Current through Register Vol. 56, No. 18, September 16, 2024
(a) Every facility shall ensure that the ratios
of substance abuse counseling staff are maintained so that 50 percent of the staff are LCADC or CADC or other
licensed health professionals doing work of an alcohol or drug counseling nature within their scope of
practice by June 1, 2012, and at all times thereafter. The remaining 50 percent of substance abuse counseling
staff will be considered counselor-interns (formerly referred to as "substance abuse counselors in training")
who are actively working toward LCADC or CADC status, or toward another health professional license that
includes work of an alcohol or drug counseling nature within its scope of practice. The director of substance
abuse counseling must maintain an active client caseload if the director of substance abuse counseling is to
be counted in the above ratios.
1. Each substance abuse counselor shall be
either an LCADC or a CADC or another licensed health professional doing work of an alcohol or drug counseling
nature within their scope of practice.
i. A CADC shall work under the
supervision of an LCADC, or another health professional licensed to supervise work of an alcohol or drug
counseling nature within their scope of practice.
ii. A CADC
cannot diagnose substance abuse without the signature approval of an LCADC or other clinical supervisor
approved to do so.
2. Substance abuse counseling staff
without LCADC or CADC status, or who are not other health professionals licensed to do work of an alcohol or
drug counseling nature within their scope of practice, shall function as counselor-interns, and shall:
i. Be enrolled in a course of study leading to CADC or LCADC status, or to
another health professional license that includes work of an alcohol and drug counseling nature within its
scope of practice, without regard to changes in employment, with progress towards certification or licensing
on file, reviewed by the facility at least semiannually and documented; and
ii. Be trained, evaluated and receiving continuing formal clinical
supervision by the director of substance abuse counseling or designee, pursuant to the clinical supervision
rules of the State health professional licensing board for the course of study in which they are enrolled:
the Board of Marriage and Family Therapy Examiners (BMFTE) for licensed marriage and family therapists; the
BMFTE's Professional Counselor Examiners Committee for licensed professional counselors; the BMFTE's Alcohol
and Drug Counselor Committee for LCADC and CADC; the State Board of Psychological Examiners for licensed
psychologists; and the State Board of Social Work Examiners for licensed clinical social workers.
(b) Counseling staff employed in an outpatient
treatment facility subsequent to June 1, 2009 shall have three years from the date of employment to obtain
LCADC or CADC status or another health professional license that includes work of an alcohol or drug
counseling nature within its scope of practice.
(c) Only staff
possessing the appropriate clinical background and educational qualifications from the appropriate clinical
discipline may provide the diagnosis, assessment and treatment of clients with co-occurring
disorders.
(d) Each substance abuse counselor shall be
responsible for the following:
1. Assessing the counseling needs of the
clients;
2. Assessing clients using the ASI or other standardized
clinical interview tool, and diagnosing clients for substance use disorder using the DSM-5;
3. Determining the appropriate level of care according to ASAM Criteria ;
4. Obtaining previous records that are relevant to the current
treatment episode;
5. Unless clinically contraindicated,
collaborating with the client to develop a written treatment plan that includes goals and measurable
objectives, and is client centered, recovery oriented;
i. The director of
substance abuse counseling shall develop, monitor and provide the client and treatment team a written
schedule to update each client treatment plan(s) in order to ensure clients' needs are met;
6. Providing the substance abuse counseling services specified
in the client treatment plan;
7. Reviewing clients throughout the
treatment episode according to the ASAM Criteria, to determine the need for continued services, transfer, or
discharge/transfer;
8. Reviewing and, where necessary, revising
the client treatment plan to address ongoing problems;
9.
Developing a client discharge/transfer plan to ensure movement to the appropriate levels of care;
10. Contact, case consultation if necessary, and coordination with referral
sources, (for example, mental health treatment providers, criminal justice agencies, schools, employers,
DCPP);
11. Participating as a member of a multidisciplinary team
for assigned clients;
12. Providing active case consultation;
and
13. Documenting all counseling and education services,
assessments, reassessments, referrals and follow-up in the client's clinical record, and providing
appropriate signatures and dating of such entries, including those made in electronic records.
