This rule waiver, which aligns state rules with federal guidelines that apply to opioid treatment programs (OTPs), which include methadone clinics, as outlined in 42 C.F.R. 8.12, will:

·    Increase access to opioid treatment services in New Jersey;

·    Reduce regulatory requirements on providers while maintaining the safe provision of services; and

·    Ensure Medications for Opioid Use Disorder (MOUD) are provided in accordance with best practices and regulatory standards.

“We are committed to making medications for opioid use disorder available to all New Jerseyans in need of this service,” said Health Commissioner Kaitlan Baston, MD, MSc, DFASAM. “In addition to aligning state rules with federal regulations, this waiver reduces duplicative requirements for behavioral health programs and will hopefully reduce barriers and improve access to this life-saving treatment.”

The Murphy Administration has prioritized facilitating access to evidence-based care in the whole-of-government response to the opioid epidemic.

Key Aspects of the Waiver

The waiver ensures opioid treatment programs in New Jersey meet the national best practice standards. Some key changes include:

·    Counseling and Treatment Phases: The waiver removes phase-based counseling and staff-to-client ratios, offering more flexibility for OTPs to provide counseling based on client needs. These changes ensure OTPs can comply with the federal rules which prohibit the denial of medication based on a patient’s refusal of counseling services.

·    Take-home Medication: The waiver removes the requirements that take-home doses be determined based on a defined “phase” of treatment, aligning with the federal rule and best practices for expanding access to take-home medication. This includes up to a seven-day take-home supply during the first 14 days of treatment.

·    Telehealth: The waiver includes clarification on telehealth services at OTPs. OTPs may use telehealth/telemedicine for screenings and evaluations, including at induction.

The waiver also addresses various treatment and administrative procedures, including those concerning drug screening, qualifications of the medical director, requirements for pharmacy and nursing services, and discharge policies.

NJDOH is committed to ensuring that these changes do not compromise patient care and that all patients continue to receive treatment that is in accordance with best practices and regulatory standards. The Department is also working closely with statewide OTPs for a smooth transition to these new standards.

“Through efforts like this, the Department of Health is continuing to improve evidence-based treatment availability and promote access to high-quality care for individuals with opioid use disorder,” added Health Commissioner Baston.

For more information about the federal rules and guidance related to this waiver, visit the SAMHSA website or review the rules available on the ECFR website.