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.

DHS 75.59(12)(e)1.1. A patient has the right to appeal an adverse decision of a hearing officer to the department’s client rights office. The patient must request this appeal in writing to the department within 3 business days following the receipt of the adverse decision. This request must be postmarked within the 3 business day time frame. The patient’s written appeal shall contain the patient’s argument in support of the appeal. The department will either affirm or reverse the hearing officer’s decision, or remand the decision to a new hearing officer for a new hearing. The decision of the department shall be made as follows in writing:

DHS 75.59(12)(e)1.a.a. In the case of an emergency termination, the department shall decide within one business day of receipt of the complete hearing record and written materials submitted by both parties.

DHS 75.59(12)(e)1.b.b. In the case of a non-emergency termination, the department shall decide within 10 business days of the department’s receipt of the complete hearing record and written materials submitted by both parties. A service’s failure to submit the complete hearing record will result in a finding for the patient. The department shall deliver a written decision, outlining the reason(s) for the decision, to the patient, the patient’s advocate, and the service. The decision of the department is final.

DHS 75.59(12)(e)2.2. In the case of a non-emergency termination, if the patient timely appeals the hearing decision, the service may not terminate the client or begin medically supervised withdrawal without first receiving, and ensuring that the client also receives, the department’s decision on appeal.

DHS 75.59(12)(f)(f) Humane taper. The process of withdrawal from medication for administrative reasons shall be conducted in a humane manner as determined by the service physician, and referral shall be made to other treatment services.

DHS 75.59(13)(a)(a) Granting take-home privileges. During treatment, a patient may benefit from less frequent required visits for dosing. This shall be based on an assessment by the treatment staff. Time in treatment is not the sole consideration for granting take-home privileges. After consideration of treatment progress, the service physician shall determine if take-home doses are appropriate or if approval to take-home doses should be rescinded. Federal and State requirements that shall be adhered to by the SOTA and the service are as follows:

DHS 75.59(13)(a)1.1. Take-home doses are not allowed during the first 30 days of treatment. Patients are expected to attend the service daily. Exception requests may be submitted for review when extenuating circumstances (i.e. pandemic) arise and will be reviewed and a determination made by the SOTA.

DHS 75.59(13)(a)2.2. Take-home doses shall not be granted if the patient continues to use illicit drugs and if the primary counselor and the treatment team determine that the patient is not making progress in treatment and has continued drug use or legal problems.

DHS 75.59(13)(a)3.3. Take-home doses shall only be provided when the patient is clearly adhering to the requirements of the service. The patient shall be expected to show responsibility for security and handling of take-home doses.

DHS 75.59(13)(a)4.4. Service staff shall go over the requirements for take-home privileges with a patient before the take-home practice for self-dosing is implemented. Clinical staff shall require the patient to provide written acknowledgment that all the rules for self-dosing have been provided and understood at the time the review occurs.