DHS 75.59(6)(a)1.1. ‘Maintenance treatment for an adult.’ The service shall maintain current procedures determined by the service physician to ensure that patients are admitted to maintenance treatment by qualified personnel who have determined, using accepted medical criteria, such as those listed in the DSM, that the person is currently addicted to an opioid drug, and that the person became addicted at least one year before admission for treatment. In addition, a service physician shall ensure that each patient voluntarily chooses maintenance treatment and that all relevant facts concerning the use of the opioid drug are clearly and adequately explained to the patient, and that each patient provides informed written consent to treatment. DHS 75.59(6)(a)2.2. ‘Maintenance treatment for a minor.’ A minor shall be eligible for maintenance treatment only if the minor has had at least 2 documented unsuccessful attempts at short-term detoxification or drug-free treatment within a 12-month period. No minor may be admitted to maintenance treatment unless a parent, legal guardian, or responsible adult designated by the relevant state authority consents in writing to such treatment. DHS 75.59(6)(a)3.3. ‘Maintenance treatment admission exceptions.’ If clinically appropriate, the program physician may waive the requirement of a one-year history of addiction of subd. 1. for any of the following: DHS 75.59(6)(a)3.c.c. A previously treated patient who was discharged from the service less than 2 years prior. DHS 75.59(6)(a)4.4. ‘Detoxification treatment.’ An OTP shall maintain current procedures that are designed to ensure that patients are admitted to short- or long-term detoxification treatment by qualified personnel, such as a service physician, who determines that such treatment is appropriate for the specific patient by applying established diagnostic criteria. Patients with two or more unsuccessful detoxification episodes within a 12-month period must be assessed by the service physician for other forms of treatment. A service shall not admit a patient for more than 2 detoxification treatment episodes in one year. DHS 75.59(6)(a)5.5. ‘Health care release of information.’ When the patient receives health care services from outside the service, the patient shall provide names, addresses and written consents for release of information from each health care provider to allow the service to contact the providers, and shall update releases if changes occur. DHS 75.59(6)(a)6.6. ‘Prohibition on reward for referral.’ No service shall provide a bounty, free services, medication or other reward for referral of potential service recipients to the clinic. DHS 75.59(6)(b)(b) Voluntary treatment. Participation in an OTP shall be voluntary. DHS 75.59(6)(c)(c) Explanation. Clinical staff shall clearly and adequately explain to the patient being admitted all relevant facts concerning the use of medications used by the service, service rules, and expectations. DHS 75.59(6)(d)(d) Consent. The service shall require a patient to complete an informed medication consent form which clearly indicates which FDA-approved medication for opioid use disorder they will be receiving, the reason for the use of the medication, the expected benefits of the use of the medication, and the potential side effects of the medication. DHS 75.59(6)(e)1.1. For each patient eligible for admission, the service shall arrange for a comprehensive physical examination and clinically indicated laboratory work-up. The comprehensive physical examination shall be ordered by the service physician on the day of admission and shall include a complete blood count and liver function testing. The service shall test for Hepatitis A, B, C and HIV if the patient gives informed consent in writing. If the patient declines permission to test shall be documented in the patient’s record. An updated comprehensive physical examination including lab work shall be completed annually. DHS 75.59(6)(e)2.2. The service shall complete a psychosocial assessment and initial treatment plan within 3 days of admission. DHS 75.59(6)(f)(f) Initial dose. If a person meets the admission criteria under par. (a), an initial dose of an FDA-approved medication may be administered to the patient on the day of admission. For each new patient enrolled in a service, the initial dose of methadone shall not exceed 30 milligrams and the total dose for the first day shall not exceed 40 milligrams, unless the service physician documents in the patient’s record that 40 milligrams did not suppress opioid abstinence symptoms. DHS 75.59(6)(g)(g) Central registry. All facilities shall participate in the department’s central registry, subject to all of the following requirements: DHS 75.59(6)(g)1.1. A patient shall be informed of the service’s participation in the central registry, and prior to initiating a central registry inquiry the service shall obtain the patient’s written consent. DHS 75.59(6)(g)2.2. To prevent simultaneous enrollment of a patient in more than one OTP, at the time of admission and prior to the dosing of a patient, the service shall initiate a clearance inquiry by submitting to the approved central registry the patient’s name, date of birth, and relevant information as required for the clearance procedure. No patient who is reported by the central registry to be participating in another such service shall be admitted to an OTP. When a dual enrollment is found, the patient shall be discharged from one OTP in order to continue enrollment at another OTP. The SOTA shall be notified within 24 hours of any dual enrollment discovered. DHS 75.59(6)(g)3.3. A disclosure shall be made with the patient’s written consent that meets the requirements of 42 CFR part 2, relating to alcohol and drug abuse patient records, except that the consent shall list the name and address of each central registry or acceptable alternative and each known OTP to which a disclosure will be made. DHS 75.59(6)(g)4.4. Reports received by the central registry shall be treated as confidential and shall not be released except to a licensed service or its designated legal representative, as required by law or as part of continuity of operations in the case of an emergency. Information made available by the central registry shall also be treated as confidential. DHS 75.59(6)(g)5.5. If a service operates not more than 200 miles away from an OTP in an adjoining state, the SOTA may direct the service to share service recipient information with the OTP in the other state to prevent simultaneous enrollment of persons in more than one OTP service. DHS 75.59(6)(g)6.6. A patient shall not be dosed prior to a central registry check being conducted. DHS 75.59(6)(g)7.7. Documentation of the central registry check shall be kept in the patient’s file. DHS 75.59(6)(h)(h) Information provided at admission. A patient admitted to the OTP shall receive written copies of the following information at the time of admission: DHS 75.59(6)(h)3.3. The service must provide access to staff support 24 hours a day 7 days a week to ensure that the service provides a mechanism to address patient emergencies (which includes medication verification by any other OTP, Emergency Department, correctional institution, or jail) by establishing an emergency contact system. The purpose of the contact system is to obtain dosage levels and other pertinent patient information on a 24 hour, 7-day-a-week-basis, as appropriate under confidentiality regulations. This subdivision does not require staff to be on site at all times, but at least one designated staff member is available “on call” as the emergency contact.