compliance with these rules and are within 50 miles of the
				physician's primary residence or primary office location. Programs must notify
				the Department in writing within 10 calendar days whenever there is a change in
				medical director.
(d) Program
				Physician. Programs are required to provide sufficient physician coverage to
				provide the medical treatment and oversight necessary to serve patient needs. A
				program physician's responsibilities for each patient include, but are not
				limited to, performing medical history and physical exams, determination of
				diagnosis under current DSM criteria, determination of narcotic dependence,
				reviewing treatment plans determining dosage and all changes in doses, ordering
				take-home privileges, discussing cases with the treatment team, and issuing any
				emergency or verbal orders relating to patient care. At all times a program is
				open and a physician is not present on site, a program physician must be
				available on call for consultation and emergency orders. Programs must be able
				to document a referral agreement with a local hospital or health care facility.
				Any program physician who is not a medical director must work under the
				supervision of the program's medical director.
(e) Physician's Assistants and Nurse
				Practitioners. Licensed physician's assistants and certified nurse
				practitioners may be employed by programs and perform any functions permitted
				under Georgia law.
(f) Nurses.
				Programs shall ensure that appropriate nursing care is provided at all times
				the program is in operation and that an appropriately licensed and qualified
				health care professional is present at all times medication is administered at
				the program.
(g) Counselors. There
				must be at least one full-time counselor for every 50 patients. To be
				considered "full-time," a counselor must work a minimum of 35 hours per week.
				The program shall assign no more than 40 patients to counselors in training who
				are not yet certified.