DHS 75.59(12)(a)1.a.a. The clinic director reasonably determines and documents that the patient’s continuance in the service presents an immediate and substantial threat of physical harm to other clients, service personnel or property.

DHS 75.59(12)(a)2.2. Upon termination under this paragraph, the service shall:

DHS 75.59(12)(a)2.d.d. Provide referrals to ensure a continuum of care for the client, including continued counseling, medication, withdrawal management, and other services, including risk reduction and outreach.

DHS 75.59(12)(a)3.3. Facilities that are in the process of termination are not required to provide medically supervised withdrawal services to clients who are discharged involuntarily on an emergency basis, but referrals for assistance elsewhere must be provided in such circumstances.

DHS 75.59(12)(b)(b) Non-emergency termination. In a non-emergency situation, the service must afford the client the following procedural rights in addition to the rights listed in s. 51.61, Stats., and ch. DHS 94:

DHS 75.59(12)(b)1.1. Prior to initiating medically supervised withdrawal, the service shall provide the client with prompt written notice which shall contain:

DHS 75.59(12)(b)1.a.a. A statement of the reasons for the proposed termination, such as violations of a specific rule or rules, non-compliance with treatment contract, and the particulars of the infraction including the date, time, and place.

DHS 75.59(12)(b)1.b.b. Notification that the client has the right, within 2 business days following receipt of written notice, to submit a written request for a fair hearing on the proposed termination; if a fair hearing is requested the medically supervised withdrawal is stopped until the hearing occurs and a decision is rendered.

DHS 75.59(12)(b)2.2. If a timely request for a hearing is made, arrange with the patient or patient’s advocate for a mutually convenient date and time for a hearing within 10 business days of receipt of the notice. Additional time to secure appropriate representation may be granted to the client under exceptional circumstances.

DHS 75.59(12)(b)3.3. Afford the client the opportunity of medically supervised withdrawal. If the client chooses medically supervised withdrawal, the service shall provide medically supervised withdrawal, or make arrangements for appropriate medically supervised withdrawal in another OTP. The rate of dosage reduction shall be determined by the services medical director in accordance with the patient’s medical condition and the dosage level at which the client was medicated before the decision was made to terminate or suspend. In determining an appropriate course of withdrawal, the medical director shall review the record, consider the patient’s physical and mental health status, and, upon request of the client, may take into account the opinions of the patients other physicians and medical providers. If a hearing is requested by the patient, the medically supervised withdrawal shall cease until the hearing occurs and a decision is rendered.

DHS 75.59(12)(b)4.4. If a patient is terminated for non-payment of fees, medically supervised withdrawal may begin immediately upon providing written notice of termination, and continue concurrent with client’s appeal, if any.

DHS 75.59(12)(c)(c) Documentation of receipt of notice. The service shall document provision of notice to the patient by obtaining the signature of the staff person providing notice and by obtaining a signed, dated receipt from the patient. If the patient refuses to sign a receipt, the service shall document that refusal on its record of notice.

DHS 75.59(12)(d)1.1. An impartial hearing officer shall preside over the hearing. The hearing officer may be any staff or other person not directly involved in the facts of the incident giving rise to the disciplinary proceedings or in the decision to commence the proceedings, provided that the persons involved in either the facts of the incident or in the decision to commence the proceedings shall not have authority over the hearing officer.

DHS 75.59(12)(d)2.2. The patient may be represented at the hearing by any responsible adult of the client’s choosing. If the patient chooses to be represented by legal counsel, the patient must give the service at least 72 hours’ notice in advance of the hearing, so that the service may consult its own legal counsel prior to the hearing.

DHS 75.59(12)(d)3.3. At a hearing, the service bears the burden of proving, by a preponderance of the evidence, that the alleged violation occurred.

DHS 75.59(12)(d)4.4. The patient shall be entitled, upon request, to examine any documentary evidence in the possession of the service that pertains to the subject matter of the hearing.

DHS 75.59(12)(d)5.5. The patient shall be entitled to call his or her own witnesses and to question any adverse witnesses.

DHS 75.59(12)(d)6.6. The service shall make an audio recording of the hearing. The patient may also make an audio recording of the hearing at the patient’s expense.

DHS 75.59(12)(d)7.7. The hearing officer shall make a decision within 7 business days after the hearing and will base the decision solely upon the information presented at the hearing. The decision shall be based upon the services policy and procedures in effect and posted at the time of the violation.

DHS 75.59(12)(d)8.8. The hearing officer shall issue the decision in writing, and shall provide the patient or and patient’s representative, or both, with a copy of the decision. The decision shall include an explanation of the reasons for the decision, and instructions explaining how to file an appeal of an adverse decision to the department. The instructions shall inform the client that the client’s written request for an appeal constitutes the client’s consent to release information to the department.