1. 1. Pain management services are provided under the direction of:

   1. a. A physician; or
   2. b. A nurse practitioner licensed according to A.R.S. Title 32, Chapter 15 with advanced pain management certification from a nationally recognized accreditation or certification entity;
2. 2. A personnel member certified in cardiopulmonary resuscitation is available on the outpatient treatment center’s premise;

3. 3. If a controlled substance is used to provide pain management services:

   1. a. A medical practitioner discusses the risks and benefits of using a controlled substance with a patient;
   2. b. If the controlled substance is an opioid, the outpatient treatment center complies with the requirements in R9-10-2006; and

   3. c. The following information is included in a patient’s medical record:

      1. i. The patient’s history of substance use disorder,
      2. ii. Documentation of the discussion in subsection (3)(a),
      3. iii. The nature and intensity of the patient’s pain, and
      4. iv. The objectives used to determine whether the patient is being successfully treated; and

4. 4. If an injection or a nerve block is used to provide pain management services:

   1. a. Before the injection or nerve block is initially used on a patient, an evaluation of the patient is performed by a physician or nurse anesthetist;
   2. b. An injection or nerve block is administered by a physician or nurse anesthetist; and

   3. c. The following information is included in a patient’s medical record:

      1. i. The evaluation of the patient required in subsection (4)(a),
      2. ii. A record of the administration of the injection or nerve block, and
      3. iii. Any resuscitation measures taken; and
5. 5. An outpatient treatment center that meets the definition of a pain management clinic in A.R.S. § 36-448.01 and complies with 9 Article 20 of this Chapter.

A medical director of an outpatient treatment center that is authorized to provide pain management services shall ensure that:

Historical Note

Adopted as an emergency effective November 17, 1983, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 83-6). Former Section R9-10-1021 adopted as an emergency now adopted and amended as a permanent rule effective February 15, 1984 (Supp. 84-1). Repealed by summary action, interim effective date July 21, 1995 (Supp. 95-3). The proposed summary action repealing R9-10-1021 was remanded by the Governor’s Regulatory Review Council which revoked the interim effectiveness of the summary rule. The Section in effect before the proposed summary action has been restored (Supp. 97-1). Section repealed by final rulemaking at 5 A.A.R. 1222, effective April 5, 1999 (Supp. 99-2). New Section made by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, pursuant to Laws 2013, Ch. 10, § 13; effective July 1, 2014 (Supp. 14-2). Amended by final rulemaking at 24 A.A.R. 3020, effective January 1, 2019 (Supp. 18-4).