D.C. Mun. Regs. r. 22-A6330
Opioid Treatment Programs ("OTPs") provide Medication Assisted Treatment ("MAT") for clients that have an SUD that could be appropriately treated in accordance with Federal regulations.
MAT is the combination of any FDA-approved medication with behavioral therapies to treat SUD. A client who receives medication to treat SUD must also receive SUD Counseling/Therapy. Use of this service should be in accordance with ASAM criteria and practice guidelines issued by the Department.
OTPs shall ensure that clients seeking MAT services are informed that there are multiple medications approved to treat SUD and provide written informed consent to the specific medication selected by the client. If the medication the client chooses is unavailable at that OTP, the provider must refer the client to another provider that offers the selected medication. No client under eighteen (18) years of age may be admitted to an OTP unless a parent or legal guardian consents in writing to such treatment.
MAT may be administered on an in-office basis or as take- home regimen. Whether in-office or take-home, MAT administrations include the unit of medication and therapeutic guidance. For clients receiving a take-home regimen, therapeutic guidance must include additional guidance related to storage and self-administration. OTPs must comply with all Federal and District laws and regulations concerning MAT.
The provision of MAT to treat SUD must be accompanied by a clinically appropriate array of SUD treatment services that include:
Providers shall have medical staff (physician, PA, APRN, or RN) on duty during all clinic hours. A physician shall be available on-call during all clinic hours, if not present on site.
An OTP shall provide a mechanism to address a client's medical or psychiatric emergencies occurring outside of program hours of operation, including an emergency system to obtain dosage levels and other pertinent client information, twenty-four (24) hour a day, seven (7) days a week. The OTP shall provide every client an identification card that identifies the pharmaco therapy being administered through the OTP. The card shall include the provider's emergency contact information so that appropriate clinical information and dosing information can be obtained in an emergency.
A physician shall evaluate the client a minimum of once per month for the first year that a client receives MAT and a minimum of every six (6) months thereafter, in coordination with the Plan of Care and as needed.
An OTP shall require that each client undergo a complete, fully documented physical evaluation prior to prescribing or renewing a prescription for MAT. If no physical is available within the past twelve (12) months, the provider shall ensure the full medical examination is completed within fourteen (14) days of admission to the OTP.
An OTP shall provide counseling on preventing exposure to, and the transmission of, HIV for each client admitted or readmitted to the program.
D.C. Mun. Regs. r. 22-A6330