Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This rule describes the goals, eligibility
and discharge criteria, available services, and performance indicators for
residential treatment.
(1)
Treatment Goals. Residential treatment shall offer an intensive set of services
in a structured alcohol and drug free setting. Services shall be organized and
directed toward the primary goals of
(A)
Stabilizing a crisis situation, where applicable;
(B) Interrupting a pattern of extensive or
severe substance abuse;
(C)
Restoring physical, mental and emotional functioning;
(D) Promoting the individual's recognition of
a substance abuse problem and its effects on his/her life;
(E) Developing recovery skills, including an
action plan for continuing sobriety and recovery; and
(F) Promoting the individual's support
systems and community reintegration.
(2) Eligibility Criteria. In order to fully
participate in and benefit from the intensive set of services offered in
residential treatment, a person must meet the following admission and
eligibility criteria:
(A) Does not
demonstrate symptoms of intoxication, impairment or withdrawal that would
hinder or prohibit full participation in treatment services. A screening
instrument, that includes vital signs, must be used with all prospective
clients to identify symptoms of intoxication, impairment, or withdrawal and,
when indicated, detoxification services must be provided or arranged;
(B) Needs an alternative, supervised living
environment to ensure safety and protection from harm;
(C) Meets the general treatment eligibility
requirement of a current diagnosis of substance abuse or dependence and, in
addition, demonstrates one or more of the following
1. Recent patterns of extensive or severe
substance abuse;
2. Inability to
establish a period of sobriety without continuous supervision and
structure;
3. Presence of
significant resistance or denial of an identified substance abuse problem;
or
4. Limited recovery skills
and/or support system; and
(D) A client may qualify for transfer from
outpatient to residential treatment if the person
1. Has been unable to establish a period of
sobriety despite active participation in the most intensive set of services
available on an outpatient basis; or
2. Presents imminent risk of serious
consequences associated with substance abuse.
(3) Safety and Supervision. The residential
setting shall ensure the safety and well being of persons served.
(A) Staff coverage shall ensure the
continuous supervision and safety of clients.
1. There shall be an adequate number of paid
staff on duty (awake and dressed) at all times. At least two (2) staff shall be
on duty, unless otherwise stipulated in these rules or authorized in writing by
the department through the exceptions process. Additional staff shall be
required, if warranted by the size of the program and the responsibilities and
duties of the staff members.
2.
Clients shall be supervised at all times by a staff member with current
certification in first aid and cardiopulmonary resuscitation.
(B) The program shall immediately
and effectively address any untoward or critical incident including, but not
limited to, any incident of alcohol or drug use by a client on its
premises.
(4) Intensive
Services with Individualized Scheduling. Services shall be responsive to the
needs of persons served.
(A) There shall be a
current schedule of program activities that offers a minimum of fifty (50)
hours of structured, therapeutic activity per week.
1. Therapeutic activities shall be provided
seven (7) days per week.
2. Group
education and group counseling must constitute at least twenty (20) of the
required hours of therapeutic activity per week.
(B) At least one (1) hour of individual
counseling per week shall be provided to each client. Additional individual
counseling shall be provided, in accordance with the individual's
needs.
(5) Discharge
Criteria. Each client's length of stay in residential treatment shall be
individualized, based on the person's needs and progress in achieving treatment
goals.
(A) To qualify for successful
completion and discharge from residential treatment, the person should
1. Demonstrate a recognition and
understanding of his/her substance abuse problem and its impacts;
2. Achieve an initial period of sobriety and
accept the need for continued care;
3. Develop a plan for continuing sobriety and
recovery; and
4. Take initial steps
to mobilize supports in the community for continuing recovery.
(B) A person may be discharged
before accomplishing these goals if maximum benefit has been achieved and
1. No further progress is imminent or likely
to occur;
2. Clinically appropriate
therapeutic efforts have been made by staff; and
3. Commitment to continuing care and recovery
is not demonstrated by the client.
(6) The program handles applications for
continued civil detention in accordance with sections
631.140,
631.145
and
631.150,
RSMo 2000.
*Original authority: 630.050, RSMo 1980, amended 1993,
1995; 630.655, RSMo 1980; and 631.010, RSMo
1980.
