The Department intends to amend 65D-30.0142, F.A.C., Clinical and Operational Standards for Medication-Assisted Treatment for Opioid Use Disorders to adopt federal regulations for take-home phases. This rule amendment will ....

 

DEPARTMENT OF CHILDREN AND FAMILIES

Substance Abuse Program

RULE NO.:RULE TITLE:

65D-30.0142Clinical and Operational Standards for Medication-Assisted Treatment for Opioid Use Disorders

PURPOSE, EFFECT AND SUMMARY: The Department intends to amend Rule 65D-30.0142, F.A.C., Clinical and Operational Standards for Medication-Assisted Treatment for Opioid Use Disorders to adopt federal regulations for take-home phases. This rule amendment will reduce staffing and fiscal burdens on providers of Medication-Assisted Treatment for Opioid Use Disorders, while maintaining the health and safety for individuals receiving these services. The proposed rule amendment adopts a rule substantively identical to the federal regulations adopted by the Substance Abuse and Mental Health Services Administration at Title 42 Code of Federal Regulations, Section 8.12(i)(3) (42 C.F.R 8.12(i)(3)) for take-home phases for Methadone Medication-Assisted Treatment.

RULEMAKING AUTHORITY: 397.321(5), FS.

LAW IMPLEMENTED: 397.311(26), 397.321, 397.410, 397.427, FS.

THIS RULEMAKING IS UNDERTAKEN PURSUANT TO SECTION

120.54(6), F.S. WRITTEN COMMENTS MAY BE SUBMITTED WITHIN 14 DAYS OF THE DATE OF THIS NOTICE TO: Jodi Abramowitz. Jodi can be reached at [e-mail].

SUBSTANTIALLY AFFECTED PERSONS MAY WITHIN 14 DAYS OF THE DATE OF THIS NOTICE, FILE AN OBJECTION TO THIS RULEMAKING WITH THE AGENCY. THE OBJECTION SHALL SPECIFY THE PORTIONS OF THE PROPOSED RULE TO WHICH THE PERSON OBJECTS AND THE SPECIFIC REASONS FOR THE OBJECTION.

 

THE FULL TEXT OF THE PROPOSED RULE IS:

65D-30.0142 Clinical and Operational Standards for Medication-Assisted Treatment for Opioid Use Disorders.

(1) No change.

(2) Maintenance Treatment Standards.

(a) through (g) No change.

(h) Take-home Phases. To be considered for take-home privileges, all individuals shall be in compliance with criteria as stated in 42 CFR 8.12(i)(2).

1. No change.

2. Take-home privileges shall be limited to the following take-home phases, in accordance with 42 CFR 8.12(i)(3):

a. During the first 90 days of  treatment, the take-home supply is limited to a single dose each week. The individual shall ingest all other doses under appropriate medical supervision.

b. In the second 90 days of treatment, the take-home supply is limited to two doses per week.

c. In the third 90 days of treatment, the take-home supply is limited to three doses per week.

d. In the remaining months of the first year, an individual may be given a maximum of six-day supply of take-home medication.

e. After one year of continuous treatment, an individual may be given a maximum two-week supply of take-home medication.

f. After two years of continuous treatment, an individual may be given a maximum of one-month supply of take-home medication, but must make monthly visits.

2. No take-homes shall be permitted during the first 30 days following placement, unless approved by both the state and federal authorities.

a. Phase I. Following 30 consecutive days in treatment, the individual may be eligible for one (1) take-home per week from day 31 through day 90, provided that the individual has had negative drug screens and is following program requirements for the preceding 30 days.

b. Phase II. Following 90 consecutive days in treatment, the individual may be eligible for two (2) take-homes per week from day 91 through day 180, provided that the individual has had negative drug screens for the preceding 60 days.

c. Phase III. Following 180 consecutive days in treatment, the individual may be eligible for three (3) take-homes per week with no more than a two (2)-day supply at any one time from day 181 through one (1) year, provided that the individual has had negative drug screens for the preceding 90 days.

d. Phase IV. Following one (1) year in continuous treatment, the individual may be eligible for four (4) take-homes per week through the second year of treatment, provided that the individual has had negative drug screens for the preceding 90 days.

e. Phase V. Following two (2) years in continuous treatment, the individual may be eligible for five (5) take-homes per week, provided that the individual has had negative drug screens for the preceding 90 days.

f. Phase VI. Following three (3) years in treatment, the individual may be eligible for six (6) take-homes per week provided that the individual had all negative drug screens for the past year.

3. Methadone Medical Maintenance. Providers may place an individual on methadone medical maintenance in cases where it can be demonstrated that the potential benefits of medical maintenance to the individual exceed the potential risks, in the professional judgment of the physician. Only a physician may authorize placement of an individual on medical maintenance. The physician shall provide justification in the clinical record regarding the decision to place an individual on medical maintenance.

The following conditions shall apply to medical maintenance.

a. To qualify for partial medical maintenance, an individual may receive no more than 13 take-homes and must have been in continuous treatment for four (4) years with negative drug screens for the previous two (2) years.

b. To qualify for full medical maintenance an individual may receive no more than 27 take-homes and must have been in continuous treatment for five (5) years with negative drug screen for the prious two (2) years.

c. through e. are renumbered a. through c. No change.

(i) through (r) No change.

(3) through (5) No change.

 

Rulemaking Authority 397.321(5) FS. Law Implemented 397.311(26), 397.321, 397.410, 397.427 FS. History–New 8-10-20. Amended______