Home » 2015 Issues » December 09, 2015 » ASA-36-15-00023-A General Service Standards for Chemical Dependence Outpatient (CD-OP) and Opioid Treatment Programs (OTP)
ASA-36-15-00023-A General Service Standards for Chemical Dependence Outpatient (CD-OP) and Opioid Treatment Programs (OTP)
12/9/15 N.Y. St. Reg. ASA-36-15-00023-A
NEW YORK STATE REGISTER
VOLUME XXXVII, ISSUE 49
December 09, 2015
RULE MAKING ACTIVITIES
OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
NOTICE OF ADOPTION
I.D No. ASA-36-15-00023-A
Filing No. 1004
Filing Date. Nov. 19, 2015
Effective Date. Nov. 20, 2015
General Service Standards for Chemical Dependence Outpatient (CD-OP) and Opioid Treatment Programs (OTP)
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Action taken:
Repeal of Part 822; and addition of new Part 822 to Title 14 NYCRR.
Statutory authority:
Mental Hygiene Law, sections 19.07(e), 19.09(b), 32.01 and 32.07(a)
Subject:
General Service Standards for Chemical Dependence Outpatient (CD-OP) and Opioid Treatment Programs (OTP).
Purpose:
Amend to accommodate Medicaid managed care and Medicaid redesign; phase out APGs; amendments to Part 800.
Substance of final rule:
The Proposed Rule Repeals Part 822 (Chemical Dependence Outpatient and Opioid Treatment Programs; effective July I, 2011) and Adds a New Part 822. The current Part 822 was substantially rewritten in 2011 to accommodate implementation of the Ambulatory Patient Group (APG) billing and reimbursement methodology. In addition that revision incorporated provisions related to opioid treatment programs, which are also outpatient treatment, from a previously separate and distinct Part 828. This current revision anticipates the "carve-in" of chemical dependence treatment services (now known as "substance use disorder services") and other behavioral health services into the Medicaid Managed Care system of service reimbursement.
Section 822.1 is a statement of background.
§ 822.2 sets forth the legal basis for regulatory action and other statutory authorizations required for medication assisted treatment.
§ 822.3 states the regulation'S applicability to chemical dependence outpatient programs (COOPs) and such outpatient programs known as opioid treatment programs (CD-OTPs).
§ 822.4 is a savings and renewals clause for purposes of a transition period for issuance of program operating certificates.
§ 822.5 sets forth definitions uniquely applicable to this Part. In conjunction with proposed concurrent amendments to 14 NYCRR Part 800, some definitions were removed to reduce page length and redundancy (i.e., "commissioner," "governing authority" or "sponsor," "Medical Director," "clinical staff," "peer advocate," "student intern," "prescribing professional"). Significant definitions unique to this Part include, for example: "accrediting body," "central registry system," "complex care coordination," "continuing care treatment," "intensive outpatient services," "opioid detoxification," and "opioid taper."
§ 822.6 sets forth minimum standards pertaining to Medicaid reimbursement (specific enumerated services are identified in 14 NYCRR Part 841) such as services which, by themselves, are not Medicaid reimbursable.
§ 822.7 details general program standards applicable to both CD-OPs and CD-OTPs or to a specific modality. These standards include requirements for policies and procedures, emergency medical kits on-site, utilization review, minimum required services, staffing, hours of operation, and optional services.
§ 822.8 relates to admission, initial services, transfers and readmission requirements for all programs and some requirements specific to CD-OPs or CD-OTPs. Requirements include preadmission testing, timing of a decision to admit, initial medications, patient orientation, documentation required for transfers or readmissions.
§ 822.9 relates to the development, documentation, implementation and periodic review of the patient-specific treatment/recovery plan; also indicates special requirements for pregnant patients required by federal block grant.
§ 822.10 relates to minimum requirements for preparation and maintenance of case records applicable to all programs. Standards include periodic review, discharge plans, document retention, transfers, patient deaths, and confidentiality.
§ 822.11 includes minimum standards for documentation of services including required signatures, content and date of service.
§ 822.12 relates to discharge planning including minimum criteria, timing of a required discharge summary, requirement for patient participation in the development of a discharge plan and special requirements for discharge of minors pursuant to mental hygiene law § 22.11.
§ 822.13 relates to a continuing care which is a service unique to CD-OPs. Continuing care requires a discharge from active treatment and subsequent admission to continuing care with limitations on the amount and types of services available to support continued recovery.
§ 822.14 regulates additional locations of a primary CD-OP location by restricting location in relation to the primary site, extent of services, and requirement for certification.
§ 822.15 identifies additional requirements for chemical dependence outpatient rehabilitation services in CD-OPs designated to provide such services. Special requirements relate to staffing, type and frequency of services, and meals.
§ 822.16 identifies additional standards unique to CD-OTPs including medication administration, regulation of take-home medications, voluntary and involuntary tapers, provisions for diversion control, and program participation in the central registry maintained by the Office to track patients receiving opioid treatment.
§ 822.17 is a standard severability clause.
Final rule as compared with last published rule:
Nonsubstantive changes were made in sections 822.5, 822.7(a), (g), 822.8(a), (b), 822.9(b), (c), 822.10(b), (f) and 822.13(b).
Text of rule and any required statements and analyses may be obtained from:
Sara Osborne, Associate Attorney, NYS Office of Alcoholism and Substance Abuse Services, 1450 Western Ave., Albany, NY 12203, (518) 485-2317, email: Sara.Osborne@oasas.ny.gov
Revised Regulatory Impact Statement
OASAS is not submitting a Revised Regulatory Impact Statement because amendments to the text of this rule subsequent to close of public comments do not constitute substantive amendments that would alter the purpose and substance of the rule as Proposed and Adopted by emergency and as published in the September 9, 2015 State Register.
Revised Regulatory Flexibility Analysis
OASAS is not submitting a Revised Regulatory Flexibility Analysis for Small Business and Local Governments because amendments to the text of this rule subsequent to close of public comments do not constitute substantive amendments that would alter the purpose and substance of the rule as Proposed and Adopted by emergency and as published in the September 9, 2015 State Register.
Revised Rural Area Flexibility Analysis
OASAS is not submitting a Revised Rural Area Flexibility Analysis because amendments to the text of this rule subsequent to close of public comments do not constitute substantive amendments that would alter the purpose and substance of the rule as Proposed and Adopted by emergency and as published in the September 9, 2015 State Register.
Revised Job Impact Statement
OASAS is not submitting a Revised Job Impact Statement because amendments to the text of this rule subsequent to close of public comments do not constitute substantive amendments that would alter the purpose and substance of the rule as Proposed and Adopted by emergency and as published in the September 9, 2015 State Register.
Initial Review of Rule
As a rule that requires a RFA, RAFA or JIS, this rule will be initially reviewed in the calendar year 2018, which is no later than the 3rd year after the year in which this rule is being adopted.
