Section 0940-05-35-.11 - SPECIAL POPULATIONS(1) Pregnant Women/Women of Child Bearing Age and Potential. Upon the initial screening, the Facility shall screen all women of child bearing age and potential for pregnancy. The Facility will ensure that pregnant women and women of child bearing age and potential shall be treated using nationally recognized best practice guidelines and within all applicable federal and state rules and regulations. If the Facility does not provide prenatal care to pregnant patients, the Facility shall ensure that there is coordination of care between the Facility and the pregnant patient's prenatal care provider. (a) The Facility shall document, in the patient's medical record, that the Facility has informed all pregnant women and women of child bearing age and potential, initially and at regular intervals, of the risks and benefits of the utilization of voluntary, reversible, long-acting contraception, of the risks and benefits of medication assisted treatment and detoxification treatment with buprenorphine containing products, and of the risks associated with the continued use of illicit opioids, including neonatal abstinence syndrome. The information provided to pregnant women and women of child bearing age and potential shall be based on current best practices and research.(2) Pain Management. The Facility shall ensure that program physicians are knowledgeable in the management of opioid use disorder in a context of chronic pain and pain management. Individuals being treated with opioids for chronic or acute pain, who have become physically dependent in the course of their medical treatment, should be treated in a medical or surgical setting due to the possibility that this type of patient may need a higher dosage of pain medication to achieve adequate pain control. Individuals who are addicted to opioids, demonstrating drug-seeking behavior, or performing illegal drug-related activity, and who also need treatment for pain may be enrolled in the Facility but the Facility shall ensure continuity of care and communication between treatment programs or physicians regarding patients receiving treatment in both a non-residential office-based opiate treatment facility and a licensed pain management clinic or a pain management specialist's office for purposes of pain management, with patient consent.(3) Co-occurring disorders. The Facility shall ensure that patients with mental health needs are identified through the initial screening and comprehensive assessment processes and are referred to appropriate treatment.(a) The Facility shall monitor patients during treatment to identify the emergence of symptoms of mental illness.(b) The Facility shall establish linkages with mental health providers in the community.(4) Polysubstance Abuse. The Facility shall address abuse of alcohol and other non-opioid substances within the context of the medication-assisted therapy effort. Ongoing polysubstance abuse is not necessarily a reason for discharge; however, the patient may be offered a referral to more intensive levels of care, to include but not be limited to, intensive outpatient or residential alcohol and drug abuse treatment.(5) Criminal Justice. The Department encourages each Facility to work with local law enforcement, probation officers, and courts, including recovery (drug) courts, to act as a resource for individuals in the criminal justice system to receive the necessary treatment services including medications and counseling.Tenn. Comp. R. & Regs. 0940-05-35-.11
Original rules filed October 14, 2016; effective January 12, 2017. Rule was previously numbered 0940-05-35-.10 but was renumbered 0940-05-35-.11 with the introduction of a new rule 0940-05-35-.10 filed March 29, 2019; effective 6/27/2019.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.