908 KAR 1:370. Licensing procedures, fees, and general requirements for nonhospital-based alcohol and other drug treatment entities

made up of a representative sample of the AODE's clinical staff responsible for providing services; (b) Assess the appropriateness and clinical necessity of client admissions; (c) Evaluate the need for continuing services immediately upon a change in a client's service needs or a change in the client's condition to ensure that proper arrangements have been made for: 1. Discharge; 2. Transfer; or 3. Referral to another service provider, if appropriate; and (d) Submit a written record of findings related to inappropriate patterns of service accompanied by recommended action for correcting a problem to the administrator or other individual with overall responsibility for the program's treatment services. Section 8. Co-occurring Services. (1) An outpatient or residential AODE shall: (a) Screen for co-occurring disorders; and (b) Treat or refer a client in need of co-occurring services. (2) An outpatient or residential AODE that provides substance use disorder treatment to clients diagnosed with a co-occurring disorder shall have clearly written policies and procedures that: (a) Govern the integrated treatment of substance use and mental health treatment, which shall include screening, assessment, diagnosis, and service provision; (b) Allow for the use of psychiatric medication when indicated; (c) Include developing and maintaining affiliation agreements, case consultation, and a referral mechanism to mental health treatment services in order to facilitate the provision of integrated treatment services; and (d) Include the qualifications of clinical staff responsible for screening, assessing, diagnosing, and treating clients with co-occurring disorders as follows: 1. Only licensed individuals whose scope of practice allows them to render a diagnosis for both mental health disorder and substance use disorder may assess and diagnose clients with co-occurring disorders; and 2

ted treatment services; and (d) Include the qualifications of clinical staff responsible for screening, assessing, diagnosing, and treating clients with co-occurring disorders as follows: 1. Only licensed individuals whose scope of practice allows them to render a diagnosis for both mental health disorder and substance use disorder may assess and diagnose clients with co-occurring disorders; and 2. The AODE shall ensure that clinical supervision is provided by staff possessing clinical credentials necessary to provide clinical supervision to any staff person who renders treatment and services to clients diagnosed with co-occurring disorders. Section 9. Implementation of Policies and Procedures. (1) An outpatient or residential AODE shall have written policies and procedures to: (a) Establish a system for responding to an: 1. Accident or injury that requires hospitalization or results in death; or 2. Incident that involves fire damage, a natural disaster, or threat to security that substantially interrupts the delivery of services; (b) Document the accident, injury, or incident in an incident file maintained electronically or in hard copy at the AODE's administrative office; and (c) Report an incident, injury, or accident to the: 1. AODE's administrator; 2. Parent or guardian of a client under the age of eighteen (18); and 3. Cabinet for Health and Family Services if the report is required by: a. KRS 620.030 in the case of suspected child dependency, abuse, or neglect; or b. KRS 209.030 in the case of suspected adult abuse, neglect, or exploitation. (2) An outpatient or residential AODE shall have a written emergency plan for responding to a disaster at the facility, including safety procedures in the event of a fire, severe weather, or other threatening situation as follows: (a) The emergency plan shall be conspicuously posted in a public area of each AODE; (b) A copy of the emergency plan shall be provided to all personnel; (c) The AODE shall provide training for all personnel on how to: 1. Report a fire; 2

) year program from an accredited college or university and 6,000 hours of clinical work experience in the substance abuse or mental health field; 11. Advanced practice registered nurse as defined by KRS 314.011(7); 12. Marriage and family therapist licensed and practicing in accordance with KRS 335.300; 13. Professional clinical counselor licensed and practicing in accordance with KRS 335.500; 14. Licensed professional art therapist as defined by KRS 309.130(2); or 15. Physician assistant as defined by KRS 311.840(3); or (d) An individual who has a bachelor's degree in any field from an accredited college or university and meets the following requirements: 1. Works under the supervision of a clinical services supervisor; 2. Receives at least four (4) hours of face-to-face clinical supervision monthly during at least two (2) supervisory meetings; 3. Meets the training requirements of subsection (5) of this section; 4. Has all treatment plans cosigned by the clinical services supervisor within ten (10) business days; and 5. Â a. Obtains temporary certification as an alcohol and drug counselor (TCADC) from the Kentucky Board of Alcohol and Drug Counselors within two (2) months of the date of employment as a clinician, if the clinician's bachelor's degree is in an area other than the field of human services; or b. Was employed as a clinician by an AODE prior to the effective date of this administrative regulation and has maintained continuous employment as a clinician. (5) A clinician as described by subsection (4)(c) or (d) of this subsection shall complete eighty (80) hours of training in alcohol and other drug abuse counseling within: (a) Four (4) years immediately prior to the date of assuming responsibility as a clinician in the AODE; or (b) Two (2) years immediately after assuming responsibility as a clinician in the AODE. Section 12. Qualifications and Responsibilities of Case Managers. (1) A case manager employed by an outpatient or residential AODE shall: (a) Â 1

training in alcohol and other drug abuse counseling within: (a) Four (4) years immediately prior to the date of assuming responsibility as a clinician in the AODE; or (b) Two (2) years immediately after assuming responsibility as a clinician in the AODE. Section 12. Qualifications and Responsibilities of Case Managers. (1) A case manager employed by an outpatient or residential AODE shall: (a) Â 1. Have a bachelor's degree from an accredited college or university; or 2. Be a CADC as defined by KRS 309.080(2); (b) Successfully complete a department-approved case management training within six (6) months of employment as a case manager; and (c) Successfully complete ten (10) hours of continuing education in alcohol and other drug-relevant training annually. (2) Case management services shall be based on the: (a) Goals established in the client's clinical assessment; and (b) Development of an individualized person-centered treatment plan that identifies the case management activities that support implementation of the plan. (3) A case manager shall not exceed a case load size of thirty (30) unique clients. Section 13. Peer Support Specialists. A peer support specialist employed by an outpatient or residential AODE shall: (1) Complete six (6) hours of training in the area of substance use disorder annually; (2) Attest in writing to at least one (1) year of recovery; and (3) Â (a) Be a registered alcohol and drug peer support specialist in accordance with KRS 309.0831; or (b) Meet the requirements of: 1. 908 KAR 2:220; 2. 908 KAR 2:230; or 3. 908 KAR 2:240. Section 14. Personnel records

nt or residential AODE shall: (1) Complete six (6) hours of training in the area of substance use disorder annually; (2) Attest in writing to at least one (1) year of recovery; and (3) Â (a) Be a registered alcohol and drug peer support specialist in accordance with KRS 309.0831; or (b) Meet the requirements of: 1. 908 KAR 2:220; 2. 908 KAR 2:230; or 3. 908 KAR 2:240. Section 14. Personnel records. A personnel record shall be kept at the outpatient or residential AODE's administrative office on each staff member and contain the following information: (1) Name and address; (2) Verification of all training and experience, including licensure, certification, registration, or renewals; (3) Verification of submission to the background check requirements of Section 15 of this administrative regulation; (4) Annual performance appraisals; and (5) Employee incident reports. Section 15. Background checks. (1) All staff of an outpatient or residential AODE who have job duties that involve providing services to a client, or who may have one-on-one contact with a client shall: (a) Have a criminal record check performed upon initial hire through the Administrative Office of the Courts or the Kentucky State Police; and (b) Not have a criminal conviction, or plea of guilty, to a: 1. Sex crime as specified in KRS 17.500; 2. Criminal offense against a minor as specified in KRS 17.500; or 3. Felony offense related to neglect, physical abuse, sexual abuse, or exploitation of a child. (2) An outpatient or residential AODE that provides services to clients under age eighteen (18) shall not employ as clinical personnel anyone listed on the central registry established by 922 KAR 1:470. (a) If a central registry check has been submitted for an individual and is pending, the individual: 1. May be hired pending the results of the registry check; and 2. Shall not be left unsupervised with a client under eighteen (18) years of age

ievances. (3) A client shall not be unlawfully discriminated against in determining eligibility for a treatment program. (4) During an outpatient or residential AODE's intake procedures, a client shall sign a statement that specifies that the client has the right to: (a) Give informed consent to receive a service, in which case: 1. An adult shall sign an informed consent to receive a service; or 2. A client under age eighteen (18) who suffers from substance use disorder or a parent, caregiver, or person who has custodial control of a client under age eighteen (18) shall sign an informed consent for the client to receive a service in accordance with KRS 222.441; (b) Have input into his or her treatment plan and be informed of the plan's content; (c) Receive individualized treatment; (d) File a grievance, recommendation, or opinion regarding the services the client receives; (e) Give informed written consent regarding participation in a research study, with the exception of a client under age eighteen (18) whose parent or guardian shall give informed written consent; (f) Confidentiality of information in accordance with the following: 1. A federally-assisted AODE in accordance with 908 KAR 1:320; or 2. A nonfederally-assisted AODE in accordance with KRS 222.271(1); (g) Request a written statement of charges for services and be informed of the policy for the assessment and payment of client fees; (h) Be informed of the rules of client conduct, including the consequences for using alcohol or other drugs, or other infractions that may result in: 1. Further assessment; 2. Modification of the treatment approach; 3. Transfer to a higher intensity level of treatment; or 4

ce in accordance with the requirements of KRS 13B.125(3). (d) The sole issue of the hearing shall be whether there is immediate danger. (e) The decision shall be rendered in accordance with KRS 13B.125(4). Section 21. Incorporation by Reference. (1) "Application for License to Operate a Nonhospital-based Alcohol and Other Drug Treatment Entity (AODE)", 12/2018 edition, is incorporated by reference. (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department for Behavioral Health, Developmental and Intellectual Disabilities, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m.