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. For this purpose, a woman of child bearing age and potential is aligned with Tennessee Code Annotated § 53-11-308(h). 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. 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 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 providers are knowledgeable in the management of opioid use disorder in a context of chronic pain and pain management. The MINIMUM PROGRAM REQUIREMENTS FOR NONRESIDENTIAL CHAPTER 0940-05-35 OFFICE-BASED OPIATE TREATMENT FACILITIES Facility shall ensure continuity of care and communication between treatment programs or physicians regarding patients receiving treatment in both a nonresidential 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, or provided, appropriate treatment. (a) The Facility shall monitor, assess, and document in the patient’s medical record the emergence of symptoms of mental illness during treatment. (b) The Facility shall establish relationships with mental health providers in the community for referral/additional treatment services as indicated. See 0940-05-35-.09(3). (4) Polysubstance Misuse. The Facility shall address misuse of alcohol and other non-opioid substances within the context of the medication-assisted therapy effort. Ongoing polysubstance misuse is not necessarily a reason for discharge; however, the Facility shall facilitate a referral of the patient, with documentation of the referral in the patient’s medical record, to more intensive levels of care, as indicated, to include but not be limited to, intensive outpatient or residential alcohol and drug use 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. The Facility shall document in their policy the extent of its work with this community.