Substance Use Disorder (SUD) Virtual Support Program

New York State Telehealth Regulatory Compliance

Full adherence to NYS Public Health Law § 2999-cc and Education Law § 6807, ensuring comprehensive coverage of informed consent protocols, permissible treatment modalities, and prescribing regulations to meet the highest legal and ethical standards.

Federal SUD Privacy Law Adaptation

Specialized protocols implementing 42 CFR Part 2 for SUD treatment records in digital environments with documented consent flows for all disclosure scenarios while maintaining strict confidentiality protections.

Ryan Haight Act Exemption Compliance

Rigorous adherence to controlled substance prescribing regulations via telehealth, including buprenorphine and other Schedule III–V medications under qualifying exemptions.

OpenTelemed Malpractice Coverage

Comprehensive malpractice insurance tailored for SUD telehealth services, including coverage for Schedule III–V prescribing across virtual addiction treatment delivery.

Corporate Compliance Framework

Strict adherence to policies covering data security, ethical billing, and platform usage guidelines to meet high standards of corporate governance.

Credentialing & Privileging Verification

Verification of NY license, DEA registration, DATA 2000 X-waiver history, and buprenorphine prescribing privileges on the platform.

The integration with OpenTelemed Services LLC provides professional liability protection, regulatory compliance, and platform reliability essential for high-quality SUD treatment.

Interprofessional Collaborative Practice Agreement

NYS-compliant agreement between Dr. Salazar and NP Davis defining supervision protocols, prescribing guidelines, and emergency coverage.

Technology Acceptance Model for SUD Patients

Pre-assessment of patient readiness and tech capacity to optimize engagement and identify support needs early.

Harm Reduction Philosophy Integration

Operationalizes harm reduction while maintaining clinical excellence and safety.

Continuous Quality Improvement Framework

Systematic review of outcomes, satisfaction, and adverse events to drive iterative improvements.

HIPAA-Compliant Platform Architecture

End-to-end encryption, comprehensive audit logging, HITRUST certification, and intuitive UX for patients and clinicians.

Business Associate Agreement Management

Comprehensive BAA defines PHI handling, breach notification, and access controls throughout care.

Secure API Integrations

FHIR-based connections with NY Prescription Monitoring Program and ISTOP for medication and controlled-substance oversight.

Multi-Factor Authentication Enforcement

Mandatory MFA including biometrics and hardware security keys for robust access protection.

1 Data Residency & Sovereignty

PHI stored exclusively in the United States to meet sovereignty requirements and protect sensitive SUD records.

2 Low-Bandwidth Contingency Protocol

Automatic fallback to audio-only or secure messaging to maintain session integrity.

3 Encrypted Asynchronous Communication

Secure messaging with clear response time expectations to sustain therapeutic connections and documentation.

“Our security architecture protects patient data from transmission to storage while enabling seamless clinical workflows that support exceptional care.”

Digital Forensics and Audit Logging

Forensic-grade activity logging for security monitoring and compliance auditing.

• Real-time activity monitoring
• Detailed access logs
• Automated anomaly detection

Cybersecurity Incident Response Plan

Immediate detection, containment, notification, and recovery procedures to minimize care impact.

• 24/7 incident monitoring
• Rapid response team activation
• Patient notification procedures

Hardware Security Key Support

Physical security keys (e.g., YubiKey) for phishing-resistant authentication and enhanced access control.

• Hardware token authentication
• Phishing protection
• Enhanced access controls

Gold-standard tools adapted for telehealth ensure accurate diagnosis and comprehensive planning for SUD and co-occurring conditions.

01 Structured Diagnostic Interview (SCID‑5‑CT)

Telehealth administration to confirm SUD and comorbidities. Primary ICD‑10 examples: F11.20, F11.21, F10.20, F17.200.

02 Addiction Severity Index (ASI) – Lite Tele‑adaptation

Multidimensional evaluation across medical, employment, use patterns, legal, family, and psychiatric domains.

03 Clinical Opiate Withdrawal Scale (COWS) Remote

Guided self-assessment via video to grade withdrawal and guide MAT decisions.

1 CIWA‑Ar (Alcohol)

Remote standardized protocol for alcohol withdrawal risk/severity and safe outpatient management.

2 Urine Drug Screen “Test‑to‑Device”

CLIA-waived cups mailed to patients; video-observed collection with real-time results for objective monitoring.

These tools provide objective, standardized measures to inform decisions while preserving telehealth accessibility.

1 EtG/EtS Hair or Nail Testing Coordination

Long-term alcohol monitoring via mail-in kits to detect use over weeks to months.

2 Psychiatric Comorbidity Screening

PHQ‑9, GAD‑7, and PCL‑5 for depression, anxiety, and PTSD assessment.

3 Overdose Risk Stratification

Assesses risk factors (history, polysubstance, isolation) to guide monitoring and interventions.

Combining biological testing and validated screens enables personalized planning and risk management.

SDOH Screening

Digital assessment of housing, food security, transportation, and social supports to inform coordinated care.

• Housing and safety
• Food and nutrition security
• Transportation access
• Support networks

Motivational Interviewing Spirit Assessment

Stages of Change (Precontemplation → Maintenance) to tailor motivational strategies.

• Readiness evaluation
• Motivation level
• Barrier identification
• Personalized planning

“Understanding social context is crucial for effective, personalized treatment plans.”

Buprenorphine Induction Protocol

Day-by-day remote induction with education on precipitated withdrawal to maximize safety and access.

EPCS (Controlled Substances)

DEA-certified e-prescribing integrated in-platform for secure transmission of buprenorphine/naloxone and other controls.

Naltrexone Management

Tele-prescribing for oral naltrexone and coordination for Vivitrol injections with local providers.

Acamprosate for AUD

Tele-prescription with coordinated remote renal monitoring to ensure safety and effectiveness.

Disulfiram (Antabuse) Therapy

Video-observed ingestion protocols for adherence and safety while maintaining autonomy.

Smart Medication Adherence

Smart blister pack (Hero) integrations reporting dosing times to clinician dashboards in real time.

Real-time Prescription Monitoring (ISTOP)

Automated queries prior to controlled-substance prescriptions to identify interactions and misuse patterns.

Buprenorphine Pharmacogenomics

Use of genetic testing (e.g., GeneSight) to optimize dosing in poor/rapid metabolizers.

Co-prescribed Medication Management

Telehealth management of psychotropics (e.g., SSRIs, gabapentin) and comorbid conditions.

MAT in Pregnancy Protocol

Enhanced monitoring with direct OB coordination and delivery planning to optimize outcomes for mother and baby.

Motivational Enhancement Therapy (MET)

Patient‑centered sessions to evoke and strengthen intrinsic motivation and resolve ambivalence.

Cognitive Behavioral Therapy (CBT) for SUD

Structured modules addressing triggers, cravings, coping strategies, and refusal skills with digital worksheets/homework.

Digital Contingency Management

Incentives (e‑gift cards) for negative screens and attendance to reinforce recovery behaviors.

CRA + Vouchers

Tele‑adapted Community Reinforcement with voucher rewards for milestones and engagement.

Digital Relapse Prevention Toolbox

Interactive skills, coping modules, and emergency planning within the patient portal.

Mindfulness‑Based Relapse Prevention

Guided exercises to increase awareness of cravings and triggers without automatic responses.

Shared‑Screen Whiteboarding

Real‑time collaborative functional analysis and visual treatment planning.

Family Behavior Therapy & Group Modality

Multi‑participant video sessions to improve communication and reinforce abstinence‑supporting behaviors; HIPAA‑compliant groups for shared recovery experiences.

12‑Step Facilitation Therapy (TSF)

Structured education and facilitated connections to online NA/AA meetings.

Group Therapy Telehealth Sessions

Peer support, shared learning, and clinician‑guided problem solving in secure video groups.

Digital peer support and 12‑step principles enable powerful connection and mutual aid with 24/7 accessibility.

Prescription Digital Therapeutics

Integration/prescription of reSET (SUD) and reSET‑O (OUD) to extend CBT and support between sessions.

Bluetooth Breathalyzer Integration

Real‑time alcohol monitoring (e.g., BACtrack) with automatic results in clinician portal.

Wearable Biomonitoring

Tracking HRV, sleep, and activity (Apple Watch, Fitbit) to detect stress, cravings, and relapse risk indicators.

Geofencing & Check‑Ins

Patient‑consented GPS to verify meeting attendance or avoidance of high‑risk locations while respecting privacy.

Ecological Momentary Assessment (EMA)

Brief smartphone prompts to track mood, cravings, and context multiple times daily in real time.

Digital Recovery Platform Integration

Connections to platforms like Connections and Workit Health for peer support and progress tracking.

AI‑Powered Predictive Alerts

EMA, wearable metrics, and screening data analyzed to predict relapse risk and trigger proactive interventions.

Video‑Based Sobriety Check‑Ins

Asynchronous, random verification options while preserving therapeutic alliance.

“AI‑powered analytics move care from reactive to predictive—identifying risk patterns before crises and intervening at optimal moments.”

Journaling & Craving Logs

Secure in‑app journals for triggers, coping, and emotions; clinicians review to spot patterns and adjust care.

Gamified Recovery Content

Points, badges, and levels increase engagement with education modules and therapy homework.

Interactive, rewarding experiences sustain motivation and generate rich clinical data for personalized care.

Virtual “Warm Handoff”

Seamless integrations with social workers, case managers, and higher levels of care via secure video to prevent gaps.

Narcan Distribution & Training

Naloxone kits mailed to patients with comprehensive video‑based training.

Digital Overdose Response Plan

Personalized safety plans stored in the portal and shared with designated emergency contacts.

OASAS Program Coordination

Seamless referrals and coordinated care across New York’s OASAS network.

Peer Recovery Specialist Integration

Certified peers augment clinical care with lived‑experience support and relatability.

Social Service Navigation

Tele‑assistance with SNAP, housing, and transportation; screen‑sharing to guide applications.

Crisis Text Line & 988 Integration

Embedded links to national and NY‑specific crisis resources for 24/7 support access.

Emergency Department e‑Consult Protocol

Direct clinician consultation pathways with EDs to ensure continuity and prevent disruptions.

Pharmacy Coordination

Secure messaging to resolve access, prior‑auth, and adherence concerns for MAT prescriptions.

Labcorp & Quest Partnerships

Local blood draws with electronic results to the portal for monitoring and medication safety.

Telehealth‑Specific CPT Codes

Modifier 95 and POS 02 for telehealth delivery identification and compliance.

MAT Management Codes

99213–99215 for office/outpatient E/M focused on MAT management.

Psychotherapy CPT Codes

90834 (45-min) and 90837 (60-min) with telehealth documentation parity.

Patient Classification Coding

Proper new vs. established E/M coding for initial comprehensive vs. ongoing care.

99490 — Chronic Care Management

Monthly non-face-to-face coordination (care planning, meds, coordination with other providers).

98975 — RTM Initial Setup

Remote Therapeutic Monitoring setup and patient education (e.g., craving logs, PDT usage).

These advanced codes reimburse comprehensive care that extends beyond face‑to‑face sessions.

RPM Codes (99453, 99454)

FDA‑cleared devices (e.g., connected breathalyzers) for data collection and clinical interpretation.

Medical Decision Making (MDM)

Documentation supports E/M level, reflecting complexity of SUD care, comorbidities, meds, and coordination.

Proper MDM documentation is essential given the multifaceted nature of SUD treatment.

Medicare Requirements

Compliance with federal telehealth coverage policies.

NY Medicaid Policies

State‑specific reimbursement and prior authorization rules.

Commercial Variations

Payer‑specific telehealth coverage and documentation standards.

Out‑of‑Network Strategy

Compliance with surprise billing laws, transparent pricing, and payment plans.

NYS Nurse Practice Act Compliance

Adherence to independent practice authority and controlled substance prescribing requirements for NPs.

DATA 2000 (X‑Waiver) Verification History

Verification/maintenance of historic buprenorphine prescribing eligibility and related obligations.

1 DEA Registration Verification

Ongoing verification of current status, categories, expirations, and cross‑state compliance.

2 Mandated Reporter Training

Procedures for child/elder abuse reporting across jurisdictions in telehealth contexts.

3 Cultural Humility & Bias Training

Education to address stigma/bias in SUD and its impact on virtual therapeutic relationships.

“Maintaining high standards requires ongoing education, supervision, and ethical practice in evolving telehealth delivery.”

Structured Supervision Sessions

Regular meetings with Dr. Salazar for case review, chart audits, and decision‑making consultation.

Peer Consultation Groups

Virtual consults for support, best practices, and collaborative problem‑solving.

Continuing Education Tracking

Systematic monitoring of CME focused on addiction medicine and telehealth competencies.

Burnout Prevention Monitoring

Regular assessment of clinician wellness to identify and address compassion fatigue and burnout.

Quality Assurance Reviews

OpenTelemed chart reviews to ensure documentation quality, prescribing patterns, outcomes, and adherence to evidence‑based practices.

Credentialing Maintenance

Tracking CME for ongoing development and maintenance of specialized certifications.

Burnout & Compassion Fatigue

Validated measures to assess wellness and implement proactive interventions.

Quality Assurance Chart Reviews

Leadership‑led audits for consistent, high‑quality patient care across all activities.

Addiction Progress Measures

Brief Addiction Monitor (BAM) and Treatment Effectiveness Assessment (TEA) administered regularly to track multi‑domain recovery.

Craving VAS

Weekly self‑report of craving intensity to guide medication and therapeutic adjustments.

Timeline Follow‑Back (TLFB)

Digital calendar‑based method for detailed retrospective substance use estimates.

Quality of Life & Alliance

WHOQOL‑BREF for overall QoL; Working Alliance Inventory (WAI) adapted for telehealth to assess relationship/goal/task alignment.

KPIs

Treatment retention, biologically verified abstinence, attendance patterns, and NPS‑based satisfaction.

“Long‑term follow‑up assesses sustained recovery, QoL improvements, social functioning, and durability over time, while engagement analytics inform early interventions.”

Data Analytics & Comparative Effectiveness Research

Real‑time dashboards support evidence‑based decisions and rapid identification of patients requiring adjustments. Comparative tracking against in‑person benchmarks demonstrates telehealth effectiveness and informs program improvement.

“This program exemplifies where evidence‑based excellence meets innovative technology—accessible, effective, compassionate care that supports patients throughout their recovery.”