DHS 75.59(13)(k)1.1. A service may reduce a patient’s take-home privileges or may require more frequent visits to the service if the patient inexcusably misses a scheduled appointment with the service, including an appointment for dosing, counseling, a medical review or a psychosocial review or for an annual physical or an evaluation.
DHS 75.59(13)(k)2.2. A service shall reduce a patient’s take-home privileges or may require more frequent visits to the service if the patient shows positive results in drug test analysis for morphine-like substances or substances of abuse or if the patient tests negative for the narcotic drug administered or dispensed by the service.
DHS 75.59(13)(L)(L) Reinstatement. A service shall not reinstate take-home privileges that have been revoked until:
DHS 75.59(13)(L)1.1. The patient has had at least 3 consecutive tests or analyses that are neither positive for morphine-like substances or substances of abuse, or negative for the narcotic drug administered or dispensed by the service. The tests must be at least one week apart.
DHS 75.59(13)(L)2.2. The service physician determines that the patient can responsibly handle narcotic drugs.
DHS 75.59(13)(m)(m) Clinical probation.
DHS 75.59(13)(m)1.1. A patient receiving a 6-day supply of take-home medication or more who has a test or analysis that is confirmed to be positive for a substance of abuse or negative for the narcotic drug dispensed by the service shall be placed on clinical probation for 3 months.
DHS 75.59(13)(m)2.2. A patient on 3-month clinical probation who has a test or analysis that is confirmed to be positive for a substance of abuse or negative for the narcotic drug administered or dispensed by the service shall be required to attend the service at least twice weekly for observation of the ingestion of medication, and may receive no more than a 3-day take-home supply of medication.
DHS 75.59(13)(n)(n) Employment-related exception to 6-day supply. A patient who is employed and working on Saturdays may apply for an exception to the dosing requirements if dosing schedules of the service conflict with working hours of the patient. A service may give the patient an additional take-home dose after verification of work hours through pay slips or other reliable means, and following approval for the exception from the SOTA and the designated federal agency.
DHS 75.59(14)(14)Exceptions to take-home requirements.
DHS 75.59(14)(a)(a) Exception requests. A service may submit a request to the designated federal authority and the SOTA for an exception to certain take-home requirements for a particular patient if, in the reasonable clinical judgment of the service physician, any of the following conditions is met:
DHS 75.59(14)(a)1.1. The patient has a physical disability that interferes with his or her ability to conform to the applicable mandatory schedule. The patient may be permitted a temporarily or permanently reduced schedule provided that she or he is found under par. (c) to be responsible in handling narcotic drugs.
DHS 75.59(14)(a)2.2. The patient, because of an exceptional circumstance such as illness, personal or family crisis, travel or other hardship, is unable to conform to the applicable mandatory schedule. The patient may be permitted a temporarily reduced schedule, provided that she or he is found under par. (c) to be responsible in handling narcotic drugs.
DHS 75.59(14)(b)(b) Rationale for exception. The program physician or program personnel supervised by the program physician shall record the rationale for an exception to an applicable mandatory schedule in the patient’s case record. A patient may not be given more than a 14-day supply of narcotic drugs at one time.
DHS 75.59(14)(c)(c) Exception criteria. The service physician’s judgment that a patient is responsible in handling narcotic drugs shall be supported by information in the patient’s case file that the patient meets all of the following criteria:
DHS 75.59(14)(c)1.1. Absence of recent abuse of narcotic or non-narcotic drugs including alcohol.
DHS 75.59(14)(c)2.2. Regularity of service attendance.
DHS 75.59(14)(c)3.3. Absence of serious behavior problems in the service.
DHS 75.59(14)(c)4.4. Absence of known recent criminal activity such as drug dealing.
DHS 75.59(14)(c)5.5. Stability of the patient’s home environment and social relationships.
DHS 75.59(14)(c)6.6. Length of time in maintenance treatment.
DHS 75.59(14)(c)7.7. Assurance that take-home medication can be safely stored within the patient’s home.
DHS 75.59(14)(c)8.8. The rehabilitative benefit to the patient derived from decreasing the frequency attendance outweighs the potential risks of diversion.
DHS 75.59(14)(d)(d) Exception outcome.
DHS 75.59(14)(d)1.1. Any exception to the take-home requirements is subject to approval of the designated federal agency and the SOTA. Both the designated federal agency and the SOTA must approve the exception. If one does not approve then the exception is considered denied.
DHS 75.59(14)(d)2.2. Service staff on receipt of notices of approval or denial of a request for an exception from the SOTA and the designated federal agency shall place the notices in the patient’s case record.
DHS 75.59(14)(e)(e) Exception review. Service staff shall review an exception when the conditions of the request change or at the time of review of the treatment plan, whichever occurs first.
DHS 75.59(14)(f)(f) Exception duration. An exception shall remain in effect only as long as the conditions establishing the exception remain in effect.
DHS 75.59(15)(15)Testing and analysis for drugs.