Tenn. Comp. R. & Regs. 0940-05-42-.14 - COUNSELING

(1) Counseling is essential to promote and guide the service recipient to a more productive life style of abstinence from illicit medications or drugs due to so many opioid addicted service recipients also abusing other illicit or prescription substances. The primary counselor is responsible for developing and implementing the service recipient's plan of care, in coordination with the medical staff. The plan of care shall address the social, environmental, psychological and familial issues maintaining the service recipient's maladaptive patterns of drug consumption and other high risk and/or destructive behaviors. The counselor is responsible for assisting the service recipient to alter life styles and patterns of behavior in order to improve the service recipient's ability to function adaptively in his or her family and community.

(2) The clinical staff caseload ratio shall:

(a) Reflect an appropriate clinical mix of sex, race and ethnicity representative of the population served;

(b) Allow the Facility to provide adequate:

1. Psychosocial assessment;

2. Treatment planning; and

3. Individualized counseling;

(c) Allow for regularly scheduled counseling sessions; and

(d) Allow service recipients access to their primary counselor if more frequent contact is merited by need or is requested by the service recipient.

(3) For all service recipients, the following counseling schedule shall be followed:

(a) During the first 30 days of treatment, counseling session(s) shall take place at least two times per week;

(b) During the next 90 days of treatment (day 31 to day 120), counseling session(s) shall take place at least one time per week;

(c) During the following 90 days of treatment (day 121 to day 210), counseling session(s) shall take place at least two times per month;

(d) For subsequent 90 day periods of treatment (day 211 forward), counseling session(s) shall take place as needed or indicated in the service recipient's IPP, but not less frequently than monthly as long as the service recipient is compliant.

(4) Exceptions to frequency of counselor to service recipient contact shall be clearly justified by Facility program documentation. The program physician or prescribing professional evaluating the service recipients eligibility for take-home doses shall carefully consider the service recipient's participation in the counseling sessions as a factor in his or her decision although justified lack of participation (such as for reasons of employment) shall not be held against the service recipient in the take-home decision.

(5) The primary counselor or medical staff is responsible for documentation of significant contact with each service recipient, which shall be filed in the service recipient record.

(6) The documentation shall include a description of:

(a) The reason for or nature of the contact;

(b) The service recipient's current condition;

(c) Significant events occurring since prior contact;

(d) The assessment of the service recipient's status; and

(e) A plan for action or further treatment that addresses the goals of the treatment plan.

(7) Each entry shall be completed within 24 hours of the contact and shall be clearly dated and initialed or signed by the staff person involved.

(8) Opportunities for family involvement in counseling shall be provided and documented.

Notes

Tenn. Comp. R. & Regs. 0940-05-42-.14

Original rule filed June 8, 1999; effective August 22, 1999. Per Executive Order 44 (February 23, 2007), rule was transferred from 1200-8-21 on May 15, 2008. Repeal and new rule filed September 20, 2012; effective December 19, 2012.

Authority: T.C.A. §§ 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.