Subpart
1.
Required services.
Unless the certificate holder has documented clinical
contraindication of a service for the client and the rationale for the
contraindication, the certificate holder must offer, or have a written
agreement in place to offer, and must document the provision of the services in
subparts
2 to
9 to program clients.
Subp. 2.
Stage-based
individual and group modalities.
A. The
certificate holder must adopt and routinely use a protocol to assess and
reassess stage of treatment and stage of change.
B. The certificate holder must offer
individual and group modalities that consider the client's stage of treatment
to help the client:
(1) identify and address
problems related to substance use disorders, mental health disorders, and the
interaction between them;
(2)
develop strategies to avoid inappropriate substance use; and
(3) maintain mental health gains and
stability after discharge.
C. Treatment delivered in a group modality
must provide each individual in the group with stage-appropriate treatment and
must include:
(1) a same-stage or mixed-stage
treatment group; and
(2) a social
skills training group.
Subp. 3.
Engagement and outreach
techniques.
The certificate holder must offer an array of assertive
engagement outreach techniques. The techniques must be appropriate to the
individual's stage of change and designed to:
A. engage the client in treatment;
and
B. foster a therapeutic
relationship.
Subp. 4.
Evidence-based practices for delivering treatment.
The certificate holder must use evidence-based practices for
delivering treatment when clinically indicated for the client in the judgment
of the treatment team (clinically indicated).
A. When clinically indicated, the certificate
holder must use motivational interviewing to help the client:
(1) recognize how the client's substance use
disorder and mental illness symptoms interfere with the client's ability to
achieve personally valued goals; and
(2) become motivated to work on symptom
management to pursue these personally valued goals.
B. When clinically indicated, the certificate
holder must use at least one other permissible evidence-based practice. Other
permissible evidence-based practices include cognitive-behavioral approaches
and other practices supported by the professional literature and appropriate
for the client's particular mental illness.
Subp. 5.
Family-based
interventions.
The certificate holder must offer family-based interventions
that use evidence-based practices, when the certificate holder determines these
interventions are available for the client's particular disorders.
Subp. 6.
Psychoeducation.
The certificate holder must offer psychoeducation about the
possible interactions between mental health disorders and substance use
disorders, including how the disorders may worsen one another, to:
A. the client. Psychoeducation must also
include information about the specific disorders experienced by the client,
including treatment information, characteristics, and the interactive course of
the disorders; and
B. the client's
family.
Subp. 7.
Access to peer support.
The certificate holder must facilitate client access to peer
support. The certificate holder must offer individual interventions to clients
that include:
A. assisting the client
to develop a support system that involves relationships with individual peer
supports;
B. referral assistance,
such as being referred, accompanied, or introduced to peer-led self-help groups
by clinical staff, designated liaisons, or peer support group
volunteers;
C. help to find peer
support groups with accepting attitudes toward people with co-occurring
disorders and the use of psychotropic medication;
D. routine facilitation intended to engage
patients in mental health peer support groups, or groups specific to the
client's mental health and substance use disorders;
E. strategies to help the client connect with
peer recovery support groups;
F.
documentation in treatment plans or progress notes that indicate the
certificate holder regularly discusses with clients the possibility of linkage
with peer support groups. The certificate holder must attempt to proactively
plan for potential barriers or difficulties the client might experience in the
peer support group environment;
G.
identification of a liaison to assist the client transition to a peer support
group, if the support is desired by the client; and
H. consultation with the peer support group
on behalf of the individual regarding the specialized mental health needs of
the individual.
Subp. 8.
Recovery coaching.
The certificate holder must offer recovery coaching that
includes nonclinical, peer-based activities to engage, educate, and support the
client in making life changes necessary to recover from co-occurring disorders.
This subpart is effective July 1, 2016.
Subp. 9.
Psychopharmacological
treatment.
The certificate holder must offer psychopharmacological
treatment and adopt a protocol that states the prescribing provider must
collaborate with the clinical team to:
A. address medication compliance;
B. reduce the client's use of potentially
addictive medications; and
C.
prescribe and manage medications used in the treatment of substance use
disorders.
Subp. 10.
Continuity of care.
The certificate holder must provide continuity of care through
follow-up, with a focus on a long-term view of addiction recovery and mental
health management. The certificate holder must:
A. have a formal protocol to coordinate
mental health and substance use disorders needs after high-intensity services
are completed;
B. include in the
protocol requirements for client follow-up at six months and one year after
completion of high-intensity services; and
C. document the specific actions taken in
compliance with the protocol for each client.
