Minnesota Administrative Rules

9533.0130 CORE TREATMENT SERVICES.

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.

Statutory Authority:

MS s 245.4863

History:

38 SR 523

Published Electronically:

November 12, 2013