Current through Register Vol. 56, No. 18, September 16, 2024
(a) An opioid treatment program may elect to
provide on-site clinic based medical maintenance services to Phase VI clients under the care of a licensed
opioid treatment program physician according to program policy and the provisions of this chapter.
(b) Prior to initiating clinic based medical maintenance, an opioid
treatment program shall:
1. Submit a written notice to DMHAS of its intent
to initiate clinic based medical maintenance to Phase VI clients who meet the criteria in (c) below. The
opioid treatment program shall identify the physician who will direct the clinic based medical maintenance
program and submit documentation of the physician's qualifications to oversee the program;
2. Provide written assurance that counseling services, drug screenings and
ancillary services will be provided as needed in accordance with this chapter;
3. Provide written assurance that the opioid treatment program can
demonstrate internal protocols for reviewing client eligibility for clinic based medical maintenance
utilizing a multidisciplinary team approach to minimally include: the program's medical director, director of
substance abuse counseling, director of nursing services and the client's counselor;
4. Have been licensed and approved by all State and Federal authorities to
operate an opioid treatment program for at least two years;
5. Be
in substantial compliance with all State and Federal rules and regulations governing opioid treatment
programs including this chapter and standards set by accrediting agencies;
6. Ensure that all clients in Phase VI designated for clinic based medical
maintenance who are receiving monthly take-homes are seen monthly by the designated program
physician;
7. Ensure that clients in clinic based medical
maintenance receive monthly drug screening and an additional two special call backs in the first year, with
subsequent call backs as determined by program policy for determining client responsibility in handling
extended take-homes and drug screening at the time of the special call backs; and
8. Ensure that clients in clinic based medical maintenance with a positive
urine screening result shall be assessed by the physician, in consultation with the multidisciplinary team,
to determine if the client has been responsible in handling take home medication, and can be retained in
medical maintenance based on an assessment of other client factors for stability. The physician shall refer
the client for counseling in accordance with the provisions of this subchapter. Clients determined to have
not been responsible in handling extended take-home medication shall be removed from clinic based medical
maintenance. A second positive urine screening within 12 months shall result in the client being removed from
clinic based medical maintenance and returned to the general program.
(c) Opioid treatment programs electing to provide clinic based medical
maintenance will be subject to a comprehensive licensure survey to determine compliance with standards set by
accrediting agencies and this chapter. Programs determined to not be operating in accordance with these
standards may be directed by DCN&L to cease clinic based medical maintenance services and extended
take-homes.
(d) With the approval of the multidisciplinary team,
those clients who are in Phase VI and eligible for up to 30 days of take-home medication may participate in a
clinic based medical maintenance program, if they have been in compliance for 36 months, with the following
provisions:
1. Clients shall be physically and emotionally
stable;
2. Clients shall be free of alcohol and drug abuse as
verified by monthly drug screening;
3. Clients shall not have
been convicted of or known by program staff to be involved in any criminal activity for 36 months;
4. Clients shall be employed, in a similar capacity (that is, student,
homemaker), or disabled, as well as living in a stable environment; and
5. Clients shall have demonstrated responsible use of take home
medication.
