W. Va. Code R. § 69-12-7

Current through Register Vol. XLI, No. 45, November 8, 2024

Section 69-12-7 - Administrative Organization and Management of OBMAT Programs

7.1. Each OBMAT program shall identify a program administrator, medical director, program physician(s), and, if applicable, counseling staff.

7.2. Program Administrator.

7.2.1. The administrator of an OBMAT program shall have at a minimum a bachelor's degree in an appropriate area of study and a minimum of two years of experience in the fields of substance use disorders, behavioral health, or health care administration; or a master's degree in an appropriate professional area of study; or six years of experience in the fields of substance use disorders, behavioral health, or health care administration; or be a program physician.

7.2.2. The administrator is responsible for the day-to-day operation of the OBMAT program in a manner consistent with the laws and regulations of the United States Department of Health and Human Services, Drug Enforcement Administration (DEA), and the laws and rules of the state of West Virginia.

7.2.3. Duties of the administrator include:

7.2.3.a. Contribution to the development of policies and procedures for operation of the program;

7.2.3.b. Maintenance and security of the facility;

7.2.3.c. Employment, credentialing, evaluation, scheduling, training, and management of staff;

7.2.3.d. Protection of patient rights;

7.2.3.e. Conformity of the program with federal confidentiality regulations, namely, 42 C.F.R. Part 2;

7.2.3.f. Security of medication storage and safe handling of medications;

7.2.3.g. Contribution to the management of the facility budget;

7.2.3.h. Implementation of program policies and procedures;

7.2.3.i. Communication with the medical director; and

7.2.3.j. Maintenance of documentation regarding the medical director's training and experience in a file that is current and readily available at all times.

7.3. Medical Director.

7.3.1. Each OBMAT program shall have a designated medical director. The medical director shall

7.3.1.a. Have a full, active, and unencumbered license to practice allopathic medicine or surgery from the West Virginia Board of Medicine or to practice osteopathic medicine or surgery from the West Virginia Board of Osteopathic Medicine in this state.

7.3.1.b. Complete the requirements for Drug Addiction Treatment Act of 2000, Pub. L. 106-310, 114 Stat. 1101, Title XXXV, §§3501, et seq., (2000) if he or she prescribes partial opioid agonist; and

7.3.1.c. Demonstrate experience in substance use disorder treatment or medication-assisted treatment or have a written plan, not to exceed 12 months, to attain competence in substance use disorder treatment or medication-assisted treatment.

7.3.2. The medical director shall maintain authority over the medical aspects of treatment offered by the OBMAT program. The medical director is responsible for:

7.3.2.a. Operation of all medical aspects of the treatment program;

7.3.2.b. Administration and supervision of all medical services;

7.3.2.c. Compliance with all applicable federal, state, and local laws, rules, and regulations;

7.3.2.d. Maintenance of his or her continuing medical education in the field of substance use disorder treatment and medication-assisted treatment on a documented and ongoing basis;

7.3.2.e. Approval of the basic and continuing education programs of all staff employed by or volunteering at the OBMAT program; and

7.3.2.f. Determination of the ability of the program physicians and physician extenders to work independently within the applicable scope of practice.

7.3.3. The medical director shall ensure regulatory compliance and carry out those duties specifically assigned to the medical director. Nothing in this rule prohibits an OBMAT from designating co-medical directors.

7.3.4. Within 10 days after the withdrawal or termination of the medical director, the owner or owners of the program shall notify the Secretary of the identity of another medical director for the program. Another licensed physician shall assume the duties of the medical director on a temporary basis, not to exceed 60 days, until a new medical director is identified and begins work at the program. The interim physician may be another owner of the program or a program physician employed by or associated with the program.

7.4. Professional Medical Staff.

7.4.1. The OBMAT program may employ and use program physicians, physician extenders, and other health care professionals working within their scope of practice who have received sufficient education, training, experience, or any combination thereof, to enable that person to perform the assigned functions. All physicians, nurses, and other licensed professional care providers must comply with the credentialing requirements of their respective professions.

7.4.2. All physicians and physician extenders employed by the OBMAT program shall be actively licensed in West Virginia and shall have:

7.4.2.a. A minimum of one year of experience in substance use disorder treatment and medication-assisted treatment settings; or

7.4.2.b. Meet the following requirements:

7.4.2.b.1. Active enrollment in a plan of education for obtaining competence in medication-assisted treatment methods and substance use disorders that is approved by the medical director. The medical director shall certify the individual's completion of the plan of education when, in the discretion of the medical director, it is satisfactorily accomplished; and

7.4.2.b.2. Completion of the certification, training programs or continuing education programs recommended and approved by the medical director of the OBMAT program.

7.4.3. During all hours of operation, every OBMAT program shall have an actively licensed program physician on call and available for consultation with other staff members at any time.

7.4.4. During all hours of operation, when parties are being medically treated, every OBMAT program shall have present and on duty at the program at least one of the following actively-licensed health care professionals:

7.4.4.a. Physician;

7.4.4.b. Physician assistant;

7.4.4.c. Advanced practice registered nurse; or

7.4.4.d. Registered nurse.

7.4.5. Plans of Education.

7.4.5.a. Program physicians and physician extenders operating under a plan of education shall be supervised by the medical director at a frequency appropriate for the qualifications and experience of the employee.

7.4.5.b. The program administrator or his or her designee shall document when an employee undertakes a plan of education, maintain all records regarding plans of education for the professional medical staff, and ensure that the medical director monitors and certifies satisfactory completion of each plan of education.

7.4.5.c. The medical director shall approve each plan of education and the ability of a program physician or physician extender to work independently within his or her scope of practice. The medical director shall document an employee's successful completion of a plan of education and approval to provide services on an independent basis within his or her scope of practice.

7.4.5.d. The state opioid treatment authority may request periodic documentation of continuing education during the probationary period and afterward if the documentation provided at the end of that period is not satisfactory.

7.5. Counseling Staff.

7.5.1. Counseling through an OBMAT program shall be provided by counseling staff that meet the qualifications as described in W. Va. Code §16-5Y-5(d).

7.5.2. The OBMAT program shall assign or make referral to a primary counselor or counseling service for each patient to contribute to the appropriate treatment plan for the patient and to monitor patient progress.

7.5.3. Each OBMAT program's policies and procedures shall ensure sufficient counseling staff to meet the needs of the patient population and to comply with the requirements of this rule.

7.5.4. Any unlicensed or uncertified counseling staff employed or used on a referral basis by the program shall be directly supervised by a licensed or certified professional or advanced alcohol and drug counselor, or both. At a minimum, the supervisor shall provide at least one hour of supervision per 20 hours of direct service. Supervision may be group in nature but must consist of case consultation and discussion or clinical training rather than administrative oversight.

7.5.5. Newly employed counselors and other non-physician clinical staff without experience in a recovery-based OBMAT program shall receive initial training lasting at least 12 hours as prescribed in a facility practice and procedures guide and consisting of, at a minimum, the following:

7.5.5.a. Substance use disorder overview;

7.5.5.b. Characteristics of the substance use disorder population;

7.5.5.c. Program policy and procedure;

7.5.5.d. Confrontation, de-escalation, and anger management;

7.5.5.e. Current strategies for identifying and treating alcohol, cocaine, and other substance use disorders; and

7.5.5.f. Identification of co-occurring behavioral health or developmental disorders.

7.5.6. An experienced counselor newly employed from another MAT program may be exempt from the mandatory initial training required by this rule, if the mandatory initial training has been received within the previous two years. If training was received more than two years prior to employment, six hours of training shall be provided.

7.5.7. Counselors with less than one year of full-time experience in the field of substance use disorder treatment and medication-assisted treatment shall accompany an experienced counselor at all times for a minimum of two weeks before seeing persons served without immediate and constant supervision.

7.6. Unlicensed Clinical Staff and Volunteers.

7.6.1. An OBMAT program may employ unlicensed clinical staff and utilize volunteers to assist in the operation of the program and facility. The program shall develop and implement policies and procedures which specify the roles and responsibilities of each unlicensed employee and volunteer. Documentation of the responsibilities, training, and other obligations of an unlicensed clinical staff employee or volunteer shall be included in the personnel file of the employee or volunteer.

7.6.2. All unlicensed clinical staff and volunteers shall receive direct on-site supervision and must be provided with assistance, directions for activity and support.

W. Va. Code R. § 69-12-7