Home » Blog Articles » Opioid Treatment Programs » COVID-19, Telehealth and Opioid Treatment Programs (OTPs) in Ohio

For community behavioral health centers (cbhc) as well as other healthcare facilities, delivering services during the Covid-19 pandemic has been a challenge. However, for Ohio mental health practitioners who are delivering services through the use telehealth technology, the state’s Department of Mental Health and Addiction Services (OhioMHAS) has offered many beneficial updates.

At ABCS RCM, one of our company’s specialties is providing revenue cycle management services for behavioral health and addiction treatment practitioners. We understand the difficulties that providers face during these challenging times. Tools like telehealth (telepsychiatry) have been helpful during the pandemic and have expanded people’s access to valuable healthcare treatments.

Yet, questions often arise over how to deliver effective addiction treatment services while reducing exposure to the coronavirus, as well as properly using telehealth tools. Here is a summary of some of the more commonly asked questions as well as some answers. The information is focused on assisting providers who deliver services to patients in opioid treatment programs (OTPs) in the state of Ohio.

In order to protect staff and patients from coronavirus infections, OhioMHAS recommends that every behavioral health organization, center and/or agency verify that they are using the most up-to-date information and strategies to support their patients. Most of the following information is available on the Ohio Department of Mental Health and Addiction Services website.

Reducing COVID-19 Transmission in a Facility:

For health care settings, the CDC (Centers for Disease Control and Prevention) has available interim infection prevention and control recommendations on their website. To summarize, the CDC recommends that:

  • Provide hand sanitizer at the front desk and at each dosing window.
  • Clean all surfaces and knobs several times each day with EPA-approved sanitizers.
  • Provide educational pamphlets to patients and staff on how patients can respond to COVID-19.
  • Discontinue use of vending machines and limit staff use of group lunchrooms as well as common areas.
  • Anyone with a respiratory illness (e.g., cough, runny nose) should be given a mask before entering the space.

Can OTPs Administer Doses in a Separate Room if a Patient has a Fever or Cough?

According to OhioMHAS, opioid treatment program providers are able to administer medication in this situation. Practices and centers should develop procedures for their staff to take patients with respiratory illness symptoms such as fever and cough to a location other than their general dispensary and/or lobby, to dose patients in closed rooms as needed.

Using telemedicine (telehealth) or telephonic services to provide medically necessary services to patients?

The Substance Abuse and Mental Health Services Administration (SAMHSA) has stated that the use of telemedicine services within OTP settings is allowed in certain cases. The DEA and OhioMHAS also agree with SAMHSA telehealth recommendations. To be certain of the most current information, OTP providers should check the respective agency’s websites. Emergency rules have changed some of the regulations for telehealth services. 

The procedures for each type of medication-assisted treatment (MAT) can change depending on the agonists and partial agonists. The following list of five points is only a guideline for Ohio-based OTPs who are delivering telemedicine services.

  1. Required physical evaluations: SAMHSA states that in-person physical evaluations are required before starting a MAT; therefore, telemedical physical evaluations are neither allowed for methadone nor buprenorphine patients.
  2. Buprenorphine induction: SAMHSA and the DEA state that telemedicine with buprenorphine is allowable if certain conditions are met. Guidance documentation is available on the SAMHSA and the DEA websites.
  3. Methadone induction: As a medical practice, is not allowed by SAMHSA. If OTPs wish to use onsite telehealth technologies for this procedure, they must have an exempted APRN (advanced practice registered nurse) in the room with the patient.
  4. Dose adjustment: This practice is only allowed for stable patients utilizing methadone or buprenorphine according to SAMHSA and OhioMHAS guidance. Only an OTP physician or exempted APRN can perform the adjustment.
  5. Routine Medical Appointments: This practice is allowable for methadone and buprenorphine.

Additional information is available on the Ohio Department of Mental Health and Addiction Services website. These details are valuable for most drug addiction treatment centers providing services in the state of Ohio. Some of this detailed material includes information on:

  • Guidance on providing patients with take-home dosing during the public health emergency
  • Blanket take-home medication exceptions for patients with lab confirmed COVID-19 disease:
  • For patients endorsing symptoms of a respiratory infection and cough and fever:
  • Patients with significant medical comorbidities:
  • For select patients with only one take home (unearned) determined by the medical provider to be appropriate:
  • Guidance on Patients using buprenorphine:
  • Guidance on patients who are considered unstable:
  • Guidance for patients who are not on a stable dose:
  • Stable patients with low risk of diversion, misuse or abuse of unsupervised dosing:
  • Patients receiving injectable forms of naltrexone or buprenorphine:

Ultimately, for more detailed information about any of these previous situations and conditions, refer directly to the mha.ohio.gov guidelines. Additional information that directly pertains to OTP centers and similar providers is available on the state’s website.

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