DHS 75.59(15)(c)4.4. Specimens shall be collected in a manner that minimizes the possibility of falsification. DHS 75.59(15)(c)5.5. When service staff must directly observe the collection of a urine sample, this task shall be done with respect for patient privacy. DHS 75.59(15)(d)1.1. Service staff shall discuss positive test results with the patient within one week of the sample being taken by the service and shall document them in the patient’s case record with the patient’s response noted. DHS 75.59(15)(d)2.2. The service shall provide counseling, casework, medical review and other interventions when continued use of substances is identified. DHS 75.59(15)(d)3.3. When there is a positive test result, service staff shall allow sufficient time before re-testing to prevent a second positive test result from the same substance use. DHS 75.59(15)(d)4.4. Service staff confronted with a patient’s denial of substance use shall consider the possibility of a false positive test. Patients shall be given the opportunity to challenge a test result by having the sample given retested. DHS 75.59(15)(d)5.5. Service staff shall review a patient’s dosage and shall counsel the patient regarding their use when test reports are positive for morphine-like substances and negative for the FDA-approved treatment. DHS 75.59(15)(e)1.1. The frequency that a service shall require drug screening shall be clinically appropriate for each patient, allow for a rapid response to the possibility of relapse, and occur at least on a monthly basis. DHS 75.59(15)(e)2.2. A service shall arrange for drug screens with sufficient frequency so that they can be used to assist in making informed decisions about take-home privileges. DHS 75.59(16)(a)(a) Patient retention. Patient retention shall be a major objective of treatment. The service shall do all of the following to retain patients for the planned course of treatment: DHS 75.59(16)(a)1.1. Render treatment in a way that is least disruptive to the patient’s travel, work, educational activities, ability to use supportive services, and family life. DHS 75.59(16)(a)3.3. Ensure that a patient has ready access to clinical staff, particularly to the patient’s primary counselor. DHS 75.59(16)(a)4.4. Ensure that clinical staff are adequately trained and are sensitive to gender- and culture-specific issues. DHS 75.59(16)(a)5.5. Provide services that incorporate evidence based practice standards for substance use treatment. DHS 75.59(16)(a)6.6. Ensure that patients receive adequate doses of medication based on their individual needs. DHS 75.59(16)(a)7.7. Ensure that all clinical staff are accepting of medication-assisted treatment. DHS 75.59(16)(a)8.8. Ensure that patients understand that they are responsible for complying with all aspects of their treatment, including participating in counseling sessions. DHS 75.59(16)(b)(b) Effort to retain patients. Since treatment duration and retention are directly correlated to rehabilitation success, a service shall make a concerted effort to retain patients within the first year following admission. Evidence of this concerted effort shall include written documentation of all of the following: DHS 75.59(16)(b)4.4. Whether continued treatment is medically necessary in the professional judgement of the service physician. DHS 75.59(16)(c)(c) Referral for further treatment. A service shall refer a patient discharged from the service to a more suitable treatment modality when further treatment is required or is requested by the patient and cannot be provided by the service. DHS 75.59(17)(17) Multiple substance use and co-occurring treatment. DHS 75.59(17)(a)(a) Assessment. A service shall assess a prospective patient for admission during the admission process to distinguish substance use, abuse and dependence, and determine patterns of other substance use and self-reported etiologies, including non-prescription, non-therapeutic and prescribed therapeutic use and mental health problems.