Notifying SAMHSA of Changes to an Existing Opioid Treatment Program
What Changes to an Existing OTP Require Notification of SAMHSA?
Existing OTPs must notify SAMHSA within 3 weeks of either of the following program
changes:
- Change of Program Sponsor
- Change of Medical Director
In addition, existing OTPs must apply to SAMHSA to receive approval for:
- Relocation
- Addition of new medical units (satellite clinics or mobile units)
What supporting documentation is required when
notifying/applying to SAMHSA for program changes?
Each notification/application purpose requires different
supporting documentation, listed below. This documentation can be attached
in electronic format on page 2 of the
online SMA-162. The attached file(s) may be in any of the following formats: .txt, .doc,
.docx, .tiff, or .pdf.
For each notification/application purpose the required supporting documentation
is/are:
New Medical Director
- A copy of the Medical Director’s State license
- A copy of the Medical Director’s Curriculum Vitae
- A copy of the Medical Director’s DEA number
- If the Medical Director is also the Medical Director for another treatment program, enclose a written justification for the feasibility of such an arrangement. This feasibility shall address the portion of the Medical Director’s time spent in the treatment of unrelated medical patients, memberships on boards and committees that compete for time allocated to the treatment programs.
New Program Sponsor
- No supporting documentation required
Relocation of Primary Dispensing Unit or Medication Unit
- A diagram and description of the facilities to be used by this program. Demonstrate how the facilities are adequate for drug dispensing and for individual and group counseling. The description shall specify how the OTP will provide adequate medical, counseling, vocational, educational, and assessment services at the primary facility, unless the program sponsor has entered into a formal documented agreement with another entity.
Addition of a new Medication Unit
- A description of how the medication unit receives the medication supply from the primary facility
- An affirmative statement that the medication unit is limited to administering and dispensing the narcotic treatment drug and collecting samples for drug testing or analysis
- An affirmative statement that the sponsor agrees to retain responsibility for patient care
How does an OTP Notify SAMHSA of these Changes?
OTPs notify/apply for these changes by submitting an online Form SMA-162 at the SAMHSA OTP Extranet Web site (http://otp-extranet.samhsa.gov).
All OTPs have an account on the SAMHSA OTP
Extranet Web site. For instructions on accessing your program's account,
contact the SAMHSA OTP Extranet Information Center at:
1-866-687-2728 (OTP-CSAT)
or
otp-extranet@opioid.samhsa.gov.
Who may submit Form SMA-162?
Form SMA-162 may only be submitted/signed by an OTP Program Sponsor. The Program Sponsor's
name and contact information, including telephone number and e-mail address, are
required on the form. After submitting an online SMA-162, a confirmation e-mail
will be sent to the Sponsor. The Sponsor will need to click a link supplied in that
e-mail to electronically sign the SMA-162 and complete the submission process. The
notification/application process will not be complete until the Sponsor clicks the link in that
e-mail. SAMHSA will contact the Sponsor after receipt of a completed SMA-162 if
additional information is required.
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For More Information
For more information about OTP certification and opening a treatment program
In states beginning in A - I and OH-TN, contact
- Mary Lou Ojeda
Division of Pharmacologic Therapies
SAMHSA Center for Substance Abuse Treatment
mary.ojeda@samhsa.hhs.gov
Voice: 240.276.2894
Fax: 240.276.2710
In states beginning in K-N and TX-WY, contact
- Sara Azimi-Bolourian
Public Health Advisor
Division of Pharmacologic Therapies
SAMHSA Center for Substance Abuse Treatment
sara.azimi-bolourian@samhsa.hhs.gov
Voice: 240.276.2708
Fax: 240.276.2710
The mailing address for the above listed personnel is:
- Division of Pharmacologic Therapies
Center for Substance Abuse Treatment
SAMHSA
1 Choke Cherry Rd.
Rockville, MD 20857
(Overnight: 20850)
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