Section 5122-40-15 - Medication units(A) Opioid treatment programs may voluntarily establish medication units with the appropriate licensure from the Ohio department of mental health and addiction services, the United States drug enforcement agency, the substance abuse and mental health services agency, and the Ohio board of pharmacy. Medication units will be associated with a single primary opioid treatment program or hub that will oversee their operations. Non-mobile medication units are stationary brick-and-mortar facilities, and mobile medication units are vehicles that may provide health care services traditionally performed at brick-and-mortar opioid treatment programs. All medication units will be licensed and located in accordance with section 5119.37 of the Revised Code. All required services that are unable to be performed at the medication unit will be performed by the primary opioid treatment program.(B) Non-mobile medication units may be located no further than ninety miles from the primary opioid treatment program in the following venues : (1) Homeless shelters, jails, prisons, or county or local boards of public health;(2) Federally qualified health centers;(3) Providers certified to provide ASAM level three residential substance use disorder services in accordance with rule 5122-29-09 of the Administrative Code;(5) Counties with under sixty thousand residents.(C) Mobile medication units may be located in: (2) Counties with under sixty thousand residents; or,(3) Areas that are greater than five miles from the nearest opioid treatment program.(D) Medication units will provide the following services:(1) Administering and dispensing medications for opioid use disorder treatment;(2) Collecting samples for drug testing or analysis; and(3) Dispensing of take-home medications.(E) Medication units may provide the following services if they provide appropriate privacy and adequate space: (1) Intake/initial psychosocial and appropriate medical assessments with a full physical examination to be completed or provided within fourteen days of admission; and,(2) Initiation of methadone, buprenorphine, or naltrexone after an appropriate medical assessment has been performed. Initiation of methadone will be performed in-person by a qualified healthcare professional and monitored following appropriate medical practices. (F) Medication units may also provide telecounseling services if they provide appropriate privacy and adequate space with appropriately credentialed staff in accordance with all federal and state regulation. Telecounseling services may include individual or group sessions. Medication units that choose to provide telecounseling will: (1) Provide telecounseling services with appropriate application of clinical judgment to best meet patient treatment needs;(2) Be in compliance with paragraphs (H)(3) and (H)(4) of rule 5122-40-09 of the Administrative Code; and, (3) Ensure that every patient has a designated counselor who is the primary contact for behavioral health treatment and care coordination. While the patient may utilize other counselors for emergencies, all counseling, including telecounseling, will be handled by the primary counselor. All patients, whether seen in person or via telehealth, count equally toward the staffing ratio specified in paragraph (F)(1) of rule 5122-40-09 of the Administrative Code, and opioid treatment programs will maintain clear and accurate caseload records for auditing purposes.(G) The primary opioid treatment program is responsible for keeping all of the documentation on each patient, which may be readily accessed through electronic means by medication units. Original paper records generated by the medication unit will be transferred to the primary treatment program after they are generated. (H) The medical director will maintain authority over the medical aspects of treatment offered by mobile and non-mobile medication units. (1) The medical director will not be expected to be present at either type of medication unit a specified number of hours, however, the medical director will attend and document weekly calls with staff from each medication unit that reviews the clinical care of patients at each medication unit.(2) The medical director will visit each non-mobile medication unit at least:(b) After any patient death that is determined to be the result of an overdose. (I) Non-mobile medication units will obtain their supply of approved controlled substances directly from the manufacturer or wholesalers and maintain their inventory in accordance with applicable state and federal regulations.(J) All medication units will participate in the central registry system to prevent clients from dosing at multiple opioid treatment programs and to ensure medication unit compliance with rule 5122-40-08 of the Administrative Code. Central registry verification can be performed either at the primary opioid treatment program or the medication unit but need not be done more than once per patient enrollment.(K) If an opioid treatment program voluntarily decides to close the operation of a medication unit, it will notify the Ohio department of mental health and addiction services, the United States drug enforcement agency, the substance abuse and mental health services agency, and the Ohio board of pharmacy at least ninety days before the planned closure of the program. The opioid treatment program will present a plan to transfer existing patients to similar opioid treatment programs or other suitable treatment programs at the time of the notification.Ohio Admin. Code 5122-40-15
Effective: 7/15/2023
Five Year Review (FYR) Dates: 6/11/2026
Promulgated Under: 119.03
Statutory Authority: 5119.37
Rule Amplifies: 5119.37
Prior Effective Dates: 01/01/2019, 06/11/2021