DEPARTMENT OF COMMUNITY HEALTH

            MENTAL HEALTH AND SUBSTANCE ABUSE ADMINISTRATION

                SUBSTANCE USE DISORDERS SERVICE PROGRAM

(By authority conferred on the director of the department of community health 
by section 6231 of 1978 PA 368, MCL  333.6231  and  Executive  Reorganization 
Order Nos. 1991-3, 1996-1, and 1997-4, MCL 333.36321, 330.3101, and 333.26324)


                        PART 1. GENERAL PROVISIONS


R 325.14101   Definitions; A to D.
  Rule 101. As used in these rules:
  (a) "Act" means 1978 PA 368, MCL 333.1101 et seq.
  (b) "Administrative record" means the formal written documents that  record 
administrative  actions  of  a  governing  authority,  including  minutes  of 
meetings, resolutions, and guidelines.
  (c) "Admission" means the point at which an individual is formally accepted 
into a substance use disorder service program and services are initiated.
  (d) "Aftercare" means the process of  providing  continued  services  to  a 
client which support and increase the gains made during treatment.
  (e) "Casefinding" means the process of systematically interacting with  the 
community for the purposes  of  identifying  persons  in  need  of  services, 
alerting persons and their families to the availability of services, locating 
needed services, and enabling persons to enter the service delivery system.
  (f) "Casefinding--screening and assessment, referral, follow-up" or  "SARF" 
means the performance of a range of activities necessary to make  preliminary 
assessments of problems. The object of these activities,  which  may  include 
interviews, psychological tests, and other diagnostic or assessment tools, is 
to effect referrals to  appropriate  treatment  or  assistance  resources  if 
indicated.
  (g) "Case Management"  means  a  substance  use  disorder  case  management 
program that coordinates, plans, provides, evaluates and monitors services or 
recovery from a variety of resources on behalf of and in collaboration with a 
client who has a substance use  disorder.   A  substance  use  disorder  case 
management program offers these services through designated staff working  in 
collaboration with the substance use disorder treatment team and as guided by 
the individualized treatment planning process.
  (h)  "Detoxification  treatment"  means  a  medically  acute  or  subacute, 
systematic reduction of the amount of a drug in the body, or the  elimination 
of a drug from the body concomitant with supportive treatment services.
April 26, 2006
  (i) "Discharge" means the point at which the  client's  active  involvement 
with a substance use disorder service is terminated and the program no longer 
maintains active responsibility for services to the client.

  History:  1981 AACS; 2006 AACS.


R 325.14102   Definitions; E to Q.
 Rule 102. As used in these rules:
  (a) "Early intervention" means a  specifically  focused  treatment  program 
including  stage-based  intervention  for  individuals  with  substance   use 
disorders as identified through a screening or assessment  process  including 
individuals who may not meet the threshold of abuse or dependence.
  (b) "Follow-up" means activities designed to determine the  present  status 
of persons previously discharged by a program or referred by that program  to 
services from another program.
  (c) "Full time" means employment of not less than 35 hours per week.
  (d) "Inpatient care" means substance use disorder treatment  services  that 
are provided to persons within a hospital setting under medical supervision.
  (e) "Integrated treatment for persons with mental health and substance  use 
disorders" means a program  that  offers  and  provides  both  substance  use 
disorder and mental health treatment in an integrated manner as evidenced  by 
staffing,  services  and  program  content.   The  program  is  designed  for 
individuals determined through an assessment process to  have  both  distinct 
substance use and mental health disorders.  Services must be provided through 
one service setting  and  through  a  single  treatment  plan  and  represent 
appropriate clinical standards including stage-based interventions.  Programs 
that focus primarily on one disorder but are able to address the  interaction 
between the disorders and/or coordinate services with other providers do  not 
require a service category license as an integrated treatment program.
Inpatient care may include both emergency services and nonemergency services.
  (f) "Intimate parts" means the primary genital area,  groin,  inner  thigh, 
buttock, or female breast of a human being.
  (g) "Maintenance treatment" means the use of relatively stable  dosages  of 
the  drugs  methadone,  levo-alpha-acetylmethadol  (LAAM),  or   propoxyphene 
napsylate (Darvon-N) as oral substitutes for heroin  or  other  morphine-like 
drugs for an individual dependent on heroin on a continuing  basis  for  more 
than  21  days  and  in  conjunction  with  the  provision   of   appropriate 
rehabilitative social and medical services.
  (h) "Methadone treatment" means chemotherapy using the drugs  methadone  or 
LAAM (levo-alpha-acetylmethadol) as rehabilitation tools in conjunction  with 
other treatment and rehabilitation care.
  (i) "Outpatient care" means scheduled, periodic care,  including  diagnosis 
and therapy, in  a  nonresidential  setting.  Correctional  institutions  are 
considered nonresidential settings.
  (j) "Peer recovery and recovery support" means  recovery  support  programs 
that are designed to support and promote recovery and prevent relapse through 
supportive services that result in the knowledge and skills necessary for  an 
individual's recovery.  Peer recovery programs  are  designed  and  delivered 
primarily by individuals  in  recovery  and  offer  social  emotional  and/or 
educational supportive services to help prevent relapse and promote recovery.
  (k) "Prevention" means services that reduce the  risk  that  an  individual 
will develop problems which might  require  that  the  individual  enter  the 
substance use disorder treatment system.
  (l) "Prevention CAIT" means a prevention service that provides at  least  1 
of the following services:
  (i) Community change.
  (ii) Alternatives.
  (iii) Information.
  (iv) Training.
  (m) "Prevention-community change" means planned efforts which are  designed 
to change specific conditions so as to reduce the probability that  substance 
use problems will occur among residents of the community.
  (n) "Prevention-information" means  providing  information  to  the  public 
which is designed to reduce the risk that an individual will develop problems 
which might require  that  he  or  she  enter  the  substance  use  disorders 
treatment system.
  (o) "Prevention-problem assistance" means helping a person  with  an  acute 
personal problem involving or related to substance use  disorders  to  reduce 
the risk that the person  might  be  required  to  enter  the  substance  use 
disorders treatment system.
  (p) "Prevention-training" means providing activities which are designed  to 
improve the personal and social skills  of  a  person  who  wishes  to  avoid 
substance use problems or who is in a position to help others avoid  problems 
with substance use.
  (q) "Program  director"  means  an  individual  who  is  appointed  by  the 
governing authority of the program or its authorized  agent  to  act  on  its 
behalf in the overall management of the program.
  (r) "Qualified handicapped," in relation to employment, means a handicapped 
person  who,  with  reasonable  accommodation,  can  perform  the   essential 
functions of the job in question. In  relation  to  substance  use  disorders 
services, "qualified handicapped" means a handicapped person  who  meets  the 
eligibility requirements for the receipt of substance use disorders services.

  History:  1981 AACS; 2006 AACS.


R 325.14103   Definitions; R to T.
  Rule 103. (1) As used in these rules:
  (a) "Recipient" means an individual who receives services from  a  licensed 
substance use disorders  program  in  the  state  of  Michigan.  "Client"  is 
synonymous with "recipient" when used in these rules.
  (b) "Recipient abuse" means either of the following:
  (i) An intentional act by a staff member  which  inflicts  physical  injury 
upon a recipient or which results in sexual contact with a recipient.
  (ii) A communication made by a staff member to a recipient, the purpose  of 
which is to curse, vilify, intimidate, or degrade a recipient or to  threaten 
a recipient with physical injury.
  (c) "Recipient neglect" means that a recipient suffers injury,  temporarily 
or permanently, because  the  staff  or  other  person  responsible  for  the 
recipient's health or welfare has been found negligent.
  (d) "Residential care" means substance  use  disorders  services  that  are 
provided in a full or partial  residential  setting.  Such  services  may  be 
supplemented with diagnostic services, counseling, vocational rehabilitation, 
work therapy, or other services which are judged to be valuable to clients in 
a therapeutic setting.
  (e) "Sexual contact" means the intentional touching, by a staff member,  of 
the recipient's intimate parts or the intentional touching  of  the  clothing 
covering the immediate area  of  the  recipient's  intimate  parts,  if  that 
intentional touching can reasonably be construed as being for the purpose  of 
sexual arousal or gratification.
  (f) "Staff" means an individual who is not a client and who works, with  or 
without remuneration, for a licensed substance use disorders program.
  (g) "Substance use disorder  program"  means  a  public  or  private  firm, 
association, organization, or group offering or purporting to offer  specific 
substance use disorders treatment, rehabilitation, casefinding, or prevention 
services. "Program" is synonymous with "substance use disorders program" when 
used in these rules.  Substance use disorders program does not include  those 
activities  necessary  for   the   purposes   of   determining   eligibility, 
authorization and/or administration of the substance abuse services system.
  (h) "Substance" means a chemical, including alcohol and other drugs, which, 
upon entering a human body,  alters  the  body's  physical  or  psychological 
status, or both.
  (i) "Substantial violation" means an infraction of a rule or of a provision 
of the act which is damaging to the intent of the rule or  provision  of  the 
act and which may be evidenced by any 1 of the following:
  (i) The violation is continuing, repetitive,  intentional,  or  has  proved 
damaging to specific clients.
  (ii) The violation is likely to result in damage to clients.
  (iii) The violation is likely to  retard  or  prevent  progress  in  client 
rehabilitation.
  (iv) The violation does not closely conform to essential  components  of  a 
rule.
  (j) "Termination" means the point at which the client's active  involvement 
with a substance use disorders service  is  discontinued  by  the program and 
 the  program  no  longer  maintains  active  responsibility  for services to 
the client.
  (k) "Triage" means the  prompt  evaluation  of  all  incoming  patients  to 
determine the nature of the problem and the level of urgency, to identify the 
kind of service needed, and to assign for attention.
  (2) The terms defined in the act have the same meaning when used  in  these 
rules.

  History:  1981 AACS; 2006 AACS.


R 325.14104   Waivers of rules.
  Rule 104. (1) In addition to the specific cases  cited,  the  administrator 
may grant waivers or variances of any of these rules for good cause shown.
  (2) A rule shall not be  waived  if  such  action  would   result   in   an 
activity which  would  endanger  the  health,  safety,  or   welfare   of   a 
recipient.
  (3) A request for waiver shall be submitted by the  program   director   to 
the administrator and  local  coordinating  agency  for   review   on   forms 
provided by the office. The form shall be fully completed   and   signed   by 
the program director.
  (4) The administrator shall notify the originator of  the  waiver   request 
and the coordinating agency in writing of the  decision  reached   concerning 
each waiver requested.
  (5) A waiver that is granted under this rule  shall  not   be   in   effect 
longer than the program license. A request for extension of a waiver shall be 
made at the time of license  renewal.  The  administrator   may   modify   or 
revoke the waiver as a condition of renewal.

  History:  1981 AACS.


R 325.14105   Relationships with coordinating agencies.
  Rule 105. (1) A program shall designate at least 1 staff member  to  act as 
liaison with the city or single- or  multi-county  coordinating  agency which 
is established or designated for that program by the  administrator.
  (2) A program shall submit reports to the  designated  coordinating  agency 
which are required in order for the coordinating  agency   to   fulfill   its 
responsibilities under the act.

  History:  1981 AACS.


R 325.14106   Reports.
  Rule 106. A program shall furnish to the office all  required  regular  and 
special reports necessary to implement the act and promulgated rules.

  History:  1981 AACS.


R 325.14107   Operating manual.
  Rule 107. A program shall have  an  operating   procedures   manual   which 
shall  be  clear  and  shall  accurately  reflect   program   activity.   The 
governing authority of the program shall annually review  the   updating   of 
the operating procedures manual. The  operating   procedures   manual   shall 
contain all of the following:
  (a) Intake procedure.
  (b) Admission criteria.
  (c) Discharge and termination criteria.
  (d) Confidentiality procedures.
  (e) Follow-up procedure after termination.
  (f) Organizational structure.
  (g) Incorporated status in the state of Michigan.
  (h) Aftercare procedures.
  (i) Recipient rights procedures.

  History:  1981 AACS.


R 325.14108   Hours of operation.
  Rule 108. Hours of operation shall be posted.

  History:  1981 AACS.


R 325.14109   Governing authority.
  Rule 109. (1) A program shall have a governing authority  which   has   the 
authority and responsibility for the overall operation of  the  program   and 
which shall ensure that the program  complies  with  licensing  standards.
Program employees shall not serve  as  voting  members   of   the   governing 
authority.
  (2) The governing authority shall adopt written bylaws  and  policies.  The 
policies of the governing authority may be part of the bylaws   or   may   be 
contained in a separate document. The bylaws or policies shall include all of 
the following:
  (a) The method of selecting members.
  (b) The number of members.
  (c) The terms of appointment  or  election  of   members,   officers,   and 
chairpersons of governing authority meetings.
  (3) Governing authority meetings shall be held at least quarterly.
  (4) Minutes of all governing authority meetings shall be  kept   and   made 
available for inspection.
  (5) The governing authority or its  authorized  agent   shall   appoint   a 
program director whose authority and duties are defined in writing.

  History:  1981 AACS.


R 325.14110   Program director.
  Rule 110. The program director shall be  responsible   to   the   governing 
authority or its  authorized  agent  for  the  overall   operation   of   the 
program.

  History:  1981 AACS.


R 325.14111   Program compliance with federal, state, and local  statutes and 
regulations;  provisions  to  assure  that  handicapped  individuals  receive 
services.
  Rule 111. (1) In addition to the requirements  of  the   act,   a   program 
shall comply with all federal,  state,  and  local   statutes,   rules,   and 
regulations that apply.
  (2) Provision shall be  made  for  assuring   that   qualified   physically 
handicapped individuals are able to receive services. This assurance shall be 
provided by operating a barrier-free  design  facility  or  by  developing  a 
written plan which describes how comparable, alternative  services   can   be 
made available to individuals with physical handicaps.
  (3) Physical facilities shall be  adequate  for  the   specific   type   of 
service provided.

  History:  1981 AACS.


R 325.14112   Personnel management.
  Rule 112. (1) A  program  shall  have  written   personnel   policies   and 
procedures, including a description of the grievance  process  for  employees 
who are charged with conduct which might result   in   disciplinary   action, 
including suspension or dismissal.
  (2) The governing authority or its authorized agent  shall   give   written 
approval to personnel policies and practices before their  implementation.
The date of such approval shall be documented.
  (3) Personnel policies and practices shall be reviewed   by   the   program 
director or his or her  superior  and,  if  necessary,   updated   at   least 
annually.
  (4) There shall be written job descriptions for all  positions.  Each   job 
description shall specifically identify all of the following:
  (a) Job title.
  (b) Tasks and responsibilities.
  (c) The skills, knowledge, training, education,  and  experience   required 
for the job.
  (5) Job descriptions shall accurately reflect the  actual   job   situation 
and  shall  be  revised  when  there  is  a   change    in    the    required 
qualifications, duties, supervision, or other job tasks.
  (6) A staff member shall be given a copy  of  his  or   her   written   job 
description and a written description of the  program's  personnel   policies 
and procedures.
  (7) A program shall not refuse employment to individuals  solely   on   the 
grounds of prior substance abuse or prior criminal   history.   A   qualified 
handicapped person shall not be subjected to discrimination in  employment on 
the basis of his or her handicap.
  (8) There shall be an orientation  program  for  all   staff   members   to 
introduce  them  to  the  program's  philosophy,   goals,    policies,    and 
procedures.
  (9) A personnel record shall be kept on each staff member.
  (10) A staff member shall be  evaluated  at  least   annually,   shall   be 
encouraged to review and comment on the evaluation, and shall  be  asked   to 
sign the evaluation to verify that he or she  has  been   informed   of   the 
evaluation's contents.
  (11) An appropriate staff  member  who  is  designated   by   the   program 
director to be responsible for overseeing the  operation   of   the   program 
shall be physically on-site when the program director is absent.

  History:  1981 AACS.


R 325.14113   Program evaluation.
  Rule 113. (1) Documentation of program evaluation  methods   that   measure 
progress and results relative to current objectives shall  be  maintained  by 
the program and shall be available for review by the office.
  (2)  A  written  statement  of  the  program's   measurable    goals    and 
objectives, developed as a result of a planning   process,   in   conjunction 
with available information, shall serve as the basis for evaluation.
  (3) A program shall develop a  written  evaluation  plan   based   on   the 
measurable goals and objectives of the  program.   The   written   evaluation 
plan shall be reviewed by the governing authority  and   updated   at   least 
annually.
  (4) An annual evaluation progress report shall be prepared by a program.
This report shall contain details on how the program   intends   to   improve 
its performance in areas needing improvement.

  History:  1981 AACS.


R 325.14114   Staff development program.
  Rule  114.  (1)  A  program  director  shall  be   responsible   for    the 
establishment of a staff development program. The   program   shall   include 
all of the following:
  (a) Orientation for entry level staff.
  (b) On-the-job training.
  (c) Inservice education.
  (d) Opportunity for continuing job-related education.
  (2) A program  shall  develop  written  policies   and   procedures   which 
specify what the staff development program is  comprised  of   and   how   it 
operates. These policies and procedures shall be  made   available   to   all 
program staff and shall be available for review by the office.
  (3) A record shall be kept of staff members  who   have   participated   in 
each staff development activity.

  History:  1981 AACS.


R 325.14115   Referrals to other resources.
  Rule 115. (1) A program shall maintain a written list  of  resources  which 
are willing and able to provide services to  program  service  recipients.
The list shall contain sufficient detail to allow a staff  member  making   a 
referral to determine the name and location of the resource,  the  types   of 
services the resource  will  provide,  and  the   resource's   criteria   for 
determining an individual's eligibility for service.
  (2) If a program is not part of a comprehensive mental  health  system,  it 
shall enter into referral agreements with  mental   health   facilities   for 
provision of acute and long-term psychiatric services when necessary.
  (3) An agreement shall exist between the licensee and 1  or  more  licensed 
medical service facilities for the provision of   emergency   inpatient   and 
ambulatory medical services. If such a facility does not  exist   within   40 
miles of the licensee's facility, an agreement  shall   exist   between   the 
licensee and a physician to provide emergency services.

  History:  1981 AACS.


R 325.14116   Confidentiality of client case records.
  Rule 116. (1) A client's records shall be kept confidential  and  shall  be 
maintained in compliance with section 6111  of  the  act   and   with   other 
applicable  federal  and  state  statutes   and    rules,    including    the 
requirements of 42 C.F.R. SS2.1 to 2.67-e, June 9, 1987. The provisions of 42 
C.F.R. SS2.1 to 2.67-e, June 9, 1987,  are  adopted  by  reference  in  these 
rules. Copies of the provisions of  42  C.F.R. SS2.1  to   2.67-e,   June  9, 
1987, are available from the Superintendent of   Documents,   United   States 
Government Printing Office, Washington, DC 20402, or   from   the   Licensing 
Section, Center for Substance Abuse Services, 3423 N.  Martin  Luther   King, 
Jr. Blvd., P.O. Box 30195, Lansing, Michigan 48909, at no cost.
  (2) An authorization for the release of information shall  become  part  of 
the client's permanent case record.

  History:  1981 AACS; 1988 AACS.


R 325.14117   Discontinuation of substance abuse programs.
  Rule 117. (1) The governing authority of a program shall  adopt  a  written 
policy governing the disposal of client case records.
  (2) A licensed substance abuse program shall, on forms  provided   by   the 
office, notify the office and coordinating agency not less   than   30   days 
before closure of a program.
  (3) It is the responsibility of the governing authority  to   ensure   that 
client records are properly disposed of pursuant  to  42   C.F.R.  SS2.1   to 
2.67-1, July, 1975.
  (4) All clients who are still in treatment when  a   program   discontinues 
its operations shall be notified of the date of closing,   where   they   can 
obtain continued treatment, and how their records can   be   transferred   to 
another program. They shall also  be  notified  of  the   procedure   to   be 
followed if, after the program has closed, the   client   wants   information 
contained in his or her record or wants the entire  record   transferred   to 
another agency or person. Client consent forms shall be  signed  before  such 
transfer of information.
  (5) Programs shall obtain  the  approval  of   the   pertinent   regulatory 
agencies, such as the center for substance abuse   services,   the   national 
institute on drug abuse, the state board of pharmacy, the  federal  food  and 
drug administration, and  the  federal  drug   enforcement   agency,   before 
destruction of records.
  (6) The governing authority of the  program  shall   be   responsible   for 
destroying client files if arrangements for  an   appropriate   transfer   of 
files cannot be made.

  History:  1981 AACS.


R 325.14125   Rescission.
  Rule 125. R 325.4001 to R 325.4084 of the  Michigan  Administrative   Code, 
appearing on pages 2033 to 2049 of the 1979  Michigan  Administrative   Code, 
are rescinded.

  History:  1981 AACS.