Staffing for Opioid Treatment Programs

Staffing for Opioid Treatment Programs A. An OTP must employ sufficient and qualified employees to meet the treatment and support needs of the population served. Services must be provided by an interdisciplinary team, all of whom are properly licensed, registered, or certified by the appropriate authority in accordance with Mississippi law. At a minimum, the team must include: 1. A licensed physician; 2. A RN; 3. A licensed pharmacist; and 4. A licensed psychologist/counselor/social worker, licensed/certified mental health therapist (or addictions therapist) who must be on-site during all hours of operation. The therapist to person ratio must be set with a limited caseload that supports and meets the needs of the people receiving services, and limits must be addressed in the agency provider’s policies and procedures. B. An OTP must designate a Medical Director who is responsible for administering and supervising all medical services performed by the program. The Medical Director must be a physician licensed in the state of Mississippi. The Medical Director must be on-site, as needed, to complete all medical needs in accordance with standard medical practice and available by phone as needed. The Medical Director may directly provide services to the OTP’s patients or delegate specific responsibility to authorized program physicians and healthcare professionals functioning under the Medical Director’s direct supervision. C. An OTP must employ at least one (1) full-time RN for the first 100 or fewer people. In addition to the one (1) full-time RN, additional registered nurses must be maintained so as to provide nursing services at least one (1) hour per week per five (5) people enrolled over 100 people. (For example, a service location serving 150 people would have one (1) full- time RN and an additional 10 hours per week of RN time from another RN on staff). Nursing functions may be supplemented by an LPN if a RN or physician is on-duty. All nursing services provided must be in compliance with the scope of practice deemed applicable by the Mississippi Licensure Board. D. A person may hold more than one (1) employee position within the facility if that person is qualified to function in both capacities, and the required hours for each job are separate and apart for each position. E. All OTPs must provide availability of employees seven (7) days a week, 24 hours a day. A record of the on-call schedule must be maintained, and the people must be informed of how to access the on-call employees; therefore, a signed statement by the person must be maintained in the person’s record. The on-call employee must be available at all times for emergencies of the people served. The on-call employee must have access to pertinent information, including dosage levels, for a person receiving services. F. Office-based Opioid Treatment using an agonist such as buprenorphine (usually as Suboxone) in which the prescribing physician must be “waivered” (having gone through eight (8)-hour training program). G. In addition to the requirement of Rule 2.10.C, entities applying for certification as an OTP must include the following: 1. Service goals and objectives. 2. Service funding (including individual fee schedules). 3. Demonstrated need to establish the service: (a) Submit sufficient justification to include: (1) Location population data. (2) Plan for service implementation. (3) Identified gaps in service. (4) Expected target population. (5) Sufficient documentation of support for services in the form of a signed letter from at least one (1) of the following: i. Person receiving services; ii. Businesses; or iii. Property-owners residing/located within the immediate area surrounding the proposed location. (6) Sufficient documentation of need in the form of a signed letter from at least one (1) of the following: i. Behavioral health program; ii. Area physician; or iii. Other health professional/agency provider. (7) Sufficient documentation of support for services in the form of a signed letter from at least one (1) of the following: i. Local governing authorities; ii. Local law enforcement officials; or iii. Local judges.