Tenn. Comp. R. & Regs. 0940-05-42-.11 - INDIVIDUALIZED PROGRAM PLAN
(1) A Facility
shall develop an Individualized Program Plan (IPP) for each service recipient
within 30 days of admission. Each service recipient shall be involved in the
development and review of his/her IPP. The initial IPP and all reviews shall be
signed by the service recipient and program physician. IPPs shall document the
following:
(a) A consistent pattern of
substance abuse treatment services and medical care appropriate to individual
service recipient needs;
(b)
Detoxification as an option for treatment that is supported by the Facility;
and
(c) A discharge plan that has
been discussed with the service recipient.
(2) The admission requirements of
0940-05-42-.06 shall first be completed prior to the development of an
IPP.
(3) Medical care, including
referral for necessary medical service, and evaluation and follow-up of service
recipient complaints shall be compatible with current and accepted standards of
medical practice. All service recipients shall receive a medical examination at
least annually. All other medical procedures performed at the time of admission
shall be reviewed by the medical staff on an annual basis, and all clinically
indicated tests and procedures shall be repeated. The medical director or
program physician shall record the results in this annual medical examination
and review of service recipient medical records in each service recipient's
record.
(4) In recognition of the
varied medical needs of service recipients, the case history, IPPs,
detoxification plan and discharge planning shall be reviewed at least every 90
days for service recipients in treatment less than one year and at least
annually for service recipients in treatment more than one year. This review
will be conducted by the medical director or program physician along with the
primary counselor and other appropriate members of the treatment team for
general quality controls and evaluation of the appropriateness of continuing
the form of treatment on an ongoing basis. This review shall also include an
assessment of the current dosage and schedule and the rehabilitative progress
of the individual, as part of a determination that additional medical services
are indicated. If this review results in a determination that additional or
different medical services are indicated the Facility shall ensure that such
services are made available to the service recipient, either at the Facility or
by referral to the appropriate medical professional.
(5) When the program physician prescribes
other controlled substances to service recipients in the Facility, the Facility
shall ensure that such prescription is in accord with all applicable statutes
and regulations and with current and accepted standards of medical practice.
Such prescriptions shall not be issued to any service recipient unless the
physician first sees the service recipient and assesses the service recipient's
potential for abuse of such medications.
(6) As part of the rehabilitative services
provided by the Facility, each service recipient shall be provided with
individual and group counseling appropriate to his/her needs. The frequency and
duration of counseling provided to service recipients shall be in conformity
with 0940-05-42-.14 and be consistent with the Individualized Program Plan.
Individualized Program Plans shall indicate a specific level of counseling
services needed by the service recipient as part of the rehabilitative
process.
(7) All service recipients
shall receive HIV and hepatitis risk reduction education appropriate to their
needs.
(8) When appropriate, each
service recipient shall be enrolled in an education program, or be engaged in
vocational activity (vocational evaluation, education or skill training) or
make documented efforts to seek gainful employment. Deviations from compliance
with these requirements shall be explained in the service recipient's record.
Each Facility shall take steps to ensure that a comprehensive range of
rehabilitative services, including vocational, educational, legal, mental
health, alcoholism and social services, are made available to the service
recipients who demonstrate a need for such services. The Facility can fulfill
this responsibility by providing support services directly or by appropriate
referral. Support service recommended and utilized shall be documented in the
service recipient's record. Each Facility shall have policies for matching
service recipient's needs to treatment.
(9) All facilities will develop and implement
policies for matching service recipient's needs to treatment. These policies
may include treatment phasing in which the intensity of medical, counseling and
rehabilitative services provided to a service recipient are individualized for
each service recipient depending upon the service recipient's phase of
treatment.
(10) If the service
recipient experiences a relapse, his/her IPP shall document evidence of
intensified services provided. Such evidence shall include, but is not limited
to, an increase in individual or group counseling session(s) and a reduction in
the service recipient's take-home privileges.
(11) Discussion shall be held with the
service recipient regarding his or her continued desire to remain in the
program for maintenance treatment. Alternatives such as medically-supervised
withdrawal shall be presented to the service recipient at the time of the
discussion and documented in the service recipient's record. The service
recipient shall sign and date a statement indicating that she or he wishes to
remain within the program in a maintenance format. If the service recipient
wishes to enter medically-supervised withdrawal, the plan of care shall reflect
that choice.
Notes
Authority: T.C.A. ยงยง 4-3-1601, 4-4-103, 33-1-302, 33-1-305, 33-1-309, 33-2-301, 33-2-302, and 33-2-404.
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