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)1.1. The mission and goals of the OTP.

DHS 75.59(6)(h)2.2. The hours during which services are provided.

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.

DHS 75.59(6)(h)4.4. Treatment costs.

DHS 75.59(6)(h)5.5. Patient rights and responsibilities.

DHS 75.59(6)(h)6.6. Federal confidentiality requirements.

DHS 75.59(6)(i)1.1. Identifies the patient on the basis of appropriate substantiated documents that contain the patient’s name and address, date of birth, sex and race or ethnic origin as evidenced by a valid driver’s license or other suitable documentation such as a passport.

DHS 75.59(6)(i)2.2. Determines the patient’s current addiction, to the extent possible, the current degree of dependence on narcotics or opiates, or both, including route of administration, length of time of the patient’s dependence, old and new needle marks, past treatment history and arrest record.

DHS 75.59(6)(i)3.3. Determines and verifies the patient’s age. If the patient is a minor, the policy shall require documentation as provided in par. (a) 2.

DHS 75.59(6)(i)4.4. Identifies all substances being used. To the extent possible, service staff shall obtain information on all substances used, route of administration, length of time used and amount and frequency of use.

DHS 75.59(6)(i)5.5. Obtains information about past treatment. To the extent possible, service staff shall obtain information on a patient’s treatment history, use of secondary substances while in the treatment, dates and length of time in treatment and reasons for discharge.

DHS 75.59(6)(i)6.6. Obtains personal information about the patient. Personal information includes history and current status regarding employment, education, legal status (including arrests and conviction history), military service, family and psychiatric and medical information.

DHS 75.59(6)(i)7.7. Identifies the patient’s reasons for seeking treatment. Reasons shall include why the patient chose the service and whether they fully understand the treatment options and the nature and requirements of medication assisted treatment are fully understood.

DHS 75.59(6)(i)8.8. Completes an initial drug screening or analysis to detect the use of opiates, methadone, buprenorphine, synthetic opioids, amphetamines, methamphetamine, benzodiazepines, cocaine, alcohol, and THC. The analysis shall show positive for narcotics, or an adequate explanation for negative results shall be provided and noted in the prospective patient’s record.