reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.208 - Staffing Pattern

Current through Register 1525, July 5, 2024
(A) The Licensed or
				Approved Provider shall designate a Medical Director who shall be responsible
				for administering all medical services performed by the program. The Medical
				Director shall have documented clinical experience with opioid-dependent,
				alcohol and other drug-dependent persons and medications used for treatment of
				addiction, including all FDA-approved medications for treatment of opioid use
				disorder. The Medical Director shall be responsible for:
(1) Ensuring each patient receives a complete
				physical examination, including a medical history;
(2) Ensuring appropriate laboratory studies
				have been performed; and
(3)
				Establishing an individualized signs of life check protocol for each patient to
				be documented in the medical record.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.209 - Hours of Operation

Current through Register 1525, July 5, 2024
The program shall be open to provide admission to outpatient
				  services as well as to provide treatment seven days per week and four hours per
				  day, at a minimum.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.211 - First Offender Driver Alcohol or Controlled Substance Education

Current through Register 1525, July 5, 2024
Provisions of 105 CMR 164.211 through
				  105 CMR
				  164.215 apply to first offender driver
				  alcohol or controlled substance education services. The Licensed or Approved
				  Provider shall also comply with all provisions of
				  105 CMR 164.000:
Part One
,
				  105 CMR 164.201 through 105
				  CMR 164.205.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.212 - Provision of Services

Current through Register 1525, July 5, 2024
(A)
Admission and Referral
.
(1)
Referral
. The
				Licensed or Approved Provider shall admit patients referred by a Massachusetts
				court, or, for patients younger than 21 years old, by the Registrar of Motor
				Vehicles, as provided for by M.G.L. c. 90, § 24P.
(2) Individuals admitted for first offender
				driver alcohol or controlled substances education services are not required to
				have a substance use disorder diagnosis.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.214 - Fees

Current through Register 1525, July 5, 2024
The Department and the Division of Health Care Finance and
				  Policy (Division) shall coordinate their respective fee and rate setting
				  responsibilities. Pursuant to 114.3 CMR 46.00:
Rate for Certain
				  Substance Abuse Programs
, the Division shall establish rates for
				  service for all government purchased driver alcohol education and treatment
				  services. The Department shall adopt the rates for services established by the
				  Division as the schedule of fees required by M.G.L. c. 90, §
				  24D.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.215 - Hours of Operation

Current through Register 1525, July 5, 2024
In addition to the requirements of 105 CMR 164.205, the
				  Licensed or Approved Provider shall be open as necessary to provide the
				  required services on a schedule that ensures patient access to day and evening
				  programs, including at least one group available in the evening or on
				  weekends.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.222 - Provision of Services

Current through Register 1525, July 5, 2024
(A)
Admission
: At the time of admission, the licensee
				shall determine that outpatient counseling services are appropriate based on:
(1) the existence of a substance use disorder
				or a mental or behavioral disorder due to psychoactive substance use;
(2) absence of withdrawal symptoms;
(3) ability to engage and remain in
				treatment; and
(4) availability of
				community support for recovery.
This determination shall be made during the first
				  visit.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.224 - Provision of Services

Current through Register 1525, July 5, 2024
(A) Individuals may
				be admitted for aftercare services following completion of a 14-day residential
				driving under the influence program or while awaiting placement in such a
				program.
(B) Counseling services
				shall emphasize consequences of alcohol and/or drug use while
				driving.
(C) The Licensed or
				Approved Provider shall provide regular reports of the patient's status to the
				referring court or other referring agency. The Licensed or Approved Provider
				shall provide to the referring court or agency a complete evaluation of the
				patient's compliance with the service plan 30 calendar days prior to the end of
				one complete year of outpatient treatment. One year of outpatient treatment
				must follow adjudication. All such reports shall comply with
				105 CMR
				164.084.
(D) The Licensed or Approved Provider shall
				ensure alcohol and drug screening is conducted on a random basis.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.223 - Second Offender Alcohol or Controlled Substance Aftercare Treatment

Current through Register 1525, July 5, 2024
Provisions of 105 CMR 164.223 through 105 CMR 164.224 apply
				  to second offender alcohol or controlled substance aftercare treatment
				  services. The Licensed or Approved Provider shall also comply with all
				  provisions of
				  105 CMR 164.000:
Part One
,
				  105 CMR 164.201 through 105
				  CMR 164.205.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.225 - Hours of Operation

Current through Register 1525, July 5, 2024
The program shall be open to provide services 40 hours per
				  week. At least seven hours shall be at a time other than between 9:00 A.M. to
				  5:00 P.M. Monday through Friday. Satellite office shall be open to clients at
				  least 20 hours a week and offer more than 40 staff hours a week of substance
				  abuse treatment services to clients.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.231 - Day Treatment

Current through Register 1525, July 5, 2024
Provisions of 105 CMR 164.231 through
				  105 CMR
				  164.234 apply to day treatment services. The
				  Licensed or Approved Provider shall also comply with all provisions of
				  105 CMR 164.000:
Part One
,
				  105 CMR 164.201 through 105
				  CMR 164.205, and, for any Licensed or Approved Provider who is also a
				  federally-certified Opioid Treatment Provider, the provisions of
				  105 CMR 164.300
				  through
				  105 CMR
				  164.317.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.232 - Provision of Services

Current through Register 1525, July 5, 2024
(A)
Admission
. At the time of admission the Licensed or
				Approved Provider shall determine that day treatment services are appropriate
				for the patient based on:
(1) the patient's
				substance use disorder;
(2) absence
				of withdrawal risk; and
(3)
				presence of substantial relapse risk and need for a structured program in order
				to engage and remain in treatment. This determination shall be made during the
				first visit.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.234 - Hours of Operation

Current through Register 1525, July 5, 2024
In addition to the requirements of 105 CMR 164.205, the
				  Licensed or Approved Provider shall ensure day treatment services are provided
				  at a minimum of 3.5 hours per day three to seven days per week based upon
				  patient needs.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.240 - Acupuncture Withdrawal Management Treatment Services

Current through Register 1525, July 5, 2024
Provisions of 105 CMR 164.241 through 164.245 apply to
				  acupuncture withdrawal management services. The Licensed or Approved Provider
				  shall also comply with all provisions of
				  105 CMR 164.000:
Part One
and
				  105 CMR 164.201 through 105
				  CMR 164.205, and, for any Licensed or Approved Provider who is also a
				  federally-certified Opioid Treatment Provider, the provisions of
				  105 CMR 164.300
				  through
				  105 CMR
				  164.317.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.241 - Provision of Services

Current through Register 1525, July 5, 2024
(A)
Assessment
. Pursuant to
				105 CMR
				164.072(B), the Licensed or
				Approved Provider may initiate patient treatment prior to completion of the
				assessment required by
				105 CMR 164.072 upon
				obtaining sufficient information to initiate treatment for the acute problem at
				the time of presentation and that the assessment is subsequently completed in a
				reasonable timeframe, provided that a Qualified Healthcare Professional must
				see such a patient prior to initiating an FDA-approved medication for treatment
				of addiction. In addition to the assessment required by
				105 CMR 164.072 and
				prior to admission, the Licensed or Approved Provider shall conduct a screening
				to determine acupuncture is not contraindicated. The screening shall include,
				at a minimum:
(1) patient's history of
				seizures, delirium tremens or other life-threatening withdrawal symptoms, which
				constitute a risk to the patient's health or well-being;
(2) neurological evidence of an appropriate
				level of consciousness; and
(3)
				vital signs.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.243 - Staffing Pattern

Current through Register 1525, July 5, 2024
In addition to the staffing requirements of
				  105 CMR 164.048,
				  the Licensed or Approved Provider shall provide an adequate number of qualified
				  personnel to fulfill the services objectives and patient needs. At a minimum,
				  such staffing shall include:
(A) An
				acupuncturist on-site during the hours of operation.
(B) Consultation to staff available from a
				fully qualified clinician, and a Practitioner, psychiatrist, registered nurse
				or licensed practical nurse either on-site or through an affiliation agreement.
				If services are to be available through a QSOA, the QSOS shall be reaffirmed
				every two years.
(C)
Supervision
. In addition to supervision requirements
				set forth in
				105 CMR
				164.044, the Licensed or Approved Providers
				shall ensure supervision of nursing staff is overseen by either a registered
				nurse, or a Licensed Practical Nurse (LPN) or other Qualified Health Care
				Professional provider defined under
				105 CMR 164.005 who
				possesses the skills and supervision experience as determined by program and/or
				meets the requirements under professional licensure; provided, however that the
				supervisor shall be educationally prepared at or above the level of the nursing
				staff under his or her supervision.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.245 - Hours of Operation

Current through Register 1525, July 5, 2024
The Licensed or Approved Provider shall provide services a
				  minimum of six days per week, 52 weeks per year. Daytime hours shall include
				  morning services and ensure maximum accessibility to patients without an
				  appointment. Hours shall include at least seven hours per week that shall be at
				  time other than the regular 9:00 A.M. to 5:00 P.M., Monday through Friday
				  schedule.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.250 - Office-based Opioid Treatment

Current through Register 1525, July 5, 2024
Provisions of 105 CMR 164.250 through 164.260 in addition to
				  provisions of
				  105 CMR 164.000:
Part One
and
				  105 CMR 164.201 through 105
				  CMR 164.205, apply to all licensed or approved for Office-based Opioid
				  Treatment.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.251 - Provision of Services

Current through Register 1525, July 5, 2024
(A)
Admission
.
(1)
Evidence of Physiologic Opioid Dependence
. The
				Licensed or Approved Provider shall obtain evidence of a diagnosis of opioid
				use disorder through reliable methods such as physical examination, laboratory
				tests and substance use history.
(2) Prior to initiating treatment, the
				Licensed or Approved Provider shall:
(a)
				complete an assessment of patient's current prescription medications prior to
				prescribing, dispensing or administering an FDA-approved medication for opioid
				dependence to ensure the approved medication is not contraindicated by the
				patient's current prescribed medications or health status;
(b) for women of child bearing age, complete
				a pregnancy test before dispensing or administering or prescribing an
				FDA-approved medication for opioid dependence; and (c) review the patient's
				prescription history through the MassPAT.
(3)
Consent to
				Treatment
. The Licensed or Approved Provider shall ensure the
				patient voluntarily chooses treatment. The information listed in 105 CMR
				164.251(A)(3)(a) through (f) shall be provided to the patient and recorded on a
				consent form, which shall be signed by the patient, and a copy shall be
				provided to the patient. The information shall also be provided orally:
(a) the nature of FDA-approved medication
				used in opioid treatment, including benefits and risks, and the benefits and
				risks of not receiving treatment;
(b) approximate length of each type of
				treatment;
(c) a clear statement of
				the goals of each type of treatment, and the tasks necessary to reach those
				goals;
(d) need for the patient to
				inform the Licensed or Approved Provider of current medical conditions and
				medications the patient is currently taking;
(e) acknowledgement the patient may withdraw
				voluntarily from treatment and discontinue use of medications; and
(f) for women of child-bearing age,
				acknowledgement of the benefits and risks of treatment during pregnancy, and
				importance of informing the Licensed or Approved Provider if she is or becomes
				pregnant.
(4)
Consent to Treatment by Minors
. Minors 12 through 17
				years of age may consent to treatment without the consent of the parent or
				guardian upon a finding of two or more physicians that the minor is drug
				dependent.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.255 - Additional Service Requirements for Opioid Maintenance

Current through Register 1525, July 5, 2024
(A)
Drug Screening
.
				The Licensed or Approved Provider shall provide for the following:
(1) An initial drug-screening completed for
				each prospective patient as required by
				105 CMR
				164.305(D)(2).
(2) Results of drug screening are to be used
				as a clinical tool and not as the sole factor in the diagnosis and treatment of
				the patient and for monitoring the patient's drug-use patterns before and
				during treatment. The Licensed or Approved Provider's Medical Director shall
				ensure drug screen results are not used to force a patient out of treatment,
				but are used as an aid in making treatment decisions.
(3) Drug screening may be done by one of the
				following: blood, oral swab, urine testing, or other method as defined by the
				Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.260 - Diversion Control

Current through Register 1525, July 5, 2024
The Licensed or Approved Provider shall maintain a diversion
				  control plan using measures to reduce the possibility of diversion of
				  controlled substances that are FDA-approved for the treatment of opioid
				  dependency, which shall include:
(A)
				Random callbacks;
(B) For patients
				who test positive for any FDA approved medications for treatment of opioid use
				disorder at admission, procedures for determining whether patients are enrolled
				in an opioid treatment program or are prescribed any medications for treatment
				of opioid use disorder, and documentation of actions taken in patient
				records;
(C) Random drug screening;
				and
(D) Initial and periodic review
				of patient's prescription history through the MassPAT.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.280 - Mental Health Services

Current through Register 1525, July 5, 2024
To provide Mental Health Services, as that term is defined in
				  105 CMR 164.005, a
				  Licensed or Approved Provider must meet the applicable Mental Health Service
				  programmatic and staffing requirements set forth in
				  105 CMR
				  140.000:
Licensure of Clinics
. The
				  Licensed or Approved Provider shall also comply with all provisions of
				  105 CMR 164.000:
Part One
,
				  105 CMR 164.201 through 105
				  CMR 164.205, and, for any Licensed or Approved Provider who is also a
				  federally-certified Opioid Treatment Provider, the provisions of
				  105 CMR 164.300
				  through
				  105 CMR
				  164.317.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.300 - Opioid Treatment Programs

Current through Register 1525, July 5, 2024
Opioid treatment programs are SAMHSA-certified organized
				  addiction treatment for opioid addicted persons, providing FDA-approved
				  medications and counseling and other services needed to assist the patient in
				  achieving stability. Opioid treatment includes interim maintenance,
				  maintenance, and medically supervised withdrawal.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.301 - Scope

Current through Register 1525, July 5, 2024
Provisions of
				  105 CMR
				  164.302 through
				  164.317, in
				  addition to provisions of
				  105 CMR 164.000:
Part One
, apply to all opioid treatment with the exception of
				  entities subject to licensure under 105 CMR 164.250.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.302 - Authority to Operate an Opioid Treatment Program

Current through Register 1525, July 5, 2024
(A)
Compliance with Other Laws,
				Rules, Regulations and Standards
. In addition to
				105 CMR 164.000, the
				Licensed or Approved Provider shall comply with the following:
(1) M.G.L. c. 94C governing controlled
				substances and 105 CMR 700.00:
Implementation of M.G.L. c. 94C
governing controlled substance registration; and
(2) 21 CFR Parts 1300 through 1399 of the
				U.S. Department of Justice, Drug Enforcement Administration (DEA) regulations
				requiring registration under the Controlled Substances Act.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.303 - Inspections

Current through Register 1525, July 5, 2024
In addition to inspections specified in
				  105
				  CMR 164.010 and
				  105 CMR
				  164.302, the Licensed or Approved Provider
				  shall permit the following inspections:
(A) The Licensed or Approved Provider shall
				allow inspections by duly authorized employees of the State Authority, Drug
				Enforcement Agency, and SAMHSA at any time.
(B) A hospital or Department of Mental Health
				licensed facility subject to 105 CMR 164.500 shall permit the State Authority
				and Drug Enforcement Agency to inspect supplies of opioid drugs for opioid
				addiction treatment which are located at the hospital or facility at any time
				and to evaluate how the drug(s) are being used. In addition, records on
				receipt, storage, and distribution of opioid medication are subject to
				inspection.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.304 - Required Notifications

Current through Register 1525, July 5, 2024
Licensed and Approved Providers shall notify the Department
				  of the following:
(A)
Change in Program Sponsor or Medical Director
. The
				opioid treatment program must provide written notice to the State Authority of
				a replacement of a program sponsor or Medical Director within two weeks of any
				replacement of these personnel.
(B)
Closure or Cessation of Operation
. The opioid
				treatment program must provide written notice to the State Authority 90
				calendar days in advance of discontinuing a program in which medication is
				administered or dispensed. In addition to requirements of
				105 CMR
				164.035(B)  and
				105 CMR 164.087, the
				Licensed or Approved Provider shall include in its notice its plan for storage,
				transfer or disposal of its supply of opioids. Such plan shall be subject to
				approval by the Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.306 - Additional Opioid Treatment Provider Requirements: Medically Supervised Withdrawal

Current through Register 1525, July 5, 2024
(A)
Admission
. In accordance with federal requirements:
(1) When admitting an individual for opioid
				medically supervised withdrawal management, the Licensed or Approved Provider
				shall obtain and include in the patient's record a medical evaluation by a
				Practitioner or psychiatrist which confirms the appropriateness of outpatient
				medically supervised withdrawal management for the patient.
(2) A program physician shall conduct an
				assessment to determine the appropriate form of treatment. Should such
				physician determine treatment other than opioid medically supervised withdrawal
				is necessary, the physician shall directly connect the patient with a provider
				for such treatment.
(3) A program
				physician may determine persons younger than 18 years old may be admitted upon
				determination such individual is currently physiologically dependent upon
				opioids as defined in
				105 CMR
				164.305(B)(2).
(4) Patients with two or more unsuccessful
				episodes of supervised withdrawal within a 12-month period may not be admitted
				to opioid medically supervised withdrawal management treatment.
(5) A waiting period of at least one week is
				required between withdrawal attempts. An authorized staff physician shall
				document in the patient record that the patient continues to be or is again
				physiologically dependent on an opioid drug.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.307 - Additional Service Requirements for Opioid Maintenance

Current through Register 1525, July 5, 2024
(A)
Admission of Persons Younger
				than 18 Years Old
. Licensed and Approved Providers may not admit a
				person younger than 18 years old to opioid maintenance treatment, unless that
				person has two documented unsuccessful attempts at short-term withdrawal or
				drug-free treatment within a 12-month period, or is pregnant.
(B)
Drug Screening
.
				The Licensed or Approved Provider shall provide for the following:
(1) An initial drug-screening completed for
				each prospective patient as required by
				105 CMR
				164.305(D)(2).
(2) An opioid treatment provider must conduct
				additional random drug screens according to federal requirements. Such drug
				screens shall, at a minimum, test for opioids including, but not be limited to,
				buprenorphine, methadone, and fentanyl; cocaine; benzodiazepines; alcohol; and
				any other drugs the Licensed or Approved Provider determines are clinically
				indicated or as approved by the Commissioner and listed in Department guidance.
				The Licensed or Approved Provider shall document measures taken to prevent
				adulteration of samples and to ensure a chain of custody.
(3) Results of drug screening are to be used
				as a clinical tool and not as the sole factor in the diagnosis and treatment of
				the patient and for monitoring the patient's drug-use patterns before and
				during treatment. The Licensed or Approved Provider's Medical Director shall
				ensure that drug screen results are not used to force a patient out of
				treatment, but are used as an aid in making treatment decisions.
(4) Drug screening may be done by one of the
				following: blood, oral swab, urine testing, or other method as defined by the
				Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.308 - Referral to Medication Unit

Current through Register 1525, July 5, 2024
In referring patients to a medication unit, the Licensed or
				  Approved Provider shall ensure that:
(A) Medication unit is staffed and equipped
				to assess patients' dosage levels;
(B) Patients continue to receive all OTP
				required services as described in their treatment plans.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.309 - Drug Screening Policy and Procedure

Current through Register 1525, July 5, 2024
The Licensed or Approved Provider shall provide for testing
				  and analysis for drugs of misuse, and shall establish written policies and
				  procedures for guarding against adulteration of such tests.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.310 - Diversion Control

Current through Register 1525, July 5, 2024
The Licensed or Approved Provider shall maintain a diversion
				  control plan using measures to reduce the possibility of diversion of
				  controlled substances that are FDA-approved for the treatment of opioid
				  dependency, which shall include:
(A)
				Random callbacks;
(B) For patients
				who test positive for any FDA approved medications for treatment of opioid use
				disorder at admission, procedures for determining whether patients are enrolled
				in an opioid treatment program or are prescribed any medications for treatment
				of opioid use disorder, and documentation of actions taken in patient
				records;
(C) Assigning specific
				responsibility to the Medical Director and administrator for carrying out the
				diversion control measures and functions described in the plan;
(D) Random drug screening; and
(E) Initial and periodic review of patient's
				prescription history through the MassPAT.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.311 - Involuntary Termination from an Opioid Treatment Program

Current through Register 1525, July 5, 2024
(A)
Emergency
				Terminations
. the Licensed or Approved Provider may terminate a
				patient immediately prior to a hearing and without provision for medically
				supervised withdrawal or Referral, under the conditions listed in 105 CMR
				164.311(A)(1) through (8):
(1) when the
				program director reasonably determines the patient's continuance in the program
				presents an immediate and substantial threat of physical harm to other
				patients, program personnel or property; or
(2) where the program's Medical Director
				reasonably determines continued treatment of a patient presents a serious
				documented medical risk; and
(3)
				the Licensed or Approved Provider shall document the reason for not providing a
				Referral in the patient record;
(4)
				the Licensed or Approved Provider immediately notifies the patient of the
				decision and the reasons for the decision to immediately terminate the
				patient;
(5) the Licensed or
				Approved Provider schedules a hearing, to be held on the next business day, on
				the decision to terminate and provides notice of the hearing to the patient as
				described in 105 CMR 164.311(B)(1)(a)1. and 3. and (C);
(6) the hearing is conducted in accordance
				with procedures specified in 105 CMR 164.311(D) providing that the decision
				required by 105 CMR 164.311(D)(7) shall be made within one business
				day;
(7) the patient is notified of
				findings of the hearing within one business day of the hearing; and
(8) Licensed and Approved Providers are not
				required to provide medically supervised withdrawal services to patients who
				are discharged on an emergency, involuntary basis.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.312 - Bureau Review of Program Decisions to Terminate

Current through Register 1525, July 5, 2024
(A) The Licensed or Approved Provider shall
				afford the patient the right to appeal the determination of the hearing
				officer. The patient must request this appeal in writing to the Bureau within
				three business days following the receipt of the adverse decision. The scope of
				the appeal shall be limited to the Bureau's review of whether the Licensed or
				Approved Provider adhered to the policies and procedures in compliance with
				105 CMR
				164.075 and
				105 CMR
				164.311(D). The patient's
				written appeal shall contain the basis of the appeal. The Bureau will either
				affirm or reverse the hearing officer's decision, or remand the decision to a
				new hearing officer for a new hearing. The decision of the Bureau will be made
				as follows:
(1) In the case of an emergency
				termination, the Bureau shall decide within one business day of receipt of the
				complete hearing record and written materials submitted by both parties;
				and
(2) In the case of a
				nonemergency termination, the Bureau shall decide within ten business days of
				the Bureau's receipt of the complete hearing record and written materials
				submitted by both parties.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.313 - Required Notifications

Current through Register 1525, July 5, 2024
Licensees shall notify the Department of the
				  following:
(A)
Change in
				Program Sponsor or Medical Director
. The opioid treatment program
				must provide written notice to the State Authority of a replacement of a
				program sponsor or Medical Director within two weeks of any replacement of
				these personnel.
(B)
Closure or Cessation of Operation
. The opioid
				treatment program must provide written notice to the State Authority 90 days in
				advance of discontinuing a program in which medication is administered or
				dispensed. In addition to requirements of
				105 CMR
				164.035(C)  and
				105 CMR 164.087:
Closure
, the licensee shall include in its notice its plan for
				storage, transfer or disposal of its supply of opioids. Such plan shall be
				subject to approval by the Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.314 - Staffing Pattern

Current through Register 1525, July 5, 2024
(A) In accordance
				with federal regulations, the Licensed or Approved Provider shall designate a
				Medical Director who shall be responsible for administering all medical
				services provided by the program, and for ensuring the program complies with
				all applicable federal, state, and local laws and regulations. The Medical
				Director shall be a physician with documented clinical experience with
				opioid-dependent, alcohol, and other drug-dependent persons or 40 hours of
				documented continuing education in treating addicted persons and medications
				for treatment of addiction, including all FDA-approved medications for
				treatment of opioid use disorder. The Medical Director shall ensure there are
				policies and procedures in place for:
(1)
				Ensuring that a medical evaluation, including a medical history is taken for
				each patient; and
(2) Ensuring that
				appropriate laboratory studies are completed and recorded in patient
				records.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.315 - Hours of Operation

Current through Register 1525, July 5, 2024
The program shall be open to provide treatment and to
				  administer medications at least six days per week, year round; provided nothing
				  shall limit the Licensed or Approved Provider's ability to dispense medication
				  for take-home use in accordance with federal requirements including on days the
				  program is closed, such as on Sundays and state and federal holidays.
				  Consideration should be given to any identified barriers to receiving and
				  remaining in treatment including, but not limited to, patient transportation,
				  childcare, employment, and educational needs. Services must be provided during
				  hours that meet the needs of the overwhelming majority of patients, including
				  hours outside of the traditional 9:00 A.M. to 5:00 P.M., Monday through Friday
				  work schedule.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.316 - Severe Weather Policy

Current through Register 1525, July 5, 2024
The Licensed or Approved Provider shall comply with federal
				  regulations for ensuring continued dispensing of medications in the event of
				  severe weather conditions such as hurricanes or blizzards, and shall document
				  such compliance in each patient's record.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.317 - Required Agreements

Current through Register 1525, July 5, 2024
Licensed and Approved Providers providing medically monitored
				  or clinically managed withdrawal services shall have QSOAs for the provision of
				  the following services as needed:
(A)
				Psychiatric consultative, diagnostic and evaluative services;
(B) Acute 24-hour diversionary services
				medical or psychiatric hospitalization;
(C) Emergency medical and psychiatric
				services; and
(D) Any specialized
				services a program provides through special arrangement, purchase or
				contract.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.400 - Residential Rehabilitation

Current through Register 1525, July 5, 2024
Residential rehabilitation services are organized substance
				  use disorder treatment and education services featuring a planned program of
				  care in a 24-hour residential setting. For purposes of 105 CMR 164.400 this
				  shall not include facilities providing services to individuals committed
				  pursuant to M.G.L. c. 123, § 35. Services are provided in permanent
				  facilities where residents reside on a temporary basis. They are staffed 24
				  hours a day. Residential rehabilitation services are provided to residents who
				  require safe and stable living environments in order to develop their recovery
				  skills. Types of residential rehabilitation services are those designed for:
				  adult individuals, adults with their families, adolescents, and driving under
				  the influence second offenders.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.401 - Scope

Current through Register 1525, July 5, 2024
Provisions of
				  105 CMR
				  164.402 through
				  164.409 apply
				  to all residential rehabilitation substance use disorder treatment services.
				  Licensed or Approved Providers shall also comply with all provisions of
				  105 CMR 164.000:
Part One
.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.402 - Hours of Operation

Current through Register 1525, July 5, 2024
Residential rehabilitation services shall operate 24 hours
				  per day, seven days per week, 365 per year.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.403 - Prohibition of Alcohol or Drugs

Current through Register 1525, July 5, 2024
Licensees shall ensure that alcohol and drugs, other than
				  those properly prescribed by a resident's physician, are prohibited on the
				  premises.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.404 - Physical Plant

Current through Register 1525, July 5, 2024
(A)
Inspections
. The Licensed or Approved Provider shall
				post in public areas certificates confirming that all local inspections
				required for operation of the facility are up to date.
(B)
Conformance with 780 CMR:
State Board of Building Regulations and
				Standards
. The Licensed or Approved Provider shall comply with the
				standards specified in 780 CMR, and those standards in
				105 CMR 410.000:
Minimum Standards of Fitness for Human Habitation (State Sanitary Code:
				Chapter II)
regarding heating, electricity, lighting, plumbing and
				sanitary facilities.
(C)
Location
. The Licensed or Approved Provider shall
				ensure that residential rehabilitation facilities meet the following
				requirements:
(1) The Licensed or Approved
				Provider shall not post signs or notices that would identify the building as a
				residential rehabilitation facility, except that programs located in large
				campuses or health care complexes may post signs to provide
				direction.
(2) A Licensed or
				Approved Provider proposing to locate a residential facility within a health
				care facility shall seek a determination from the Bureau of Health Care Safety
				and Quality that the residential recovery program in that facility does not
				jeopardize the status of that facility for purposes of state licensure or
				federal Medicare or Medicaid certification.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.405 - Meals and Food Handling

Current through Register 1525, July 5, 2024
(A)
Food Storage
. The Licensed or Approved Provider shall
				have a written plan for protecting food from contamination and spoilage during
				its storage, preparation, distribution and service. The plan shall provide for:
(1) Procuring all food only from sources that
				ensure that the food is processed under regulated quality and sanitation
				controls;
(2) Clearly labeling
				supplies;
(3) Storing all nonfood
				supplies in an area separate from that used for storing food
				supplies;
(4) Storing perishable
				foods in refrigerators at 41 °F or less;
(5) Ensuring that any walk-in refrigerators
				or freezers can be opened from the inside even if closed; if the Licensed or
				Approved Provider padlocks walk-in refrigerators or freezers, the Licensed or
				Approved Provider shall establish a procedure requiring written documentation
				that no one is in the refrigerator or freezer prior to securing the lock; and
(6) Frozen foods remaining
				frozen.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.406 - Safe Storage and Administration of Medications

Current through Register 1525, July 5, 2024
Licensed and Approved Providers shall comply with all federal
				  and state laws and regulations relating to the procurement, storage,
				  dispensing, administration, recording and disposal of medications and shall
				  comply with the following:
(A)
Written Policy and Procedure
. The Licensed or Approved
				Provider shall establish a written policy and procedure governing the storage
				and administration of residents' prescription medications.
(B)
Storage
. All
				medications shall be maintained in a locked, secure cabinet, accessible only to
				designated staff positions. The titles of designated positions shall be posted
				on the cabinet. The Licensed or Approved Provider shall ensure patients do not
				have direct access to the medication cabinet.
(C) Medications brought by residents to the
				program shall be stored in a locked, secure cabinet that is separate from the
				facility's supply, except that residents shall retain medications required to
				treat acute episodes, such as asthma attacks or allergic reactions.
(1) If injectable drugs are used, Licensed or
				Approved Providers shall provide containers for safe storage and proper
				disposal of sharps.
(2) Medications
				requiring refrigeration shall be kept in a refrigerator in the same area where
				other medications are stored. Medications shall not be stored in kitchen
				refrigerators.
(3) The Licensed or
				Approved Provider shall also establish a record of medications which remain in
				the possession of residents for treatment of acute episodes.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.407 - Resident Personal Effects and Affairs

Current through Register 1525, July 5, 2024
(A)
Written Policy and Procedure
. The Licensed or Approved
				Provider shall establish a written policy and procedure governing the care of
				resident personal belongings and support of resident personal
				affairs.
(B)
Safekeeping
. The Licensed or Approved Provider may
				allow residents to bring monies and valuables into the program, if the Licensed
				or Approved Provider provides for the secure, locked safekeeping of the
				personal property.
(C)
Right to Confiscate
. All residents shall be notified
				that by accepting admission they authorize the Licensed or Approved Provider
				to:
(1) confiscate and dispose of any alcohol
				or drugs (other than those properly provided by prescription) or paraphernalia
				for the use of illegal drugs found in the possession of the resident;
				and
(2) confiscate any weapons or
				other articles found in the possession of the resident, which may constitute a
				threat to the life, health, safety, or well-being of the resident, the staff or
				public, and to turn over any guns to the police.
The Licensed or Approved Provider shall establish a record of
				  any items confiscated or turned over to the police.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.408 - Required Agreements

Current through Register 1525, July 5, 2024
Each residential program shall have QSOAs for the provision
				  of the following services as needed:
(A) Psychiatric consultative, diagnostic and
				evaluative services;
(B) Acute
				24-hour diversionary service medical or psychiatric hospitalization;
(C) Emergency medical and psychiatric
				services; and
(D) Any specialized
				services that a program provides through special arrangement, purchase or
				contract.