disorder. For methadone treatment, the recipient shall be diagnosed with a substance use
disorder and have documented opioid use disorder for 1 year or more.
(9) At the time of admission and prior to any medications being prescribed, the
medical director, a physician, physician’s assistant, or advanced practice registered nurse
shall complete and document the medical and drug history, as well as a physical
examination, of the recipient. In addition, any modification to medications or course of
treatment must be documented in recipient record and ordered by a physician, physician’s
assistant, or advanced practice registered nurse.
(10) Prior to treatment, a licensee shall provide a recipient, or a person acting on the
recipient’s behalf, all available medical treatment options and FDA approved medications
related to the recipient’s assessment, including all FDA approved forms of MAT, as well
as the risks and benefits of each treatment option. The recipient record must contain a
written document that the recipient has been informed of the risks and benefits of all
treatment options, and the option selected by the recipient.
(11) By days 30, 60, and 90 of treatment, and at least every 90 days thereafter, the
medical director, a physician, physician’s assistant, or advanced practice registered nurse
shall meet with the recipient to review recipient’s treatment plan, including a review of the
counseling services progress notes, drug tests, and document the medical necessity for
continued treatment in the program and any recommended adjustments to the treatment
plan.
(12) A licensee shall have onsite at all times the appropriate licensed health
professional, as identified in the program assessment as required in R 325.1349.
(13) A licensee shall have a policy and procedure for testing to determine the status
of recipient’s drug use. Testing shall be conducted according to manufacturer’s guidelines.
(14) A licensee shall perform and document the tests completed for opioids,
benzodiazepine, methadone and methadone metabolites, buprenorphine and buprenorphine
metabolites, barbiturates, amphetamines, cocaine, and other drugs on all recipients,
according to all of the following:
(a) For a new recipient to a program, the test results must be documented in the
recipient record prior to the initial dosing.
(b) Biweekly testing on a random collection schedule with results documented in the
recipient record within 72 hours of collection, excluding weekends and holidays.
(c) For a recipient who has maintained biweekly drug-free results for a period of 6
months, monthly testing on a random collection schedule with results documented in the
recipient record within 72 hours of collection, excluding weekends and holidays.
(d) A positive test for drugs other than methadone and methadone metabolites,
buprenorphine and buprenorphine metabolites, legally prescribed drugs, or medical
marihuana, requires the licensee to perform weekly testing until 3 consecutive weekly
drug-free results are documented.
(e) A positive test for drugs other than methadone and methadone metabolites,
buprenorphine and buprenorphine metabolites, legally prescribed drugs, or medical
marihuana, requires the licensee to address and record all interventions in the recipient
record.
(15) A licensee shall have a policy and procedure to address when methadone take-
home medications are appropriate for recipients and the frequency of take-home doses,
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