(iv) The amount of take-home medication shall be based on the clinical judgment of the physician in consultation with the multidisciplinary treatment team. If it is determined that a client meets the criteria for unsupervised dosing the supply shall be limited to the following schedule:(I) Phase 1 Treatment. Clients who are not eligible for any take home medication shall be designated by the program as in Phase 1 of Opioid Maintenance Therapy.I. During the first ninety (90) days of treatment, clients shall not be eligible for any take home medication.II. Twice-a-month drug tests shall document that each client in Phase I is free of all substances of abuse including alcohol and positive for the prescribed maintenance drug for at least ninety (90) consecutive days in order to be eligible for consideration for unsupervised dosing.(II) Phase 2 Treatment. Clients in treatment between ninety-one (91) and one hundred eighty (180) days, who satisfy the criteria specified in Rule 580-9-44-.29 8(i)(II) shall be eligible for a take-home supply that shall not exceed two (2) doses per week.I. Clients who are eligible for a two (2) day take home medication supply shall be designated by the program as in "Phase 2" of Opioid Maintenance Therapy.II. A minimum of one (1) random drug test per month must be conducted while the patient is in Phase 2.III. It shall be documented that the client is free of all substances of abuse including alcohol and positive for the prescribed maintenance drug for at least ninety (90) consecutive days in order to be considered for Phase 2 unsupervised dosing.(III) Phase 3 Treatment. Clients in treatment between one hundred eighty-one (181) and two-hundred seventy (270) days, who satisfy the criteria specified in Rule 580-9-44-.29 8(i)(II) shall be eligible for a take-home supply that shall not exceed three (3) doses per week.I. Clients who are eligible for a three (3) day take home medication supply shall be designated by the program as in Phase 3 of Opioid Maintenance Therapy.II. A minimum of one (1) random drug test per month must be conducted while the patient is in Phase 3.III. It shall be documented that the client is free of all substances of abuse including alcohol and positive for the prescribed maintenance drug for at least one hundred eighty (180) consecutive days in order to be considered for Phase 3 unsupervised dosing.(IV) Phase 4 Treatment. Clients in treatment between two hundred seventy-one (271) and three hundred sixty-five (365) days, who satisfy the criteria specified in Rule 580-9-44-.29 8(i)(II) shall be eligible for a take-home supply that shall not exceed six (6) doses per weekI. Clients who are eligible for a six (6) day take home medication supply shall be designated by the program as in Phase 4 of Opioid Maintenance Therapy.II. A minimum of one (1) random drug test per month must be conducted while the patient is in Phase 4.III. It shall be documented that the client is free of all substances of abuse including alcohol and positive for the prescribed maintenance drug two hundred seventy (270) consecutive days in order to be considered for Phase 4 unsupervised dosing.(V) Phase 5 Treatment. After two (2) years of continuous treatment with uninterrupted clean drug screens, client shall be eligible for up to a thirteen (13) day take home medication supply.I. Clients who are eligible for a thirteen (13) day take home medication supply shall be designated by the program as in Phase 5 of Opioid Maintenance Therapy.II. A minimum of one (1) random drug test per month must be conducted while the patient is in Phase 5.(iv) Temporary Special Take-Home Medication for Non-Emergency: The entity shall develop, maintain and document implementation of written policies and procedures that govern the process utilized to provide temporary take home medication for exceptional circumstances, which shall at a minimum include the following specifications:(I) The need for temporary special unsupervised take-home medication shall be clearly delineated with verifiable documentation in the clinical record.(II) A client seeking approval for temporary special unsupervised take-home medication shall, at a minimum, meet the criteria to determine eligibility for take home medication specified in Rule 580-9-44-.29 9.(III) Requests for temporary special take-home medication shall be approved in writing by the entity's medical director, the State Opioid Treatment Authority and SAMHSA.(IV) The provision and supply of temporary special unsupervised take-home medication shall be at the direction of the State Opioid Treatment Authority.(v) Temporary Special Take-Home Medication for Emergency: The entity shall develop, maintain and document implementation of written policies and procedures that govern the process utilized to provide emergency take-home medication for exceptional circumstances, which at a minimum include:(I) The need for emergency unsupervised take-home medication shall be clearly delineated with verifiable documentation in the client's clinical record.(II) Requests for emergency take-home medication shall be approved in writing by the entity's Medical Director and shall not exceed a three (3) day medication supply at any one time.I. Situations that might warrant emergency take-home medication include:A. Death in the family.B. Illness.C. Inclement weather.D. Other uniquely identified situations.
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