Section 0940-05-42-.11 - INDIVIDUALIZED PROGRAM PLAN(1) A Facility shall develop an Individualized Program Plan (IPP) for each service recipient within 30 days of admission. Each service recipient shall be involved in the development and review of his/her IPP. The initial IPP and all reviews shall be signed by the service recipient and program physician. IPPs shall document the following:(a) A consistent pattern of substance abuse treatment services and medical care appropriate to individual service recipient needs;(b) Detoxification as an option for treatment that is supported by the Facility; and(c) A discharge plan that has been discussed with the service recipient.(2) The admission requirements of 0940-05-42-.06 shall first be completed prior to the development of an IPP.(3) Medical care, including referral for necessary medical service, and evaluation and follow-up of service recipient complaints shall be compatible with current and accepted standards of medical practice. All service recipients shall receive a medical examination at least annually. All other medical procedures performed at the time of admission shall be reviewed by the medical staff on an annual basis, and all clinically indicated tests and procedures shall be repeated. The medical director or program physician shall record the results in this annual medical examination and review of service recipient medical records in each service recipient's record.(4) In recognition of the varied medical needs of service recipients, the case history, IPPs, detoxification plan and discharge planning shall be reviewed at least every 90 days for service recipients in treatment less than one year and at least annually for service recipients in treatment more than one year. This review will be conducted by the medical director or program physician along with the primary counselor and other appropriate members of the treatment team for general quality controls and evaluation of the appropriateness of continuing the form of treatment on an ongoing basis. This review shall also include an assessment of the current dosage and schedule and the rehabilitative progress of the individual, as part of a determination that additional medical services are indicated. If this review results in a determination that additional or different medical services are indicated the Facility shall ensure that such services are made available to the service recipient, either at the Facility or by referral to the appropriate medical professional.(5) When the program physician prescribes other controlled substances to service recipients in the Facility, the Facility shall ensure that such prescription is in accord with all applicable statutes and regulations and with current and accepted standards of medical practice. Such prescriptions shall not be issued to any service recipient unless the physician first sees the service recipient and assesses the service recipient's potential for abuse of such medications.(6) As part of the rehabilitative services provided by the Facility, each service recipient shall be provided with individual and group counseling appropriate to his/her needs. The frequency and duration of counseling provided to service recipients shall be in conformity with 0940-05-42-.14 and be consistent with the Individualized Program Plan. Individualized Program Plans shall indicate a specific level of counseling services needed by the service recipient as part of the rehabilitative process.(7) All service recipients shall receive HIV and hepatitis risk reduction education appropriate to their needs.(8) When appropriate, each service recipient shall be enrolled in an education program, or be engaged in vocational activity (vocational evaluation, education or skill training) or make documented efforts to seek gainful employment. Deviations from compliance with these requirements shall be explained in the service recipient's record. Each Facility shall take steps to ensure that a comprehensive range of rehabilitative services, including vocational, educational, legal, mental health, alcoholism and social services, are made available to the service recipients who demonstrate a need for such services. The Facility can fulfill this responsibility by providing support services directly or by appropriate referral. Support service recommended and utilized shall be documented in the service recipient's record. Each Facility shall have policies for matching service recipient's needs to treatment.(9) All facilities will develop and implement policies for matching service recipient's needs to treatment. These policies may include treatment phasing in which the intensity of medical, counseling and rehabilitative services provided to a service recipient are individualized for each service recipient depending upon the service recipient's phase of treatment.(10) If the service recipient experiences a relapse, his/her IPP shall document evidence of intensified services provided. Such evidence shall include, but is not limited to, an increase in individual or group counseling session(s) and a reduction in the service recipient's take-home privileges.(11) Discussion shall be held with the service recipient regarding his or her continued desire to remain in the program for maintenance treatment. Alternatives such as medically-supervised withdrawal shall be presented to the service recipient at the time of the discussion and documented in the service recipient's record. The service recipient shall sign and date a statement indicating that she or he wishes to remain within the program in a maintenance format. If the service recipient wishes to enter medically-supervised withdrawal, the plan of care shall reflect that choice.Tenn. Comp. R. & Regs. 0940-05-42-.11
Original rule filed June 8, 1999; effective August 22, 1999. Amendment filed April 11, 2003; effective June 25, 2003. 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.