SECTION 450:18-13-181. Halfway house services

(a)   Halfway house services shall provide low intensity treatment in a supportive living environment to facilitate reintegration into the community. Major emphasis shall be on continuing substance use disorder care and follow-up, and community ancillary services in an environment supporting continued abstinence. Consumers shall participate in a minimum of six (6) hours of structured substance use disorder treatment per week.

(b)   Each facility shall maintain written programmatic descriptions and operational methods addressing the following:

(1)   Environment: The facility shall be a freestanding facility or portion of a related healthcare facility having at least one (1) each of toilet, lavatory, and bathing facilities for each eight (8) residents. The facility shall provide a safe, welcoming, and culturally/age appropriate environment.

(2)   Support system:

(A)   A licensed physician shall be available, by telephone twenty-four (24) hours a day, seven (7) days a week;

(B)   The facility shall have a written plan for emergency procedures, approved by a licensed physician;

(C)   The facility shall have supplies, as designated by the written emergency procedures plan, which shall be accessible to staff at all times; and

(D)   Specialized professional consultation or professional supervision shall be available.

(3)   Staff:

(A)   Service providers shall be knowledgeable regarding biopsychsocial dimensions of substance use disorders, evidenced based practices, co-occurring disorder issues gender, cultural, and age-specific issues;

(B)   Staff shall be knowledgeable regarding facility-required education, training, and policies;

(C)   Staff shall be knowledgeable about emergency procedures as specified in the emergency procedures plan;

(D)   The facility shall have staff members on site twenty-four (24) hours per day, seven (7) days per week;

(E)   Staff shall be at least eighteen (18) years of age; and

(F)   The facility shall document in personnel records all education, training, and experience stated above prior to the provision of direct care services.

(4)   Treatment services. The facility shall have scheduled rehabilitation services to assess and address the individual needs of each consumer. Such services shall include, but not limited to:

(A)   Therapy. Therapy must be provided by a Licensed Behavioral Health Professional (LBHP) or Licensure Candidate who must use and document a clinical approach generally accepted as reliable in the relevant community, such as cognitive behavioral treatment, narrative therapy, solution focused brief therapy or another widely accepted theoretical framework for treatment. The therapy must be goal directed utilizing techniques appropriate to the individual consumer's service plan and the consumer's developmental and cognitive abilities. This service does not include social skill development or daily living skill activities. For adults, group therapy is limited to a total of eight adult individuals. For all children under the age of eighteen, the total group size is limited to six.

(B)   Rehabilitation Services. Rehabilitation services must be provided by a LBHP, Licensure Candidate, Certified Alcohol and Drug Counselor (CADC) or Certified Behavioral Health Case Manager II (CM II). This service includes educational and supportive services regarding independent living, self-care, social skills regarding development, lifestyle changes and recovery principles and practices (including relapse prevention). Services provided typically take the form of curriculum based education and skills practice, and should be goal specific in accordance with an individualized service plan. The maximum staffing ratio for group rehabilitation services is fourteen members for each qualified provider for adults and eight to one for children under the age of eighteen.

(C)   Educational Groups. Education groups must be conducted by a LBHP, Licensure Candidate, CADC, CM II or Peer Recovery Support Specialist (PRSS).

(D)   Case Management. Case management must be provided by a LBHP, Licensure Candidate, CADC, CM II or CM I as clinically indicated.

(E)   Crisis Intervention. Crisis intervention services must be provided by a LBHP or Licensure Candidate. Crisis intervention services are provided as needed for the purpose of responding to acute behavioral or emotional dysfunction as evidenced by psychotic, suicidal, homicidal severe psychiatric distress, and/or imminent danger of substance relapse. The crisis situation including the symptoms exhibited and the resulting intervention or recommendations must be clearly documented in the consumer's record.

(F)   Vocational services. Any level of provider can provide vocational services (Employment consultants, or other staff who have completed some form of job coach training, are preferred). Vocational services include the process of developing or creating appropriate employment situations for individuals who desire employment to include, but not be limited to: the identification of employment positions, conducting job analysis, matching individuals to specific jobs, facilitating job expansion or advancement and communicating with employers about training needs.

(5)   Treatment documentation:

(A)   All documentation for therapy, case management and crisis intervention must be documented in an individual note and reflect the content of each session provided. Documentation must include, at a minimum, the following:

(i)   Date;

(ii)   start and stop time for each session;

(iii)   Specific problems, goals, and objectives addressed;

(iv)   type of service and method(s) used to address problems;

(v)   Summary of progress made toward goals and objectives, or lack of;

(vi)   Consumer response to overall treatment services;

(vii)   Any new problems, goals, or objectives identified during the week;

(viii)   Dated signature and credentials of the service provider completing the documentation; and

(ix)   Consumer's name.

(B)   Documentation for rehabilitation services and education groups must include daily member sign-in/sign-out record of member attendance (including date, time, type of service and service focus), and a daily progress note or a summary progress note weekly.

(C)   Documentation shall reflect that the consumer works or attempts to find work while receiving halfway house services.

(c)   Compliance with 450:18-13-181 may be determined by a review of the following:

(1)   Licenses;

(2)   Policies and procedures;

(3)   Treatment protocols;

(4)   Personnel records, documentation of professional licensure, certification or licensure as an alcohol and drug counselor, documentation of professional work experience, ongoing in-service trainings;

(5)   Treatment records;

(6)   Interviews with staff and consumers; and

(7)   Other facility records.

[Source: Amended and renumbered from 450:18-3-181 at 23 Ok Reg 1953, eff 7-1-06; Amended at 27 Ok Reg 2237, eff 7-11-10; Amended at 31 Ok Reg 2004, eff 10-1-14; Amended at 32 Ok Reg 2091, eff 9-15-15; Added at 35 Ok Reg 1821, eff 10-1-18]