(13) Take home dose restrictions and terminations.(a) In determining the client's take-home medications, the medical director or program physician shall act in accordance with 42 C.F.R. Part 8.12 and subsections (7) through (12) of this section.(b) An NTP shall restrict a client's take-home dosage privileges by moving the client back at least one (1) phase level on the schedule for take-home dosages if the client's drug screening results disclose the unauthorized presence any substance established in subsection (9)(b) of this section.(c) An NTP shall restrict a client's take-home dosage by moving the client back on the takehome dosage schedule if the medical director or program physician concludes that the client is no longer a suitable candidate for take-home privileges as presently scheduled.(d) An NTP shall revoke a client's take-home privileges for not less than thirty (30) days and shall require the client to ingest each dosage at the facility for any of the following reasons:1. The client's drug screening discloses an absence of the controlled substance prescribed by the program;2. The client is discovered to be misusing medication, as established in subparagraph 5. of this paragraph;3. The client attempts to enroll in another NTP;4. The client alters or attempts to alter a drug screen; or5. The client is not satisfactorily adhering to the requirements of the NTP by the following:a. The client has not complied with the rules of the NTP;b. There is indication that the client has repeatedly used drugs improperly;c. The client is sharing, giving away, selling, or trading his or her approved controlled substance dosage;d. The client is not ingesting his or her approved controlled substance dose in accordance with treatment program rules;e. There is indication that the client is selling, distributing, or otherwise involved with illicit drugs and their use; orf. The client is not participating in an educational, vocational, or home-making activity.(e) A client whose daily dosage is twenty-five (25) milligrams or less shall be exempt from paragraph (d)1. of this subsection.(f) A client whose take-home privileges were revoked or restricted may regain take-home privileges according to the following schedule:1. Phase one (1) -- satisfactory adherence for at least thirty (30) days;2. Phase two (2) -- satisfactory adherence for at least thirty (30) days after regaining phase one (1) privileges;3. Phase three (3) -- satisfactory adherence for at least thirty (30) days after regaining phase two (2) privileges;4. Phase four (4) -- satisfactory adherence for at least thirty (30) days after regaining phase three (3) privileges; and5. Phase five (5) -- satisfactory adherence for at least thirty (30) days after regaining phase four (4) privileges.(g) This subsection shall not be used to circumvent the requirements of this administrative regulation. A client shall not be advanced to a phase level pursuant to this subsection unless the client has previously been at that phase level after having satisfied the requirements of each phase.(h) Treatment shall be continued as long as it is medically necessary based upon the clinical judgment of the medical director or program physician and staff.(i) Scheduled withdrawal shall be under the immediate direction of the medical director or program physician and shall be individualized.(j) A client may voluntarily terminate participation in an NTP even if termination is against the advice of the NTP.(k) Except as established in subsection (15)(e) of this section, either voluntary or involuntary termination shall take place over a period of time not less than fifteen (15) days, unless:1. The medical director or program physician deems it clinically necessary to terminate participation sooner and documents the reason in the client's record; or2. The client requests in writing a shorter termination period.
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