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Self-administration of non-SUD medications for individuals with acute and chronic conditions:
Neighboring states have not removed this barrier to care. However, there are efforts under way in Minnesota though
no rule has been implemented.
Remove requirement that an individual in a methadone program has a diagnosis of opioid disorder for at least one
year prior to admission:
Illinois, Indiana, and Ohio all use admission criteria that are in line with the Federal regulation (42 C.F.R. 8.12(e)). This
criteria is based on a clinical assessment used to determine the need for admission rather than a requirement of a
specific amount of time spent with a diagnosis.
A. If the rules exceed standards in those states, please explain why and specify the costs and benefits
arising out of the deviation.
The proposed rules do not exceed standards in other states.
3. Identify any laws, rules, and other legal requirements that may duplicate, overlap, or conflict with the
proposed rules.
The regulation of SUD services programs is a state function; there are no other laws, rules, or other legal
requirements that duplicate, overlap, or conflict with the proposed rules. There are ancillary federal regulations
administered by SAMHSA in the U.S. Department of Health and Human Services that addresses reimbursement and
funding. However, these responsibilities are handled by MDHHS. The proposed rules do not change this established
system.
A. Explain how the rules have been coordinated, to the extent practicable, with other federal, state, and
local laws applicable to the same activity or subject matter. This section should include a discussion of
the efforts undertaken by the agency to avoid or minimize duplication.
The coordination and interplay with other federal, state, and local laws remains the same and consistent in the
proposed rules as with the existing rules. The proposed rules do comport with, and do not duplicate or conflict
with federal regulations, Drug Enforcement Agency (DEA) regulations, or ASAM guidelines.
PURPOSE AND OBJECTIVES OF THE RULE(S)
4. Identify the behavior and frequency of behavior that the proposed rules are designed to alter.
The SUD Administrative Rules provide for the regulation of licensed SUD service programs. The prosed changes will
reduce the entry barrier for a low-risk service, outpatient counseling programs, by removing the duplicative licensure
requirement and related licensure expenditures. There remains oversight of the counseling professionals through the
Bureau of Professional Licensing (BPL), The Michigan Certification Board for Addiction Professionals (MCBAP), and
local Community Mental Health (CMH) authorities.
The proposed changes allow for increased access to care by removing the requirement that individuals entering
methadone treatment have a documented opioid use disorder diagnosis for at least one year prior to admission. The
proposed changes also permit individuals with acute or chronic conditions to self-administer non-SUD medications
while receiving treatment services in residential, residential withdrawal management, and methadone providers.
A. Estimate the change in the frequency of the targeted behavior expected from the proposed rules.
The proposed rules will allow increased access to care for patients and reduce costs to providers by eliminating
costs associated with licensure of facilities fees to the low-risk service of outpatient counseling programs.
B. Describe the difference between current behavior/practice and desired behavior/practice.
The current behavior places unnecessary barriers on access to care to individuals seeking treatment. The new
behavior removes these barriers and should allow more options for individuals who need treatment across
Michigan. In addition, removing the duplicative licensure of outpatient counseling programs is a cost reduction
to those providers.
C. What is the desired outcome?
Increased access to treatment and reduced costs to providers while still protecting the health, safety, and
welfare of patients as BPL, MCBAP, and local CMH authorities have oversight for outpatient counseling
services. BPL regulates the licensing of health professionals under the authority of the Public Health Code that
can provide SUD counseling services including counselors, marriage and family therapists, social workers, and
psychologists. MCBAP provides protection and promotes quality services through certification of professionals
engaging in the prevention of alcohol, tobacco, and other drug problems and the assessment and treatment of
MCL 24.245(3)