Current through Register No. 40, October 3, 2024
(a) The licensee shall only admit an
individual or retain a client who has been determined to need the level(s) of
care that the facility offers, and whose needs can be met by the
SUD-RTF.
(b) A licensee shall not
deny admission to any person because that person does not have a guardian or an
advanced directive, such as a living will or durable power of attorney for
health care, established in accordance with RSA 137-H or RSA 137-J.
(c) The client shall be transferred or
discharged, as defined under
RSA 151:19, I-a and
VII, in accordance with
RSA 151:21,
V, for reasons including the following:
(1) The client's medical or other needs
exceed the services offered by the licensee or are not otherwise met by third
party providers that the licensee has contracted with;
(2) The client cannot be safely evacuated in
accordance with Saf-C 6000;
(3) The
client or the client's guardian agent, or surrogate decision-maker if any,
determines that the client shall leave the facility;
(4) The client is a danger to himself/herself
or others;
(5) Program completion
or transfer based on changes in the client's functioning relative to ASAM
criteria; and
(6) Program
termination, including:
a. Administrative
discharge;
b. Non-compliance with
the program;
c. The client left the
program before completion against advice of treatment staff; and
d. The client is inaccessible, such as the
client has been jailed or hospitalized.
(d) In all cases of client discharge or
transfer, the counselor shall complete a narrative discharge summary, which
includes:
(1) The dates of admission and
discharge or transfer;
(2) The
client's psychosocial substance use history and legal history;
(3) A summary of the client's progress toward
treatment goals in all ASAM domains;
(4) The reason for discharge or
transfer;
(5) The client's DSM 5
diagnosis and summary, to include other evaluation testing completed during
treatment;
(6) A summary of the
client's physical condition at the time of discharge or transfer;
(7) A continuing care plan, including all
ASAM domains;
(8) The dated
signature of the counselor completing the summary; and
(9) Any other information pertinent to the
client's discharge or transfer.
(e) The discharge summary shall be completed:
(1) No later than 7 days following a client's
discharge or transfer from the program; or
(2) For withdrawal management services, by
the end of the next business day following a client's discharge or transfer
from the program.
(f) If
the transfer or discharge referenced in (d) above is required by the reasons
listed in
RSA 151:26,
II(b) , a written notice shall be given to
the client as soon as practicable prior to transfer or discharge.
(g) When transferring a client, either from
one level of care to another within the same certified provider agency or to
another treatment provider, the counselor shall:
(1) Complete a progress note on the client's
treatment and progress towards treatment goals, to be included in the client's
record; and
(2) Update the client
evaluation and treatment plan.
(h) When transferring a client to another
treatment provider, the current provider shall forward copies of the following
information to the receiving provider, only after a release of confidential
information is signed by the client:
(1) The
discharge summary;
(2) Client
demographic information, including the client's name, date of birth, address,
telephone number, and the last 4 digits of his or her Social Security number;
and
(3) A diagnostic evaluation
statement and other evaluation information, including:
a. TB test results;
b. A record of the client's treatment
history; and
c. Documentation of
any court-mandated or agency-recommended follow-up treatment.
(i) A licensed
counselor shall meet with the client at the time of discharge or transfer to
establish a continuing care plan that:
(1)
Includes recommendations for continuing care in all ASAM domains;
(2) Addresses the use of self-help groups
including, when indicated, facilitated self-help; and
(3) Assists the client in making contact with
other agencies or services.
(j) A licensed counselor shall document in
the client record if and why the meeting in (i) could not take place.
(k) A provider may involuntarily discharge a
client from a treatment program only if:
(1)
The client's behavior on program premises is abusive, violent, or
illegal;
(2) The client is
non-compliant with prescription medications;
(3) Clinical staff documents therapeutic
reasons for discharge; or
(4) The
client violates program rules in a manner that is consistent with the
provider's progressive discipline policy.
