DAR File No. 44005

Human Services, Substance Abuse and Mental Health

Rule R523-4

Certification Requirements for Screening, Assessment, Prevention, Treatment and Recovery Support Programs for Adults

Notice of Proposed Rule

(Amendment)

DAR File No.: 44005
Filed: 08/20/2019 10:51:07 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rule prescribes the minimum standards required for justice certification of mental health and substance use disorder (SUD) providers serving adults participating in mandatory education and treatment programs designed to reduce criminogenic risk. These changes are being proposed based on the agency's self-review of the statutory requirements placed on the Division of Substance Abuse and Mental Health (Division), and analysis of how to best meet the intent of Justice Reinvestment Initiative (JRI) certification.

Summary of the rule or change:

These amendments include: 1) formatting of sections has been changed; 2) an emphasis has been placed on the intent for certification to be extended to programs serving adults with criminogenic risk factors; 3) mandatory services has been defined; 4) a section for justice certification eligibility has been added to this rule; 5) requirements for criminogenic risk assessments has been removed; 6) criminogenic screening requirements have been updated; 7) standards for substance use and mental health screening and assessments have been combined and updated; 8) standards for providers of educational series have been updated; 9) the "Standards for Community-based Treatment" section has been updated and combined with the "Program Standards" section, and provisions for sole proprietorships and health clinics have been added; 10) the "Standards for Jail or Prison Treatment Programs" and "Documentation Standards for Community and Jail/Prison Based Treatment Services" sections have been eliminated; 11) justice certification requirements have been updated to reflect current agency expectations and actions; and 12) key search phrases have been updated to reflect the current justice certification nomenclature.

Statutory or constitutional authorization for this rule:

• Subsection 62A-15-103(j)
• 42 CFR Part 2

Anticipated cost or savings to:

the state budget:

The proposed changes in this rule amendment update procedures and expectation to meet current Division expectations and procedures, and do not require additional cost to the state budget beyond that which already exist with this rule as it is currently written.

local governments:

The proposed changes in this rule amendment update procedures and expectation to meet current Division expectations and procedures, and do not require additional cost to local governments service provider systems beyond that which already exist with this rule as it is currently written.

small businesses:

The proposed changes in this rule amendment update procedures and expectation to meet current Division expectations and procedures, and do not require additional cost to small businesses holding current justice certifications or small businesses that will potentially apply to be justice certified in the future beyond that which already exist with this rule as it is currently written.

persons other than small businesses, businesses, or local governmental entities:

There are no costs or benefits in this rule change associated with other persons.

Compliance costs for affected persons:

There are no compliance cost in this rule amendment.

Comments by the department head on the fiscal impact the rule may have on businesses:

After conducting a thorough analysis, it was determined that these proposed rule amendments will not result in a fiscal impact to businesses.

Ann Williamson, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Human Services
Substance Abuse and Mental Health
195 N 1950 W
SALT LAKE CITY, UT 84116

Direct questions regarding this rule to:

• Thomas Dunford at the above address, by phone at 801-538-4181, by FAX at 801-538-4696, or by Internet E-mail at tdunford@utah.gov
• Jonah Shaw at the above address, by phone at 801-538-4219, by FAX at 801-538-3942, or by Internet E-mail at jshaw@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

10/15/2019

This rule may become effective on:

10/22/2019

Authorized by:

Doug Thomas, Director

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs	FY 2020	FY 2021	FY 2022
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Person	$0	$0	$0
Total Fiscal Costs:	$0	$0	$0
Fiscal Benefits
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Persons	$0	$0	$0
Total Fiscal Benefits:	$0	$0	$0
Net Fiscal Benefits:	$0	$0	$0

 

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described in the narrative. Inestimable impacts for Non - Small Businesses are described in Appendix 2.

 

Appendix 2: Regulatory Impact to Non - Small Businesses

These rule changes are not expected to have any fiscal impact on non-small businesses' revenues or expenditures, because there are not any non-small businesses that are currently providing substance use and/or mental health services to individuals who are required to participate in treatment; and it is unlikely a non-small business will ever participate in the activities describe in these rule changes.

 

The director of the Department of Human Services, Ann Williamson, has reviewed and approved this fiscal analysis.

 

 

R523. Human Services, Substance Abuse and Mental Health.

R523-4. Certification Requirements for Screening, Assessment, Prevention, Treatment and Recovery Support Programs for Adults.

R523-4-1. Authority.

This rule is authorized by Section 62A-15-103[(h)](j) and 62A-15-103(2)(a)(v) requiring the Division of Substance Abuse and Mental Health (Division) to establish by rule, in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, minimum standards and requirements for the provision of substance use disorder and mental health treatment for adults[to individuals who are] required to participate in treatment by the court or the Board of Pardons and Parole[, or who are incarcerated and to develop, in collaboration with public and private programs, minimum standards for public and private providers of substance abuse and mental health programs licensed by the Department of Human Services under Title 62A, Chapter 2, Licensure of Programs and Facilities].

 

R523-4-2. Purpose.

This rule prescribes the minimum standards required for [programs that provide mental health and substance use disorder screening, assessment, prevention, treatment, education and recovery supports services for adults, and requirements to obtain a quality certification]justice certification of mental health and substance use disorder (SUD) providers serving adults participating in mandatory education and treatment programs designed to reduce criminogenic risk.

 

R523-4-3. Definitions.

(1) "Screening" means a preliminary appraisal of an [individual]adult to determine if further assessment of mental health, and/or substance use risk and needs is warranted.

(2) "Assessment" means an in-depth clinical interview with a licensed mental health therapist, used to:

(a) Determine if an [individual]adult is in need of:

(i) Mental health or substance use disorder treatment[services];

(ii) An [Educational or Prevention]educational series;

(iii) Recovery support services;

(b) Recommend a needed level of care or array of services.

(3) "Criminogenic Risk" means individual characteristics that are directly related to researched causations of crime.

(4) "Level of Care" means the intensity of either substance use disorder services needed as defined by the American Society of Addiction Medicine (ASAM) or the array of services needed to address an individual's mental health issues.

(5) "Treatment" means the array of therapeutic services, including individual, family, group services, medications and interventions designed to improve and enhance social or psychological functioning and reduce criminogenic risk for individuals identified as having either mental health or substance use disorders.[ The ultimate goal of treatment services is to engage the individual in a process of recovery.]

(6) "Educational[ or Prevention] Series" means an evidence-based instructional series[ for individuals with low criminogenic risk] obtained at a substance use disorder program that is approved by the Division of Substance Abuse and Mental Health in accordance with Section 62A-15-105 designed to prevent the onset of substance use and/or mental health disorders.

(7) "Recovery" means a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

(8) "Recovery Support" means social support services or activities provided before, during or after completion of acute treatment services to enhance an individual's ability to either attain or retain their recovery from either mental health or substance use disorders.

(9) "Mandatory" means education or treatment ordered, motivated, or supervised by the criminal justice system.

 

R523-4. Eligibility for Justice Certification.

(1) All programs or providers desiring to deliver mandatory education, or treatment services shall apply for and achieve a justice certification.

(2) The Division shall accept applications for certification from licensed human services programs providing SUD and mental health services, sole practitioners and health care facilities.

(3) Applicants for certification shall:

(a) Obtain and maintain facility license from the Department of Human Services, Office of Licensing or a health care facility license issued by Utah Department of Health, or;

(b) Sole practitioners shall submit proof of:

(i) An unencumbered license from the Utah Department of Occupational Licensing;

(ii) Adequate and appropriate malpractice insurance, and

(iii) An ability to meet all the requirements of R523-4-4 through R523-4-9.

(4) Justice certification is not required for the following programs and providers:

(a) Health care providers providing physical healthcare and limited behavioral health services and counseling;

(b) Health providers prescribing medication for physical health, substance use disorder or behavioral health treatment; and

(c) Opioid Treatment Programs engaged in opioid treatment of individuals with an opioid agonist treatment medication registered under 21 U.S.C. Sec. 823(g),licensed by the Office of Licensing, within the Department of Human Services, and certified by the Substance Abuse and Mental Health Services Administration in accordance with 42 C.F.R. 8.11;

(d) Recovery residences licensed by the Office of Licensing, within the Department of Human Services and in compliance with R501-18; and

(e) Programs and Sole Practitioners working with adults with low criminogenic risk identified using a valid and reliable screening instrument consistent with the standards in R523-4-5.

 

R523-4-[4]5. Standards for Criminogenic Risk Screening[and Assessment for Agencies Treating Justice Involved Individuals].

(1) Prior to participating in any compelled[educational, preventative] education or treatment, [services ]adults shall [be given]complete a brief, validated criminogenic[,] risk[and needs] screen[ to determine whether the adult is of low, moderate, or high risk to re-offend].

(2) [Screenings shall:]The screen shall evaluate behaviors and characteristics known to predict re-offending including delinquency history, social history, and attitudes/behaviors about substance use, antisocial cognition, antisocial associates, family and marital relations, employment, and leisure and recreational activities;

[(a) Be conducted by an individual that has completed training recommended by the developer of the specific instrument being used and/or approved by the Division;

(b) Collect information about behaviors and characteristics known to predict re-offending including delinquency history, social history, and attitudes/behaviors.

(3) If the screen indicates a high or moderate likelihood of re-offending the adult shall be given an in-depth assessment of criminogenic risk and need with an instrument that has been evaluated and found reliable and valid by the scientific community for the purpose of identifying specific criminogenic risks and needs.

(4) The criminogenic assessment shall examine a wide variety of factors related to the adult's strengths and challenges including: criminal history, school, employment, relationships, environment, current living arrangements, alcohol and drugs, mental health, attitudes, behaviors, and skills.

(5) The criminogenic assessment shall also identify protective factors that are related to the reduced likelihood of re-offending and risk factors that are related to the increased likelihood of re-offending.]

(3) Screens shall be used to inform the probability of whether the adult is of low, moderate, or high risk to re-offend

(4) Screens may be completed by partner agencies such as the courts, law enforcement or supervising entity and reported to treatment providers.

(5) Screens shall be included and documented in the adult's service records.

(6) When a screen identifies an adult with low criminogenic risk the provider shall:

(a) Report the results of the screen to the court;

(b) Refer the adult to non-criminal justice agencies for any desired treatment, or

(c) Provide services in a manner that limits exposure to adults with high criminogenic risk.

(7) When a screen identifies an adult with moderate or high criminogenic risk, the provider shall refer the adult to a justice certified provider or deliver services that meet the standards outlined in this rule.

 

R523-4-[5]6. Standards for Substance Use and Mental Health Disorder Screening[s] and Assessment.

(1) [Adults shall be screened]All adults shall complete a mental health/substance use disorder screen using an instrument(s) that has been evaluated and found reliable and valid by the scientific community[ to determine whether the adult is in need of a comprehensive assessment].

(2) [Screenings shall be:

(a) Conducted by an individual that has completed training recommended by the developer of the specific instrument being used and/or approved by the Division;

(b) Trauma-sensitive, developmentally appropriate, and culturally sensitive.]If the screening indicates a low probability for a substance use disorder or mental illness, the screening agency may recommend participation in an educational series.

(3) [The individual shall be referred for an]An assessment shall be completed if the screening [identifies]indicates a need for further assessment for potential substance use and/or mental health disorders.

(4) [Screenings shall not be used to determine diagnosis but may assist in determining the need for further assessment.

 

R523-4-6. Standards for Substance Use and Mental Health Disorder Assessments.

(1) Assessments shall be conducted by a licensed mental health therapist using a standardized process/instrument(s) that has been evaluated by the scientific community and determined to be reliable and valid for the purpose of assessing individuals.

(2) Assessments shall identify the individual's level of motivation for treatment and implement strategies to increase engagement and need for clinically appropriate Mental Health Disorder services and/or Substance Use Disorder services in the following modified ASAM Patient Placement Criteria dimensions:]An assessment shall be conducted prior to admission to a clinical treatment level of care.

(5) An initial assessments shall:

(a) Determine the adult's eligibility for treatment, provide the basis for a treatment plan, and establish a baseline measure for use in evaluating a patient's response to treatment.

(b) Identify comorbid medical and psychiatric conditions and diagnosis and to determine how, when and where they will be addressed;

(c) Identify communicable diseases and address them as needed;

(d) Evaluate the adult's level of physical, psychological and social functioning or impairment;

(e) Assess the adult's access to social supports, family, friends, employment, housing, finances and legal problems; and

(f) Determine the adult's readiness to participate in treatment.

(6) Substance use disorder assessments shall address:

(a) Risk of acute psychosis, intoxication/withdrawal;

(b) Biomedical conditions or complications;

(c) Emotional, behavioral, or cognitive conditions;

(d) Readiness to change;

(e) Relapse, continued use or continued problem potential; and

(f) Recovery environment.

(7) Individuals in need of treatment shall only be referred to agencies that are justice certified.

[(3) The assessment shall include relevant information on:

(a) The individual's psychosocial function, substance use including tobacco/nicotine, mental and physical health, and other factors, such as educational experiences, trauma history, cultural issues, legal involvement, and family relationships that are relevant to the purpose of the assessment;

(b) Strengths, resiliencies, natural supports, interests of the individual, and an evaluation of the individual's unique abilities;

(c) Developmental and functional levels, social, emotional, communication abilities and strengths, and independent living skills;

(d) Cognitive, social, and affective development; family, peer, and intimate relationships; trauma; current or past emotional, physical or sexual abuse; suicidality; and safety;

(e) Collateral information from other sources that are relevant to the individual's situation and provides insight into the issues in Subsection R523-4-6(2)(a) through (2)(d).

(4) The assessment shall include a diagnosis when clinically indicated.

(5) Based on the screening and the assessment, the assessor shall make recommendations regarding the needed level of care and services to address the identified clinical needs.

(6) The levels of care and array of services shall be based on the ASAM or equivalent Mental Health criteria.]

 

R523-4-7. Standards for Providers of an Educational[ or Prevention ] Series.

(1) [Entities wishing to provide an intervention, program, activity or curriculum to individuals with a substance use disorder shall:

(a) Obtain and maintain an outpatient or residential facility license from the Department of Human Services, Office of Licensing.]Applicants for certification shall:

[(b) Use only educational and prevention material that meets](a) Use only educational series materials that meet the requirements for listing on Utah's registry of evidence-based practices identified in Section R523-9[that:];

(b) Ensure all adults have received screens, and if indicated, assessed for criminogenic risk, SUD and mental illness prior to entry into services;

(c) Provide serves only to individuals that will benefit from an educational series;

[(i) Address the substance use, and mental health needs of the targeted population;

(ii)](d) Provide[s] accurate information [that is ]designed to promote compliance with Utah laws;[ and]

(e) Address the risk factors related to substance use, and assist the adult in recognizing the harmful consequences of inappropriate substance use;

(f) Target adults whose problems and risk factors appear to be related to substance use, but do not appear to meet any diagnostic criteria for substance related disorders;

[(iii)](g) Meet the requirements set forth in Subsection 62A-15-103(h) and Subsection R523-4-7(1)(b) through 1(f)[.];

[(c) Not implement any educational programs until approved by the Division.

(d)](h) Maintain records documenting the individual's attendance and course completion or failure to attend and/or complete[.];

[(e) Not include minors in adult groups.

(f) Serve low criminogenic risk individuals and high criminogenic risk individuals separately.

(g) Provide accurate information and be designed to promote compliance with Utah laws.](i) Serve adults and minors in separate groups;

(j) Serve individuals with low criminogenic risk in separate settings;

(k) Complete surveys and data requests as requested by the Division; and

(l) Provide communication with the court that includes appropriate clinical justification prior to referring individuals to higher levels of care.

 

R523-4-8. [Program ]Standards for Community-Based Treatment[ Programs].

(1) All substance use programs [shall maintain the appropriate license from]licensed by the Department of Human Services Office of Licensing [for the type(s) of services being provided]shall annually complete and submit the National Survey on Substance Abuse Treatment Survey (N-SSATS), and all mental health programs shall annually complete and submit the National Mental Health Service Survey (N-MHSS).

(2) [Treatment programs shall:

(a) Ensure that public funds are the payor of last resort and:

(i) Coordinate or refer individuals to the Department of Workforce Services or healthcare navigators for assistance with eligibility for public or private insurance plans.

(ii) May negotiate and assess usual and customary fees to adults.

(b) All substance use providers complete and submit the National Survey on Substance Abuse Treatment Services (N-SSATS), and all mental health providers complete the National Mental Health Services Survey (N-MHSS).

(4) All public substance use providers, including the Local Substance Abuse Authorities and their contracted providers, shall submit Treatment Episode Data (TEDs) admission and discharge data as outlined in the Division's most current Division Directives.

(5) Programs seeking a quality certification that provides services to justice involved individuals shall:

(a) Evaluate all participants for criminogenic risk and need, and deliver services that target the specific risk and needs identified;

(b) Ensure individuals with high risk and individuals with low risk to re-offend are treated separately;

(c) Provide multi-dimensional treatment that targets the validated criminogenic risk factors; and

(d) Coordinate and communicate with Adult Probation and Parole, county sheriff's offices, or other necessary criminal justice agencies on a regular and consistent basis as agreed.

 

R523-4-9. Treatment Standards for Community-Based Treatment Programs.

(1) Treatment intensity, duration and modality for:

(a) Substance use disorders shall be based on the current ASAM criteria; and

(b) Mental health disorders shall be determined by the clinical assessment process and medical necessity.

(2) Treatment programs shall:

(a) Have qualified staff licensed and capable of assessing individuals for both mental health and substance use disorders;

(b) Develop strategies to screen for, prevent, and refer to treatment adults with serious chronic conditions such as, but not limited to, HIV/AIDS, Hepatitis B and C, and tuberculosis;

(c) Ensure that assessment is an ongoing component of treatment;

(d) Diagnose, treat or ensure treatment for co-occurring conditions;

(e) Ensure treatment participation and length shall be of sufficient dosage/duration to affect stable behavioral change and long term recovery supports;

(f) Develop an individualized treatment plan that identifies a comprehensive set of tools and strategies that address the client's identifiable strengths as well as their problems and deficits;

(g) Provide comprehensive treatment services that includes but is not limited to:

(i) Developmentally appropriate and informed treatments;

(ii) Recognition of gender, cultural, linguistic, and other individual differences in the treatment approach;

(iii) Ensuring all individuals with alcohol and/or opioid disorders are educated and screened for the potential use of medication-assisted treatment;

(iv) Monitoring drug use through drug testing and other means;

(v) Individuals testing positive for drugs or alcohol shall not be denied entry or removed from treatment from a program solely for positive drug tests;

(vi) All public substance use providers, including the Local Substance Abuse Authorities and their contracted providers shall comply with all Division Directives for Drug testing as published in the annual DSAMH Division Directives and/or preferred practice guidelines;

(vii) As appropriate and with consent, involve families and support persons in the treatment and recovery process; and

(viii) Provide Naloxone education, training and assistance to individuals with opiate use disorders and when possible to their families, friends, and significant others.

(2) Treatment programs shall work with individuals to identify needed and desired recovery supports and ensure that:

(a) Participation in recovery support shall be voluntary; and

(b) Whenever possible, individuals are encouraged and given a choice of potential recovery support services and a choice of programs.

(3) Services such as case management, housing, employment training, transportation, childcare, healthcare, peer support and other social supports shall be strongly considered and implemented if appropriate before, during and after the completion of acute treatment services.]Certified programs, sole proprietors and health clinics providing behavioral health treatment shall:

(a) Conduct risk, need, and responsivity (RNR) screens and clinical assessments to determine effective supervision and treatment strategies;

(b) Base interventions on the person's level of criminogenic risk, and level of substance use disorder and/or mental illness;

(c) Ensure treatment is tailored to the individual and addresses:

(i) motivation,

(ii) problem solving,

(iii) skill building to improve cognitive, social, emotional, and coping skills, and

(iv) assists in building prosocial supports and activities;

(d) Ensure service for SUD including assessment, treatment planning, continued stay and discharge planning are consistent with the most current ASAM Criteria;

(e) Include medication assisted treatment (MAT) in opioid use disorder and alcohol use disorder interventions;

(f) Provide random, unpredictable, and frequent drug testing in the supervision of persons with SUD, and ensure drug testing procedures and policies are compliant with R523-15;

(g) Assist adults with housing, employment, vocational activities, and building social supports;

(h) Maintain a complete and accurate record of all clinical services for each individual served that contains the following information:

(i) any and all screenings and assessments completed,

(ii) any and all consent forms or required disclosures,

(iii) a comprehensive treatment plan,

(iv) progress notes,

(v) continuing recovery recommendations upon discharge, and

(vi) documentation of receipt for all payments made by participants as contributions to the cost of treatment; and

(i) Complete any training required by the Division as a condition of certification.

 

[R523-4-10. Standards for Jail or Prison Treatment Programs.

(1) All individuals shall be screened for criminogenic risk, mental health, substance use disorders and substance withdrawal syndromes as part of the intake process.

(2) Individuals with signs and symptoms of withdrawal shall receive timely medical care or a transfer to a more appropriate facility that can provide standard detoxification services.

(3) Jail or prison-based treatment service providers shall coordinate care with community-based treatment providers so that individuals may transition to treatment services in the community.

(4) Treatment programs shall:

(a) First assess level of motivation for treatment and implement strategies to increase engagement;

(b) Assess individuals for mental health, substance use disorders and criminogenic risk using scientifically validated instruments and protocols;

(c) Diagnose and treat or ensure treatment for co-occurring conditions;

(d) Provide comprehensive treatment services;

(e) As appropriate and with consent, involve families and support persons in the treatment process;

(f) Use developmentally appropriate and informed treatments;

(g) Monitor drug use through drug testing and other means;

(i) Programs shall comply with all Division Directives for drug testing as published in the annual DSAMH Division Directives;

(h) Have qualified staff licensed and capable of assessing individuals for both mental health and substance use disorders;

(i) Recognize gender, cultural, linguistic, and other individual differences in their treatment approach;

(j) Provide ongoing chronic disease management, recovery support, monitoring and link to needed community supports;

(k) All individuals with alcohol and/or opioid disorders shall be educated and screened for the potential use of medication-assisted treatment;

(l) Treatment providers shall develop strategies to screen for, prevent, and refer to treatment adults with serious chronic conditions such as HIV/AIDS, Hepatitis B and C, and tuberculosis;

(m) Work with individuals to identify needed and desired recovery supports;

(i) Recovery supports may include preparation/planning for housing, employment, health care, peer support or other services upon release;

(ii) Recovery supports may be provided before, during or after the completion of acute treatment services.

 

R523-4-11. Documentation Standards for Community and Jail/Prison Based Treatment Services.

(1) A complete and accurate record of all clinical services shall be kept for each individual served that contains the following information:

(a) Any and all screenings and assessments completed;

(b) Any and all consent forms or required disclosures;

(c) A comprehensive treatment plan;

(d) Progress notes;

(e) Continuing recovery recommendations upon discharge; and

(f) Record reflects cultural and gender specificity in treatment.

(2) The individual record is maintained in a manner so as to protect confidentiality and comply with 42 CFR Part 2 and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) documentation/privacy standards. The record is organized, clear, complete, current and legible.

(a) Consent forms for any release of information shall be found in the file.

(b) Consent forms shall be complete, and contain a statement that consent is subject to revocation, and shall be signed and dated by the patient.

(c) Each file shall contain a signed and witnessed Acknowledgement of Receipt of Privacy Statement.

(3) The individual record shall contain documentation of the initial assessment/engagement session.

(a) The assessment/engagement session identifies presenting problems and individual goals.

(b) The assessment/engagement session includes a statement of the individual's presenting problem(s) and:

(i) Identification and documentation of acute psychosis, intoxication/withdrawal relevant to the presenting problem.

(ii) Identification and documentation of biomedical conditions and complications relevant to the presenting problem.

(iii) Identification and documentation of emotional, behavioral, cognitive conditions, and/or complications relevant to the individual's current situation and presenting problem.

(iv) Identification, evaluation and documentation of readiness to change relevant to presenting problem.

(v) Identification and documentation of relapse, or continued problem potential relevant to presenting problem.

(vi) Identification and documentation of the individual's recovery environment relative to presenting problem.

(vii) Identification of recovery support services needed relevant to presenting problem.

(viii) An assessment/engagement session summary includes recommendations for level of care and intensity of services needed.

(ix) Documentation of an assignment for the individual to complete for their next session.

(4) Assessment process is ongoing and changes to assessment information are reflected throughout the record.

(5) Level of care and intensity of services are supported by ongoing assessment information, or differences are clinically justified.

(6) Assessment shall be signed and include the title of a person licensed in the State of Utah to diagnose, assess and treat people with mental health and substance use disorders.

(7) A treatment plan that contains the following:

(a) Specific, individualized, long-range goals;

(b) Behaviorally measurable, short-term objectives that support long-range goals;

(c) Evidence of the individual's participation in development of the plan;

(d) Evidence that the plan is based on the individual's goals and other needs identified in the screening and assessments;

(e) Objectives that are measurable, achievable within a specified time frame and reflect developmentally appropriate activities that support progress towards achievement of individual goals;

(f) Substance use disorder treatment plans should be based on the six ASAM Patient Placement Dimensions and shall address critical areas identified in each dimension. Mental Health Recovery Plans shall be organized in a similar manner;

(g) Interventions designed to help the patient complete the objectives; and

(h) Signature and title of a person licensed in the State of Utah to diagnose, assess and treat people with mental health and substance use disorders.

(6) The individual file shall include documentation of the individual's status throughout the individual record including:

(a) Changes in types, schedule, duration and frequency of therapeutic interventions to facilitate individual progress as well as changes in individual objectives and goals;

(b) Each contact shall be documented in a timely manner;

(c) Progress notes shall be kept that identify the date, duration and type of intervention;

(d) Progress notes shall document progress or lack of progress on the individual's goals as well as the clinician's assessment of the individual's changes in behaviors, attitudes and beliefs;

(e) Progress notes shall reflect clinician's assessment of the effectiveness of the therapeutic interventions and plans for future interventions, which is ideally accomplished through the use of standardized evidence based tools;

(f) Notes shall be legible and signed by a qualified staff indicating appropriate credentials;

(g) No-shows, cancellations or gaps in service such as vacation, incarceration or home visits shall be documented;

(h) Notes shall reflect behavioral changes as well as changes in attitudes and beliefs;

(i) Other group activities such as psychosocial rehabilitation, psychoeducation, life skills, case management, recreational therapy and recovery support services are documented to the extent required for clinical continuity and in order to meet financial requirements; and

(k) Upon discharge, recommendations for ongoing services include the extent to which established goals and objectives were achieved, what ongoing services are recommended, and a description of the individual's recovery support plan.]

 

R523-4-[12]9. [Quality]Justice Certification Procedures[ for Educational Series and Community-Based Treatment Provider Sites That Do Not Provide Opioid Replacement Treatment].

(1) [Programs]Providers seeking first-time approval or re-approval shall make application to the Division at least 60 days prior to delivering services.

(2) Each [treatment site ]provider seeking certification shall submit a completed and signed application and assurances form to the Division.

(3) All application forms shall be reviewed by the Division.

(4) The Division shall determine if the application is complete and demonstrates compliance with this rule.

(5) [The]If the Division approves the application and determines the program has met all other requirements, the Division shall provisionally certify the program for a period of up to one year.

(6) The Division shall notify [in writing ]all applicants of the status of their applications in writing. [within 30 days of submission of an application, whether the application is]The status of an application may be:

(a) Approved,

(b) Denied, or

(c) Requires additional information.

(7) A final certification shall[:

(a) Be] be completed within the one year provisional certification period of time, according to the procedures established by the Division[; and

(b) The final certification may last up to two years from the end date of the provisional certification].

(8) If an application for re-approval requires additional information, a previously certified program may continue to provide services for 30 days from the date of notification unless notified by the [Department of Human Services]Division to cease and desist.

 

R523-4-[13]10. Corrective Action.

(1) When the Division becomes aware that a provider is in violation of this rule the Division shall:

(a) Identify in writing the specific areas in which the provider is not in compliance; and

(b) Send written notice to the provider within 30 days after becoming aware of the violation.

(2) The provider shall submit a written plan for achieving compliance within 30 days of notification of noncompliance.

 

R523-4-[14]11. Suspension and Revocation.

(1) The Division may suspend the approval of a provider when a provider fails to:

(a) Respond in writing to areas of noncompliance identified in writing by the Division within the defined period;

(b) Comply with corrective action as agreed upon in its written response to the Division; or

(c) Allow the Division access to information or records necessary to determine the provider's compliance under this rule.

(2) The Division may revoke approval if a provider:

(a) Continues to provide the educational series after suspension;

(b) Fails to comply with corrective action while under a suspension; or

(c) Commits a second violation which constitutes grounds for suspension when a previous violation resulted in a suspension during the last 24 months.

(3) The Division shall notify the Administrative Office of the Courts, the Utah Department of Corrections, the Department of Human Services, Office of Licensing and county local authorities when a certification is suspended or revoked.

 

R523-4-[15]12. Procedure for Denial, Suspension, or Revocation.

(1) If the Division has grounds for action under this rule and intends to deny, suspend or revoke approval of a provider, the Division shall notify the applicant or provider of the action to be taken.

(2) A notice to deny, suspend or revoke approval shall contain the reasons for the action, to include all statutory or rule violations, and a date when the action shall become effective.

(3) The provider may request a meeting with the Director or their designee within ten calendar days of receipt of notification.

(4) A request for a meeting for this purpose shall be in writing.

(5) Within ten days following the close of the meeting the Division shall inform the provider or applicant in writing of the decision of the Director or Designee of the Division.

 

R523-4-[16]13. Posting of Certified Providers.

(1) The Division shall maintain and make public a list of all certified educational or prevention series and treatment programs.

(2) The list shall include agency contact information, service location address, and target population , and a brief description of services offered.

 

KEY: [offender substance abuse screenings, offender substance abuse assessments, offender substance abuse education series, offender substance abuse treatments]justice certification requirements, justice certification screening standards, justice certification assessment standards, justice certification treatment standards

Date of Enactment or Last Substantive Amendment: [January 17, 2017]2019

Authorizing, and Implemented or Interpreted Law: 62A-15-103[ (h) ] (j) ; 62A-15-103.5; 42 CFR Part 2