Utah Administrative Code

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R523. Human Services, Substance Abuse and Mental Health.

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

As in effect on January 1, 2020

Table of Contents
R523-4-1. Authority.

This rule is authorized by Section 62A-15-103(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 required to participate in treatment by the court or the Board of Pardons and Parole.

R523-4-2. Purpose.

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.

R523-4-3. Definitions.

(1) "Screening" means a preliminary appraisal of an 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 adult is in need of:

(i) Mental health or substance use disorder treatment;

(ii) An 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.

(6) "Educational Series" means an evidence-based instructional series 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.

R523-4-5. Standards for Criminogenic Risk Screening.

(1) Prior to participating in any compelled education or treatment, adults shall complete a brief, validated criminogenic risk screen.

(2) 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;

(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.

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

(1) 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.

(2) 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) An assessment shall be completed if the screening indicates a need for further assessment for potential substance use and/or mental health disorders.

(4) 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.

R523-4-7. Standards for Providers of an Educational Series.

(1) Applicants for certification shall:

(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;

(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;

(d) Provide accurate information designed to promote compliance with Utah laws;

(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;

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

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

(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. Standards for Community-Based Treatment.

(1) All substance use programs licensed by the Department of Human Services Office of Licensing 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) 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.

R523-4-9. Justice Certification Procedures.

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

(2) Each 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) 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 all applicants of the status of their applications in writing. The status of an application may be:

(a) Approved,

(b) Denied, or

(c) Requires additional information.

(7) A final certification shall be completed within the one year provisional certification period of time, according to the procedures established by the Division.

(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 Division to cease and desist.

R523-4-10. 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.

R523-4-11. 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.

R523-4-12. 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.

R523-4-13. 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.


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Date of Enactment or Last Substantive Amendment

October 23, 2019

Authorizing, Implemented, or Interpreted Law

62A-15-103(j); 62A-15-103.5; 42 CFR Part 2

Additional Information

For questions regarding the content or application of rules under Title R523, please contact the promulgating agency (Human Services, Substance Abuse and Mental Health). A list of agencies with links to their homepages is available at http://www.utah.gov/government/agencylist.html or from https://rules.utah.gov/help-rules-who-to-contact/.