Wisconsin Administrative Code › Department of Health Services › DHS 30-100 - Community Services › Chapter DHS 75 - Community Substance Use Service Standards › Subchapter VII - Opioid Treatment Programs and Office-Based Opioid Treatment › Section DHS 75.59 - Opioid treatment program

Current through June 24, 2024
(1)
SERVICE
				  DESCRIPTION.
In this section, oopioid treatment program, or "OTP", means
				  a service that provides for the management and rehabilitation of persons with
				  an opioid use disorder through the use of methadone and other FDA-approved
				  medications for the treatment of persons with an opioid use disorder, and also
				  provides a broad range of medical and psychological services, substance use
				  counseling and social services. OTPs shall provide adequate medical,
				  counseling, vocational, educational, and other assessment and treatment
				  services. These services must be available at the primary facility, except
				  where the program sponsor has entered into a formal, documented agreement with
				  a private or public agency, organization, practitioner, or institution to
				  provide these services to patients enrolled in the OTP. The program sponsor, in
				  any event, must be able to document that these services are fully and
				  reasonably available to patients. An OTP is subject to the oversight of the
				  SOTA.
(2)
REQUIREMENTS.
To receive certification from the department under
				  this chapter, an OTP shall comply with all requirements included in subch. IV,
				  as applicable, be certified under and follow all requirements included in s.
				  DHS 75.50, and the requirements of this section. If a requirement in this
				  section conflicts with an applicable requirement in subch. IV or s. DHS 75.50,
				  the requirement in this section shall be followed.
(3)
DEFINITIONS.
In this
				  section:
(a) "Biochemical monitoring" means
				  the collection and analysis of specimens of body fluids such as blood or urine
				  to determine use of licit or illicit drugs.
(b) "Central registry" means an organization
				  that obtains patient identifying information from 2 or more OTPs about
				  individuals applying for maintenance treatment or detoxification treatment for
				  the purpose of preventing an individual's concurrent enrollment in more than
				  one program.
(c) "Clinical
				  probation means the period of time determined by the treatment team that a
				  patient is required to increase frequency of service attendance due to rule
				  violations.
(d) "Guest dose means
				  administration of a medication used for the treatment of opioid addiction to a
				  person who is not a client of the program that is administering or dispensing
				  the medication.
(e) "Initial dosing
				  means the first administration of methadone or other FDA-approved medication
				  for the treatment of opioid use disorder to relieve a degree of withdrawal and
				  drug craving of the patient.
(f)
				  "Maintenance treatment means the dispensing of a narcotic drug in the treatment
				  of an individual for opioid dependence.
(g) "Mandatory schedule means the required
				  dosing schedule for a patient and the established frequency that the patient
				  must attend the service.
(h)
				  "Medically-supervised withdrawal means dispensing, administering, or
				  prescribing of an FDA-approved medication for the treatment of opioid use
				  disorder in gradually decreasing doses to alleviate adverse physical or
				  psychological effects incident to withdrawal from the continuous or sustained
				  use of opioid drugs. The purpose of medically supervised withdrawal is to bring
				  a patient maintained on maintenance medication to a medication-free state
				  within a target period.
(i)
				  "Medication unit means a facility established as part of a service but
				  geographically separate from the service, from which licensed private
				  practitioners and community pharmacists are:
1. Permitted to administer and dispense a
				  narcotic drug.
2. Authorized to
				  conduct biochemical monitoring for narcotic drugs.
(j) "Objectively intoxicated person means a
				  person who is determined through a breathalyzer test to be under the influence
				  of alcohol.
(k) "Opioid addiction
				  means psychological and physiological dependence on an opiate substance, either
				  natural or synthetic, that is beyond voluntary control.
(l) "Patient identifying information means
				  the name, address, social security number, photograph or similar information by
				  which the identity of a patient can be determined with reasonable accuracy and
				  speed, either directly or by reference to other publicly available
				  information.
(m) "Phase means a
				  patient's level of dosing frequency.
(n) "Potentiation means the increasing of
				  potency and, in particular, the synergistic action of two or more drugs which
				  produces an effect that is greater than the effect of each drug used
				  alone.
(o) "SAMHSA means the
				  Substance Abuse and Mental Health Services Administration.
(p) "Service physician means a physician
				  licensed to practice medicine in the jurisdiction in which the service is
				  located, and knowledgeable in addiction treatment, who assumes responsibility
				  for the administration of all medical services performed by the OTP including
				  ensuring that the service is in compliance with all federal, state and local
				  laws relating to medical treatment of an opioid use disorder with an FDA
				  approved medication for the treatment of an opioid use disorder.
(q) "Program sponsor means the person named
				  in the application for certification described in
				  42 CFR
				  8.11(b) who is responsible
				  for the operation of the OTP and who assumes responsibility for all its
				  employees, including any practitioners, agents, or other persons providing
				  medical, rehabilitative, or counseling services at the program or any of its
				  medication units. The program sponsor need not be a licensed physician but
				  shall employ a licensed physician for the position of medical director. The
				  program sponsor is responsible for ensuring the service is in continuous
				  compliance with all federal, state, and local laws and regulations.
(r) "State opioid treatment authority (SOTA)
				  means the subunit of the department designated by the governor to exercise the
				  responsibility and authority in this state for governing the treatment of a
				  narcotic addiction with a narcotic drug.
(s) "Take-homes means medications such as
				  methadone that reduce the frequency of a patient's service visits and with the
				  approval of the service physician, are dispensed in an oral form and are in a
				  container that at a minimum discloses the treatment service name, address and
				  telephone number and the patient's name, the dosage amount and the date on
				  which the medication is to be ingested.
(t) "Treatment contracting means an agreement
				  developed between the primary counselor or the clinic director and the patient
				  in an effort to allow the patient to remain in treatment on condition that the
				  patient adheres to service rules.
(u) "Treatment team means a team established
				  to evaluate the progress of a patient and consisting of at least the primary
				  counselor, the service staff nurse who administers doses and the clinic
				  director.