HB2665 HH&HR AM 3-20
The Committee on Health and Human Resources moves to amend the
bill on page two, section one, line five, after the word
"authorized", by striking out the period and inserting in lieu
thereof the following:
"with the following amendment:
On page 14 by striking section 7.3 and inserting a new section
7.3 to read as follows:
'7.3. License Fees and Inspection Costs.
7.3.a. All applications for an initial or renewed license
shall be accompanied by a non-refundable license fee in the amount
required by this rule. The annual renewal fee is based upon the
average daily total census of the program. In addition to the set
fee, the annual renewal fee shall be adjusted on the first day of
June of each year to correspond with increases in the consumer
price index. The base amounts for initial and renewal fees are as
7.3.a.1. Initial license fee - $250;
7.3.a.2. Renewal fee - fewer than 500 patients - $500
7.3.a.3. Renewal fee - 500 to 1,000 patients - $1,000
7.3.a.4. Renewal fee - more than 1,000 patients - $1,500 plus adjustment.
7.3.b. An opioid treatment program shall pay for the cost of
the initial inspection made by the secretary prior to issuing a
license. The cost of the initial inspection is $400, and shall be
billed to the applicant by the secretary within five business days
after the inspection. The cost of the initial inspection must be
paid in full by the applicant before a license may be issued.
7.3c. The Office of Health Facility Licensure and
Certification shall use the fee for increased oversight on opioid
On page 32 by inserting a new subdivision 18.3.j. to read as
'18.3.j. There shall be one (1) counselor for every forty (40)
clients in the program.'
On page 53 by striking section 30.8 and inserting a new
section 30.8 to read as follows:
'30.8. Each opioid treatment program must provide counseling
on preventing exposure to, and the transmission of, human
immunodeficiency virus (HIV) disease and Hepatitis C disease for
each patient admitted or re-admitted to maintenance or
detoxification treatment. Services rendered to patients with HIV
disease shall comply with the requirements of section 44 of this rule.'
On page 54 by striking subdivision 31.4.a and inserting a new
subdivision 31.4.a to read as follows:
'31.4.a. Preventing exposure to, and the transmission of, HIV
disease and Hepatitis C disease for each patient admitted or
readmitted to maintenance or detoxification treatment; and'
On page 56 by striking subdivision 32.2.a and inserting a new
subdivion 32.2.a to read as follows:
'32.2.a. The initial post-admission assessment shall consist
of a comprehensive medical evaluation, which shall include, but not
be limited to:
32.2.a.1. A comprehensive physical evaluation;
32.2.a.2. A comprehensive psychiatric evaluation,
including mental status examination and psychiatric history;
32.2.a.3. A personal and family medical history;
32.2.a.4. A comprehensive history of substance
abuse, both personal and family;
32.2.a.5. A tuberculosis skin test and chest X-ray,
if skin test is positive;
32.2.a.6. A screening test for syphilis;
32.2.a.7. A Hepatitis C test;
32.2.a.8. An HIV test; and
32.2.a.9. Other tests as necessary or appropriate
(e.g., CBC, EKG, chest X-ray, pap smear, hepatitis B surface
antigen and hepatitis B antibody testing).'
On page 70 by striking section 37.14 and inserting a new
section 37.14 to read as follows:
'37.14 The state authority may approve exceptional
unsupervised-medication dosages, including alternative medications,
on a case-by-case basis upon application for an exemption by the
program physician. Any authorization for exceptions shall be
consistent with guidelines and protocols of approved authorities,
provided that the authority may not grant any exceptions during a
calendar month which exceed three (3) exceptions or ten (10)
percent of the number of patients enrolled in the program on the
last day of the previous month, whichever is greater.'
On page 73 by inserting a new subdivision 38.14 to read as
'38.14 Maintenance treatment shall be discontinued within two
(2) continuous years after the treatment is begun unless, based
upon the clinical judgement of the medical director or program
physician and staff which shall be recorded in the client's record by the medical director or program physician, the client's status
indicates that the treatment should be continued for a longer
period of time because discontinuance from treatment would lead to
a return to illicit opiate abuse or dependence.'
On page 75 by striking subdivision 41.2.d.3 and inserting a
new subdivision 41.2.d.3 to read as follows:
'41.2.d.3. When using urine as a screening mechanism, all
patient drug testing shall be observed to minimize the chance of
adulterating or substituting another individual's urine.'
On page 81 by striking subdivision 44.5.d.1. and inserting a
new subdivision 44.5.d.1. to read as follows:
Maintenance treatment dosage levels of pregnant
clients shall be maintained at the lowest possible dosage level'."