| 14 | 13 | | A BILL TO BE ENTITLED 1 |
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| 15 | 14 | | AN ACT DIRECTING THE COMMISSION FOR MENTAL HEALTH, DEVELOPMENTAL 2 |
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| 16 | 15 | | DISABILITIES, AND SUBSTANCE USE SERVICES TO AMEND THE RULES 3 |
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| 17 | 16 | | REGARDING OUTPATIENT OPIOID TREATMENT PROGRAMS FOR GREATER 4 |
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| 18 | 17 | | CONSISTENCY WITH FEDERAL REGULATIONS. 5 |
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| 19 | 18 | | The General Assembly of North Carolina enacts: 6 |
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| 20 | 19 | | SECTION 1.(a) The Commission for Mental Health, Developmental Disabilities, 7 |
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| 21 | 20 | | and Substance Use Services (Commission) shall amend the rules applicable to outpatient opioid 8 |
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| 22 | 21 | | treatment programs (OTPs) in 10A NCAC 27G .3600 through 10A NCAC 27G .3605, to be more 9 |
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| 23 | 22 | | consistent with 42 C.F.R. Part 8 governing medications for the treatment of opioid use disorder. 10 |
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| 24 | 23 | | In amending these rules, the Commission shall make at least all of the following changes: 11 |
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| 25 | 24 | | (1) Remove stability of a patient's home environment and social relationships as 12 |
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| 26 | 25 | | an eligibility criterion for take-home medication. 13 |
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| 27 | 26 | | (2) Explicitly prohibit administrative discharge from treatment due to continued 14 |
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| 28 | 27 | | substance use, missed doses, and nonparticipation in ancillary services such 15 |
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| 29 | 28 | | as counseling. 16 |
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| 30 | 29 | | (3) Remove structured counseling schedules to better align with federal 17 |
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| 31 | 30 | | regulations that promote individualized care that is more patient-centered and 18 |
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| 32 | 31 | | flexible. 19 |
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| 33 | 32 | | (4) Reduce the number of required drug tests to align with the frequency required 20 |
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| 34 | 33 | | by federal regulations. 21 |
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| 35 | 34 | | (5) Remove the requirement for observed urine drug testing. 22 |
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| 36 | 35 | | (6) Explicitly permit OTPs to administer methadone to patients who are not 23 |
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| 37 | 36 | | enrolled with the OTPs as their patients. 24 |
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| 38 | 37 | | SECTION 1.(b) In determining whether to include any additional changes to the 25 |
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| 39 | 38 | | rules applicable to OTPs to achieve greater consistency with 42 C.F.R. Part 8, the Commission 26 |
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| 40 | 39 | | shall engage with current and former OTP clients and OTP providers for input on other changes 27 |
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| 41 | 40 | | that would serve the goal of improving access to patient-centered care and achieving better 28 |
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| 42 | 41 | | alignment with federal regulations. However, the Commission shall not amend the rules to 29 |
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| 43 | 42 | | include any input that is inconsistent with State or federal law. 30 |
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| 44 | 43 | | SECTION 1.(c) The Commission shall publish the proposed text of the amended 31 |
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| 45 | 44 | | rules applicable to OTPs by July 1, 2025. 32 |
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| 46 | 45 | | SECTION 2. This act is effective when it becomes law. 33 |
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