B. Treatment Phases1. Initial Treatment. During the initial treatment phase that lasts from three to seven days in duration, the provider shall:a. conduct client orientation;b. provide individual counseling; andc. develop the initial treatment plan including initial dose of medication and plan for treatment of critical health or social issues.2. Early Stabilization. In the early stabilization period that begins on the third to seventh day following initial treatment through 90 days duration, the provider shall:a. conduct weekly monitoring by a nurse of the client's response to medication;b. provide at least four individual counseling sessions;c. revise the treatment plan within 30 days to include input by all disciplines, the client and significant others; andd. conduct random monthly drug screen tests.3. Maintenance Treatment. In the maintenance treatment phase that follows the end of early stabilization and lasts for an indefinite period of time, the provider shall provide:a. random monthly drug screen tests until the client has negative drug screen tests for 90 consecutive days as well as random testing for alcohol when indicated;b. thereafter, monthly testing to clients who are allowed six days of take-home doses, as well as random testing for alcohol when indicated;c. continuous evaluation by the nurse of the client's use of medication and treatment from the program and from other sources;d. documented reviews of the treatment plan every 90 days in the first 2 years of treatment by the treatment team; ande. documentation of response to treatment in a progress note at least every 30 days.4. Medically Supervised Withdrawal from Synthetic Narcotic with Continuing Care. Medically supervised withdrawal is provided if and when appropriate. If provided, the provider shall:a. decrease the dose of the synthetic narcotic to accomplish gradual, but complete withdrawal, as medically tolerated by the client;b. provide counseling of the type and quantity determined by the indicators and the reason for the medically supervised withdrawal from the synthetic narcotic; andc. conduct discharge planning with continuity of care to assist client to function without support of the medication and treatment activities.5. Required Withdrawal. The provider shall provide medically-approved and medically-supervised assistance to withdrawal from the synthetic narcotic when:a. the client requests withdrawal;b. quality indicators predict successful withdrawal; orc. client or payer source suspends payment of fees.
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