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37.27.120    ALL PROGRAMS - ORGANIZATION AND MANAGEMENT

(1) The administrative organization of all approved chemical dependency treatment programs shall ensure that:

(a) Lines and delegation of authority, responsibilities, structure and reporting relationships are explicitly stated in writing and delineate all staff positions and functions. Supervision must be clearly demonstrated.

(b) Development and implementation of a policies and procedures manual describing in detail the program services and personnel services and includes all policies and procedures required by these rules.

(c) The policy and procedure manual is reviewed and revised as necessary to keep it current.

(d) The program administrator reports to the governing body at least quarterly on progress toward goals and objectives which contain all of the required effectiveness indicators.

(e) The program will develop and conduct program self evaluations and report results to the governing body.

(f) Adequate staff to meet client requests for services and professional counseling staff/client ratios are at an acceptable level as determined by the department.

(g) All clients have individualized treatment plans. These treatment plans shall:

(i) Be designed to help the client understand and overcome his or her illness.

(ii) Be the focal point in the documentation of the treatment of the client.

(iii) provide summary statements of the clients' problems, appropriate realistic goals, and strategies for achieving goals. Goals should be defined as long or short term.

(iv) Delineate the treatment process.

(v) Reflect all services provided to the client and itemize the basic purpose of each service.

(vi) Be reviewed and updated as appropriate for the component.

(h) That progress notes are maintained on all clients. Progress notes shall:

(i) Be required to provide documentary evidence of person-to-person services provided to the client.

(ii) Be used in conjunction with the treatment plan to assess progress made in attaining treatment plan goals and ensure needed modifications. (These may occur as staffing notes.)

(iii) Relate to the treatment plan, i.e., if a new problem is identified in the note it must also be entered on the plan.

(iv) Be the primary tool for reviewing clients' progress.

(v) Include documentation of important events, information, reported third party statements affecting the client and contacts from referral sources.

(vi) Be written specific to each service component. One

of these should be a staffing note.

(i) A properly completed "authorization for release of information form" which meets all the federal and state requirements is completed for each disclosure of information concerning the client.

(j) Dimensional admission, continued stay and discharge criteria must be developed for each component to promote the least restrictive level of care and encompass the following dimensions:

(i) Alcohol and/or drug intoxication and/or potential withdrawal;

(ii) Physical conditions or complications;

(iii) Emotional/behavioral conditions and complications;

(iv) Treatment acceptance/resistance;

(v) Relapse potential;

(vi) Recovery environment (support systems) ;

(vii) Considerations - two factors must be considered in making treatment placement decisions which override the patient treatment match determined by these criteria:

(A) prior treatment failure and

(B) availability of the selected level of care. A treatment failure at any given level of care may indicate the need for treatment at a higher level of care. Note: Nationally recognized samples of dimensional admission, continued stay, and discharge criteria are available at the department of public health and human services, addictive and mental disorders division.

(k) Security measures are adequate and are in compliance with the confidentiality rules and regulations.

(l) Client records are retained according to the following guidelines:

(i) If a state approved chemical dependency program is receiving public funds through a contract, grant or written agreement with federal, state, county or city agencies, records must be retained 5 years beyond the termination date of said contract, grant or written agreement. Records shall be retained beyond the 5 year period if an audit is in process or if any audit findings, litigations or claims involving the records have not been resolved. The retention period for each year's records starts from date of submission of the annual or final report of expenditures (financial status report or equivalent) .

(ii) If a state approved program is not receiving public funds (federal, state, county or city) records must be retained 5 years beyond the fiscal year end (June 30th) in which that client was most recently discharged from that program. Records shall be retained beyond the 5 year period if an audit is in process or if any audit findings, litigations or claims involving the records have not been resolved.

(m) Facilities are clean and well maintained.

(n) Accounting and fiscal procedures are adopted which ensure financial accountability and meet all federal, state and county requirements.

(o) A sliding fee schedule is adopted based on ability to pay for all individuals receiving treatment services provided by approved chemical dependency programs. ( 53-24-108 (4) , MCA)

(p) They maintain at least $300,000 liability insurance and professional liability insurance on all staff providing counseling service and workers' compensation on all personnel.

(q) Sub-contracts and service agreements include a description of services; basis for payment; total amount of contract; duration of contract; and appropriate signatures of program administration and a representative of the governing body.

History: Sec. 53-24-204, 53-24-207 and 53-24-208, MCA; IMP, Sec. 53-24-208, 53-24-209 and 53-24-306, MCA; TRANS, C. 280, L. 1975, Eff. 1/2/77; AMD, 1981 MAR p. 1899, Eff. 1/1/82; AMD, 1983 MAR p. 1463, Eff. 10/14/83; AMD, 1985 MAR p. 1768, Eff. 11/15/85; AMD, 1987 MAR p. 2383, Eff. 12/25/87; AMD, 1992 MAR p. 1477, Eff. 7/17/92; TRANS, from DOC, 1998 MAR p. 1502.

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