Pa. Code 715.6

Physician staffing

This regulation establishes physician staffing requirements for narcotic treatment programs (opioid treatment programs) in Pennsylvania. Operators must designate a qualified medical director with addiction medicine credentials or experience, and may hire an interim medical director under an approved training plan for up to 36 months. The rule specifies the responsibilities of both the medical director and narcotic treatment physicians, sets minimum onsite physician time (at least 1 hour per week per 10 patients), and permits physician assistants or certified registered nurse practitioners to perform certain physician functions subject to defined limits and countersignature requirements.

28 Pa. Code § 715.6 - Physician staffing 

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(a)
 A narcotic treatment program shall designate a medical director to assume responsibility for administering all medical services performed by the narcotic treatment program.
(1)
 A medical director shall be a physician and shall have obtained one of the following: 
(i)
 Three years documented experience in the provision of services to persons who are addicted to alcohol or other drugs, including at least 1 year of experience in the treatment of narcotic addiction with a narcotic drug.

(ii)
 Certification in addiction medicine by the American Society of Addiction Medicine.

(iii)
 A certificate of added qualifications in addiction psychiatry by the American Board of Psychiatry and Neurology, Inc.

(2)
 When a narcotic treatment program is unable to hire a medical director who meets the qualifications in paragraph (1), the narcotic treatment program may hire an interim medical director. The narcotic treatment program shall develop and submit to the Department for approval a training plan for the interim medical director, addressing the measures to be taken for the interim medical director to achieve minimal competencies and proficiencies until the interim medical director meets qualifications identified in paragraph (1)(i), (ii) or (iii). The interim medical director shall meet the qualifications within 36 months of being hired.

(3)
 The medical director's responsibilities include the following:
(i)
 Supervision of narcotic treatment physicians.

(ii)
 Supervision of licensed practical nurses if the narcotic treatment program does not employ a registered nurse to supervise the nursing staff. In addition, the medical director in these instances shall ensure that licensed practical nurses adhere to written protocols for dispensing and administration of medication.

(b)
 A narcotic treatment program may employ narcotic treatment physicians to assist the medical director. A narcotic treatment physician's responsibilities include: 
(1)
 Performing a medical history and physical exam.

(2)
 Determining diagnosis and determining narcotic dependence.

(3)
 Reviewing treatment plans.

(4)
 Determining dosage and all changes in doses.

(5)
 Ordering take-home privileges.

(6)
 Discussing cases with the treatment team.

(7)
 Issuing verbal orders pertaining to patient care.

(8)
 Assessing coexisting medical and psychiatric disorders.

(9)
 Treating or making appropriate referrals for treatment of these disorders.

(c)
 A narcotic treatment physician shall be otherwise available for consultation and verbal medication orders at all times when a narcotic treatment program is open and a narcotic treatment physician is not present.

(d)
 A narcotic treatment program shall provide narcotic treatment physician services at least 1 hour per week onsite for every ten patients.

(e)
 A physician assistant or certified registered nurse practitioner may perform functions of a narcotic treatment physician in a narcotic treatment program if authorized by Federal, State and local laws and regulations, and if these functions are delegated to the physician assistant or certified registered nurse practitioner by the medical director, and records are properly countersigned by the medical director or a narcotic treatment physician. One-third of all required narcotic treatment physician time shall be provided by a narcotic treatment physician. Time provided by a physician assistant or certified registered nurse practitioner may not exceed two-thirds of the required narcotic treatment physician time.

Notes

28
 Pa. Code §
 
715.6

This section cited in 28 Pa. Code §
 
701.1
 (relating to
 definitions).

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