77 Ill. Adm. Code 946.625
Persons Receiving Care at U.S. Department of Veterans Affairs Facilities Seeking to Qualify for the Opioid Alternative Pilot Program
Section 946.625
Persons Receiving
Care at U.S. Department of Veterans Affairs Facilities Seeking to Qualify for
the Opioid Alternative Pilot Program
a)Â Â Â Â Â Â Â Â A
veteran or spouse of a veteran receiving care at a VA health care facility, who
has a current prescription for an opioid, may apply for the Opioid Alternative
Pilot Program by submitting a completed electronic application to the
Department.
b)Â Â Â Â Â Â Â Â The applicant
shall:
1)Â Â Â Â Â Â Â Â Be a
resident of the State of Illinois, as defined in Section 946.200(c), at the
time of application and remain a resident during participation in the program;
2)Â Â Â Â Â Â Â Â Submit
a photograph of the patient as follows:
A)Â Â Â Â Â Â Â Current
digital passport-size photograph, taken no more than 30 calendar days before
the submission of the application;
B)Â Â Â Â Â Â Â Taken
against a plain, light-colored background or backdrop;
C)Â Â Â Â Â Â Â At
least 2 inches by 2 inches in size;
D)Â Â Â Â Â Â Â In
natural color; and
E)Â Â Â Â Â Â Â That
provides an unobstructed front view of the full face. A full-faced photograph
must be taken without any obstruction of the applicant's facial features or any
items covering any portion of the face. Â Prescription glasses and religious
head coverings not covering any areas of the open face will be allowed. Head
coverings for persons diagnosed and undergoing treatment for cancer are
allowed;
5)Â Â Â Â Â Â Â Â Pay
the registration co-payment of $10 for the initial registration in the Opioid
Alternative Pilot Program;
6)Â Â Â Â Â Â Â Â Provide
a copy of medical records from the patient's VA health record found at
www.myhealth.va.gov. The medical records shall include, but not be limited to,
the VA Problem List, VA Appointments, and VA Medication History for the most
current 12-month period. The VA Medication History must show proof of a
current, ongoing prescription for an opioid;
7)Â Â Â Â Â Â Â Â Provide
a copy of the patient's DD-214 or equivalent certified document indicating
character and dates of service or, if the spouse of a veteran, a copy of the
veteran's documents; and
c)Â Â Â Â Â Â Â Â A
veteran or the spouse of a veteran enrolled in the Opioid Alternative Pilot
Program who submits an application to the Department for a medical cannabis
registry identification card shall cease to be registered with the Opioid
Alternative Pilot Program immediately upon submission of the application and
associated fee.
d)Â Â Â Â Â Â Â Â Opioid
Alternative Pilot Program participants shall notify the Department of changes
in the participant's name or address.