ARTICLE 46:05

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ARTICLE 4605

• ALCOHOL AND DRUG ABUSE

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Where are they now?

• Copies have been sent to agency directors for
  review and comments.
• Comments must be received by the division June
  1st, 2007 to be considered for the rules package.

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What happens next?

• Once comments are received by the division, they
  will be reviewed and considered for rules
  modification. (Approximately 30 days end of
  June, 2007).
• A fiscal statement shall be prepared to determine
  financial impact on community agencies.

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• Begin the legislative review process.
• It takes approximately 90 days for the rules to
  go thru the Legislative Research Council.
• Once signed by the Secretary of State, the rules
  become provisionally accepted and the division
  will begin operating under the new rules.
• They become finally effective on July 1st after
  the next legislative session.

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Chapter 460501 Definitions. 460502 Accreditati
on. 460503 Governance. 460504 Fiscal
management. 460505 Personnel. 460506 Statistic
al reporting.
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460507 Clients rights. 460508 Quality of
care review. 460509 Client case
records. 460510 Medication control in
residential programs. 460511 Dietary
services. 460512 Environmental sanitation
safety and fire prevention. 460513 Prevention
program.
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460514 Level 0.5 early intervention
program. 460515 Level I.0 outpatient services
program. 460516 Level II.1 intensive
outpatient treatment program. 460517
Level II.5 day treatment program. 460518
Level III.2-D clinically-managed residential
detoxification program.
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460519 Level III.7 medically-monitored
intensive inpatient treatment program for
adults and Level III.7 medically-monitored
intensive inpatient treatment program for
adolescents. 460520 Level III.1
clinically-managed low- intensity residential
treatment program. 460521 Gambling programs.
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Chapter 460501 Definitions

• Added some
• Deleted others
• Changed a few

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CHAPTER 460502ACCREDITATION

• Provisional new term (deleted conditional)
• Renewal went from 1 and 2 year accreditation to
  2 and 3 year accreditation.
• Created probation, suspension, and revocation
  procedures.
• Included an appeals procedure.

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Governance 460503

• Incorporation of agencies has changed only
  agencies accredited for levels II.1, II.5,
  III.2-D, III.7, and III.1 must be incorporated.

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Fiscal Management 460504

• Significant changes
• annual budget,
• availability and content of fiscal reports,
• accounting systems,
• cost reporting and annual audit.

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Personnel 460505

• TB (includes agency risk assessment)
• Repeal rules related to
• adequate personnel to be provided
• personnel policies and procedures manual
• staff development training plan
• personnel performance reviews and volunteer
  service policies
• (The division will no longer look at these
  articles during site reviews).

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Personnel 460505 (cont.)

• Personnel files has changed significantly the
  following rules will be repealed thus, the
  division will no longer review
• An application for employment
• Letter of hire
• Copies of annual written job descriptions
• Disciplinary action
• Letters of commendations
• Documentation of training
• Personal performance reviews repealed.

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Statistical Reporting 460506

• Created a new rule for the reporting of outcome
  measures.

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Clients Rights 460507

• Clients consent required repealed.
• Discharge policies additional requirements.

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Quality of care review 460508

• Quality of care reviews only need to be completed
  for trainees and Level I certified counselors.

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Client Case Records 460509

• Information included in the Standardized TNA will
  follow the Stars Manual
• Treatment plan review Repealed
• The treatment plan review and continuing stay
  review will be the same document

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Medication control in residential settings
460510

• No significant changes.

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Dietary Services 460511

• Annual review of menus Repealed.

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Environmental sanitation safety and fire
prevention

• Change in the NFPA 101 Life Safety Code from 1997
  to the 2000 edition.

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Prevention Program 460513

• Defined prevention program classifications.
• Changes in quality assurance and evaluation.

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Changes within all levels of care

• Level 0.5 Early intervention program 460514
• Level 1.0 outpatient services program 460515
• Level II.1 intensive outpatient treatment program
  460516
• Level II.5 day treatment program 460517
• Level III.2-D clinically managed residential
  detoxification program 460518
• Level III.7 medically-monitored intensive
  inpatient treatment program for adults and
  adolescents 460519
• III.1 clinically-managed low-intensity
  residential treatment program 460520

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• Treatment plan reviews have been deleted from
  rule.
• Treatment plan reviews will be replaced with the
  continued service criteria (CSC)
• TB testing has changed for outpatient levels of
  care based on the agency risk assessment. All
  residential programs must conduct the TB
  screening on all clients admitted to their
  programs.

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Documentation for continued service criteria
(CSC) has been updated.

• Level 0.5 went from 10 days to every 14
  calendar days
• Level I.0 went from 30 days to every 30
  calendar days.
• Level II.1 went from 10 days to every 14
  calendar days.
• Level II.5 went from 10 days to every 14
  calendar days.
• Level III.2-D went from 2 days to every 2
  calendar days.
• III.7 (adults and adolescents) went from 7 days
  to every 14 calendar days.
• III.1 went from 14 days to every 30 calendar
  days.

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Intensity of services

• Level I.0 Up to 9 hours of individual, group,
  or family counseling per week.
• Level II.1 At least 9 hours of individual,
  group, or family counseling three times per week.
  
• II.5 At least 15 hours of individual, group, or
  family counseling per week. Adults shall also
  receive an additional 5 hours per week of
  specialized topics which address the specific
  needs of the client. Additional services shall
  be provided by an individual trained in the
  specific topic being presented.

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Intensity of services (cont.)

• Level III.2-D At least 90 minutes of
  individual, group, or family counseling.
• Level III.7 (Adults) - At least 21 hours of
  individual, group, or family counseling per week.
  An additional 9 hours per week of specialized
  topics which address the specific needs of the
  client. Additional services shall be provided by
  an individual trained in the specific topic being
  presented.

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Intensity of services (cont. 3)

• Level III.7 (Adolescent) - At least 15 hours of
  individual, group, or family counseling per week.
  
• III.1 At least 5 hours of individual, group, or
  family counseling services per week.

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Gambling CSCs follow the other levels of care.
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Gambling Intensity of services

• Level I.0 Up to 9 hours of individual, group,
  or family counseling per week. One hour must be
  gambling specific.
• Level II.1 A minimum of 9 hours per week, 6
  hours must be gambling specific.
• Level II.5 A minimum of 20 hours per week, 10
  hours must be gambling specific.
• Level III.7 A minimum of 30 hours per week, 15
  hours must be gambling specific.