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PDFWAC 246-341-1000

Opioid treatment programs (OTP)General.

(1) Opioid treatment programs (OTP) may order, possess, dispense, and administer medications approved by the United States Food and Drug Administration for the treatment of opioid use disorder, alcohol use disorder, tobacco use disorder, and reversal of opioid overdose. OTP services include withdrawal management and maintenance treatment along with evidence-based therapy.
(2) An agency providing opioid treatment program services must ensure that the agency's individual record system complies with all federal and state reporting requirements relevant to opioid drugs approved for use in treatment of opioid use disorder, alcohol use disorder, tobacco use disorder, and reversal of opioid overdose.
(3) An agency must:
(a) Use evidence-based therapy in addition to medication in the treatment program;
(b) Identify individual mental health needs during assessment process and refer them to appropriate treatment if not available on-site;
(c) Provide education to each individual admitted, totaling no more than fifty percent of treatment services, on:
(i) Alcohol, other drugs, and substance use disorder;
(ii) Relapse prevention;
(iii) Infectious diseases including human immunodeficiency virus (HIV) and hepatitis A, B, and C;
(iv) Sexually transmitted infections; and
(v) Tuberculosis (TB);
(d) Provide information to each individual on:
(i) Emotional, physical, and sexual abuse;
(ii) Nicotine use disorder;
(iii) The impact of substance use during pregnancy, risks to the developing fetus before prescribing any medications to treat opioid use disorder, the risks to both the expecting parent and fetus of not treating opioid use disorder, and the importance of informing medical practitioners of substance use during pregnancy; and
(iv) Family planning.
(e) Create and implement policies and procedures for:
(i) Diversion control that contains specific measures to reduce the possibility of the diversion of controlled substances from legitimate treatment use, and assign specific responsibility to the medical and administrative staff members for carrying out the described diversion control measures and functions;
(ii) Urinalysis and drug testing, to include:
(A) Obtaining specimen samples from each individual, at least eight times within twelve consecutive months;
(B) Documentation indicating the clinical need for additional urinalysis;
(C) Random samples, without notice to the individual;
(D) Samples in a therapeutic manner that minimizes falsification;
(E) Observed samples, when clinically appropriate; and
(F) Samples handled through proper chain of custody techniques.
(iii) Laboratory testing;
(iv) The response to medical and psychiatric emergencies; and
(v) Verifying the identity of an individual receiving treatment services, including maintaining a file in the dispensary with a photograph of the individual and updating the photographs when the individual's physical appearance changes significantly.
(4) An agency must ensure that an individual is not admitted to opioid treatment withdrawal management services more than two times in a twelve-month period following admission to services.
(5) An agency providing services to a pregnant woman must have a written procedure to address specific issues regarding their pregnancy and prenatal care needs, and to provide referral information to applicable resources.
(6) An agency providing youth opioid treatment program services must:
(a) Ensure that before admission the youth has had two documented attempts at short-term withdrawal management or drug-free treatment within a twelve-month period, with a waiting period of no less than seven days between the first and second short-term withdrawal management treatment; and
(b) Ensure that when a youth is admitted for maintenance treatment, written consent by a parent or if applicable, legal guardian or responsible adult designated by the relevant state authority, is obtained.
(7) An agency providing opioid treatment program services must ensure:
(a) That notification to the federal Substance Abuse and Mental Health Services Administration (SAMHSA) and the department is made within three weeks of any replacement or other change in the status of the program, program sponsor as defined in 42 C.F.R. Part 8, or medical director;
(b) Treatment is provided to an individual in compliance with 42 C.F.R. Part 8;
(c) The individual record system complies with all federal and state reporting requirements relevant to opioid drugs approved for use in treatment of opioid use disorder; and
(d) The death of an individual enrolled in an opioid treatment program is reported to the department within forty-eight hours.
[Statutory Authority: RCW 71.24.037, 71.05.560, 71.34.380, 18.205.160, 71.24.037 and chapters 71.05, 71.24, and 71.34 RCW. WSR 21-12-042, § 246-341-1000, filed 5/25/21, effective 7/1/21. Statutory Authority: 2018 c 201 and 2018 c 291. WSR 19-09-062, § 246-341-1000, filed 4/16/19, effective 5/17/19.]
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