Licensing In Tennessee
Tennessee’s state code prohibits residential or community-based treatment facilities from providing drug and alcohol treatment services without a license. Violating the state licensing code is a Class B Misdemeanor, which includes providing drug and alcohol services without a license.
Providers must renew licenses annually on June 30. The license can only be issued for the premises provided in the organization’s application for licensure. If a new facility is opened, a new application for licensing must be made.
Tennessee also maintains a database of licensed providers, which is helpful for resource and referral purposes. According to the state, licensing is essential to obtain government contracts for alcohol and other drug (AOD) services in Tennessee.
Tennessee specifies minimum program requirements for:
- residential treatment programs
- opioid treatment programs
- DUI programs
- outpatient programs
- detox programs
Programs serving children and youth have additional requirements that differ from those serving adults.
Licensed AOD Program Standards
All licensed AOD programs in Tennessee must maintain written policy and procedure manuals and comply with facility safety and sanitation standards.
Residential treatment programs in Tennessee must have a physician on staff or serving as a consultant on-call with a written contract. As one example of staffing requirements, staff ratios for adult rehab programs are 1:16 (staff per client). This means staff must be present in each building at all times for licensed adult rehab programs.
Patient Rights, Including Assessment And Medical Evaluation
Tennessee requires alcohol and drug programs providing residential or outpatient treatment to adults, children, and youth to provide a written statement explaining their rights in “simple, non-technical language.”
The rights of patients in Tennessee AOD treatment facilities are specified in the Comprehensive Alcohol and Drug Treatment Act of 1973.
All AOD facilities must conduct an assessment of patients upon intake in Tennessee. The assessment should include the following elements:
- assessment of current functioning and presenting problem
- basic medical history and determination of the need for a medical evaluation
- conduct of medical evaluation (if necessary) by the program physician
- screening for tuberculosis and TB skin test
- medico-social-emotional assessment, including history of substance use, employment, and educational achievement
- six-month history of prescribed medications and non-prescribed substance use
An Individual Program Plan (IPP) developed as a result of the intake and assessment process must be provided to each program participant within seven days of program admission. IPPs must use diagnostic formulations in accordance with the Diagnostic and Statistical Manual (DSM) and/or ICD or ASAM PPC protocols.
Service recipients in residential treatment or detox programs must have medication log sheets with prescription records, date and time of administration, and frequency and amount of medication.
Providers must have a narrative summary review of medication provided and specific reasons for prescribing and continuing medication, including medication-assisted treatment (MAT) drugs.
Patients must have their belongings recorded, along with disposition of personal possessions which are no longer in use and worth $100 or more.
Additional Patient Rights
All patients must have a written discharge summary and a written aftercare plan. If the patient chooses not to participate in aftercare services, this must be documented in writing. Additional referrals to treatment must also be documented in writing.
Programs must also provide referrals to additional services, including social, family, housing, and other supportive services.
In Tennessee, patients are allowed to have designated smoking areas outside residential and outpatient treatment facilities. Residential treatment patients must also have access to exercise facilities, grooming facilities, and healthy nutrition, including assistance with weight control.
Service recipients cannot be denied:
- adequate food
- treatment and rehabilitation services
- religious services
- mail or other family contact
Recipients cannot be confined to isolation as a form of punishment. They can be removed from situations that may cause harm to themselves or others.
Legislation Affecting Addiction Treatment In Tennessee
In August 2015, the Tennessee State Legislature unanimously passed the Addiction Treatment Act which limited prescribing of medication-assisted treatment (MAT) drugs Suboxone and Subutex. The drugs can only be prescribed for addiction treatment, not off-label purposes.
Pregnant women may not be prescribed Subutex in Tennessee under the 2015 law. The law also specifies that people who seek treatment for a first-time drug overdose will have legal protection against prosecution.
Tennessee’s State Legislature also passed an amendment to the state’s Title 33 code in 2018 to regulate how addiction treatment programs are marketed.
The 2018 amendment strictly prohibits false and misleading marketing of alcohol and drug programs, including providing false information about a program’s location, or offering commissions, kickbacks, or other split fee arrangements in exchange for treatment referrals and placements.
Tennessee Department Of Mental Health And Developmental Disabilities—Minimum Program Requirements for Alcohol and Drug Use Non-Residential Treatment Facilities
Tennessee General Assembly—HOUSE BILL 2068 By Love AN ACT to amend Tennessee Code Annotated, Title 4; Title 33; Title 39;
Tennessee Secretary of State—Mental Health and Substance Use Services
WJHL 11—New Tennessee law puts restrictions on Suboxone, Subutex prescribing