La. Admin. Code tit. 48 § I-5729

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-5729 - Medications

A. The provider shall ensure that all medications are administered by a nurse, pharmacist or other practitioner licensed under state law and authorized by federal and state law to administer or dispense opioid drugs.

B. Take-Home Dose(s)

1. The provider shall ensure that:

a. determinations for take-home dose(s), the factors considered, and the rationale to provide unsupervised doses of methadone are made by the client's OTP practitioner, and are documented in the client's record when each take-home dose is authorized;

b. date and recommended dosage are documented in the client's record and the methadone central registry; and

c. take-home dose(s) are ordered by the OTP practitioner operating within the scope of his/her license.

2. In determining which clients may receive unsupervised doses, the OTP practitioner shall consider, among other pertinent factors that indicate whether the therapeutic benefits of unsupervised doses outweigh the risks, the following criteria:

a. absence of active substance use disorders, other physical or behavioral health conditions that increase the risk of client harm as it relates to the potential for overdose, or the ability to function safely;

b. regularity of attendance for supervised medication administration;

c. absence of serious behavioral problems that endanger the client, the public, or others;

d. absence of known recent diversion activity;

e. whether take-home medication can be safely transported and stored; and;

f. any other criteria that the OTP practitioner considers relevant to the client's safety and the public's health.

g. - h. Repealed.

3. If it is determined that a client is safely able to manage unsupervised doses of methadone, the OTP practitioner operating within the scope of his/her license shall determine the number of take-home doses authorized within the following dispensing restrictions.

a. During the first 14 days of treatment, the take-home supply shall be limited to 7 days of take home doses.

b. From 15 days of treatment, the take-home supply shall be limited to 14 days of take home doses.

c. From 31 days of treatment, the take-home supply provided to a client shall not exceed 28 days of take home doses at a time.

d. - f. Repealed.

4. Loss of Privilege. Positive drug screens at any time for any drug other than those prescribed shall require a new determination to be made by the OTP practitioner regarding take-home doses. Operating within the scope of his/her license, the OTP practitioner shall determine the actual number of take-home doses and whether the client is allowed to maintain take-home medication.

5. Exceptions. The provider shall request and obtain approval for a federally identified exception to the take-home dispensing restrictions from the State Opioid Treatment Authority (SOTA). Any exception shall be for an emergency or severe travel hardship.

C. Temporary Transfers or Guest Dosing. The providers involved in a temporary transfer or guest dosing shall ensure the following:

1. the receiving provider shall verify dosage prior to dispensing and administering medication;

2. the sending provider shall verify dosage and obtain approval and acceptance from receiving provider prior to client's transfer; and

3. that documentation to support all temporary transfers and guest dosing is maintained.

La. Admin. Code tit. 48, § I-5729

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 411722 (9/1/2015), Amended by the Department of Health, Bureau of Health Services Financing, LR 431388 (7/1/2017), Amended LR 481289 (5/1/2022), Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 411722 (9/1/2015), Amended by the Department of Health, Bureau of Health Services Financing, LR 431388 (7/1/2017), Amended LR 481289 (5/1/2022), Amended by the Department of Health, Health Standards Section, LR 51 (EMERGENCY).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and R.S. 40:2151-2161.