Section 75-09.1-10-12 - Risk management1. Each opioid treatment program shall:a. Establish procedures to guard against critical incidents.b. Provide a mechanism to address patient emergencies by establishing an emergency contact system, as appropriate within confidentiality requirements.c. Ensure that there are staff members on duty who are trained and proficient in cardiopulmonary resuscitation, management of opioid overdose, medical emergencies, and other techniques as appropriate.d. Establish and regularly update policies and procedures which address safety and security issues for patients and staff, including training for staff to handle physical or verbal threats, acts of violence, inappropriate behavior, and other escalating and potentially dangerous situations, especially those in which security guards or police need to be summoned.e. Shall provide information to patients on an ongoing basis, on the risks of discontinuing services, and on the potential consequences of using other substances.f. Establish a policy on creation and use of individualized induction and dosing schedules for each patient.g. Establish a policy for patients to take home medication for unsupervised use.2. Each opioid treatment program shall create and maintain a plan for continuity of care for patients, including emergency procedures for obtaining access to medications in case of temporary program closure during service disruptions, such as those that may occur due to a major disaster or a more routine event, such as a snow storm. Each opioid treatment program shall develop and maintain an electronic database consisting of client identification, emergency contact information, patient's current dose, last date medication administered, and number of take-home doses allowed as part of the patient's plan and must include a mechanism for informing each patient of the emergency arrangements. If there is a service disruption, the opioid treatment program shall implement its emergency plan and shall forward its database and plan to the division.3. Each opioid treatment program shall: a. Develop procedures for reporting critical incidents to appropriate opioid treatment program staff, to the facility's accrediting body, and to the division within twenty-four hours of the critical incident.b. Establish procedures to ensure:(1) Full documentation of each critical incident.(2) Prompt investigation and review of the situation surrounding each critical incident.(3) Implementation of timely and appropriate corrective action.(4) Corrective actions are monitored until their effectiveness is assured.(5) Medication is dispensed safely if a patient presents with concerning behavioral or medical signs and symptoms.4. If a patient chooses to discontinue services against medical advice, the opioid treatment program shall explain the risks of discontinuing services and offer information about, and referral to, alternative treatment options.N.D. Admin Code 75-09.1-10-12
Amended by Administrative Rules Supplement 2014-352, April 2014, effective April 1, 2014. .General Authority: NDCC 50-31-08
Law Implemented: NDCC 50-31-08
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