Special Populations

(1) The Facility shall ensure that program providers are knowledgeable in the management of opioid use disorder in the context of chronic pain and pain management. The Facility may not prohibit a service recipient diagnosed with chronic pain from receiving medication-assisted treatment for either maintenance treatment or short-term withdrawal management. (a) With the service recipient’s written consent, the Facility shall ensure continuity of care and communication between the Facility’s program providers and any outside providers regarding the service recipients receiving opioid use disorder and pain treatment. MINIMUM PROGRAM REQUIREMENTS FOR NON-RESIDENTIAL CHAPTER 0940-05-42 OPIOD TREATMENT PROGRAM FACILITIES (b) If the service recipient refuses consent for the two (2) entities to communicate and coordinate care, the Facility shall document refusal and may make clinically appropriate decisions regarding treatment, such as, take-home medication privileges, medication dosing, or an increase in counseling. (2) The Facility shall ensure that service recipients with mental health needs are identified and referred to appropriate treatment with appropriate follow up. Any referrals or attempts at referrals shall be documented in the service recipient’s medical record. (a) The Facility shall closely monitor service recipients during medically supervised withdrawal, or dose tapering, to identify symptoms of mental illness. (b) The Facility shall establish and document a list of available mental health providers in the community that the Facility can refer patients to, as appropriate. (3) The Facility shall have a policy regarding the treatment of co-morbid disorders such as psychiatric and medical disorders. The goal of treatment shall be to facilitate treatment for these disorders as seamlessly as possible, while maximizing service recipient convenience and compliance with appointments and recommendations. The Facility shall attempt to ensure a smooth referral process and exchange of information. The Facility shall organize and facilitate communication between two or more participants involved in a service recipient’s care (such as the Facility and primary care provider, specialty services, mental health services, family members, and/or significant others) to achieve safer and more effective care. This shall be documented in the service recipient’s medical record. (4) The Facility shall address misuse of alcohol and other non-opioid substances by providing treatment or referral to outside providers, as appropriate. (a) The Facility shall ensure that staff is trained and knowledgeable regarding current effective strategies for treating misuse of alcohol, opioids, methadone, amphetamines, cocaine, barbiturates, benzodiazepines and other drugs. (b) Ongoing multi-drug use is not necessarily a reason for discharge. The treatment team shall consider the service recipient’s condition and address the situation from an individualized clinical perspective. The program provider shall consider the risks and benefits of the service recipient’s current level of care being provided, medication dosage, and other services being provided when treating service recipients with ongoing multi-drug use. The program provider shall refer the service recipient to a higher level of care when indicated. This referral shall be documented in the service recipient’s medical record. (c) Social barriers to higher levels of care, such as inability to pay or concerns regarding loss of employment, shall be documented. In cases where a higher level of care is recommended yet declined by the client or unattainable due to external factors, the clinician shall document the rationale for the refusal or reasons for not being able to access the recommended higher level of care.