West Virginia Code of State Rules › Agency 69 - Health And Human Resources › Title 69 - LEGISLATIVE RULE DEPARTMENT OF HEALTH AND HUMAN RESOURCES › Series 69-12 - Medication-Assisted Treatment - Office-Based Medication-Assisted Treatment › Section 69-12-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1. Definitions
				incorporated by reference. -- Those terms defined in W. Va. Code
				§§16-5Y-1,
et seq.
are incorporated herein by reference.
2.2. Administrative Detoxification or
				Administrative Withdrawal -- The detoxification from the approved
				medication-assisted treatment medication for the safety and well-being of the
				patient, other patients and staff of the OBMAT program.
2.3. Advanced Practice Registered Nurse -- A
				registered nurse who has acquired advanced clinical knowledge and skills
				preparing him or her to provide direct and indirect care to patients, completed
				a board approved graduate-level education program, passed a board-approved
				national certification examination, and has met all the requirements set forth
				by the West Virginia Board of Examiners for Professional Registered
				Nurses.
2.4. Adverse Event or
				Incident -- An event involving an immediate threat to the care or safety of an
				individual, either staff, patient, or visitor; the possibility of serious
				operational or personnel problems within the OBMAT program facility; or the
				potential to undermine public confidence in the OBMAT program.
2.5. Approved Authorities -- Programs or
				authorities that publish practice or treatment guidelines, standards, or
				protocols that the Secretary has approved for use by MAT programs. Approved
				authorities include, but are not limited to, the American Society of Addiction
				Medicine (ASAM); the Center for Substance Abuse Treatment (CSAT); the National
				Institute on Drug Abuse (NIDA); the American Association for the Treatment of
				Opioid Dependence (AATOD); the Federation of State Medical Boards (FSMB); and
				any other program or authority approved by the Secretary.
2.6. Case Management -- The process of
				coordinating and monitoring the services provided to a patient both within the
				program and in conjunction with other providers.
2.7. Clinical Staff -- The individuals
				employed by or associated with an OBMAT program who provide treatment, care, or
				rehabilitation to program patients or patients' families.
2.8. Co-Occurring Disorders -- The
				combination of current or former substance use disorders and any other mental
				disorders recognized in the current edition of the
Diagnostic and
				Statistical Manual of Mental Disorders
published by the American
				Psychiatric Association.
2.9.
				Coordination of Care Agreement -- An agreement signed by the physician,
				counsel, and patient allowing open communication and the exchange of health
				information between the indicated providers to ensure the patient is provided
				comprehensive and holistic treatment for substance use disorder, when medical
				treatment and counseling services are not being treated within the same
				program;
2.10. Counseling Session
				-- A face-to-face interaction, which may include telehealth, in a private
				location between a patient(s) and a primary counselor for a period of no less
				than 30 continuous minutes designated to address patient substance use disorder
				issues or coping strategies and individualized treatment plan of
				care.
2.11. Counselor -- A person
				who, by education, training, and experience, is qualified to provide
				psychosocial education, treatment, and guidance to patients enrolled with an
				OBMAT program and, if desired, to the families of such patients, in order to
				accomplish behavioral health, wellness, education, and other life
				goals.
2.12. Crisis -- A
				deteriorating or unstable situation often developing suddenly or rapidly that
				produces acute, heightened, emotional, mental, physical, medical or behavioral
				distress; or any situation or circumstance in which the individual perceives or
				experiences a sudden loss of his ability to use effective problem-solving and
				coping skills.
2.13. Critical
				Incident -- A life, safety, or health threat involving the staff or patients
				participating in a program, including, but not limited to, death or physical or
				sexual assault.
2.14.
				Detoxification or Medically Supervised Withdrawal Treatment -- The prescribing
				of a medication-assisted treatment medication to a patient in decreasing doses
				over time, under the supervision of a program physician, to alleviate adverse
				physical or psychosocial effects incident to withdrawal from the continuous or
				substantial use of an opioid drug.
2.15. Discharge Plan -- The written plan that
				establishes the criteria for a patient's discharge from a service and
				identifies and coordinates delivery of any services needed after
				discharge.
2.16. Diversion -- An
				activity involving the legitimate acquisition of pharmaceutical agents
				illegally diverted to entities not intended as the recipients by the initial
				supplier.
2.17. Diversion Control
				Plan -- A required plan developed and implemented by the OBMAT program, which
				may include, but is not limited to, the assigning of responsibilities to
				medical and administrative staff and other specific measures to reduce the
				possibility of diversion of controlled substances from legitimate treatment to
				illicit use.
2.18. For-Cause
				Inspection -- An inspection by any federal or state agency or accreditation
				body of an OBMAT program that may be operating in violation of 42 C.F.R.
				§8 or state medication-assisted treatment rules, may be providing
				substandard treatment or may be serving as a possible source of diverted
				medications.
2.19. Grievance -- A
				written or oral complaint filed by a patient with a program administrator,
				medical director, or state agency alleging inadequate treatment by the OBMAT
				program.
2.20. Individualized Plan
				of Care or Treatment Strategy -- A plan or strategy of treatment and care
				developed by the patient's physician, counselors, and other health care
				professionals in conjunction with the patient that outlines attainable
				short-term treatment goals that are mutually acceptable to the patient and the
				OBMAT program and which specifies the services to be provided and the frequency
				and schedule for their provision.
2.21. Induction -- Initial treatment of a
				patient with medication-assisted treatment medication in order to suppress
				signs or symptoms of withdrawal or substance cravings; and generally, includes
				a gradual increase in medication-assisted treatment medication therapy until
				the symptoms are regularly and reliably suppressed or controlled.
2.22. Inspection or Survey -- Any examination
				by the Secretary or his or her designee of an OBMAT program including, but not
				limited to, the premises, staff, patients, and documents pertinent to initial
				and continued registration, so that the Secretary or his or her designee may
				determine whether a program is operating in compliance with registration. This
				includes any survey, monitoring visit, complaint investigation, or other
				inquiry conducted for the purposes of making a compliance determination with
				respect to registration requirements.
2.23. Long-Term Detoxification Treatment --
				Detoxification or medically supervised withdrawal treatment for a period of
				more than 30 days.
2.24.
				Maintenance Treatment -- Treatment following induction and stabilization phases
				of treatment, and means the prescribing of a partial agonist treatment
				medication at stable dosage levels for a period in excess of twenty-one days in
				the treatment of an individual for opioid use disorder;
2.25. Maintenance Dose -- The level of
				medication-assisted treatment medication considered medically necessary to
				consistently suppress signs or symptoms of substance use disorders and
				substance cravings for individuals with a substance use disorder; and is
				generally administered at the end of the induction period and is individualized
				for each patient and may gradually change over time.
2.26. Medical and Rehabilitative Services --
				Treatment and recovery services such as medical evaluations, counseling, and
				rehabilitative and other social programs intended to help patients in OBMAT
				programs become and remain productive members of society.
2.27. Medical or Patient Record -- Medical
				histories, records, reports, summaries, diagnoses, prognoses, records of
				treatments, and medication ordered and given, entries, x-rays, radiology
				interpretations, and other written electronic, or graphic data prepared, kept,
				made, or maintained in a facility that pertains to services rendered to
				patients.
2.28. Medical Withdrawal
				-- The medically managed, gradual, voluntary and therapeutic withdrawal of a
				patient from medication-assisted treatment, agreed upon by the patient and
				appropriate staff.
2.29. Medication
				Error -- An error in administering a medication to an individual and includes
				when any of the following occur: the wrong medication is given to an
				individual; the wrong individual is given the medication; the wrong dosage is
				given to an individual; medication is given to an individual at the wrong time
				or not at all; or the wrong method is used to administer the
				medication.
2.30. Mental Health
				Professional -- A person licensed under Chapter 30 of the West Virginia Code as
				a psychiatrist, a social worker, a psychologist, or a professional
				counselor.
2.31. Misuse or
				Non-Medical Use -- All uses of a prescription medication or substance other
				than those that are directed by a health care provider acting within his or her
				scope of practice and used by an intended patient within the law and the
				requirements of good medical practice.
2.32. Opioid Antagonist -- A drug that blocks
				opioid reception by attaching to the opioid receptors without activating them
				thereby causing no opioid effect and blocking full agonist opioids.
2.33. Opioid Drug -- Any substance or drug
				having an addiction-forming or addiction-sustaining liability similar to
				morphine or being capable of conversion into a drug or substance having such
				addiction-forming or addiction-sustaining liability including, but not limited
				to, heroin, morphine, codeine, oxycodone, hydrocodone, fentanyl, oxymorphone,
				hydromorphone, methadone, and any natural, semi-synthetic or synthetic drug
				that acts primarily through mu opioid receptor in the brain.
2.34. Opioid Treatment Services -- Treatment
				and services provided by an OBMAT program that uses medication-assisted
				treatment medications as a part of its treatment modality. Opioid treatment
				services may be provided through outpatient, residential, or hospital settings;
				and may include medical maintenance, medically supervised withdrawal, and
				detoxification, various levels of medical, psychosocial, and other types of
				care, detoxification treatment, and maintenance treatment.
2.35. Peer Recovery Support Services --
				Non-clinical recovery support services that are recipient directed and
				delivered by peers who have life experience with recovery.
2.36. Pharmacotherapy -- The treatment of
				disease or medical condition through the administration of drugs.
2.37. Physical Dependence -- A state of
				biologic adaption that is evidenced by a class-specific withdrawal syndrome
				when the substance is abruptly discontinued or the dose rapidly reduced, or by
				the administration of an antagonist.
2.38. Physician Assistant -- A person who
				meets the qualifications set forth in W. Va. Code §§30-3E-1,
et seq.
,
				and is licensed pursuant to that article to practice medicine under the
				supervision of a physician or podiatrist licensed by the West Virginia Board of
				Medicine or the West Virginia Board of Osteopathic Medicine.
2.39. Physician Extender -- A medical staff
				person other than a program physician, functioning within his or her scope of
				practice to provide medical services to patients admitted to OBMAT programs.
				Physician extenders approved for employment at an OBMAT program include
				advanced practice registered nurses and physician assistants. Registered nurses
				and licensed practical nurses are not authorized to act as physician extenders
				in a MAT program, although they may work within the program in other
				capacities.
2.40. Plan of
				Correction -- A written description of the actions the OBMAT program intends to
				take to correct and prevent the reoccurrence of violations of a statute, rule,
				regulation or policy identified by the designated state oversight agency during
				an investigation or survey.
2.41.
				Plan of Education -- An approved continuing education plan that results in a
				physician, counselor or physician extender attaining professional competence in
				the field of substance use disorder treatment.
2.42. Positive Drug Screen -- A test that
				results in the presence of any drug or substance listed in this rule or any
				other drug or substance prohibited by the OBMAT program. The presence of
				medication which is part of the patient's individualized plan of care or
				treatment strategy shall not be considered a positive test.
2.43. Primary Counselor -- The individual
				designated by the OBMAT program to serve as a consultant and advisor to a
				patient on a regular basis. The primary counselor may be an addiction counselor
				and shall be included as a member of the patient's interdisciplinary team for
				opioid treatment programs.
2.44.
				Program Physician -- Any physician licensed in this state pursuant to Chapter
				30 of the West Virginia Code, designated and approved by the medical director
				to prescribe and monitor medication-assisted treatment for patients admitted to
				an OBMAT program. The medical director may serve as a program
				physician.
2.45. Random Drug
				Testing -- Approved medical screening and testing of patients for drugs,
				alcohol, or other substances that shall be conducted so each patient of an
				OBMAT program has a statistically equal chance of being selected for testing at
				random, unscheduled times.
2.46.
				Recovery -- A process of change through which an individual improves his or her
				health and wellness, lives a self-directed life, and strives to achieve his or
				her full potential.
2.47. Relapse
				Prevention Plan -- A plan of action developed by a patient and his or her
				health and wellness, lives a self-directed life, and strives to achieve his or
				her full potential.
2.48. Titration
				-- The gradual increasing or decreasing of doses of a medication-assisted
				treatment medication to the minimal level clinically required for
				maintenance.