AN ACT directing the commission for mental health, developmental disabilities, and substance use services to amend the rules regarding outpatient opioid treatment programs for greater consistency with federal regulations.

The General Assembly of North Carolina enacts:

SECTION 1.(a)  The Commission for Mental Health, Developmental Disabilities, and Substance Use Services (Commission) shall amend the rules applicable to outpatient opioid treatment programs (OTPs) in 10A NCAC 27G .3600 through 10A NCAC 27G .3605, to be more consistent with 42 C.F.R. Part 8 governing medications for the treatment of opioid use disorder. In amending these rules, the Commission shall make at least all of the following changes:

(1)        Remove stability of a patient's home environment and social relationships as an eligibility criterion for take‑home medication.

(2)        Explicitly prohibit administrative discharge from treatment due to continued substance use, missed doses, and nonparticipation in ancillary services such as counseling.

(3)        Remove structured counseling schedules to better align with federal regulations that promote individualized care that is more patient‑centered and flexible.

(4)        Reduce the number of required drug tests to align with the frequency required by federal regulations.

(5)        Remove the requirement for observed urine drug testing.

(6)        Explicitly permit OTPs to administer methadone to patients who are not enrolled with the OTPs as their patients.

SECTION 1.(b)  In determining whether to include any additional changes to the rules applicable to OTPs to achieve greater consistency with 42 C.F.R. Part 8, the Commission shall engage with current and former OTP clients and OTP providers for input on other changes that would serve the goal of improving access to patient‑centered care and achieving better alignment with federal regulations. However, the Commission shall not amend the rules to include any input that is inconsistent with State or federal law.

SECTION 1.(c)  The Commission shall publish the proposed text of the amended rules applicable to OTPs by July 1, 2025.

SECTION 2.  This act is effective when it becomes law.