Section 440IAC9-2-8. Residential services for adults with addictions

   (a) Each managed care provider for addiction services and each community mental health center shall provide residential services according to the standards set out in this section. Managed care providers and community mental health centers shall ensure that their subcontractors who provide residential services also meet the same standards.

  (b) Residential treatment services for adults with addictions can take place in a variety of settings, as appropriate for the individual consumer.

  (c) Residential treatment services must be based on a written, cohesive, and clearly stated philosophy and treatment orientation and must include the following standards:

(1) There must be evidence that the philosophy is based on literature, research, and proven practice models.

(2) The services must be client centered.

(3) The services must consider client preferences and choices.

(4) There must be a stated commitment to quality services.

(5) The residents must be provided a safe, alcohol free, and drug free environment.

(6) The individual environment must be as homelike as possible.

(7) The services must provide transportation or ensure access to public transportation in accordance with the treatment plan.

  (d) The services must provide flexible alternatives with a variety of levels of supervision, support, and treatment as follows:

(1) Service flexibility must allow movement toward the least restrictive environment but allow increases in intensity during relapses or cycles of relapse.

(2) The residential services must provide continuous or reasonably incremental steps between levels.

(3) An agency cannot terminate a consumer from all services because of a need for more supervision, care, or direction without the agency making a good faith effort to continue to provide adequate, safe, and continuing treatment unless the resident is transferred to another entity with continuing treatment provided to the resident by that entity.

  (e) The treatment services must be carried out in residences that meet all life safety requirements and are licensed or certified as appropriate.

  (f) Residential services shall include specific functions that shall be made available to consumers based upon the individual treatment plan. These functions include the following:

(1) A treatment plan partially based on a functional assessment of each resident's daily living, socialization, and coping skills that is based on structured evaluation and observation of behavior.

(2) Crisis services, including access to more intensive services, including detoxification, within twenty-four (24) hours of problem identification.

(3) Case management services, including access to medical services, for the duration of treatment, provided by a case manager or primary therapist.

  (g) A consumer of residential treatment services must have access to psychiatric or addictions treatment as needed, including the following:

(1) Day treatment that may include the following:

(A) Daily living skills development.

(B) Social, recreational, and recovery support activities.

(C) Parenting skills development.

(2) Vocational services, that may include the following:

(A) Supported employment.

(B) Volunteering.

(C) Vocational rehabilitation services.

(D) Competitive employment.

(E) Job training.

(3) Appropriate educational services must be available in as normal a setting as possible.

(4) Psychiatric or addiction treatment, that may include the following:

(A) Group therapy.

(B) Individual counseling.

(C) Medication evaluation and monitoring.

  (h) Family involvement must be offered to the resident as part of the service unless it is refused by the resident.

  (i) If the resident agrees to family participation and signs a release of information, the following requirements apply:

(1) The program must solicit and consider input from the family or legal representative in the diagnosis and treatment planning process.

(2) Families or legal representatives shall be contacted when admitting residents and moving them between residences within the total service.

(3) Families or legal representatives shall be contacted quarterly regarding the resident's progress and situation.

(4) Families shall be encouraged to use appropriate family support services.

(Division of Mental Health and Addiction; 440 IAC 9-2-8; filed Jul 8, 2002, 1:58 p.m.: 25 IR 3763; readopted filed Apr 7, 2008, 3:40 p.m.: 20080507-IR-440070745RFA; readopted filed Aug 11, 2014, 11:21 a.m.: 20140910-IR-440140240RFA)