New Mexico Register / Volume
XXXVII, Issue 9 / May 5, 2026
TITLE 8 SOCIAL
SERVICES
CHAPTER 321 SPECIALIZED BEHAVIORAL HEALTH SERVICES
PART 10 OPIOID TREATMENT PROGRAMS
8.321.10.1 ISSUING AGENCY: New
Mexico Health Care Authority (HCA).
[8.321.10.1 NMAC - Rp, 8.321.10.1 NMAC 5/5/2026]
8.321.10.2 SCOPE: This rule is applicable to opioid treatment
programs. These regulations are not
intended to preempt county or municipal ordinances that supplement and do not
conflict with these regulations. County
and municipal ordinances are preempted when they conflict with these
regulations.
[8.321.10.2 NMAC - Rp, 8.321.10.2 NMAC 5/5/2026]
8.321.10.3 STATUTORY AUTHORITY: Section
9-8-1 et seq. NMSA 1978 establishes the
health care authority (authority) as a single, unified department to administer
laws and exercise functions relating to health care facility licensure and
health care purchasing and regulation.
[8.321.10.3 NMAC - Rp,
8.321.10.3 NMAC 5/5/2026]
8.321.10.4 DURATION: Permanent.
[8.321.10.4 NMAC – Rp, 8.321.10.4 NMAC 5/5/2026]
8.321.10.5 EFFECTIVE DATE: April 21, 2026,
unless a later date is cited at the end of a section.
[8.321.10.5 NMAC - Rp, 8.321.10.5 NMAC 5/5/2026]
8.321.10.6 OBJECTIVE: This
rule establishes standards for opioid treatment programs, in their provision of
methadone treatment services, to be consistent with the SAMHSA/CSAT regulations
and the OTP accreditation requirements of nationally recognized accreditation
bodies approved by SAMHSA/CSAT, such as CARF and TJC. The intent is to:
A. be
consistent with, and complimentary to, the substance abuse and mental health
services administration/center for substance abuse treatment (SAMHSA/CSAT)
regulations, and the OTP accreditation requirements of nationally recognized
accreditation bodies approved by SAMHSA/CSAT, such as commission on
accreditation of rehabilitation facilities (CARF) and the joint commission
(TJC);
B. reduce
the stigma sometimes associated with opioid use disorder treatment and ensure
access to it comparable to treatment availability for other chronic medical
conditions;
C. consider the possible adverse impact
on communities in which OTP providers are located in making application
approval decisions, and to provide measures to promote mutually satisfactory
relationships between OTP providers and their communities.
[8.321.10.6 NMAC - Rp, 8.321.10.6 NMAC 5/5/2026]
8.321.10.7
DEFINITIONS:
A. Definitions beginning with “A”:
(1) “Accrediting bodies” means nationally recognized organizations, such as
the joint commission (TJC) and the commission on accreditation of
rehabilitation facilities (CARF), which promulgate standards for OTPs that are
approved by the substance abuse and mental health services
administration/center for substance abuse treatment (SAMHSA/CSAT), and offer
accreditation to programs that meet these standards.
(2) “Administrative discharge” means the procedure for withdrawal of a patient’s
methadone coinciding with the patient’s involuntary discharge from methadone
treatment services as a result of, violent or disruptive behavior or
incarceration or other confinement.
(3) “Application form” means the form created by the health care authority,
which must be completed by a program sponsor who wishes to obtain approval to
operate an methadone treatment program.
(4) “Approval” and “approval to operate” means the written permission given by the health care
authority to a program sponsor to operate an opioid treatment program.
B Definitions beginning with “B”: “Behavioral health services division”
(BHSD) is the division of the New Mexico health care authority that is the
single state authority for mental health and substance use treatment and
prevention programs and methadone authority.
C. Definitions beginning with “C”: [RESERVED]
D. Definitions beginning with “D”:
(1) “Dispense” has the same meaning as in Subsection I of Section
61-11-2 NMSA 1978 as amended or renumbered.
(2) “Diversion” means the unauthorized transfer of an opioid agonist
treatment medication, such as a street sale.
(3) “Dosage” means the amount, frequency and number of doses of
methadone for an individual.
(4) “Dose” means a single unit of methadone.
E. Definitions beginning with “E”: [RESERVED]
F. Definitions beginning with “F”: [RESERVED]
G. Definitions beginning with “G”: [RESERVED]
H. Definitions beginning with “H”: “Harm
reduction”:
(1) Refers
to practical, evidence-based strategies, including overdose education; testing
and intervention for infectious diseases, including counseling and risk
mitigation activities forming part of a comprehensive, integrated approach to
address HIV, viral hepatitis, sexually transmitted infections, and bacterial
and fungal infections; distribution of opioid overdose reversal medications;
linkage to other public health services; and connecting those who have
expressed interest in additional support-to-peer services (see 42 CFR § 8.2).
(2) This definition refers to SAMHSA’s
definition of harm reduction as “a practical and transformative approach that
incorporates community driven public health strategies including prevention,
risk reduction, and health promotion to empower people who use drugs (PWUD) and
their families with the choice to live healthier, self-directed, and
purpose-filled lives.
(3) Harm reduction centers the lived and
living experience of PWUD, especially those in underserved communities, in
these strategies and the practices that flow from them.”
I. Definitions beginning with “I”:
(1) “In-take assessment” means the collection and analysis of a patient’s preliminary
social, medical, psychological and treatment history which results in a
patient-centered intake treatment plan of care with the most appropriate
combination of services and treatment,
This must be completed within 24 hours of admission.
(2) “Illicit opioid drug” means an illegally obtained opioid drug, such as
heroin, that causes dependence and reduces or destroys an individual’s
physical, social, occupational, or educational functioning, or misuse of
legally prescribed medication.
(3) “Intake screening” means determining whether an individual meets the
initial criteria for receiving methadone treatment.
J. Definitions beginning with “J”: [RESERVED]
K. Definitions beginning with “K”: [RESERVED]
L. Definitions beginning with “L”: [RESERVED]
M. Definitions beginning with “M”:
(1) “Methadone Continuous Medication
Treatment program” means a program
designed with the intention of lasting longer than six months, for the purpose
of maintaining the patient such that they will be free of opioid withdrawal and
cravings; such programs are typified by:
(a) dispensing or administering methadone
at stable dosage levels for a period in excess of 21 days to an individual for
opioid use disorder; and
(b) providing medical, therapeutic and
supportive services to the individual with opioid use disorder.
(2) “Medical practitioner” means an individual who:
(a) has been accredited through
appropriate national procedures as a health professional;
(b) fulfills the national requirements on
training and experience for prescribing procedures;
(c) is a registrant or a licensee, or a
worker who has been designated by a registered or licensed employer for the
purpose of prescribing procedures;
(d) may be a physician, physician’s
assistant, registered nurse, nurse practitioner, or licensed practical nurse.
(3) “Medication for opioid use disorder
(MOUD)” means medications, including opioid agonist medications, approved
by the food and drug administration under section 505 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 355)
for use in the treatment of OUD.
N. Definitions beginning with “N”: [RESERVED]
O. Definitions beginning with “O”:
(1) “Opioid treatment”, for the terms of this rule, means:
(a) methadone treatment withdrawal
procedure; and
(b) methadone continuous medication
treatment.
(2) “Opioid treatment medication” means a prescription medication that is approved by
the U.S. food and drug administration
under 21 U.S.C. section 355 and by the code of federal regulations title 42,
part 8.12 for use in the treatment of opioid use disorder.
(3) “Opioid treatment program” (OTP), for the terms of this rule, means a single
location (may include approved medication units operating under the certified
and licensed OTP) at which opioid use disorder treatment with methadone and
rehabilitative services, are provided to patients as a substantial part of the
activity conducted on the premises.
(4) “Opioid treatment withdrawal
procedure” is dispensing or
administering methadone treatment medication in decreasing medication levels to
an individual to alleviate adverse physical or psychological effects of
withdrawal from the continuous or sustained use of an opioid drug.
P. Definitions beginning with “P”: [RESERVED]
(1) “Physiologically dependent” means physically addicted to an opioid drug, as
manifested by the symptoms of withdrawal in the absence of the opioid drug.
(2) “Program clinician” means a behavioral health clinician practicing at an
opioid treatment program who is licensed to practice substance use disorder
treatment in New Mexico.
(3) “Program medical director” means a physician licensed to practice medicine in New
Mexico, who assumes responsibility for administering all medical services,
either by performing them directly or by delegating specific responsibility to
authorized program medical practitioners functioning under the medical
director’s direct supervision.
(4) “Program sponsor” means the person named in the application as
responsible for the operation of the opioid treatment program and who
assumes responsibility directly, by personal oversight, or through policy and
procedure, or a combination of both, for the acts and omissions of staff
members or employees of the opioid treatment program.
(5) “Psycho-social diagnostic assessment” means the collection and
analysis
of a patient’s psychological, social
and treatment history to include preparation of a care plan that identifies the
patient’s goals and mutually agreed-upon actions for the patient to meet those
goals, including harm reduction interventions; the patient’s needs and goals in
the areas of education, vocational training, and employment; and the medical
and psychiatric, psychosocial, economic, legal, housing, and other recovery
support services that a patient needs and wishes to pursue. The care plan also must identify the
recommended frequency with which services are to be provided. This must be completed within 14 days of
admission.
Q. Definitions beginning with “Q”: [RESERVED]
R. Definitions beginning with “R”: [RESERVED]
S. Definitions beginning with “S”:
(1) “Short-term opioid
treatment withdrawal procedure” means a treatment program designed to
dispense methadone treatment medication to a patient in decreasing doses, over
a continuous period of 30 days or less.
(2) “State opioid treatment authority,” (SOTA) means the single state agency for substance use
disorder designated by the governor or another appropriate official designated
by the governor to exercise authority within the state for governing treatment
of opioid use disorder with methadone.
In New Mexico it is within the health care authority, behavioral health
services division.
T. Definitions beginning with T”: Take-home medication” means one or more doses of a methadone treatment
medication dispensed to a patient for use off the premises of the OTP or
medication unit.
U. Definitions beginning with “U”: [RESERVED]
V. Definitions beginning with “V”: [RESERVED]
W. Definitions beginning with “W”: [RESERVED]
X. Definitions beginning with “X”: [RESERVED]
Y. Definitions beginning with “Y”: [RESERVED]
Z. Definitions beginning with “Z”: [RESERVED]
[8.321.10.7
NMAC - Rp, 8.321.10.7 NMAC 5/5/2026]
8.321.10.8 APPROVAL TO OPERATE AN OPIOID
TREATMENT PROGRAM REQUIRED:
Providers who receive written approval by the health
care authority, shall be permitted to provide opioid use disorder treatment
services with methadone.
[8.321.10.8 NMAC - Rp, 8.321.10.8 NMAC 5/5/2026]
8.321.10.9 ELIGIBILITY FOR APPROVAL TO OPERATE
AN OPIOID TREATMENT PROGRAM:
Only applicants who possess all of the following shall
be eligible to receive approval to operate from the New Mexico health care
authority (HCA):
A. Drug enforcement agency (DEA)
approval to operate an OTP;
B. SAMHSA/CSAT approval to operate an OTP;
C. Accreditation by a SAMHSA/CSAT-approved nationally
recognized accreditation body, such as TJC or CARF, to operate an OTP:
(1) if the applicant is a start-up program
unable to obtain such accreditation prior to beginning operation because the
accreditation body requires a period of program operation, typically six
months, before it will grant accreditation:
(2) the HCA shall grant provisional
approval to operate pending accreditation, provided that all other requirements
of these regulations are met; and
(3) the program demonstrates in its
application to the HCA that it is taking the steps necessary to become
accredited as quickly as possible, and provides a timeline for the anticipated
accreditation;
(4) during this interim period, the
provisional approval to operate is contingent on the ongoing progress of the
program, as determined by the HCA, to obtain accreditation within the timeline
contained in the application; the program shall immediately inform the HCA of
anything that will delay or prevent accreditation according to that timeline;
(5) the HCA shall withdraw its provisional
approval if it concludes that accreditation will not be forthcoming; in any
event, the program shall obtain accreditation within 12 months of beginning
operation, or the provisional approval shall be withdrawn, unless the HCA
elects to extend the provisional approval period after consultation with the
appropriate federal and accrediting entities.
D. A license from the New Mexico state
board of pharmacy to operate an OTP;
E. Other permits and licenses such as a
business license from the applicant’s local governmental entity, as required by
local ordinances;
F. Evidence of appropriate liability
insurance coverage for the program and its employees.
[8.321.10.9 NMAC - Rp, 8.321.10.9 NMAC 5/5/2026]
8.321.10.10 APPLICATION FOR APPROVAL TO OPERATE AN
OPIOID TREATMENT PROGRAM:
A. Each OTP sponsor applicant shall
submit to the HCA an application for approval to operate a methadone treatment
program, to include a detailed policy and procedure cross walk with state
regulations, using the forms provided by the HCA. The application shall be in addition to the
application for approval to drug enforcement agency, SAMHSA/CSAT, the NM board
of pharmacy, local government, etc.
B. The HCA shall approve or deny the
application within 45 working days of submission, unless the HCA and applicant
mutually agree to extend the application review period.
C. The HCA may require the applicant to
provide additional written or verbal information in order to reach its decision
to grant or deny approval. Such further
information shall be considered an integral part of the application.
D. Approval shall be for a duration of
three years, except as otherwise provided below for initial grandfathered
approvals.
E. The HCA shall not grant approval to
operate an OTP to any program sponsor who has been convicted of any crime
related to controlled substances laws or any felony within the last five
years. No person who has been convicted
of any felony in the last five years shall be employed by the OTP in any
capacity that gives that person access to controlled medications.
F. The HCA shall not grant approval to
any entity that poses a risk to the health and safety of the public based on a
history of noncompliance with state and federal regulations as verified by the
DEA, New Mexico state board of pharmacy, FDA, SAMHSA approved accreditation
bodies, or the state licensure agency in any state in which the program sponsor
currently operates.
G. The HCA may deny approval if there is
a documented history of repeated and serious negative neighborhood impact with
respect to other OTP programs currently operated by the program sponsor or by
any corporation, LLC or partnership with whom the program sponsor has been
associated in the past five years.
H. As a condition of approval to operate
an OTP, the OTP must maintain or obtain accreditation with a
SAMHSA/CSAT-approved nationally recognized accreditation body, (e.g. CARF or TJC.). In the event that such accreditation lapses,
or approval of an application for accreditation becomes doubtful, or continued
accreditation is subject to any formal or informal finding of need for
improvement, the OTP program will notify the HCA within two business days of
such event. The OTP program will furnish
the HCA with all information related to its accreditation status, or the status
of its application for accreditation, upon request.
I. The HCA shall perform on-site
inspection of the proposed OTP facility as part of the review and approval
process.
J. In the event of change of ownership
of an approved opioid treatment program, the HCA approval is not transferable;
the new ownership must institute an application for approval as a new program,
in accordance with these regulations.
[8.321.10.10 NMAC - Rp, 8.321.10.10 NMAC 5/5/2026]
8.321.10.11 DENIAL OF HCA APPROVAL TO OPERATE;
APPEAL OF DENIAL:
A. The HCA shall not deny approval to
operate until the applicant has been notified in writing of the deficiency in
the application resulting in the contemplated denial and given opportunity to
remedy the application deficiency within a specified time period.
B. The HCA shall provide a written
explanation for any denied application.
Denial may be appealed to the secretary of the HCA, whose decision shall
be final.
C. An applicant who is denied approval
may re-apply by submitting a new application 90 days or more after notification
of denial.
D. Failure to complete the application
form in its entirety, including requests for additional information as
specified above, shall be grounds for denial of approval.
[8.321.10.11 NMAC - Rp, 8.321.10.11 NMAC 5/5/2026]
8.321.10.12 RENEWAL OF HCA APPROVAL TO OPERATE:
A. OTP providers who wish to renew their
approval shall submit an application form and requested documentation no less
than 90 calendar days, and no more than 180 calendar days, before its
expiration date.
B. The HCA shall consider the operating
history of the OTP provider in making its determination to grant or deny an
application to a previously approved provider.
[8.321.10.12 NMAC - Rp, 8.321.10.12 NMAC 5/5/2026]
8.321.10.13 APPROVAL FOR OTPS IN EXISTENCE PRIOR
TO THESE REGULATIONS: Opioid treatment programs operating in New Mexico
prior to the effective date of these regulations shall be granted approval on
the effective date of these regulations (“grandfathered in”).
A. The term of these initial grandfathered
approvals shall be not less than 24 months nor more than 36 months and may have
staggered expiration dates to avoid simultaneous expiration.
B. “Grandfathered” opioid treatment
programs shall provide the HCA with all written policies, procedures and other
documentation required of new opioid treatment programs under these regulations
within 90 days of the effective date of these regulations.
[8.321.10.13 NMAC - Rp, 8.321.10.13 NMAC 5/5/2026]
8.321.10.14 RENEWAL OF GRANDFATHERED OPERATING
PERMITS: Renewal of grandfathered approvals shall
follow the ordinary renewal process.
Such approvals shall have a term of 36 months.
[8.321.10.14 NMAC - Rp, 8.321.10.14 NMAC 5/5/2026]
8.321.10.15 INSPECTION AUTHORITY: The
HCA shall have the authority to conduct inspections of the records, policies,
procedures, physical plant or any other aspect of an OTP for the purpose of
determining its compliance with these regulations or the presence of any factor
posing a danger to the health or welfare of its patients or the public. Failure of an OTP to cooperate with such
inspection shall be grounds for immediate suspension of the approval.
[8.321.10.15 NMAC - Rp, 8.321.10.15 NMAC 5/5/2026]
8.321.10.16 NONCOMPLIANCE WITH REGULATIONS:
A. If an inspection conducted by the HCA
shows that an OTP is not in compliance with these regulations, the HCA shall
deliver to the program a written notice of the deficiencies identified.
B. The program shall respond to the notification
of deficiencies within 30 days of the notification. The program response shall include a
corrective action plan together with timeline for implementation, or an
explanation, satisfactory to the HCA, of the reason for any deviations from the
requirements of these regulations.
C. Failure of the OTP to respond within
30 days of receipt of the notification of deficiencies shall be grounds for
immediate suspension of the approval.
[8.321.10.16 NMAC - Rp, 8.321.10.16 NMAC 5/5/2026]
8.321.10.17 IMMEDIATE SUSPENSION OF OTP OPERATING
APPROVAL:
A. The HCA, at its discretion, may
immediately suspend the approval of any OTP found to be in a substantial
violation of this regulation that results in danger to the health and welfare
of any patient or of the public, until such time as the violation(s) are
corrected to the satisfaction of the HCA.
B. In the event of such suspension, the
OTP shall immediately:
(1) cease accepting new patients; and
(2) consult with the HCA regarding the
orderly transfer of patients to other OTPs and implementation of the program
closure action plan required under the “preparedness planning” section of these
regulations in order to minimize adverse impact on its patients;
notwithstanding the suspension of the approval, the HCA may allow the OTP to
conduct limited operations of its program as the HCA finds necessary to
minimize adverse impact on patients.
[8.321.10.17 NMAC - Rp, 8.321.10.17 NMAC 5/5/2026]
8.321.10.18 MEDICATION
UNITS:
A. Medication units are
defined to include either a ‘brick and mortar location or a mobile unit,
through which OTPs can provide patients with access to medication (or other
services, as identified) in their home community without establishing a new
clinic. Medication Units function as an
extension of the home clinic so a new clinic application is not required.
B. Application for Approval
of Medication Unit(s):
(1) Interested registered OTP applicants shall submit the
following to the BHSD for approval to add a medication unit to their existing
registration:
(a) a
written letter of intent that demonstrates how this service will increase
access to methadone in rural or difficult to reach communities and avoid
duplication with other OTP services;
(b) standard
operating policy and procedure;
(c) commitment
to obtaining approval from the drug enforcement administration;
(d) commitment
to obtaining approval from the NM board of pharmacy; and
(e) application
to SAMHSA/CSAT following BHSD approval.
(2) BHSD shall approve or deny the application within 30
working days of submission, unless the BHSD and applicant mutually agree to
extend the application review period.
(3) BHSD may require the applicant to provide additional
written or verbal information in order to reach its decision. Such further information shall be considered
an integral part of the application and may extend the application review
period.
(4) the following
services may be provided where space allows for quality patient care in mobile
medication units, assuming compliance with all applicable federal, state, and
local law:
(a) administering and dispensing
medications for opioid use disorder treatment;
(b) collecting samples for drug testing or
analysis;
(c) dispensing of take-home medications;
(d) in units that provide appropriate
privacy and adequate space, intake/initial psychosocial and appropriate medical
assessments (with a full physical examination to be completed or provided
within 14-days of admission);
(e) initiation of methadone or
buprenorphine after an appropriate medical assessment (screening) has been
performed;
(f) in units that provide appropriate
privacy and have adequate space, other OTP services, such as counseling, may be
provided directly or when permissible through use of telehealth services.
(5) any required services not provided in mobile and
non-mobile medication units must be conducted at the OTP, including medical,
counseling, vocational, educational, and other assessment, and treatment
services (42 CFR 8.12(f)(1)).
(6) Medication Unit approved for
operation must be reviewed and renewed by NM SOTA at three-year intervals (as
is the case with OTPs).
[8.321.10.18 NMAC - N, 5/5/2026]
8.321.10.19 ADMINISTRATION: The
program sponsor shall ensure that:
A. A physician licensed to practice in
New Mexico is designated to serve as medical director and to have authority
over all medical aspects of opioid treatment.
B. The medical director is responsible
for ensuring that the OTP is in compliance with all applicable federal, state
and local laws and regulations.
C. A healthcare practitioner with
prescribing authority may provide medical services as the medical director’s
designee.
D. The OTP shall be open for patients
every day of the week except for federal and state holidays, and Sundays, and
be closed only as allowed in advance in writing by CSAT and the state opioid
treatment authority (SOTA).
E. Written
policies and procedures are developed, implemented, complied with and
maintained at the OTP and include:
(1) procedures to prevent a patient from
receiving opioid use disorder treatment from more than one agency or physician
concurrently;
(2) procedures to meet the unique needs of
diverse populations, such as pregnant women, children, individuals with
communicable diseases, (e.g. hepatitis
C, tuberculosis, HIV or AIDS), or individuals involved in the criminal justice
system;
(3) procedures for conducting a physical
examination, assessment and laboratory tests;
(4) procedures for establishing substance
use disorder counselor caseloads, based on the intensity and duration of
counseling mutually agreed upon between the patient and their respective
clinician;
(5) criteria for when the patient’s blood
serum levels should be tested and procedures for having the test performed;
(6) procedures for performing laboratory
tests, such as urine drug screens or toxicological
tests, including procedures for collecting specimens
for testing;
(7) procedures for addressing and managing
a patient’s concurrent use of alcohol or other drugs;
(8) procedures for providing take-home
medication to patients;
(9) procedures for conducting methadone
treatment withdrawal;
(10) procedures for conducting an
administrative discharge:
(11) procedures for referrals for clients
with symptoms of mental illness or a medical condition and those requesting
assistance to manage symptoms;
(12) procedures for voluntary discharge,
including that a patient discharged voluntarily be provided or offered
follow-up services, such as counseling or a referral for medical treatment.
(13) procedures for making temporary or
permanent transfer of a patient from the OTP to another OTP;
(14) procedures for receiving the temporary
or permanent transfer of a patient from another OTP to the OTP;
(15) procedures to minimize the following
adverse events:
(a) a patient’s loss of ability to
function;
(b) a medication error;
(c) harm to a patient’s family member or
another individual resulting from ingesting a patient’s medication;
(d) sales of illegal drugs on the
premises;
(e) diversion of a patient’s medication;
(f) harassment or abuse of a patient by a
staff member or another patient; and
(g) violence on the premises.
(16) procedures to respond to an adverse
event, including:
a
requirement that the program sponsor immediately investigate the adverse event
and the surrounding circumstances;
(a) a requirement that the program sponsor
develop and implement a plan of action to prevent a similar adverse event from
occurring in the future; monitor the action taken; and take additional action,
as necessary, to prevent a similar adverse event;
(b) a requirement that action taken under
the plan of action be documented; and
(c) a requirement that the documentation
be maintained at the agency for at least two years after the date of the
adverse event; and
(d) a requirement that the program sponsor
file a Critical Incident Report (CIR), following CIR reporting protocol, as
well as behavioral health services division and managed care organization
protocol.
(17) procedures for infection control;
(18) criteria for determining the amount and
frequency of counseling that is offered to a patient;
(19) procedures to ensure that the facility’s
physical appearance is clean and orderly;
(20) a process for resolution of patient
complaints, including a provision that complaints which cannot be resolved
through the clinic’s process may be referred to by either party to the HCA:
(a) the complaint process shall be
explained to the patient at admission;
(b) the patient complaint process shall be
posted prominently in its waiting area or other location where it will be
easily seen by patients and include the HCA contact information for use in the
event that the complaint cannot be resolved through the clinic’s process.
F. A written
quality assurance plan is developed and implemented.
G. All information and instructions for the patient are
provided in the patient’s primary language, and, when provided in writing, are
clear and easily understandable by the patient.
[8.321.10.19 NMAC - Rp, 8.321.10.18 NMAC 5/5/2026]
8.321.10.20 ADMISSION:
A. The
program sponsor shall ensure through policy and procedure that an individual is
only admitted for opioid use disorder treatment with methadone after the
program medical director or other qualified healthcare practitioner conducts
the following:
(1) a screening examination to ensure that
the patient meets the definition of opioid use disorder using generally
accepted medical criteria such as those contained in the diagnostic and
statistical manual for mental disorders (DSM-IV or subsequent editions);
(2) the screening examination may be
conducted by a non-OTP practitioner. If
the licensed practitioner is not an OTP practitioner;
(3) the screening examination must be
completed no more than seven days prior to OTP admission.
(a) assuming no contraindications, a
patient may commence methadone medication treatment after the screening
examination has been completed:
(b) a full history and physical
examination (as described by Subsection C of NMAC 8.321.10.20) to determine the
patient's broader health status, with lab testing as determined to be required
by an appropriately licensed practitioner within the first 14 days following
admission;
(c) a patient's refusal to undergo lab
testing for co-occurring physical health conditions should not preclude them
from access to methadone treatment, provided such refusal does not have
potential to negatively impact treatment with medications.
(4) the screening examination and full
physical examination may be completed via telehealth for those patients being
admitted for methadone treatment if the medical director or health care
practitioner designee determines that an adequate evaluation of the patient can
be accomplished via telehealth;
(5) when using telehealth, the following
caveats apply:
(a) in evaluating patients for treatment
with methadone, audio-visual telehealth platforms must be used, except when not
available to the patient. When not
available, it is acceptable to use audio-only devices, but only when the
patient is in the presence of a licensed practitioner who is registered to
prescribe (including dispense) controlled medications. The OTP practitioner shall review the
examination results and order treatment medications as indicated.
(b) in evaluating patients for treatment
with schedule III medications (such as Buprenorphine) or medications not
classified as a controlled medication (such as Naltrexone), audio-visual or
audio only platforms may be used. The
OTP practitioner shall review the examination results and order treatment
medications as indicated.
B. The full physical exam can be
completed by a non-OTP practitioner, if the exam is verified by a licensed OTP
practitioner as being true and accurate and transmitted in accordance with
applicable privacy laws.
C. The
OTP shall ensure that each patient at the time of admission:
(1) provides written, voluntary,
program-specific informed consent to treatment;
(2) informed consent for persons under the
age of 18: NM state law does not grant
persons under 18 years of age the ability to consent to OTP treatment without
the consent of another, including parent or legal guardian.
(3) as such, no person under 18 years of
age may be admitted to OTP treatment unless a parent, legal guardian, or
responsible adult designated by the relevant state authority consents in
writing (electronically or hard copy) to such treatment.
(4) is informed of all services that are
available to the patient through the program and of all policies and procedures
that impact the patient’s treatment; and is informed of the following:
(a) the progression of opioid use disorder
and the patient’s apparent stage of opioid use disorder;
(b) the goals and benefits of opioid use
disorder treatment;
(c) the signs and symptoms of overdose and
when to seek emergency assistance;
(d) the characteristics of opioid use
disorder treatment medication, such as its effects and common side effects, the
dangers of exceeding the prescribed dose, and potential interaction effects
with other drugs, such as other non-opioid agonist treatment medications,
prescription medications, and illicit drugs;
(e) the requirement for a staff member to
report suspected or alleged abuse or neglect of a child or an incapacitated or
vulnerable adult according to state law;
(f) the requirement for a staff member to
comply with the confidentiality requirements of title 42 CFR part 2 of the code
of federal regulations, incorporated by reference;
(g) drug screening and toxicological
testing procedures;
(h) requirements to receive take-home
medication;
(i) testing and treatment available for
HIV and other communicable diseases, the availability of immunization for
hepatitis A and B, and the availability of harm reduction services;
(j) availability of counseling on
preventing exposure to and transmission of human immunodeficiency virus (HIV),
sexually transmitted diseases, and blood-born pathogens;
(k) the patient’s right to file a
complaint with the program for any reason, including involuntary discharge, and
to have the patient’s complaint handled in a fair and timely manner;
(l) the patient’s access to methadone
medication will not be contingent upon the patient’s engagement in counseling
services.
D. A
program sponsor shall ensure that the program medical director or medical
practitioner designee (or other non-OTP physician or healthcare practitioner)
conducts a complete, fully documented physical examination of an individual who
requests admission to the program, within 14 days of admission to the program.
The physical examination includes:
(1) reviewing the individual’s bodily
systems;
(2) obtaining a medical and family history
and documentation of current information to determine chronic or acute medical
conditions such as diabetes, renal diseases, hepatitis, HIV infection,
tuberculosis, sexually transmitted disease, pregnancy or cardiovascular
disease;
(3) obtaining a history of behavioral
health issues and treatment, including any diagnoses and medications;
(4) initiating the following laboratory
tests:
a tuberculosis test
in accordance with the most current CDC guidelines;
(a) a syphilis test in accordance with the most current CDC guidelines;
(b) hepatitis
screening in accordance with the most current CDC guidelines; and
(c) a laboratory drug detection test for
at least opioids, methadone, amphetamines, cocaine, barbiturates,
benzodiazepines and other substances as may be appropriate, based upon patient
history and prevailing patterns of availability and use in the local area;
(5) recommending additional tests based
upon the individual’s history and physical condition, such as:
(a) complete blood count;
(b) EKG, chest X-ray, pap smear or
screening for sickle cell disease;
(c) HIV testing.
(6) the full medical examination including
test results must be completed within 14 days of admission to the program;
(7) a patient re-admitted within three
months after discharge does not require a repeat physical examination unless
requested by the program medical director.
E. A program
sponsor shall ensure that the results of a patient’s physical examination are
documented in the patient record.
F. A
patient may not be enrolled in more than one OTP program except under
exceptional circumstances, such as residence in one city and employment that
requires extended absences from that city, which must be documented in the
patient chart by the medical directors of both programs:
(1) an OTP shall make and document good
faith efforts to determine that a patient seeking admission is not receiving
opioid use disorder treatment medication from any other source, within the
bounds of all applicable patient confidentiality laws and regulations;
(2) the OTP shall confirm that the patient
is not receiving treatment from any other OTP in the state, as provided in
Subsection F of 8.321.10.19 NMAC,
G. The
HCA has established an internet-based central OTP registry (NM STAR) of all
persons in New Mexico who are current patients of a New Mexico OTP program, for
the purpose of preventing patients from receiving medication from more than one
OTP. Each OTP, as a condition of
approval to operate, shall participate in the central registry as directed by
the HCA, ensuring that all patient records are uploaded to NM STAR within 24
hours of dose provision.
H. Guest
dosing is an essential service of OTPs and a critical tool in ensuring
medication continuity for patients during periods of disruptions or temporary
changes in residence. Program Sponsor
shall ensure that policies and procedures regarding courtesy dosing are
developed and implemented. The policies
shall address situations in which the OTP is requesting courtesy dosing for a
client and when it is providing courtesy dosing. Policies shall be based on best practice
standards and reflect minimum administrative burden for the patient. Policies shall address verification of client
identify, verification of dose and medication, documentation of medication
administration.
(1) OTPs should not automatically turn
away patients requesting guest dosing without advanced notice; and
(2) OTPs should make every reasonable
effort to maintain the patient's current dose.
If a change is required, the OTP should consult with the home OTP and
the patient regarding this change.
[8.321.10.20 NMAC - Rp, 8.321.10.19 NMAC 5/5/2026]
8.321.10.21 ASSESSMENT AND TREATMENT PLANS: The
program sponsor shall ensure that:
A. Each
patient receives an intake assessment within 24 hours of admission, conducted
by a qualified professional, to determine a patient-centered intake treatment
plan of care with the most appropriate combination of services and treatment.
B. The
full psychosocial diagnostic assessment must be completed by a qualified
professional within 14 calendar days of admission and include preparation of a
care plan that includes the patient’s goals and mutually agreed-upon actions
for the patient to meet those goals, including harm reduction interventions;
the patient’s needs and goals in the areas of education, vocational training,
and employment; and the medical and psychiatric, psychosocial, economic, legal,
housing, and other recovery support services that a patient needs and wishes to
pursue. The care plan also must identify
the recommended frequency with which services are to be provided.
C. An
individualized treatment plan shall replace the intake treatment plan within 30
days of admission and be documented in the patient record;
D. The
individualized treatment plan must be reviewed and updated to reflect responses
to treatment and recovery support services, and adjustments made that reflect
changes in the context of the person’s life, their current needs for and
interests in medical, psychiatric, social, and psychological services, and
current needs for and interests in education, vocational training, and
employment services.
E. All
updates or revisions to any treatment plan or assessment shall be documented in
the patient record within seven working days;
F. All
assessments and treatment plans shall reflect shared decision-making between
the patient and health care practitioner or counselor and patient-centered
care, to include but not necessarily be limited to:
a description of the patient’s presenting issue,
identification of the patient’s behavioral health symptoms and the behavioral
health issue or issues that require treatment;
(1) a list of the medical services,
including medication, needed by the patient, as identified in the physical
examination;
(2) recommendations for further assessment
or examination of the patient’s needs if indicated;
(3) recommendations for treatment needed
by the patient, such as psychosocial counseling (though the patient’s access to
methadone medication will not be contingent upon their engagement in
psychosocial counseling) or mental health treatment, if indicated;
(4) recommendations for ancillary services
or other services needed by the patient, if indicated;
(5) the signature, professional
credential, printed name, and date signed of the staff member conducting and
developing the assessment, treatment plan, update or revision;
(6) in the case of updated or revised
treatment plans, a summary of the patient’s progress or lack of progress toward
each goal on the previous plan and the program’s response; and any new goals;
(7) the signature and date signed, or
documentation of the refusal to sign, of the patient or the patient’s guardian
or agent or, if the patient is a child, the patient’s parent, guardian, or
custodian;
G. Treatment
plans shall be reviewed at least every 90 days for the first two years of
continuous methadone medication treatment, and at least every six months
thereafter, in accordance with the program’s established policy and procedure,
and the treatment plan modified accordingly, except initial treatment plans
must be replaced with individualized plans as provided for in Subsection C of
8.321.10.21 NMAC above;
H. Adequate
medical, psychosocial counseling, mental health, vocational, educational and
other assessment and treatment services are fully and reasonably available to
patients, either by the program directly, or through formal, documented
referral agreements with other providers.
[8.321.10.21 NMAC - Rp, 8.321.10.20 NMAC 5/5/2026]
8.321.10.22 DOSAGE: The program sponsor shall ensure that:
A. A dose
of methadone is administered only after an order from the OTP prescribing
provider;
B. A
patient’s dosage of methadone is individually determined;
C. A dose
of methadone is sufficient to produce the desired response in a patient for the
desired duration of time and with consideration for patient safety.
D. A dose
of methadone is prescribed to meet a patient’s treatment needs by:
(1) preventing the onset of subjective or objective signs
of withdrawal for 24 hours or more;
(2) reducing or eliminating the drug
craving that is experienced by individuals living with opioid use disorder who
are not in opioid use disorder treatment;
(3) a patient receiving continuous
medication treatment with methadone receives an initial dose of methadone based
upon the program prescriber’s physical examination and with consideration for
local issues, such as the relative purity of available illicit opioid drugs;
(4) the total dose of methadone for the
first day should not exceed 50 mg unless the OTP prescriber finds and documents
sufficient medical rationale for a higher dose; and
(5) OTP prescribing practitioners may
prescribe split doses of methadone where such dosing regimens are indicated.
(6) a patient receives subsequent doses of
methadone medication:
(a) based on the patient’s individual needs and the results of the physical
examination and assessment;
(b) sufficient to achieve the desired response for at least 24 hours, with
consideration for day-to-day fluctuations and elimination patterns;
(c) that are not used to reinforce positive behavior or punish
negative behavior;
(d) as long as the patient benefits from and desires continuous treatment
with methadone; and
(e) that are adjusted if a provider changes from one type of opioid
use disorder treatment medication to another.
[8.321.10.22 NMAC - RP, 8.321.10.21 NMAC 5/5/2026]
8.321.10.23 DRUG SCREENING: The
program sponsor shall ensure that:
A. Staff
members have knowledge of the benefits and limitations of laboratory drug
detection tests and other toxicological testing procedures.
B. A
patient in methadone continuous treatment receives at least eight random
laboratory drug detection tests per year; short-term opioid treatment
withdrawal procedure patients receive at least one initial drug detection test;
and other toxicological tests are performed according to written orders from
the program medical director or medical practitioner designee.
C. Laboratory
drug detection tests and other toxicological testing specimens are collected in
a manner that minimizes falsification.
D. Laboratory
drug detection tests for:
(1) opioids;
(2) methadone;
(3) amphetamines;
(4) cocaine;
(5) barbiturates;
(6) benzodiazepines; and
(7) other substances as may be
appropriate, based upon patient history and prevailing patterns of drug
availability and use in the local area.
E. The results of a
patient’s laboratory drug detection tests or other toxicological tests and any
action taken relating to the results are documented in the patient record.
[8.321.10.23 NMAC - Rp, 8.321.10.22 NMAC 5/5/2026]
8.321.10.24 TAKE-HOME MEDICATIONS:
A. The
program sponsor shall ensure that policies and procedures are developed,
implemented, and complied with for the use of take-home medication and include:
(1) criteria for determining when a
patient is ready to receive take-home medication;
(2) criteria for when a patient’s
take-home medication is increased or decreased;
(3) a requirement that take-home
medication be dispensed according to federal and state law;
(4) a requirement that the program medical
director review a patient’s take-home medication regimen at intervals of no
less than 90 days and adjust the patient’s dosage, as needed;
(5) procedures for safe handling and
secure storage of take-home medication in a patient’s home; and
(6) criteria and duration of allowing a
physician or prescribing medical practitioner to prescribe a split medication
regimen.
B. Active
OTP recipients, regardless of the length of time in treatment, may receive
take-home doses for days during which the clinic is closed including one
weekend day as well as state and federal holidays. Beyond the standing approval to allow
take-home doses when the clinic is closed, OTP decisions on dispensing
methadone to recipients for unsupervised use shall be determined by an
appropriately licensed OTP medical practitioner or the medical director.
C. The
OTP medical practitioner or medical director shall consider, among other
pertinent factors that indicate that the therapeutic benefits of unsupervised
doses outweigh the risks, the following criteria:
(1) absence of active substance use
disorders, other physical or behavioral health conditions that increase the
risk of patient harm as it relates to the potential for overdose, or the
ability to function safely;
(2) regularity of attendance for
supervised medication administration;
(3) absence of serious behavioral problems
that endanger the patient, the public or others;
(4) absence of known recent diversion
activity;
(5) whether take-home medication can be
safely transported and stored; and
(6) any other criteria that the medical director
or medical practitioner considers relevant to the patient's safety and the
public's health.
D. During
the first 14 days of treatment, the take-home supply is limited to seven
days. It remains within the OTP
practitioner's discretion to determine the number of take-home doses up to
seven days, but decisions must be based on the criteria listed in Subsection C
of 8.321.10.24 NMAC.
E. From
15 days of treatment, the take-home supply is limited to 14 days. It remains within the OTP practitioner's
discretion to determine the number of take-home doses up to 14 days, but this
determination must be based on the criteria listed in Subsection C of
8.321.10.24 NMAC.
F. From
31 days of treatment, the take-home supply to a patient is not to exceed 28
days. It remains within the OTP
practitioner's discretion to determine the number of take-home doses up to 28
days, but this determination must be based on the criteria listed in Subsection
C of 8.321.10.24 NMAC.
G. A
program sponsor shall ensure that a patient receiving take-home medication
receives:
(1) take-home medication in a child-proof
container; and
(2) written and verbal information on the
patient’s responsibilities in protecting the security of take-home medication.
H. The
program sponsor shall ensure that the program medical director’s (or
prescribing medical practitioner’s) determination made under Subsection C of
8.321.10.24 NMAC and the reasons for the determination are documented in the
patient record.
I. In
accordance with DEA regulations, the program shall not use U.S. mail or express
services such as fedex or united parcel service to transport, furnish or
transfer opioid treatment medication to any patient, agency, facility or
person.
J. The
program shall establish policy and procedure to provide for the safe and secure
transportation of opioid treatment medication from its facility to another
agency where the program’s patient temporarily resides,
[8.321.10.24 NMAC - Rp, 8.321.10.23 NMAC 5/5/2026]
8.321.10.25 INTERIM TREATMENT:
A. The program sponsor of an OTP may admit an
individual, who is eligible for admission to comprehensive treatment, into
interim treatment if comprehensive services are not readily available within a
reasonable geographic area and within 14 days of the individual’s seeking
treatment.
B. At least two drug tests shall be obtained
from patients during the maximum of 180 days permitted for interim treatment.
C. A program shall establish and follow
reasonable criteria for establishing priorities for moving patients from
interim to comprehensive treatment.
These transition criteria shall be in writing and shall include, at a
minimum, prioritization of pregnant patients in admitting patients to interim
treatment and from interim to comprehensive treatment.
D. Interim treatment shall be provided in a
manner consistent with all applicable Federal and State laws, including
sections 1923, 1927(a), and 1976 of the Public Health Service Act (21
U.S.C. 300x–23, 300x– 27(a), and
300y–11).
E. The program shall notify the SOTA when a
patient begins interim treatment, when a patient leaves interim treatment, and
before the date of transfer to comprehensive services, and shall document such
notifications.
F. The
secretary of health and human services may revoke the interim authorization for
programs that fail to comply with the provisions of this paragraph.
G. All
requirements for comprehensive treatment apply to interim treatment with the
following exceptions:
A primary counselor is not
required to be assigned to the patient, but crisis services, including shelter
support, should be available;
(1) interim treatment cannot be provided
for longer than 180 days in any 12-month period;
(2) by day 120, a plan for continuing
treatment beyond 180 days must be created, and documented in the patient’s
clinical record; and
(3) formal counseling, vocational
training, employment, economic, legal, educational, and other recovery support
services are not required to be offered to the patient. However, information pertaining to locally
available, community-based resources for ancillary services should be made
available to individual patients in interim treatment.
[8.321.10.25 NMAC - N, 5/5/2026]
8.321.10.26 WITHDRAWAL TREATMENT AND MEDICALLY
SUPERVISED DOSE REDUCTION: The program sponsor shall ensure that:
A. policies
and procedures are developed, implemented, and complied with for withdrawal
treatment and:
(1) are designed to promote successful withdrawal treatment;
(2) require that dose reduction occur at a
rate deemed medically appropriate by the program medical director or
prescribing practitioner;
(3) require that a variety of ancillary
services, such as self-help groups, be available to the patient through the
program or through referral;
(4) require that the amount of counseling
available to the patient be increased before discharge; and
(5) require that a patient be re-admitted
to the program or referred to another program if relapse occurs;
B. a
patient’s withdrawal treatment:
(1) for a patient involved in methadone
continuous medication treatment, is only initiated as administrative discharge
or when voluntarily requested by the patient and approved by a program medical
director or prescribing practitioner; and
(2) is planned and supervised by the
program medical director or prescribing practitioner;
C. before
a patient begins withdrawal treatment, whether with or against the advice of
the program medical director or prescribing practitioner, the patient:
(1) is informed by the program medical director or a prescribing practitioner:
(a) that the patient has the right to
leave opioid treatment at any time; and
(b) of the risks of withdrawal treatment;
and
(2) upon request, receives a schedule for
withdrawal treatment that is developed by the program medical director or
prescribing practitioner with input from the patient;
(3) receives a copy of the program policy
regarding withdrawal of opioid treatment medication (methadone) against medical
advice and a verbal explanation of that policy;
D. agency
providers are prohibited from utilizing administrative discharge (involuntary
termination of services) for a patient pursuant to non-prescribed substance
use, or for any instance of displaying symptoms of mental or physical illness;
E. if
a patient who is receiving withdrawal treatment, other than a patient
experiencing administrative discharge, appears to a staff member to relapse,
the patient is permitted to begin methadone continuous medication treatment, if
otherwise eligible;
F. if a
patient who has completed withdrawal treatment within the past 30 days appears
to a staff member to relapse, the patient may be re-admitted without a physical
examination or assessment with the consent of the program medical director or
prescribing practitioner;
G. a
patient experiencing administrative discharge is referred or transferred to any
program that is capable of or more suitable for meeting the patient’s needs,
and the referral or transfer is documented in the patient record;
H. The
following information is documented in the patient record:
(1) the reason that the patient sought
withdrawal treatment or was placed on administrative discharge; and
(2) the information and assistance
provided to the patient in medical withdrawal or administrative discharge.
[8.321.10.26 NMAC - Rp, 8.321.10.24 NMAC 5/5/2026]
8.321.10.27 COUNSELING AND MEDICAL SERVICES: The
program sponsor shall ensure that:
A. Substance
use disorder counseling and behavioral health treatment planning is provided by
a practitioner licensed in the state of New Mexico to provide behavioral health
treatment services to each patient based upon the patient’s individual needs,
treatment plan and stage of readiness to change behavior.
B. behavioral health counseling services
must be made available to a patient but the patient’s access to medication
cannot be contingent upon their engagement in counseling services.
C. The
program has substance use disorder counselors in a number sufficient:
(1) to ensure that patients have access to
counselors;
(2) to provide the treatment in patients’
treatment plans; and
(3) to provide unscheduled treatment or
counseling to patient.
D. each patient
seeking opioid use disorder treatment with methadone is screened for the
presence of a co-occurring mental health disorder by means approved by the HCA,
and if indicated, referred for assessment and possible treatment if the program
is not able to provide mental health services; an OTP referring a patient to
another provider for mental health assessment shall make and document its good
faith efforts to follow up with that provider on the results of the referral,
and to coordinate its treatment with any subsequent treatment by other
providers, within the limits of all applicable laws and regulations pertaining
to release of patient information and confidentiality.
E. a
program sponsor shall ensure that a patient is offered medical, psychiatric and
psychological services, if needed, either at its program or through referral:
(1) if a patient receives medical,
psychiatric or psychological services, from provider(s) not affiliated with the
program, program staff members shall make a good faith effort to communicate
and coordinate its treatment services with such provider, including monitoring
and evaluating interactions between the patient’s opioid treatment medication
and medications used to treat the patient’s mental disorder, if any;
(2) the OTP shall have a procedure to
ensure that such good faith coordination efforts are made in accordance with
all state and federal laws and regulations for the release of patient records
or information;
F. Good faith
efforts are made to establish effective working relationships with the relevant
behavioral health treatment providers in its patient catchment area in order to
facilitate patient access to the services available through those providers.
G. A
patient has access to a self-help group or support group, such as narcotics
anonymous, either at the agency or through referral to a community group.
H. Treatment
services are provided by appropriately licensed staff.
[8.321.10.27 NMAC - Rp, 8.321.10.25 NMAC 5/5/2026]
8.321.10.28 DIVERSE POPULATIONS:
A. The
program sponsor shall ensure that:
(1) opioid use disorder treatment with
methadone is provided regardless of race, ethnicity, gender, age, or sexual
orientation;
(2) the program facility is compliant with
the Americans with Disabilities Act (ADA);
(3) opioid use disorder treatment with
methadone is provided with consideration for a patient’s individual needs,
cultural background, and values;
(4) provider staff members are culturally
competent;
(5) unbiased language is used in the
provider’s print materials, electronic media, and other training or educational
materials;
(6) HIV testing and education are
available to patients either at the provider or through referral;
(7) a patient who is HIV-positive and who
requests treatment for HIV or AIDS:
(a) is offered treatment for HIV or AIDS
either at the OTP or through referral; and
(b) has access to an HIV- or AIDS-related
peer group or support group and to social services either at the OTP or through
referral to a community group; and
(8) a patient who is HCV-positive and who
requests treatment for HCV is offered treatment for HCV either at the OTP or
through referral, and
(9) for patients with a communicable
disease such as HIV, AIDS, or hepatitis C, the provider has a procedure for
transferring a patient’s opioid treatment to a non-program medical practitioner
treating the patient for the communicable disease when it becomes the patient’s
primary health concern;
(10) an individual who requires
administration of opioid use disorder treatment with methadone only for relief
of chronic pain is:
(a) identified during the physical
examination or assessment;
(b) not admitted for opioid use disorder
treatment with methadone; and
(c) referred for medical services; and
(d) for a patient with a chronic pain
disorder who is also physically dependent the OTP makes a good faith effort to
coordinate treatment and services with the medical practitioner treating the
patient for pain management.
B. A
program sponsor shall ensure that a policy and procedure is developed,
implemented, and complied with for the treatment of female patients, to include
requirements that:
(1) pregnancy tests shall be administered
and reviewed for all women of childbearing age prior to initiating a opioid
treatment withdrawal procedure or medically supervised withdrawal;
(2) a refusal of pregnancy testing should
not preclude access to treatment.
(3) appropriate staff members be educated
in the unique needs of female patients; and
(4) each female patient be informed about
or referred to an appropriate support group, at the provider or in the
community.
C. The program
sponsor shall ensure that a policy and procedure is developed, implemented, and
complied with that reflect the special needs and priority for the treatment
admission for patients with OUD who are confirmed to be pregnant, to include:
(1) priority be given to pregnant
individuals seeking opioid use disorder treatment with methadone;
(2) the reasons for a pregnant
individual’s denial of admission to an opioid treatment provider must be
documented;
(3) evidence-based treatment protocols for
the pregnant patient, such as split dosing regimens, may be instituted after
assessment by an OTP practitioner and documentation that confirms the clinical
appropriateness of such an evidence-based treatment protocol;
(4) prenatal care and other sex specific
services, including reproductive health services, for pregnant and postpartum
patients must be provided and documented either by the OTP or by referral to
appropriate healthcare practitioners.
(5) the program must ensure effort to
communicate with any non-program medical practitioners who are providing
prenatal and post-partum care to a pregnant patient, to coordinate opioid use
disorder treatment with methadone and prenatal and post-partum care, in
accordance with all state and federal laws and regulations for the release of
patient records or information; and document all such communications in the
patient records;
(6) a pregnant patient discharged from the
program must be referred to a nonprogram medical practitioner and a staff
member must document the name, address, and telephone number of the medical
practitioner in the patient record.
D. A
program sponsor who is officially notified by a correctional facility that a
patient is in their custody shall ensure that the program:
(1) makes efforts to obtain approval from
the criminal justice system for the continued substance use disorder treatment
with methadone for the patient by the program while the patient is
incarcerated; and
(2) if approval is obtained, the program
continues to treat the patient while the patient is incarcerated, within the
limits of the program’s ability to provide such treatment to the incarcerated
patient; and
(3) if approval is not obtained, the
program’s attempts to obtain approval are documented in the patient’s record.
[8.321.10.28 NMAC - Rp, 8.321.10.26 NMAC 5/5/2026]
8.321.10.29 PREPAREDNESS PLANNING:
A. The
program sponsor shall ensure that the program has:
(1) a written plan to ensure uninterrupted
dispensing of methadone in the event of dispensing staff turnover; and
(2) a written agreement with at least one
other provider for the provision of opioid use disorder treatment with
methadone to program patients in the event that the program is unable to
provide services;
(3) 24-hour telephone answering service or
other method to reach the program at all times; and
(4) a list of all patients and the
patients’ dosage requirements available and accessible to program on-call staff
members.
B. A
program sponsor shall ensure that a written plan is developed and implemented
for continuity of patient services if the program is voluntarily or
involuntarily closed. Such planning
shall include a disaster plan that addresses unforeseeable circumstances such
as natural disaster or involuntary closure from any cause, and:
(1) includes steps for the orderly
transfer of patients to other programs, individuals, or entities that provide
opioid use disorder treatment with methadone;
(2) includes procedures for securing,
maintaining, and transferring patient records according to federal and state
law; and
(3) the plan is reviewed and updated, as appropriate, at least
once every 12 months.
[8.321.10.29 NMAC - Rp, 8.321.10.27 NMAC 5/5/2026]
8.321.10.30 PATIENT RECORDS:
A. The
OTP program shall establish and maintain a recordkeeping system that is
adequate to document and monitor patient care.
The system shall comply with all federal and state requirements relevant
to OTPs and to confidentiality of patient records.
B. Each
patient record shall include:
(1) the results of the physical
examination;
(2) the results of all assessments;
(3) the treatment plan and all updates or
revisions;
(4) the results of laboratory tests and a
description of any action taken based upon the results;
(5) documentation of the patient’s current
dose and dosage history;
(6) documentation of counseling provided
to the patient;
(7) dates and results of meetings or
conferences regarding the patient’s treatment services;
(8) documentation of the process used and
factors considered in making decisions that
impact a patient’s treatment services, such as whether
to allow take-home medication and the frequency of laboratory drug detection
tests; and
(9) documentation of the agency’s efforts
to learn of multiple methadone treatment program enrollment;
(10) documentation that the patient has
received and understood information regarding the harmful effects of diversion
of methadone.
[8.321.10.30 NMAC - Rp, 8.321.10.28 NMAC 5/5/2026]
8.321.10.31 COMMUNITY RELATIONS:
A. A
program sponsor shall ensure that policies and procedures are developed,
implemented, and complied with to educate and promote understanding in the
community about opioid use disorder treatment with methadone and include:
(1) a mechanism for eliciting input from
the community about the provider’s impact on the community;
(2) a requirement that the program sponsor
or designee interface with community leaders to foster positive relations;
(3) a requirement that the program sponsor
or designee establish a liaison with community representatives to share
information about the program;
(4) a requirement that the agency have
information on opioid use disorder
treatment and related health and social issues available to the public;
(5) a mechanism for addressing and
resolving community concerns about opioid use disorder treatment with methadone
or the program’s presence in the community;
(6) a mechanism that addresses getting
approval for continued treatment in treatment or care facilities and
correctional facilities; and
(7) willingness to partner with any local
certified community behavioral health center (CCBHC).
B. A
program sponsor shall ensure that community relations efforts are documented
and are evaluated at least once every six months.
C. A
program sponsor shall comply with all valid county and municipal ordinances regarding
community relations, and the HCA may consult with local governmental entities
when enforcing this section.
[8.321.10.31 NMAC - Rp, 8.321.10.29 NMAC 5/5/2026]
8.321.10.32 DIVERSION CONTROL:
The program sponsor shall ensure that a written plan
is developed, implemented, and complied with to prevent diversion of methadone
from its intended purpose to illicit purposes.
This plan shall assign specific responsibility to licensed and
administrative staff for carrying out the diversion control measures and
functions described in the plan. The
program shall develop and implement a policy and procedure providing for the reporting
of theft or diversion of methadone to
the relevant regulatory agencies, and law enforcement authorities.
[8.321.10.32 NMAC - Rp, 8.321.10.30 NMAC 5/5/2026]
HISTORY OF
8.321.10 NMAC: [RESERVED]
History of
Repealed Material: 8.321.10 NMAC - Opioid
Treatment Programs filed 6/13/2024, Repealed effective 5/5/2026.
OTHER: 8.321.10 NMAC - Opioid Treatment Programs filed
6/13/2024, Replaced by 8.321.10 NMAC - Opioid Treatment Programs effective
5/5/2026.