Rule 111-8-53-.09 - Administration(1) Program Purpose. A licensed program shall operate, in accordance with these rules, under written policies and procedures that define its philosophy, purpose, program orientation, and procedures. Such policies and procedures must identify the types of drug-dependent individuals and the ages of the patients that the program serves, including referral sources.(2) Program Description. A licensed program shall develop and fully implement written policies and procedures that describe the range of treatment and services provided by the program. These policies and procedures must describe how identified treatment and services will be provided and how such treatment and services will be assessed and evaluated. A program description must show what services are provided directly by the program and what treatment and services are provided in cooperation with available community or contract resources.(3) Finances. The governing body shall provide for the preparation of an annual budget and approve such budget. Copies of the current year's budget and expenditure records must be made available to the Department for examination and review by the Department upon request.(4) Fees. The program shall develop and implement a written schedule of patient fees. The schedule must identify all fees that are chargeable to patients and a copy of the current schedule shall be posted in a conspicuous place so as to inform patients and their parents, guardians, or responsible parties of such schedule of fees.(5) Patient Records. The patient record must accurately reflect the course of appropriate treatment provided to the patients. Programs must organize and coordinate patient records in a manner that demonstrates that all pertinent patient information is accessible to all appropriate staff and to the Department. The patient's Central Registry I.D. number must be maintained in each patient record and some form of a patient identification must appear on each page of the record. Each patient record must contain, at a minimum, the following: (a) Basic identifying information including name, current address, current telephone number, date of birth, sex, and race;(b) If applicable, the names, addresses, and telephone number of parents, or guardians, or responsible parties;(c) Persons to notify in case of an emergency if different from above;(d) Appropriate evidence of a history of opiate addiction prior to entry into the program;(e) Records of screening and assessment, including information about expected charges for services;(f) If applicable, documentation of why the patient was not admitted for treatment and suggested referrals given to patient;(g) Written consents, signed by the patient and dated and witnessed, as required in Rule 111-8-53-.12(1)(c)1.;(h) Documentation of Central Registry clearance as required in Rule 111-8-53-.19;(i) Documentation of orientation as required in Rule 111-8-53-.12(1)(c)3.;(j) The individual treatment plan and documentation of patient involvement in the development of the individual treatment plan;(k) Medical reports, nursing notes, laboratory results including reports of drug screens, progress notes, and documentation of current dose and other dosage data, with all entries signed and dated by the appropriate professional staff;(l) Dated and signed case entries of all significant contacts with or concerning patients, including a record of each counseling session in chronological order, as well as dated and signed forms and assessments;(m) Correspondence with the patient, his or her family members, and other individuals and record of each referral for service and the results thereof;(n) Documentation by appropriate professional staff that supports the course of treatment being provided; and(o) Discharge summary, including reasons for discharge and any referral.(6) Confidentiality of Patient Records. Written policies and procedures shall be established and implemented for the maintenance and security of patient records specifying who shall supervise the maintenance of such records, who shall have custody of such records, and to whom records may be released. Confidentiality of patient records and release of such records must comply with 42 CFR, Part 2, Confidentiality of Alcohol and Drug Abuse Patient Records and any applicable state laws, including but not limited to O.C.G.A. § 26-5-56. Patients shall be informed that all clinical records are subject to inspection by the Department in connection with the initial and on-going licensure of the program.(7) Drug Records. Medication orders and dosage changes must be written or printed on a physician's order sheet or a form that clearly displays the physician's signature and tracks orders over time. Dosage dispensed, prepared, or received must be recorded and accounted for by written or printed notation in a manner that reflects an accurate inventory at all times. Every dose shall be recorded in the patient's individual medication record at the time the dose is dispensed or administered and shall be properly authenticated by the licensed person administering such dose. Where computerized systems are used, authentication procedures will be strictly enforced. If initials are used, the full signature and credentials of the qualified person administering or dispensing must appear at the end of each page of the medication sheet. The perpetual inventory must be totaled and recorded in milligrams daily. Methadone and related drugs shall be counted and reconciled with the written inventory at the beginning and end of each dosing day with all discrepancies satisfactorily resolved.(8) Personnel Records. A program shall maintain written and verified records for each employee. Each employee file shall include:(a) Identifying information including name, current address, current telephone number, and emergency contact persons;(b) A five-year employment history or a complete employment history if the person has not worked five years;(c) Evidence of a criminal record check obtained from a state or local law enforcement agency that reflects the individual does not have any convictions of a crime, as defined in paragraph (f) of Rule 111-8-53-.03, within the previous five years; for employees working in an administrative capacity who are not providing care to patients and for employees working as peer counselors, the program may accept a criminal record check which includes conviction of a nonviolent crime such as those listed in 111-8-53-.03(f)(12) - (17);(d) Records of educational qualifications if applicable;(f) The person's job description or statements of the person's duties and responsibilities;(g) Documentation of training and orientation required by these rules;(h) Any records relevant to the employee's performance, including an appropriate health status of the employee; and(i) Evidence that any professional license required as a condition of employment is current and in good standing.(9) Referral to Other Programs. Each program shall have arrangements for referral of patients to other programs that offer different treatment modalities.(10) Closing of a Program. A program that intends to close the program voluntarily shall notify the Department no later than sixty (60) days prior to closure. Any program that closes, either voluntarily or involuntarily, shall submit satisfactory evidence to the Department that the program has developed a transition plan for the continuity of care for its patients. Such transition plan shall include, at a minimum: (a) Written notice to all current patients of record that the program is closing. Such notice shall be provided to patients at least thirty (30) days prior to closure and shall include information on other programs in close proximity which have availability to treat new patients;(b) Coordination with other programs to ensure continuity of care for patients that need assistance in locating a new treatment program;(c) Use of the Central Registry to transfer patients to the receiving program;(d) A plan for the transfer of appropriate clinical/treatment records to the receiving program in a manner that complies with state and federal privacy laws;(e) A timeline for management of closure-related activities; and(f) A protocol for securing all medications to ensure that there is no diversion and to transfer any excess medications to the U.S. Drug Enforcement Administration.(11) Hours of Operation. Program hours of operation shall accommodate persons involved in activities such as school, homemaking, childcare, and variable-shift work. Programs shall offer comprehensive services, including, but not limited to, individual and group counseling, medical services, and referral services, at least five days per week. A program may close on Sundays and state and federal holidays provided appropriate treatment arrangements are made for patients. In order to accommodate patients for whom take-home medication has not been authorized, the program shall dispense medication at least seven days per week when necessary. Programs shall further develop a plan for contingencies, emergencies, etc., including 24 hour emergency services during non-operating hours to assist patients in crisis situations.(12) Community Liaison and Concerns. A program shall schedule and provide services to its patients in such a manner as to minimize the impact on local community services.Ga. Comp. R. & Regs. R. 111-8-53-.09
O.C.G.A. §§ 26-5-2et seq., 31-2-5, 31-2-7.
Original Rule entitled "Administration" adopted. F. Sep. 9, 2013; eff. Sept. 29, 2013.Amended: F. Feb. 15, 2018; eff. Mar. 7, 2018.