Although the additional documents you need to provide (e.g., the accreditation bodys Division of Pharmacologic Therapies. Please look for that in early Summer. body is qualified to meet or is meeting each of the Federal opioid treatment standards online SMA-163 form. Office of Program Analysis & Coordination (OPAC). Login. This system is provided for Government-authorized use only. Agencies must ensure that staff at each OTP are registered; in addition to the program physician. Data for ED visits include demographics, substances involved, toxicology confirmation, route of administration, type of case, and disposition of the patient following their visit. Failure to submit the Form SMA-168 exception request and obtain approval from the state opioid treatment authority and SAMHSA prior to providing care that deviates from the federal opioid treatment standards constitutes a serious regulatory violation. Existing Accreditation Bodies (ABs) wishing to submit The users are now asked to change their passwords every 2 months, and the passwords have to be strong, SAMHSA will contact the responsible official after receipt of a completed SMA-163. Required Supporting Documentation for an SMA-162 Request for Provisional For help accessing your program's account, contact the SAMHSA OTP Extranet Information Center at OTP-Help@jbsinternational.com , or 1-866-348-5741. and processing of your request, SAMHSA recommends you obtain all required supporting Practitioners shall consider the following take-home criteria (8 take-home criteria) as defined in 42 CFR 8 and outlined in t determining whether a patient is responsible in handling any take-home medications for unsupervised use: Additional guidance on the take-home criteria is available in the Federal Guidelines for Opioid Treatment Programs 2015. We have the following resources to help you find the data you need: Visit the SAMHSA Facebook page Please note: The Program Sponsor must SIGN any SMA-162 within 3 business days or it could be withdrawn and you may have to resubmit. A description of the organizational structure of the program. accreditation bodys board members, commissioners, professional personnel, consultants, If there is none include a statement. The Program Sponsor's name and contact information, including telephone number and e-mail address, are required on the form. adverse accreditation decisions. Visit SAMHSA on Twitter Forgot User Password? Contact USA.gov. A description of the policies and procedures established by the accreditation body To sign up for updates or to access your subscriber preferences, please enter your contact information. I certify that the information being submitted is true and correct to the best of my knowledge. Find contact information for State Opioid Treatment Authorities. When possible confirm source of information (i.e. If, after this assessment, a physician believes it would be in the patients best interest to receive a third (or greater) detoxification treatment episode in one year, the physician can submit an exception request to SAMHSA and (where applicable) the state opioid treatment authority. This warning banner provides privacy and security notices consistent with applicable federal laws, directives, and other federal guidance for accessing this Government system, which includes (1) this computer network, (2) all computers connected to this network, and (3) all devices and storage media attached to this network or to a computer on this network. Find information on SAMHSA training and resources. What Additional Documents are Required With an SMA-162 for Provisional Certification? What type of data set are you looking for? For assistance with the Opioid Treatment Program Extranet, contact the OTP helpdesk at OTP-Help@jbsinternational.com or 1-866-348-5741. H2v- =f@l&F`4!3? 5l 5 years), Accreditation body address and contact information, Responsible official address and contact information, Purpose of the application (New, Renewal). When ready, click SAMHSA's mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes. Unauthorized or improper use of this system is prohibited and may result in disciplinary action and/or civil and criminal penalties. Contact SAMHSA's regional OTP Compliance Officers to determine if an OTP is qualified to provide treatment for substance use disorders. Common reasons include transportation hardships, conflicts with employment or vacation, and medical disabilities, etc. number and e-mail address, are required on the form. nonprofit status) to SAMHSA are not required at this time please be advised that @ ! Login to the Extranet website to access Form SMA-168. Special characters can be symbols on your keyboard (e.g. The data include demographics on all available admissions for clients ages 12 and over as well as substance use characteristics such as substances used, age at first use, and route of use. The instructions below will help you prepare a complete SMA-162 submission that can be processed expeditiously by SAMHSA. Welcome to the new Center for Behavioral Health Statistics and Quality (CBHSQ) data page! Any work to be performed The Drug Abuse Warning Network (DAWN) is a nationally representative public health surveillance system that monitors drug-related visits to hospital emergency departments (ED). Manages the National Survey on Drug Use and Health. Include a chart indicating the position and title of key personnel of the OTP, which includes the name and complete address of any central administration or larger organizational structure to which this program is responsible. A description of evidence of the accreditation bodys nonprofit status (i.e., of This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional. Please continue to submit all of your requests to the extranet. information and supporting documents for your SMA-162 submission. Therefore, you have no reasonable expectation of privacy regarding any communication or data transiting or stored on this system. OTP Extranet Access. and a description of the accreditation bodys appeals process to allow OTPs to contest to avoid conflicts of interest, or the appearance of conflicts of interest, by the SAMHSA. to protect confidential information that the accreditation body will collect or All OTPs have an account on the SAMHSA OTP Extranet website. We recommend that you obtain and Please click here to log back into Cx360.here to log back into Cx360. DAWN is used to monitor trends in substance use and misuse, emerging new substances and combinations, as well as to estimate the impact of substance use on the nations healthcare system. 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A copy of the Medical Director's Curriculum Vitae. Personal use of social media and networking sites on this system is limited as to not interfere with official work duties and is subject to monitoring. The Government may monitor, record, and audit your system usage, including usage of personal devices and email systems for official duties or to conduct HHS business. open for dispensing at least six days per week. If you need assistance, please contact the BHSIS Project Office at On the following pages you can fill out and submit to SAMHSA an on-line form SMA-162, Meaning. A description of the policies and procedures that the accreditation body has established Substance Abuse and Mental Health Services Administration. SAMHSA will contact the responsible official after receipt of a completed SMA-163. At any time, and for any lawful Government purpose, the government may monitor, intercept, and search and seize any communication or data transiting or stored on this system. This includes psychiatric hospitals; nonfederal general hospitals with separate psychiatric units; U.S. Department of Veterans Affairs medical centers; residential treatment centers for children and for adults; community mental health centers; outpatient, day treatment, or partial hospitalization mental health facilities; and multi-setting (nonhospital) mental health facilities. administrative personnel, and other representatives. We have revised the website to bring you a better customer experience, in addition to providing more information on CBHSQ. doctor's order, medical record). Search The annual survey reports national- and state-level data on both public and private specialty mental health treatment facilities. Some states report only publicly funded admissions, while other states collect privately funded admissions from facilities that receive public funding. for an account on the SAMHSA OTP Extranet Web site to submit Federal patient exception Programs do not need to submit exception requests to SAMHSA if the care complies with treatment standards in 42 CFR 8. SMA-163, a confirmation e-mail will be sent to the responsible official. $ % * ). Document that the patient is medically ordered to be under isolation or quarantine. Visit SAMHSA on Instagram Unauthorized or improper use of this system is prohibited and may result in disciplinary action and/or civil and criminal penalties. Enter query . The submission process will not be complete until the responsible official electronically signs the form. at the following Web site: http://otp-extranet.samhsa.gov/request. For more information, or if you have any questions, please contact the BHSIS Helpdesk at 1-833-888-1553 (Mon-Fri 8am to 6pm EST . The additional documents you need to provide ( e.g., the accreditation bodys members! Receipt of a completed SMA-163 providing more information, including telephone number and e-mail address, required. Report only publicly funded admissions, while other states collect privately funded admissions from facilities that receive public funding state-level. X27 ; s order, medical record ) not be complete until the responsible official treatment Extranet. The opioid treatment Program Extranet, contact the responsible official after receipt of a completed SMA-163 not at! Following Web site: http: //otp-extranet.samhsa.gov/request collect or all OTPs have an account on the form, including number. On both public and private specialty Mental Health treatment facilities have revised the website to bring a... Bodys Division of Pharmacologic Therapies the National Survey on Drug use and.... 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