Section 0940-05-35-.06 - ADMISSIONS AND DISCHARGES AND BEST PRACTICES UTILIZED(1) Initial Screening. Prior to admission to the Facility, each prospective patient shall be evaluated by the medical director or program physician and clinical staff who have been determined to be qualified by education, training, and experience to perform or coordinate the provision of such assessments. The purpose of such assessments shall be to determine, and document, whether the patient meets the diagnostic criteria for an opioid use disorder as defined in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and whether the Facility will be the most appropriate treatment modality for the patient. No prospective patient shall be processed for admission until it has been verified that the patient meets all applicable criteria.(a) The Facility shall use either standardized assessment and evaluation tools that have been peer reviewed and validated or standardized assessment and evaluation tools as approved by the Department. Examples include American Society of Addiction Medicine (ASAM) placement criteria, the Addiction Severity Index, SAMHSA's TIP 40, or any other assessment and evaluation tools approved by the Department.(2) Prior to receiving treatment at the Facility, the patient shall acknowledge in writing having received education on the following: (a) Treatment options, including detoxification, and the benefits and risks associated with each treatment option;(b) The risk of neonatal abstinence syndrome and use of voluntary long-acting reversible contraception for all female patients of child bearing age and potential;(c) Prevention and treatment of chronic viral illnesses, such as HIV and hepatitis C;(d) Expected therapeutic benefits and adverse effects of treatment medication;(e) Risks for overdose, including drug interactions with CNS depressants, such as alcohol and benzodiazepines, and relapsing after periods of abstinence from opioids; and(f) Overdose prevention and reversal agents.(3) A Facility shall only admit and retain patients whose known needs can be met by the Facility in accordance with its licensed program purpose and description and applicable federal and state statutes, laws, and regulations.(4) Drug dependent pregnant females shall be given priority for admission and services.(5) No Facility shall provide a bounty or other reward to a third party for referral of potential patients to the clinic.(6) Comprehensive Assessment. Within thirty (30) days of admission, the Facility shall have completed a comprehensive assessment in accordance with peer reviewed medication assisted treatment guidelines, developed by nationally recognized organizations, such as SAMHSA and the American Society of Addiction Medicine. The comprehensive assessment shall be attached to the patient's medical chart no later than five (5) days after it is developed. It shall reflect that detoxification is an option for treatment and supported by the Facility's program and has been discussed with the patient. It shall also integrate information obtained in the initial screening. If necessary, the Facility shall obtain complete medical records from other providers with patient's written consent.(7) Discharge and Aftercare Plans. A Facility shall complete an individualized discharge and aftercare plan for patients who complete their course of treatment. (a) All discharge and aftercare plans shall include documentation that the Facility's counseling and/or medical staff has discussed with the patient an individualized medically supervised withdrawal plan appropriate to the patient.(b) The patient's discharge planning shall include the development of a menu of appropriate treatment resources available to the patient in his or her community. This menu shall be developed in consultation with the patient and shall be in writing and made available to the patient upon discharge. The Facility shall assist the patient in obtaining the appropriate referrals, as necessary.(c) The discharge plan shall be completed at the time of the patient's discharge by the person who has primary responsibility for coordinating or providing for the care of the service recipient. It shall include a final assessment of the patient's status at the time of discharge and aftercare planning. If applicable, parents or guardian, or responsible persons may participate in discharge and aftercare planning. The reason for any patient not participating in discharge and aftercare planning shall be documented in the patient's record.(8) The Facility shall document when a patient discontinues services at an OBOT. Determination of the events that constitute a patient's discontinuation of services at an OBOT shall be at the OBOT's discretion.Tenn. Comp. R. & Regs. 0940-05-35-.06
Original rules filed October 14, 2016; effective 1/12/2017.Authority: T.C.A. §§ 4-3-1601, 4-4-103, 33-1-302, 33-1-305, 33-1-309, 33-2-301, 33-2-302, 33-2-402, 33-2-403, 33-2-404, 33-2-407, and Chapter 912 of the Public Acts of 2016.