reglab/statecodes huggingface dataset:
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1454 - CLIENT RECORD CONTENT REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) The
				substance use disorder residential facility (SUDF) must develop and implement
				procedures to ensure each client record is available on-site and includes:
(a) demographic information;
(b) a substance related disorder diagnosis
				and supporting documentation for diagnosis;
(c) biopsychosocial assessment including diagnosis showing the
				rationale for admission;
(d) signed
				documentation the client was informed of federal confidentiality requirements
				and received a copy of the client notice as required in ARM
				37.106.1416;
(e) signed
				documentation the client received orientation to the SUDF's treatment services,
				infectious disease information, and disaster plan described in ARM
				37.106.322;
(f) a voluntary consent
				to treatment signed and dated by the client or legal guardian;
(g) individualized treatment plan and
				treatment plan reviews;
(h)
				progress notes;
(i) clinical
				notes;
(j) continuing care
				plan;
(k) medication records, if
				applicable;
(l) laboratory reports,
				if applicable;
(m) authorizations
				for release of information, as needed;
(n) copies of all correspondence related to the client, including
				any court orders and reports of noncompliance; and
(o) documentation pertaining to client
				receipt of grievance policies and procedures.
(p) documentation of any client-filed written grievances and
				resolution;
(q) documentation the
				client received a copy of the client rights policy and the client's signature
				indicating he/she received the policy; and
(r) documentation of school educational courses attended or
				provided.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1455 - ADOLESCENT FACILITIES

Current through Register Vol. 13, July 5, 2024
(1) In addition to
				policies required throughout this rule, a SUDF licensed to serve adolescents
				must have written policies and procedures that address:
(a) limiting admission to adolescents 17
				years of age or younger or adolescents 18, 19, and 20 years of age if a client
				is enrolled in certified secondary school, and the assessment completed by a
				LAC or mental health professional with substance use in the scope of their
				license determines their appropriateness for adolescent treatment;
(b) age-appropriate treatment;
(c) separation of adolescents from adults in
				all characteristics of the treatment process;
(d) separation of adolescents from adults in
				all non-treatment aspects including eating, sleeping, bathing, and recreation
				activities; and
(e) staffing
				patterns to ensure staff members of the same sex as clients are present at all
				times.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1456 - CARE MANAGEMENT

Current through Register Vol. 13, July 5, 2024
(1) In addition to
				the requirements established in this subchapter, each SUDF must provide care
				management services and comply with the requirements established in this
				rule.
(2) A care manager must have
				a bachelor's degree in a human services field, an equivalent combination of
				education and experience, or a minimum of two years of experience serving
				individuals with behavioral health issues. Evidence of experience must be
				documented in the employee personnel record.
(3) Care management services must be provided
				by staff whose primary duty is the provision of care management
				services.
(4) The SUDF must develop
				written policies and procedures addressing the independence of the care manager
				and care management program. At a minimum, the policies and procedures must
				address:
(a) the care manager's role in
				conflicts between the client and the SUDF or other agencies;
(b) the ability of the care manager to freely
				advocate for services from the SUDF or other agencies on behalf of the
				client;
(c) the relationship
				between the licensed addiction counselor or mental health professional and the
				care manager;
(d) the obligation to
				report information to the SUDF staff that the client has requested to be kept
				confidential; and
(e) the ability
				of the care manager to contact an advocacy organization if the care manager
				believes the SUDF is unresponsive to the needs of the
				client.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1457 - MEDICATION STORAGE AND ADMINISTRATION

Current through Register Vol. 13, July 5, 2024
(1)
				A substance use disorder facility (SUDF) must have a written policy addressing
				requirements for the storage, administration, and disposal of prescription,
				nonprescription, and over-the-counter medication.
(a) Policies must include protocols for daily
				monitoring, counting of stored narcotics and other medication that has the
				potential for abuse.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1458 - COMMUNICABLE DISEASE CONTROL

Current through Register Vol. 13, July 5, 2024
(1) The SUDF
				must develop and implement an infection prevention and control program and
				review the program annually.
(2)
				The SUDF must have written policies and procedures regarding infection
				prevention and control which include:
(a)
				procedures to identify high risk individuals;
(b) specific procedures to address
				tuberculosis (TB), Hepatitis A, Hepatitis C, sexually transmitted infections
				(STI), and human immunodeficiency virus (HIV); and
(c) the identification of methods used to
				protect, contain, or minimize the risk to clients, staff members, and
				visitors.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1460 - QUALITY MANAGEMENT REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) The
				substance use disorder facility (SUDF) must have a quality management committee
				that is representative of the SUDF's administration and staff
				members.
(2) The quality management
				committee must meet on a quarterly basis and is responsible for:
(a) developing a written plan for a
				continuous quality improvement program that is applicable to the entire
				organization;
(b) implementing the
				quality improvement plan and monitoring the quality and appropriateness of
				services;
(c) identifying problems,
				taking corrective action as indicated, and monitoring results of those actions;
				and
(d) at least annually,
				reviewing and updating the quality improvement plan.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1462 - REQUIRED OUTCOME MEASURES (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 50-5-103,
					 53-24-208, MCA
					 IMP:
					 50-5-101,
					 50-5-103,
					 53-24-208,
					 76-2-411,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1466 - PETS

Current through Register Vol. 13, July 5, 2024
(1) When pets are kept on the premises, the
				SUDF must write and adhere to procedures for their care and
				maintenance.
(2) When animals are
				kept on the premises, the following conditions must be met:
(a) proof of current vaccinations must be
				kept on file at the facility;
(b)
				pets not confined in enclosures must be under control;
(c) pets must not present a danger to
				clients, staff members, or visitors;
(d) pets are not permitted in food
				preparation, storage, or dining areas during meal preparation time or during
				meal service or in an area where their presence would create a significant
				health or safety risk to others;
(e) staff members and clients must wash their
				hands after handling animal food and animal waste;
(f) pets must be kept clean and
				disease-free;
(g) pet enclosures,
				bedding, equipment, and supplies are kept clean and in good repair;
				and
(h) protocols are in place to
				address how reasonable accommodations will be made for clients and staff
				members with allergies to animals housed in the facility or who may visit the
				facility as part of a therapeutic treatment program.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1467 - FOOD SERVICE

Current through Register Vol. 13, July 5, 2024
(1) An inpatient or
				residential SUDF must establish policies and procedures for standards relative
				to safe food handling, storage, preparation, and serving, to prevent food
				spoilage and the transmission of infectious disease. The policies and
				procedures must include provisions that:
(a)
				all food must be from an approved source and shall be transported, stored,
				covered, prepared, and served in a sanitary manner to prevent
				contamination;
(b) food must be
				free from adulteration or other contamination and must be safe for human
				consumption;
(c) food removed from
				the original container must be dated, labeled, and sealed;
(d) milk and other dairy products must be
				pasteurized;
(e) use of home canned
				foods other than jams, jellies, and fruits is prohibited;
(f) use of thermometers is required to check
				food temperatures;
(g) cold storage
				of potentially hazardous food must be at 41°F or below;
(h) frozen food must be kept
				frozen;
(i) hot storage of
				potentially hazardous food must be 135°F or above;
(j) each type of food must be stored and
				arranged so that cross-contamination of one type with another is
				prevented;
(k) raw fruits and
				vegetable must be thoroughly washed in potable water to remove soil and other
				contaminants before being cut, combined with other ingredients, cooked, served,
				or offered for human consumption in ready-to-eat form. Fruits and vegetables
				may be washed by using chemicals approved by the U.S. Environmental Protection
				Agency;
(l) food packages must be
				in good condition and protect their contents, so that the food is not exposed
				to adulteration or potential contaminants; and
(m) packaged food may not be stored in direct
				contact with water or undrained ice if the food package could allow water
				entry.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1468 - OUTPATIENT SUBSTANCE USE DISORDER FACILITY

Current through Register Vol. 13, July 5, 2024
(1) To be licensed to provide SUD services in
				an outpatient setting, a SUDF must meet the following staffing requirements:
(a) clinical director;
(b) licensed addiction counselors or mental
				health professionals in sufficient numbers to provide counseling and therapy
				services to patients with substance use disorders as described by this chapter
				and in accordance with the patients' individualized treatment plans;
				and
(c) care managers in sufficient
				numbers to provide services to patients required by this chapter and in
				accordance with the patients' individualized treatment plans.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1469 - ASAM 2.5 PARTIAL HOSPITALIZATION SUBSTANCE USE DISORDER FACILITY

Current through Register Vol. 13, July 5, 2024
(1) To be licensed to provide ASAM 2.5
				services as outlined in the ASAM Criteria, a SUDF must meet the following
				staffing requirements:
(a) clinical
				director;
(b) licensed addiction
				counselors or mental health professionals in sufficient numbers to provide
				counseling and therapy services to clients with substance use disorders as
				described by this chapter and in accordance with the clients' individualized
				treatment plans;
(c) care managers
				in sufficient numbers to provide services to clients required by this chapter
				and in accordance with the clients' individualized treatment plans;
				and
(d) rehabilitation aides in
				sufficient number to provide direct care services and supervision of
				clients.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1470 - FACILITY REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) In addition to
				requirements found in ARM
				37.106.320,
				substance use disorder facilities (SUDF) must comply with additional
				requirements in this rule.
(2)
				Facilities must be accessible to a person with a physical disability. If a SUDF
				is unable to provide access to a person with a physical disability, the program
				must make arrangements for a referral or other accommodations to assure the
				person receives appropriate services.
(3) Facilities must meet all applicable
				building and fire codes and be approved by the authority having jurisdiction to
				determine if the appropriate building and fire codes are met.
(4) An inpatient or residential SUDF must
				have an annual fire inspection conducted by the state fire marshal or by the
				authority having jurisdiction, and must maintain a record of the inspection for
				at least three years following the date of the inspection.
(5) Exit doors shall not include locks which
				prevent evacuation, except as approved by the fire marshal and building codes
				agency having jurisdiction.
(6)
				Stairways, halls doorways, passageways and exits from rooms and from the
				facility must be kept unobstructed at all times.
(7) All exterior pathways, entrances, and
				exit ways shall be of hard, smooth material, and be unobstructed and in good
				repair at all times.
(8) A 2A10BC
				portable fire extinguisher shall be available on each floor of the facility or
				as required by the fire authority having jurisdiction.
(9) Portable fire extinguishers must be
				inspected, recharged, and tagged at least once a year by a person certified by
				the state to perform these services.
(10) A smoke detector, approved by a
				recognized testing laboratory, which is properly maintained and regularly
				tested, must be located on each level and in all sleeping areas, bedroom
				hallways, and common living areas, with the exception of the kitchen and
				bathrooms of a SUDF or as required by the fire authority having
				jurisdiction.
(11) If individual
				battery-operated smoke detectors are used, the following maintenance is
				required:
(a) smoke detectors must be tested
				at least once a month to ensure that they are operating correctly;
(b) new operating batteries must be installed
				at least once each calendar year; and
(c) documentation demonstrating required
				maintenance must be kept on-site for a period of 24 months.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1471 - ASAM 3.1 CLINICALLY MANAGED LOW INTENSITY RESIDENTIAL (ADULT OR ADOLESCENT) SUBSTANCE USE DISORDER FACILITY

Current through Register Vol. 13, July 5, 2024
(1) To be
				licensed to provide ASAM 3.1 services as outlined in the ASAM Criteria, a SUDF
				must meet the following staffing requirements:
(a) clinical director;
(b) licensed addiction counselors or mental
				health professionals in sufficient numbers to provide counseling and therapy
				services to clients with substance use disorders as described by this chapter
				and in accordance with the clients' individualized treatment plans;
(c) care managers in sufficient numbers to
				provide services to clients required by this chapter and in accordance with the
				clients' individualized treatment plans;
(d) rehabilitation aides in sufficient numbers to provide direct
				care support services as outlined in the clients' individualized treatment
				plans; and
(e) on-site awake
				staffing whenever clients are present in the facility.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1472 - ASAM 3.3 CLINICALLY MANAGED POPULATION-SPECIFIC HIGH INTENSITY RESIDENTIAL (ADULT ONLY) SUBSTANCE USE DISORDER FACILITY

Current through Register Vol. 13, July 5, 2024
(1) To be licensed to provide ASAM 3.3
				services as outlined in the ASAM Criteria, a SUDF must provide on-site 24-hour
				awake staffing and meet the following staffing requirements:
(a) a physician, physician assistant, or
				advanced practice registered nurse acting within the scope of the license
				issued by the Department of Labor and Industry available for consultation
				within 24 hours in person or by telephone;
(b) clinical director;
(c) licensed addiction counselors or mental
				health professionals in sufficient numbers to provide counseling and therapy
				services to clients with substance use and mental disorders as described by
				this chapter and in accordance with the clients' individualized treatment
				plans;
(d) a licensed addiction
				counselor or mental health professional must be on-site or on call 24 hours a
				day, seven days a week;
(e) care
				managers in sufficient numbers to provide services to clients required by this
				chapter and in accordance with the clients' individualized treatment plans;
				and
(f) rehabilitation aides in
				sufficient number to provide direct care support services as outlined in the
				clients' individualized treatment plans.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1473 - ASAM 3.5 CLINICALLY MANAGED HIGH INTENSITY RESIDENTIAL (ADULT)/MEDIUM INTENSITY RESIDENTIAL (ADOLESCENT) SUBSTANCE USE DISORDER FACILITY REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) To be licensed
				to provide ASAM 3.5 services as outlined in the ASAM Criteria, a SUDF must
				provide on-site 24-hour awake staffing and meet the following staffing
				requirements:
(a) a physician, physician
				assistant, or advanced practice registered nurse acting within the scope of the
				license issued by the Department of Labor and Industry available for
				consultation within 24 hours in person or by telephone;
(b) clinical director;
(c) licensed addiction counselors or mental
				health professionals in sufficient numbers to provide counseling and therapy
				services to clients with substance use and mental disorders as described by
				this chapter and in accordance with the clients' individualized treatment
				plans;
(d) a licensed addiction
				counselor or mental health professional must be on-site or on call 24 hours a
				day, seven days a week;
(e) care
				managers in sufficient numbers to provide services to clients required by this
				chapter and in accordance with the clients' individualized treatment plans;
				and
(f) rehabilitation aides in
				sufficient number to provide direct care support services as outlined in the
				clients' individualized treatment plans.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1475 - ASAM 3.7 MEDICALLY MONITORED INTENSIVE INPATIENT REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) To be licensed to provide ASAM 3.7
				services, as outlined in the ASAM criteria, a substance use disorder facility
				(SUDF) must meet the following staffing requirements:
(a) a medical director that oversees the
				treatment process, medication management, and all medical services;
(b) a physician, nurse practitioner, or
				physician assistant licensed under Title 37, chapters 3 or 20, MCA, available
				on-call 24 hours a day, seven days a week to provide medical consultation,
				evaluate clients, and prescribe medications;
(c) a registered nurse (RN) licensed under
				Title 37, MCA, on-site or on call 24 hours a day, seven days a week to
				supervise nursing services;
(d) a
				RN or licensed practical nurse (LPN) on-site 24 hours a day, seven days a
				week;
(e) additional RNs, LPNs or
				certified nurse aides (CNA) in sufficient numbers to assist in the
				administration of medical protocols and assure the client's safety. LPNs and
				CNAs must be under the supervision of the RN;
(f) licensed addiction counselors or mental
				health professionals in sufficient numbers to provide therapeutic services to
				clients with substance use and mental disorders, as described by this chapter
				and in accordance with the clients' individualized treatment plans;
(g) a licensed addiction counselor or mental
				health professional must be on-site or on-call 16 hours a day, seven days a
				week;
(h) care managers in
				sufficient numbers to provide adequate services to clients; and
(i) rehabilitation aides in sufficient number
				to provide on-site 24 hours a day, seven days a week staffing patterns to
				ensure the safety of clients and to provide direct care services and
				appropriate supervision of clients.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1480 - WITHDRAWAL MANAGEMENT PROGRAM REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) To be licensed to provide clinically
				managed residential withdrawal management defined as ASAM 3.2-WM, a provider
				must be licensed as an inpatient or residential health care facility program
				pursuant to
				50-5-101,
				MCA, and meet the following:
(a) The facility
				must be equipped for clients who are impaired due to substances and may require
				safety rails on beds pursuant to ARM Title 37, chapter 106, subchapter 29,
				handrails on showers, and other related equipment to assure the safety of
				impaired clients.
(b) The SUDF must
				have physician approved protocols for the monitoring of clients in withdrawal
				including when and under what circumstances clients should be transferred to
				another health care facility.
(c)
				The SUDF must have a written agreement with the health care facility or
				physician providing for emergency services when needed.
(d) The SUDF must have written procedures
				specifying how staff will respond to emergencies and for the transfer of
				medically unstable clients.
(e) The
				SUDF must have sufficient staff on duty 24 hours a day, seven days a week to
				supervise, observe, and support clients who are intoxicated or experiencing
				withdrawals.
(f) The SUDF must
				train staff in physician approved protocols for monitoring clients in
				withdrawal and in medication management if medication is
				administered.
(g) The SUDF must
				have licensed addiction counselors (LAC) or mental health professionals in
				sufficient numbers to provide counseling and therapy services as described in
				this chapter and in accordance with the client's individualized treatment
				plan.
(h) The initial
				biopsychosocial assessment indicating this level of care must be reviewed by a
				licensed physician, nurse practitioner, or physician assistant during the
				admission process.
(i) The SUDF
				must provide daily clinical skilled treatment services to address the needs of
				each client. Clinical skilled treatment services may include medical services,
				individual and group therapy, and withdrawal support as required in the
				client's individualized treatment plan.
(j) The SUDF must ensure regular vital signs
				are taken and recorded by staff trained to recognize symptoms indicating the
				client is becoming physically unstable.
(k) All progress notes must be completed in a
				timely manner and before the next session of the same type, or there must be
				documentation why this did not occur.
(l) Coordination of necessary services
				(medical, laboratory, toxicology, psychiatric, psychological, emergency) or
				other levels of care must be available through direct affiliation or referral
				processes.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1482 - HALFWAY HOUSE COMMUNITY-BASED RESIDENTIAL PROGRAM REQUIREMENTS (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 53-24-208, MCA
					 IMP:
					 50-5-101,
					 50-5-103,
					 53-24-208,
					 53-24-209,
					 76-2-411,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1485 - SINGLE SEX PARENT AND CHILDREN REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) In addition to the licensing requirements
				in ARM 37.106.1471, a SUDF operating as a single sex parent and children ASAM
				3.1 facility, must meet the following requirements:
(a) care management services must address the
				needs of the client's children in care;
(b) parenting skills must be addressed with
				evidence-based models that focus on the demands of being a parent in recovery;
				and
(c) the SUDF must provide
				age-appropriate services to meet the children's needs. Services include
				childcare, medical appointments, legal services, transportation, educational
				services, and recreational services.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1487 - HALFWAY HOUSE SINGLE GENDER RESIDENTIAL HOMES (ASAM LEVEL III.5 - HIGH INTENSITY) (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 50-5-103,
					 53-24-208,
					 MCA; IMP:
					 50-5-101,
					 50-5-103,
					 53-24-208,
					 53-24-209,
					 76-2-411,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1489 - HALFWAY HOUSE SINGLE GENDER COMMUNITY-BASED RESIDENTIAL HOMES (ASAM LEVEL III.3 - MEDIUM INTENSITY)

Current through Register Vol. 13, July 5, 2024
(1) Community-based
				single gender residential homes for individuals with substance use disorders
				may be located in residential neighborhoods, comparable to other homes in the
				neighborhood, and shall reflect the environment of a home. To be licensed to
				provide community-based residential homes for individuals with substance use
				disorders ASAM Level III.3 medium intensity treatment, a provider must meet the
				following:
(a) staffing or security measures
				sufficient to assure the safety of residents, staffing requirements may include
				but are not limited to:
(i) licensed
				addiction counselor (LAC);
(ii)
				individuals trained in managing co-occurring disorders;
(iii) case managers that have a minimum of
				two years of higher education or four or more years of related work experience
				and orientation to the facility's policies and procedures; and
(iv) rehabilitation aides that have a minimum
				of a high school diploma or GED and orientation to the facilities policies and
				procedures.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.14 - Minimum Standards for Chemical Dependency Facilities › Rule 37.106.1491 - HALFWAY HOUSE COMMUNITY-BASED SINGLE GENDER RESIDENTIAL HOMES (ASAM LEVEL III.1 - LOW INTENSITY) (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 50-5-103,
					 53-24-208,
					 MCA; IMP:
					 50-5-101,
					 50-5-103,
					 53-24-208,
					 53-24-209,
					 76-2-411,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.15 - Minimum Standards for Specialty Care Health Care Facilities › Rule 37.106.1505 - MINIMUM STANDARDS FOR A HOME HEALTH AGENCY

Current through Register Vol. 13, July 5, 2024
(1) A home health agency shall comply with
				the Conditions of Participation for Home Health Agencies as set forth in 42 CFR
				subchapter G part 484. A copy of the cited requirements may be obtained from
				the Department of Public Health and Human Services, Office of Inspector
				General, 2401 Colonial Drive, P.O. Box 202953, Helena, MT 59620-2953.
AUTH:
					 50-5-103,
					 50-5-404,
					 MCA; IMP:
					 50-5-103,
					 50-5-204,
					 50-5-404,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.15 - Minimum Standards for Specialty Care Health Care Facilities › Rule 37.106.1506 - MINIMUM STANDARDS FOR A HEALTH MAINTENANCE ORGANIZATION (REPEALED)

Current through Register Vol. 13, July 5, 2024
Sec.
					 50-5-103
					 and
					 50-5-404,
					 MCA; IMP, Sec.
					 50-5-103,
					 50-5-204
					 and
					 50-5-404,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1601 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) These rules
				establish minimum standards for a licensed mental health center to operate a
				secured forensic mental health facility (FMHF) for adults who are committed for
				custody, care, treatment, or evaluation pursuant to Title 46, chapter 14, MCA,
				or who are inmates of a correctional facility receiving treatment in a separate
				mental health setting.
AUTH:
					 50-5-103,
					 MCA; IMP:
					 50-5-103,
					 50-5-204,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1602 - SCOPE

Current through Register Vol. 13, July 5, 2024
(1) A forensic
				mental health facility (FMHF) of a licensed mental health center provides
				twenty-four hour, seven days a week, secured nonhospital-based forensic mental
				health services for adults who are:
(a)
				committed to a mental health facility for evaluation of fitness to proceed
				pursuant to
				46-14-202(2),
				MCA;
(b) committed to the custody
				of the director of the department to be placed for treatment to gain fitness to
				proceed pursuant to
				46-14-221,
				MCA;
(c) committed to the custody
				of the director of the department to be placed for custody, care, and treatment
				under
				46-14-301,
				MCA;
(d) admitted to an FMHF under
				a court order for a mental evaluation to be included in a pre-sentence
				investigation under
				46-14-311,
				MCA;
(e) sentenced to be committed
				to the custody of the director of the department to be placed for custody,
				care, and treatment under
				46-14-312,
				MCA;
(f) in the custody of the
				Department of Corrections and transferred to an FMHF under
				53-21-130,
				MCA, or accepted for voluntary admission following such a transfer under
				53-21-111,
				MCA; or
(g) committed to the
				Montana State Hospital under
				53-21-127,
				MCA, while serving a sentence at a correctional facility.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1603 - APPLICATION OF RULES

Current through Register Vol. 13, July 5, 2024
(1) In addition to
				the requirements established in this subchapter, a licensed mental health
				center operating a forensic mental health facility (FMHF) must have an FMHF
				program endorsement issued by the department. To receive an FMHF program
				endorsement, the licensed mental health center must establish, to the
				department's satisfaction, that it meets the requirements stated in these
				rules.
AUTH:
					 50-5-103,
					 MCA; IMP:
					 50-5-103,
					 50-5-204,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1604 - APPLICATION OF OTHER RULES

Current through Register Vol. 13, July 5, 2024
(1) In addition to
				the requirements established in this subchapter, each licensed mental health
				center operating a forensic mental health facility (FMHF) must comply with all
				the requirements established in ARM Title 37, chapter 106, subchapter 3, with
				the exception of ARM
				37.106.302 and
				37.106.316.
(2) To the extent that other licensure rules
				in ARM Title 37, chapter 106, subchapter 3 conflict with the terms of this
				subchapter, the terms of this subchapter will apply to an FMHF.
AUTH:
					 50-5-103,
					 MCA; IMP:
					 50-5-103,
					 50-5-204,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1605 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
(1) "Adult" means
				an individual 18 years of age and older.
(2) "Emergency situation" has the meaning
				given to it by
				53-21-102,
				MCA.
(3) "Forensic mental health
				services" means mental health services for persons referred for care, custody,
				treatment, or evaluation by or through the criminal justice system.
(4) "Immediate emergency" means a situation
				involving a client that jeopardizes the immediate physical safety of a client,
				a staff member, or others.
(5)
				"Involuntary medication" means medication administered to a client when one or
				more of the following circumstances are present:
(a) administration of medication is against
				the specific wish of a client, made evident by verbal or nonverbal behavior
				reasonably interpreted as an objection;
(b) a client who does not have a legally
				appointed guardian lacks capacity to give informed consent; or
(c) a client's legally appointed guardian
				cannot or will not give consent.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1608 - CONSTRUCTION REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) Prior to
				construction or operation of a forensic mental health facility (FMHF), floor
				plans for the FMHF must be submitted to the department for review, comment, and
				approval. The department must also inspect and approve any new construction or
				any addition or alteration to an FMHF prior to occupancy.
(2) Prior to occupancy of an FMHF, or any
				addition or alteration to an FMHF, the FMHF must undergo an onsite inspection
				and receive the approval of the department's License Bureau, Construction
				Consultant.
(3) Any building used
				as an FMHF must be classified at a minimum as International Conference of
				Building Officials (ICBO) Construction type I-FR, or greater.
(4) All areas of an FMHF must be protected by
				automatic fire suppression. In unsupervised client areas, sprinkler heads must
				be recessed or of a design to restrict client access. An FMHF must provide the
				following:
(a) an operable UL listed fire
				alarm system with automatic response notification on alarm; and
(b) supervised smoke detectors throughout the
				facility reporting to the fire alarm system.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1609 - SECURED UNITS

Current through Register Vol. 13, July 5, 2024
(1) A forensic
				mental health facility (FMHF) must have one or more separate secured unit(s)
				within the facility for housing clients that includes bedrooms and common
				space.
(2) A secured unit must be
				staffed at all times clients are present in the unit.
(3) A secured unit must have a staff station
				to include the following:
(a) provisions for
				charting;
(b) provisions for hand
				washing;
(c) provisions for secured
				medication storage and preparation; and
(d) telephone access.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1610 - COMMON USE AREAS

Current through Register Vol. 13, July 5, 2024
(1) A forensic
				mental health facility (FMHF) must have an area for social activities at a
				minimum of 25 square feet per client.
(2) An FMHF must have a quiet area for
				clients to utilize according to facility policy.
(3) An FMHF must have a dining space at a
				minimum of 35 square feet per client. The dining space may be located off a
				secured unit in a central area.
(4)
				An FMHF must have a minimum of two classrooms with work tables or desks for
				client use.
(5) If an FMHF has a
				vocational training area, it must be equipped with appropriate tools and
				code-compliant equipment for client use.
(6) An FMHF must have a gymnasium and a
				separate client exercise room which includes appropriate exercise equipment in
				sufficient quantity for client use.
(7) An FMHF must have a secured outside
				recreational exercise area with both an enclosed individual client area and a
				large fenced group area.
(8) An
				FMHF must have examination or treatment rooms for private consultation. These
				rooms must have at a minimum the following:
(a) 100 square foot floor area;
(b) a hand-washing station;
(c) storage facilities; and
(d) a desk, counter, or shelf space for
				writing or electronic documentation.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1611 - OBSERVATION AND SECLUSION ROOM(S)

Current through Register Vol. 13, July 5, 2024
(1) A forensic
				mental health facility must designate specific room(s) designed for
				observation, seclusion, and restraint purposes.
(2) The location of these rooms must
				facilitate staff observation and monitoring of clients in these
				areas.
(3) The room must be
				equipped with video and audio monitoring equipment.
(4) The room must have a minimum of 60 square
				feet and a ceiling height of nine feet. Ceilings in seclusion rooms must be
				monolithic.
(5) Rooms used for
				observation, seclusion, and restraint must be designed to prevent injury to
				clients. All finishes, light fixtures, vents and diffusers, and sprinklers must
				be tamper resistant. These rooms must not have: electrical outlets, medical gas
				outlets or similar devices; sharp corners, edges, or protrusions. The wall must
				be free of objects or accessories of any kind. Doors must swing out or be a
				slide in pocket door and have hardware on the exterior side only. The door must
				be a minimum width of 44 inches and include an impact resistant view panel for
				discreet staff observation of the client. The use of impact resistant one-way
				observation windows is permitted.
AUTH:
					 50-5-103,
					 MCA; IMP:
					 50-5-103,
					 50-5-201,
					 50-5-204,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1614 - WRITTEN POLICIES AND PROCEDURES

Current through Register Vol. 13, July 5, 2024
(1) As required in
				ARM 37.106.1908, a forensic mental
				health facility (FMHF) must maintain a policy and procedure manual. The policy
				and procedure manual must be reviewed and updated as necessary, but at a
				minimum annually.
(2) In addition
				to the other requirements of ARM 37.106.1908, the manual must include policies
				and procedures for:
(a) security;
(b) involuntary administration of
				medication;
(c) client discharge
				and transfer procedure;
(d) client
				rights and grievances;
(e) client
				admission criteria;
(f) restraint
				and seclusion;
(g) establishing
				fiscal policies governing the management of organizational and individual
				funds;
(h) establishing and
				maintaining staffing requirements;
(i) informing clients of policies pertaining
				to the FMHF;
(j) food services;
				and
(k) the detection, reporting,
				and investigation of abuse and neglect.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1615 - SECURITY

Current through Register Vol. 13, July 5, 2024
(1) A forensic
				mental health facility (FMHF) must develop security policies and procedures. At
				a minimum the policies and procedures must address the following:
(a) securing the facility;
(b) summoning outside assistance in the event
				of an emergency;
(c) addressing
				relevant types of natural or client-caused emergency situations; and
(d) contraband searches.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1616 - INVOLUNTARY MEDICATION ADMINISTRATION

Current through Register Vol. 13, July 5, 2024
(1) A forensic
				mental health facility (FMHF) must develop and implement a policy for
				involuntary medication administration that includes:
(a) procedures for use in an immediate
				emergency or an emergency situation to ensure the physical safety of the
				client, a staff member, or others;
(b) an administrative review process for use
				when involuntary medication is clinically indicated for a client who is gravely
				disabled or poses a likelihood of serious harm to themselves, others, or
				property as a result of a mental disease or disorder. The process must include:
(i) a formal review within five working days
				of beginning the involuntary administration of medication, by a medication
				review committee which includes the medical director of the FMHF, the designee,
				or both and at least one qualified psychiatrist who is not employed at the
				FMHF. No committee member may be directly involved in the client's
				care;
(ii) an opportunity for the
				client to appear before the panel in person and with a representative of the
				client's choice, and to provide testimony and evidence;
(iii) written advance notice of the review
				and the right to participate which must be given to the client, guardian, and
				Mental Disabilities Board of Visitors;
(iv) an opportunity for review of the
				decision of the panel by the director of the licensed mental health
				center;
(v) review by the committee
				at 14 and 90 days after the initial authorization of involuntary administration
				of medication.
(c)
				procedures for seeking and implementing a court order authorizing involuntary
				administration of medication for clients who are placed at the FMHF under
				46-14-221,
				MCA, and for whom the sole purpose of involuntary medication is to gain fitness
				to proceed.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1617 - RESTRAINT AND SECLUSION

Current through Register Vol. 13, July 5, 2024
(1) A forensic
				mental health facility (FMHF) must be capable of providing restraint or
				seclusion and must ensure that such restraint or seclusion is performed in
				compliance with
				53-21-146,
				MCA.
(2) The use of medication
				solely for restraint is prohibited.
(3) Restraint or seclusion may only be used
				when less restrictive interventions have been determined to be ineffective to
				protect the client, staff, or others from harm.
(4) The type and technique of restraint or
				seclusion must be the least restrictive intervention that will be effective to
				protect the client, staff, or others from harm.
(5) The use of restraint or seclusion must be
				implemented in accordance with safe and appropriate restraint and seclusion
				techniques as determined by facility policy.
(6) Orders for the use of restraint or
				seclusion must never be written as a standing order or on an as-needed basis
				(PRN).
(7) A verbal or written
				order must be obtained from the licensed health care practitioner prior to
				initiation or as soon as possible after emergency initiation of seclusion or
				restraint.
(8) A licensed health
				care practitioner or registered nurse, in accordance with facility policy, must
				see the client face-to-face within one hour of the initiation of restraint or
				seclusion to evaluate:
(a) the client's
				immediate situation;
(b) the
				client's reaction to the intervention;
(c) the client's medical and behavioral
				condition; and
(d) the need to
				continue or terminate the restraint or seclusion.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.16 - Minimum Standards for a Forensic Mental Health Facility › Rule 37.106.1618 - STAFFING REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) Employees of a
				forensic mental health facility (FMHF) must be 18 years of age and possess a
				high school diploma or general equivalency diploma (GED) at a
				minimum.
(2) Employees must receive
				orientation and training in areas relevant to the employee's duties and
				responsibilities including:
(a) an overview
				of the FMHF policy and procedure manual in areas relevant to the employee job
				responsibilities;
(b) a review of
				the employee job description;
(c)
				services provided by the facility;
(d) rights of persons served;
(e) safety and emergency response
				procedures;
(f) basic first aid;
				and
(g) certification in
				cardiopulmonary resuscitation (CPR).