6314

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6319

6320

6321

6322

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6325

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6330

LEVEL OF CARE 1: OPIOID TREATMENT PROGRAMS

6330.1 Opioid Treatment Programs (OTPs) provide MOUD and other treatment services for clients that meet diagnostic criteria for:

1. (a) Active moderate to severe opioid use disorder (OUD);
2. (b) Being in OUD remission; or
3. (c) Being at high risk for recurrence or overdose.

6330.2 MOUD are medications, including opioid agonist medications, approved by the FDA, for use in the treatment of OUD. OTPs shall not preclude clients who refuse SUD Counseling/Therapy from receiving MOUD. OTPs shall administer MOUD in accordance with 42 Code of Federal Regulations Part 8.

6330.3 OTPs shall obtain informed consent for MOUD treatment. OTPs shall present the client with information about the proposed medication, including its purpose, side effects, and potential risks and benefits, as well as information about feasible alternative treatments and other medications approved to treat OUD. OTPs shall document a client's written or verbal informed consent in the client's medical records.

6330.4 Minors may consent to MOUD at an OTP without parental or guardian consent or court authorization only under the following circumstances:

1. (a) If the parent or guardian is not available to consent, and the treating physician determines that the medication is medically necessary and the minor has the

capacity to give informed consent;

(b) If requiring parental or guardian consent would jeopardize the health or safety of the minor, and the treating physician determines the minor has the capacity to give informed consent and the medication is medically necessary; or

(c) If the parent or guardian refuses consent, and the treating physician determines the minor has the capacity to give informed consent and the medication is medically necessary. The OTP shall notify the parent or guardian in writing of the decision to administer the medication to the minor under this paragraph.

6330.5 OTPs may administer MOUD in an office, through a mobile unit, or as a take-home regimen. OTPs shall ensure that all MOUD administrations are documented in the medical record and include the unit of medication and therapeutic guidance. For clients receiving a take-home regimen, therapeutic guidance shall include guidance related to storage and self-administration.

6330.6 OTPs shall provide clinically appropriate treatment services tailored to each client's Plan of Care. OTPs shall provide an array of OUD treatment services that include:

(a) Diagnostic Assessment and Plan of Care in accordance with § 6339;

(b) MOUD in accordance with § 6346;

(c) SUD Counseling/Therapy in accordance with § 6342;

(d) CCC in accordance with § 6340;

(e) Drug Screening in accordance with § 6343 and including at least eight (8) random drug screens per year, per client;

(f) Crisis Intervention in accordance with § 6341; and

(g) RSS in accordance with § 6344.

6330.7 Providers shall have a physician, Physician Assistant (PA), Advanced Practice Registered Nurse (APRN), or Registered Nurse (RN) on duty during all clinic hours. A physician shall be available on-call during all clinic hours, if not present on site.

6330.8 An OTP shall provide a mechanism to address a client's medical or psychiatric emergencies occurring outside of program hours of operation, including an emergency system to obtain dosage levels and other pertinent client information, twenty-four (24) hours a day, seven (7) days a week. OTPs shall provide every client an identification card that identifies the pharmacotherapy being administered through the OTP. The card shall include the provider's emergency contact information so that appropriate clinical information and dosing information can be obtained in an emergency.

6330.9 OTPs shall ensure that each client undergoes a complete, fully documented physical and behavioral health evaluation within fourteen (14) calendar days following admission, and at least yearly thereafter and in accordance with the Plan of Care. Evaluations shall include:

(a) Screening for imminent risk of harm to self or others;

(b) Review of patient-identified goals, MOUD dosing, treatment response, and other SUD treatment needs;

(c) Assessment of the client's need for any necessary adjustments to treatment

interventions, including MOUD and other relevant physical and psychiatric treatment needs and goals; and

(d) Updates to client’s person-centered Plan of Care to incorporate recommendations from these assessments, as needed.

6330.10 OTPs shall address in the client’s Plan of Care the client’s needs and interests in harm reduction interventions, physical and mental health care, and health-related social supports, including education, vocational training, employment, housing, and other recovery support services. The OTP shall specify the recommended service frequency and update the Plan of Care to address the client’s progress, treatment response, and changes in their current life, needs, and interests in medical, psychological, and socio-economic services.

6330.11 An OTP shall provide counseling on preventing exposure to, and the transmission of, HIV for each client admitted or readmitted to the program.

SOURCE: Final Rulemaking published at 62 DCR 12056 (September 4, 2015); as amended by Final Rulemaking published at 67 DCR 011585 (October 9, 2020); as amended by Final Rulemaking published at 72 DCR 008497 (August 1, 2025).