DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
BUREAU OF COMMUNITY AND HEALTH SYSTEMS  
SUBSTANCE USE DISORDERS SERVICE PROGRAM  
Filed with the secretary of state on June 26, 2023  
These rules take effect immediately upon filing with the secretary of state unless adopted  
under section 33, 44, or 45a(9) of the administrative procedures act of 1969, 1969 PA  
306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become  
effective 7 days after filing with the secretary of state.  
(By authority conferred on the director of the department of licensing and regulatory  
affairs by section 6234 of the public health code, 1978 PA 368, MCL 333.6234, and  
Executive Reorganization Order Nos. 1991-3, 1994-1, 1996-1, 1996-2, 1997-4, 2009-1,  
and 2011-4, MCL 333.26321, 333.26322, 330.3101, 445.2001, 333.26324, 333.26327,  
and 445.2030)  
R 325.1301, R 325.1303, R 325.1305, R 325.1307, R 325.1315, R 325.1331, R  
325.1335,R 325.1337, R 325.1339, R 325.1349, R 325.1351, R 325.1353, R 325.1355,  
R 325.1357, R 325.1359, R 325.1361, R 325.1363, R 325.1365, R 325.1367, R 325.1371,  
R 325.1381, R 325.1383, R 325.1385, R 325.1391, R 325.1393, and R 325.1395 of the  
Michigan Administrative Code are amended, R 325.1302, R 325.1304, and R 325.1388  
are added, and R 325.1377, R 325.1379, R 325.1387, and R 325.1389 are rescinded, as  
follows:  
PART 1. DEFINITIONS  
R 325.1301 Definitions.  
Rule 1301. (1) As used in these rules:  
(a) “Admission” means the point at which an individual is formally accepted into a  
substance use disorder services program and services are initiated.  
(b) “Aftercare” means the process of providing recommendations to a recipient for  
continued support after discharge from the program.  
(c) “Article 6” means article 6 of the public health code, MCL 333.6230 to 333.6251.  
(d) “Article 15” means article 15 of the public health code, MCL 333.16101 to  
333.18838.  
(e) “Branch office” means a state-approved location physically separate from the state-  
licensed substance use disorder services program location. The state-licensed program is  
considered the parent organization and provides supervision and administration of the  
branch location.  
(f) “Certified counselor” means an individual who is employed or volunteers to work  
by providing counseling to recipients in a substance use disorder services program  
licensed by the department under part 62 of the public health code, MCL 333.6230 to  
June 23, 2022  
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333.6251, and who is certified as an alcohol and drug counselor by an organization  
approved or recognized by the department.  
(g) “Complaint investigation” means a visit or an inspection of a licensee based upon a  
complaint with an allegation of noncompliance or violation of the public health code, the  
mental health code, or these rules.  
(h) “Department” means the department of licensing and regulatory affairs.  
(i) “Discharge” means the point at which the recipient's active involvement with a  
substance use disorder services program is terminated and the program has provided the  
necessary aftercare recommendations.  
(j) “Evidence-based practice or services” means a practice or service offered by a  
licensee based on a national or international medical professional association, public  
health agency, governmental body, or accrediting organization document that is available  
to the department upon request.  
(k) “Follow-up” means activities designed for a screening, assessment, referral, and  
follow up program to determine the present status of persons previously discharged by  
the program.  
(l) “Full-time” means employment of not less than 35 hours per week.  
(m) “License” means a license issued by the department under article 6 to establish,  
conduct, or maintain a substance use disorder services program. License does not include  
a program located in a facility operated by a local, state, or federal government, even if  
the program is not owned or operated by a state or federal government.  
(n) “Licensed counselor” means an individual engaged in counseling recipients in a  
substance use disorder services program and who is licensed under part 181 of the public  
health code, MCL 333.18101 to 333.18117, and providing services in compliance with  
the scope of his or her license.  
(o) “Licensed marriage and family therapist” or “LMFT” means an individual engaged  
in counseling recipients in a substance use disorder services program and who is licensed  
under part 169 of the public health code, MCL 333.16901 to 333.16915, and providing  
services in compliance with the scope of his or her license.  
(p) “Licensed master’s social worker” or “LMSW” means an individual engaged in  
counseling recipients in a substance use disorder services program and who is licensed  
under part 185 of the public health code, MCL 333.18501 to 333.18518, and providing  
services in compliance with the scope of his or her license.  
(q) “Licensed psychologist” means an individual engaged in the practice of psychology  
of recipients in a substance use disorder services program and who is licensed under  
part 182 of the public health code, MCL 333.18201 to 333.18237, and providing services  
in compliance with the scope of his or her license.  
(r) “Licensee” means a person, as that term is defined by section 1106 of the public  
health code, MCL 333.1106, that holds the license issued under article 6 to operate a  
substance use disorder services program. Unless otherwise specified in these rules, a  
licensee does not include a person individually licensed under article 15 to provide  
psychological, medical, or social services through the individual’s license and whose  
recipients are limited to those of the individual licensed professional maintaining and  
operating the office.  
(s) “Licensure survey” means a visit or inspection to an applicant or licensee to  
evaluate compliance with the public health code, the mental health code, or these rules.  
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(t) “Limited certified counselor” means an individual who is employed or who  
volunteers to work providing counseling to recipients in a substance use disorder services  
program licensed by the department under part 62 of the public health code, MCL  
333.6230 to 333.6251, and who has completed a minimum set of state-approved  
requirements before completing the necessary prerequisites to become a certified alcohol  
and drug counselor by an organization approved or recognized by the department.  
(u) “Medical director” means an individual licensed to engage in the practice of  
medicine or the practice of osteopathic medicine and surgery under part 170 or part 175  
of the public health code, MCL 333.17001 to 333.17097 and 333.17501 to 333.17556.  
(v) “Mental health code” means the mental health code, 1974 PA 258, MCL 330.1001  
to 330.2106.  
(w) “Methadone program” means a program engaged in opioid treatment of an  
individual with an opioid agonist treatment medication registered under 21 USC  
823(g)(1), methadone.  
(x) “Mobile unit” means a state-approved mobile unit assigned to a state-licensed  
substance use disorder services program location. The state-licensed program is  
considered the parent organization and provides supervision and administration of the  
mobile unit.  
(y) “Nurse” means a licensed practical nurse, registered professional nurse, or advanced  
practice registered nurse licensed under part 172 of the public health code, MCL  
333.17201 to 333.17242.  
(z) “Outpatient counseling program” means a non-residential program engaged in  
behavioral health counseling for substance used disorders provided by an identified  
health professional, as that term is defined in these rules. Outpatient counseling program  
does not include services offered by other individuals, such as peer recovery coaches,  
case managers, or other individuals not defined in these rules.  
(aa) “Pharmacist” means an individual licensed to engage in the practice of pharmacy  
under article 15.  
(bb) “Physician” means an individual licensed to engage in the practice of medicine or  
the practice of osteopathic medicine and surgery under article 15.  
(cc) “Physician’s assistant” means an individual who is licensed to practice as a  
physician’s assistant under part 170 of the public health code, MCL 333.17001 to  
333.17097.  
(dd) “Public health code” means the public health code, 1978 PA 368, MCL 333.1101  
to 333.25211.  
(ee) “Recipient” means an individual who receives services from a licensed substance  
use disorder services program in this state.  
(ff) “Regional entity” means an agency designated by this state to coordinate substance  
use disorder services in a specified region.  
(gg) “Residential program” means a residential setting that is staffed and provides  
substance use disorder treatment or rehabilitation services onsite.  
(hh) “Residential withdrawal management program” means a residential setting  
offering either clinically managed or medically monitored withdrawal management  
services for the purposes of detoxification.  
(ii) “Staff” means an individual who is not a recipient and who works, with or without  
remuneration, for a licensed substance use disorder services program.  
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(jj) “Substance” means an agent or a chemical that, upon entering a human body, alters  
the body's physical or psychological status, or both. Substance includes alcohol and other  
drugs.  
(kk) “Substance use disorder services program” or “program” means a public or private  
person or entity offering or purporting to offer specific substance use disorder prevention,  
treatment, and rehabilitation services.  
(ll) “United States Food and Drug Administration” or “FDA” means the federal agency  
of the United States Department of Health and Human Services.  
(2) A term defined in the public health code or the mental health code has the same  
meaning when used in these rules.  
R 325.1302 Certified counselor; limited certified counselor; physician who provides  
counseling.  
Rule 1302. (1) A certified counselor and a limited certified counselor may provide  
alcohol and drug counseling to recipients in a substance use disorder services program  
licensed by the department under part 62 of the public health code, MCL 333.6230 to  
333.6251, but not under any other circumstances unless otherwise provided by law.  
(2) A physician who provides counseling may be counted as part of the counseling  
services requirement if the physician meets the applicable counseling related  
requirements in these rules.  
PART 2: STATE AGENCY REQUIREMENTS  
SUBPART A: LICENSING  
R 325.1303 Application; licensing requirement; review process; licensure.  
Rule 1303. (1) As authorized in article 6 and chapter 2A of the mental health code,  
MCL 330.1260 to 330.1287, an application for initial licensure or licensure change,  
including change in ownership, change in business name, relocation of the program,  
addition or deletion of service levels, or addition or deletion of a branch site or mobile  
unit, must be made on the most recent applicable form authorized and provided by the  
department.  
(2) A person offering substance use disorder services shall be licensed under article 6,  
except as provided in subrule (3) of this rule.  
(3) A license is not required for an individual licensed under article 15 to provide  
psychological, medical, or social services if all of the following are met:  
(a) The individual is offering psychological, medical, or social services within the  
scope of his or her individual professional license and not under a group or organization  
offering substance use disorder services.  
(b) The individual is offering psychological or medical services and not providing  
methadone treatment.  
(4) If the application is incomplete and requires additional information, the department  
shall notify an applicant in writing within 30 days after receipt of application. An  
application is not considered complete by the department until both of the following are  
received:  
(a) The application form and required attachments.  
(b) The application or licensing fee, as applicable.  
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(5) The department shall conduct a prelicensure survey and make a determination on an  
application within 3 months after an application is considered complete.  
(6) Upon determination of compliance with the public health code, the mental health  
code, and these rules, the department shall issue a license that identifies all of the  
following:  
(a) Name of the licensee.  
(b) Business name of the substance use disorder services program.  
(c) Physical address of the substance use disorder services program.  
(d) Program service categories authorized are any of the following:  
(i) Outpatient counseling program.  
(ii) Methadone program.  
(iii) Residential program.  
(iv) Residential withdrawal management program.  
(7) The department shall conduct a post licensure survey within 3 months after the  
initial license is issued.  
(8) A licensee shall post the license and the hours of operation of the program in a  
conspicuous public area of the program.  
(9) A license is not transferable.  
(10) A new license shall be issued by the department before the transfer of a license to a  
different owner of a program through a change of ownership application, or from 1  
physical location to another physical location, through an application to relocate the  
program.  
R 325.1304 Application for branch office or mobile unit; requirements; review  
process; approval.  
Rule 1304. (1) Before operation of a branch location or mobile unit, a licensee shall  
submit an application for review and approval on the most recent applicable form  
authorized and provided by the department.  
(2) If an application is incomplete and requires additional information, the department  
shall notify the licensee in writing within 45 days after receipt of the application.  
(3) The licensee submitting an application for a branch location or mobile unit shall  
have been licensed for a minimum of 2 years and be in compliance with the public health  
code, the mental health code, and these rules.  
(4) An application for a branch location must be approved if the branch location satisfies  
all of the following requirements:  
(a) The parent organization provides outpatient counseling services and is proposing to  
offer outpatient counseling services at the branch office.  
(b) The branch office is open to recipients no more than 20 hours per week.  
(c) The branch office has applicable policies and procedures required for outpatient  
counseling services.  
(d) The branch office is located within 75 miles from the parent location.  
(e) The total number of branch offices does not exceed 3 locations for the parent  
organization.  
(f) The branch office shall post the hours of operation of the location in a conspicuous  
area for public view.  
(5) An application for a mobile unit must be approved if the mobile unit satisfies all of  
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the following requirements:  
(a) The parent organization provides the treatment or rehabilitation service offered in  
the mobile unit.  
(b) The mobile unit must return each night to the licensed location if the unit offers  
methadone treatment.  
(c) The total number of mobile units does not exceed 3 for the parent organization.  
(6) A licensee shall post the branch office or mobile unit license in a conspicuous area  
for public view.  
(7) For purposes of these rules and all compliance purposes, a branch or mobile unit is  
considered part of the licensed site.  
R 325.1305 License renewal process.  
Rule 1305. (1) Renewal of a license must be completed through an electronic  
web-based system authorized and provided by the department.  
(2) A license is renewed and valid only upon electronic payment of the applicable  
renewal fee.  
(3) A license must be renewed before August 1 of each calendar year, unless otherwise  
specified on the license.  
(4) The department may require changes or corrections to a license before renewal.  
(5) If a license is not renewed within 30 days after the expiration date, the department  
may take any enforcement action authorized by section 6243 of the public health code,  
MCL 333.6243.  
(6) A license cannot be renewed if the location has not offered the covered service  
within the 12 months immediately preceding the renewal period.  
R 325.1307 Licensure survey and complaint investigation process.  
Rule 1307. (1) A prelicensure survey is scheduled and announced.  
(2) All other licensure surveys and compliant investigations are unannounced.  
(3) A licensure survey or complaint investigation may be conducted by the department  
during any hours of operation of the program.  
(4) A licensure survey or complaint investigation may use information not collected  
from an applicant or licensee during its review. If this information is used, an applicant or  
licensee shall be notified of this information.  
(5) An applicant or licensee shall grant access to the program and cooperate during a  
licensure survey or complaint investigation for the department to determine compliance  
with applicable statutory and regulatory requirements. The department shall consider lack  
of access or cooperation as evidence of noncompliance.  
SUBPART C: ENFORCEMENT AND HEARING  
R 325.1315 Denial of application; revocation of license.  
Rule 1315. An application or license may be denied or revoked for 1 or more of the  
following reasons:  
(a) Violation of the public health code, the mental health code, or these rules.  
(b) Submission of false information to the department that is related and material to the  
requirements of applying for or holding a license.  
(c) Denial, revocation, suspension, or failure to renew a federal registration to distribute  
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or dispense methadone.  
(d) Disciplinary action, suspension, or revocation of the license issued under article 15  
for the medical director of the program, or any other health professional who is directly  
responsible for the care of a recipient.  
(e) Failure of an applicant or licensee to cooperate with the department in connection  
with a licensure survey, complaint investigation, or any other investigation or inquiry.  
(f) Failure to provide information necessary to conduct a thorough assessment of an  
applicant, application, licensee, license, complainants, or complaint investigation.  
PART 3: SUBSTANCE USE DISORDER SERVICES PROGRAM REQUIREMENTS  
SUBPART A: ADMINISTRATION  
R 325.1331 Policies and procedures.  
Rule 1331. (1) An applicant or licensee shall have policies and procedures for the  
services offered. A licensee shall review and update the policies and procedures  
triennially or as necessary, whichever is sooner. Reviews must be documented through  
date and signature on the policy and procedure or by meeting minutes that list the specific  
policies and procedures reviewed.  
(2) Policies and procedures must include all of the following:  
(a) Confidentiality.  
(b) Recipient rights.  
(c) Referrals, including access to medication-assisted treatment. The policy and  
procedure must facilitate access to medication-assisted treatment if desired by the  
recipient.  
(d) Admissions. This policy and procedure must include a consent for treatment that  
outlines the benefits and risks of each treatment and rehabilitative service offered by the  
program, other FDA-approved treatments not offered by the program, and the risk of no  
treatment consistent with current clinical standards supported by national guidelines for  
evidence-based practices.  
(e) Discharge, including aftercare. This policy and procedure may not allow discharge  
of a recipient due to a return to use as long as the recipient reengages in treatment and  
complies with program policies and treatment protocol prospectively.  
(f) Naloxone access. This policy and procedure must include protocol to offer a  
naloxone kit to, at a minimum, all recipients with a history of opioid use or who are  
otherwise determined to be at risk for overdose.  
(g) Follow-up.  
(h) Intake.  
(i) Telehealth, telemedicine, or other communication modalities. This policy and  
procedure must conform with applicable state and federal regulations on the use of  
electronic information and telecommunication technologies to support or promote long-  
distance clinical health care, patient and professional health-related education, public  
health, or health administration.  
R 325.1335 Program assessment and evaluation.  
Rule 1335. (1) An applicant or licensee shall develop written goals and objectives to  
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assess the needs and evaluate the effectiveness of the program and services offered.  
(2) An assessment must identify the staffing needs, supplies, and other necessary  
components to ensure the effectiveness of the delivery of services.  
(3) A licensee shall review and document the evaluation of the program and services  
offered. The evaluation must be completed annually or when there is a change in services  
or the needs assessment of the recipients, whichever is sooner.  
(4) A licensee shall make the reports available to the department upon request and  
during any licensure survey or complaint investigation.  
R 325.1337 Data reporting; informal advisory group.  
Rule 1337. (1) The department may collect information and aggregated data from  
licensees, including, but not limited to, any of the following:  
(a) Availability of services.  
(b) Hours of operation.  
(c) Demographic data.  
(d) Morbidity and mortality data.  
(e) Volume of care provided to recipients from all payor sources.  
(2) Before any data collection under this rule, the department shall establish an informal  
advisory group, with representation from providers of substance use disorder services  
programs, to determine the data elements to be collected.  
(3) The licensee shall provide the required data on an individual basis for each licensed  
site in a format and media designated by the department.  
(4) The department may elect to verify the data through onsite review of appropriate  
records.  
R 325.1339 Emergency preparedness plan.  
Rule 1339. An applicant or licensee shall have an all-hazard emergency preparedness  
plan to meet the health and safety needs of its recipient population and personnel. The  
emergency preparedness plan must provide guidance on how to respond to emergency  
situations that could impact the operation of the program, such as natural or man-made  
disasters or other emergent situations. The emergency preparedness plan must include all  
of the following components:  
(a) A risk assessment.  
(b) A written emergency response plan.  
(c) Written policies and procedures that support the successful execution of the  
emergency response plan.  
(d) A written communication plan.  
(e) A written training and testing plan.  
SUBPART B: STAFFING  
R 325.1349 Staffing assessment.  
Rule 1349. (1) An applicant or licensee shall conduct an assessment of services offered  
by the program to identify additional staffing levels beyond minimum licensing  
requirements. The assessment must identify the services offered by the program, the staff  
required to provide those services, licensing and credentialing requirements for the staff  
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identified, and the level of staffing needed. The assessment must be completed and  
documented by the applicant or licensee annually or when there is a change in services or  
the needs assessment of the recipients, whichever is sooner.  
(2) The licensee shall maintain staffing levels according to the requirements of these  
rules and the assessment completed by the program outlined in subrule (1) of this rule,  
except in documented short-term instances less than 2 weeks in length due to an illness, a  
vacation, or other leave. This subrule does not preclude the licensee from the  
appropriate use of other staff or professions not identified in these rules. If these other  
staff or professions are not identified in these rules, then these individuals cannot be used  
to meet the minimum staffing requirements set forth in these rules.  
(3) A program that is licensed for residential and residential withdrawal management at  
a single licensed site may share a licensed counselor, LMSW, or licensed psychologist, if  
other staffing requirements are maintained.  
R 325.1351 Staff development and training.  
Rule 1351. (1) An applicant or licensee shall establish a staff development and training  
program that includes all of the following:  
(a) Orientation for staff.  
(b) On-the-job training.  
(c) In-service education.  
(d) Opportunity for continuing job-related education.  
(2) Excluding outpatient services, an applicant or licensee shall establish an in-service  
education program for all staff who treat, monitor, or interact with a recipient for care  
issues at orientation and at regular intervals as appropriate but at a minimum of every 3  
years. The in-service education program must include, at a minimum, all of the  
following:  
(a) First aid and cardiopulmonary resuscitation (CPR).  
(b) Training to identify signs and symptoms of a medical emergency.  
(c) Training on potential medical risks associated with withdrawal from substances and  
combinations of substances and appropriate acute interventions.  
(d) Medication administration and monitoring.  
(e) Emergency response protocols, including medical, psychiatric, and safety  
emergencies.  
(f) Signs and symptoms of intoxication and withdrawal, including seizures.  
(g) Vital sign measurement and interpretation.  
(h) Naloxone administration.  
(3) An applicant or licensee shall establish an in-service education program for all staff  
who treat, monitor, or interact with a recipient for care issues and management staff at  
orientation and at regular intervals as appropriate but at a minimum of every 3 years. The  
in-service education program must include, at a minimum, all of the following:  
(a) Cultural competency and diversity.  
(b) State and federal rules and regulations regarding confidentiality.  
(c) Mandated reporting of suspected abuse and neglect.  
(d) Assessment and management of intention to harm oneself or others.  
(e) Individualized treatment.  
(f) Recipient rights.  
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(4) An applicant or licensee shall maintain training records for each staff person.  
R 325.1353 Medical director.  
Rule 1353. (1) An applicant or licensee for methadone or residential withdrawal  
management service categories shall have a physician as the medical director. The  
medical director shall oversee all medical services performed by the program. For a  
program where there is only 1 physician, that physician is considered the medical director  
for purposes of these rules.  
(2) The medical director shall comply with either of the following:  
(a) Be certified in addiction psychiatry or addiction medicine by a recognized board of  
the American Board of Medical Specialties, including the American Board of Psychiatry  
and Neurology or the American Board of Preventive Medicine or have held a prior  
certification by the American Board of Addiction Medicine.  
(b) Received 30 hours of continuing medical education and training accredited by the  
Accrediting Council for Continuing Medical Education within 1 year after the date of  
hire in addiction psychiatry or addiction medicine through continuing medical education  
offered by the American Board of Medical Specialties, American Board of Preventative  
Medicine, American Society of Addiction Medicine, American Academy of Addiction  
Psychiatry, American Association for Treatment of Opioid Dependence, American  
Association of Osteopathic Addiction Medicine, the Michigan counterparts of these  
organizations, or other national or state programs acknowledged and accepted by the  
department.  
(3) The medical director shall demonstrate ongoing accredited education related to  
substance use disorders comprised of 30 hours every 3 years.  
(4) The medical director is responsible for all of the following activities as outlined in  
written policy and procedures or the position description for the medical director:  
(a) Developing admission criteria.  
(b) Developing treatment protocols.  
(c) Ensuring adequacy of individual treatment prescriptions developed with the  
participation of professional staff, to include notations of contraindications and  
precautions.  
(d) Providing or arranging for daily medical coverage to meet recipient needs.  
(e) Determining the credentials of other physicians working under the medical director.  
(f) Determining the credentials of clinicians who may prescribe pharma-therapies.  
(5) The medical director shall provide oversight of all program physicians, physician’s  
assistants, or advanced practice registered nurses.  
R 325.1355 Medical staffing.  
Rule 1355. (1) An individual physician, physician’s assistant, or advanced practice  
registered nurse is responsible for all of the following:  
(a) Ensuring completeness of a recipient record upon admission to the program.  
(b) Reviewing and signing a recipient’s service plan.  
(c) Signing or countersigning standing and verbal medical orders as required by federal  
or state law and as follows:  
(i) Documenting verbal orders in a recipient’s record and signed by the individual  
taking the verbal order and countersigned within 72 hours by the licensed health  
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professional that gave the verbal order.  
(ii) Documenting standing orders in a recipient’s record and signed by the licensed  
health professional that gave the standing order.  
(iii) Ensuring that justification is recorded in a recipient's record when the frequency of  
treatment is changed.  
(2) Compliance with applicable state requirements for the delivery of controlled  
substances including, but not limited to, possessing a drug control license.  
SUBPART C: SERVICES  
R 325.1357 Program services.  
Rule 1357. (1) A licensee shall provide all of the following information to the recipient  
upon admission:  
(a) Services to be offered and the role of the licensee.  
(b) Services available through referral.  
(c) Costs associated with services, including any costs to be paid by therecipient.  
(d) Recipient rights and responsibilities.  
(e) Hours during which services will be available.  
(f) General overview of treatment and rehabilitation services to be offered based upon  
recipient records.  
(g) Copy of the complaint process.  
(h) Copy of the recipients’ rights process.  
(i) A notice listing the program’s policies and procedures that are available to view  
upon request.  
(2) A licensee shall update the recipient before any changes to the requirements set forth  
in subrule (1) of this rule.  
R 325.1359 Support and referral services.  
Rule 1359. (1) A licensee shall offer support services either onsite, via telehealth, or by  
referral based upon its assessment of the service categories offered and recipient needs.  
The assessment must address all of the following support services:  
(a) Medication-assisted treatment if not offered on site.  
(b) Support and rehabilitation services, including social, educational, and recreational.  
(c) Job development and placement.  
(d) Financial counseling.  
(e) Legal counseling.  
(f) Nutritional education and counseling.  
(2) A licensee shall maintain a current list of support services available onsite or by  
referral. A licensee shall review the list with each recipient as part of the admission  
procedure and as part of ongoing treatment planning, management, and coordination.  
SUBPART D: RECIPIENT AND ADMINISTRATIVE RECORDS  
R 325.1361 Recipient records.  
Rule 1361. (1) A licensee of a treatment and rehabilitation program shall keep and  
maintain a record for each recipient, including all of the following:  
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(a) Identification, including name, address, and birth date.  
(b) History of substance use, including all of the following:  
(i) Past substance use, including prescribed drugs.  
(ii) Preferred substances.  
(iii) Frequency of use.  
(iv) History of overdose, withdrawal, or adverse drug or alcohol reactions.  
(v) History of substance use disorder services received, including location and dates  
services were received.  
(vi) Year of first use of each substance.  
(c) Admission, including initiation of service date and signed consent for treatment, or  
reasons for denial of admission.  
(d) Physical disabilities, limitations, and ailments.  
(e) Information submitted by a referral source, if any.  
(f) Diagnosis.  
(g) Medical or clinical diagnostic test findings.  
(h) Service plans.  
(i) Progress notes.  
(j) Notes and observations by other personnel providing care.  
(k) Discharge from a program, record of discharge, discharge summary, transfer to  
another program, or death must be documented within 14 days.  
(l) Emergency contact information, including, but not limited to, guardian and durable  
power of attorney contact information.  
(m) Consent forms as required and appropriate.  
(2) The recipient record for residential service categories must also include both of the  
following:  
(a) Medical history and physical examination.  
(b) Medication records.  
(3) The recipient record for residential withdrawal management or methadone must also  
include all of the following:  
(a) Medical history and physical examination.  
(b) Physician, physician’s assistant, or advanced practice registered nurseorders.  
(c) Physician, physician’s assistant, or advanced practice registered nurse progress  
notes.  
(d) Nurse notes.  
(e) Medication records.  
R 325.1363 Service plan.  
Rule 1363. (1) Based upon the assessment made of a recipient's needs, a written service  
plan, which may include both medical and counseling services, must be developed and  
recorded in the recipient's record. A service plan must be developed by a licensed or  
certified professional as referenced in these rules and as promptly after the recipient's  
admission as feasible, but no later than either of the following:  
(a) The conclusion of the next session attended by the client for outpatient counseling  
programs.  
(b) Twenty-four hours for methadone, residential, and residential withdrawal  
management programs.  
13  
(2) A service plan must include the recipient’s signature agreeing to the plan and state  
when updates are made.  
(3) The service plan must comply with all of the following:  
(a) Be individualized based upon the assessment of the recipient's needs and, if  
applicable, the medical evaluation.  
(b) Define the sequence, frequency, and duration of the services and therapeutic  
activities to be provided to the recipient, including required counseling from a licensed  
counselor, limited licensed counselor under the supervision of a licensed counselor,  
LMSW, limited LMSW under the supervision of a LMSW, licensed psychologist, limited  
licensed psychologist under the supervision of a licensed psychologist, temporary limited  
licensed psychologist under the supervision of a licensed psychologist, post-doctoral  
education limited licensed psychologist under the supervision of a licensed psychologist,  
LMFT, limited LMFT under the supervision of an LMFT, certified counselor, or limited  
certified counselor. This subdivision does not preclude the use of other counseling  
services where licensing or certification is not required. Other counseling services shall  
not be used to meet the minimum counseling requirements set forth in these rules.  
(c) Include referrals for services that are not available in the program.  
(d) Contain objectives that the recipient will attempt to achieve, together with a realistic  
time schedule for their achievement.  
(4) Review of, and changes in, the service plan must be recorded in the recipient's  
record. The date of the review of change, together with the names of the individuals  
involved in the review, must also be recorded. A service plan must be reviewed at least  
once every 120 days by a licensed or certified professional as referenced in these rules,  
including the service plans under a limited certified counselor.  
R 325.1365 Controlled substances and medication records, excluding outpatient  
counseling programs.  
Rule 1365. (1) A licensee shall maintain controlled substance and medication records  
that include all of the following:  
(a) Inventory of controlled substances that includes all of the following:  
(i) Date and quantity received, including lot numbers.  
(ii) Date and amount dispensed, including lot number, recipient name, method of  
dispensing, and signature of recipient and the dispensing licensed health professional.  
(iii) Disposal record and signatures.  
(b) Inventory of recipient medications.  
(2) Outpatient programs are excluded from this rule.  
R 325.1367 Administrative records; program requirements.  
Rule 1367. A program shall maintain the following administrative records, as  
applicable:  
(a) Daily census records that identify the specific number of recipients receiving  
services.  
(b) Incident records, including all instances of accidents, injuries, or deaths.  
R 325.1371 Recipient and administrative records; confidentiality.  
Rule 1371. (1) Recipient and administrative records must be available for licensure  
14  
survey and review of content at any time by the department.  
(2) Records must be maintained as confidential documents with 1 or more of the  
following exceptions:  
(a) Information required under these rules.  
(b) Information required by law.  
(c) Information authorized for disclosure by written release of the recipient or the  
recipient’s designated representative.  
PART 4: SPECIAL REQUIREMENTS BY SERVICE CATEGORIES  
R 325.1377 Rescinded.  
R 325.1379 Rescinded.  
R 325.1381 Outpatient counseling program requirements.  
Rule 1381. (1) Outpatient counseling must be based on a documented assessment of the  
recipient's needs and a subsequent agreement between the recipient and the provider  
about the services to be offered.  
(2) An applicant or licensee shall employ a licensed counselor, LMSW, licensed  
psychologist, or LMFT.  
(3) A licensee shall establish, maintain, and publicly post hours for counseling services.  
(4) A licensed counselor, limited licensed counselor under the supervision of a licensed  
counselor, LMSW, limited LMSW under the supervision of a LMSW, licensed  
psychologist, limited licensed psychologist under the supervision of a licensed  
psychologist, temporary limited licensed psychologist under the supervision of a licensed  
psychologist, post-doctoral education limited licensed psychologist under the supervision  
of a licensed psychologist, LMFT, limited LMFT under the supervision of an LMFT,  
certified counselor, or limited certified counselor under the supervision of a licensed or  
certified individual listed in these rules must be available to provide counseling services  
as required in a recipient service plan.  
(5) A licensee shall ensure that any licensed counselor, limited licensed counselor,  
LMSW, limited LMSW, licensed psychologist, limited licensed psychologist, temporary  
limited licensed psychologist, post-doctoral education limited licensed psychologist,  
LMFT, limited LMFT, or certified counselor is not responsible for more than 65  
recipients.  
(6) A licensee shall ensure that a limited certified counselor is not responsible for more  
than 32 recipients.  
(7) Records for all recipients must be maintained or accessible at the licensed site.  
R 325.1383 Methadone program requirements.  
Rule 1383. (1) Methadone program services must be based on a documented assessment  
of the recipient's needs and a subsequent agreement between the recipient and the  
provider about the services to be offered.  
(2) An applicant or licensee shall employ a licensed counselor, LMSW, licensed  
psychologist, or LMFT.  
15  
(3) A licensee shall establish, maintain, and publicly post hours for counseling services.  
(4) A licensed counselor, limited licensed counselor under the supervision of a licensed  
counselor, LMSW, limited LMSW under the supervision of a LMSW, licensed  
psychologist, limited licensed psychologist under the supervision of a licensed  
psychologist, temporary limited licensed psychologist under the supervision of a licensed  
psychologist, post-doctoral education limited licensed psychologist under the supervision  
of a licensed psychologist, LMFT, limited LMFT under the supervision of an LMFT,  
certified counselor, or limited certified counselor under the supervision of a licensed or  
certified individual listed in these rules must be available to provide counseling services  
as required in a recipient service plan.  
(5) A licensee shall ensure that any licensed counselor, limited licensed counselor,  
LMSW, limited LMSW, licensed psychologist, limited licensed psychologist, temporary  
limited licensed psychologist, post-doctoral education limited licensed psychologist,  
LMFT, limited LMFT, or certified counselor is not responsible for more than 65  
recipients.  
(6) A licensee shall ensure that a limited certified counselor is not responsible for more  
than 32 recipients.  
(7) An applicant or licensee shall employ a medical director. If the medical director is  
not onsite during all hours of operation, then the licensee shall establish specific  
timeframes in which the medical director shall be onsite.  
(8) During all hours that recipients are receiving medication, a licensee shall have onsite  
a physician, physician’s assistant, advanced practice registered nurse, registered  
professional nurse, or licensed practical nurse under the supervision of a registered  
professional nurse or physician.  
(9) The medical director, physician, physician’s assistant, or advanced practice  
registered nurse shall document that the recipient has been diagnosed with a substance  
use disorder. The recipient shall be diagnosed with a substance use disorder and have  
documented opioid use disorder for 1 year or more.  
(10) Before any medications are prescribed, the medical director, a physician,  
physician’s assistant, or advanced practice registered nurse shall complete and document  
the medical and drug history and physical examination of the recipient. In addition, any  
modification to medications or course of treatment must be documented in the recipient  
record and ordered by a physician, physician’s assistant, or advanced practice registered  
nurse.  
(11) Within 30, 60, and 90 days of treatment, and not less than every 90 days thereafter,  
the medical director, a physician, physician’s assistant, or advanced practice registered  
nurse shall meet with the recipient to review the recipient’s service plan, including a  
review of the counseling services progress notes and drug tests, and document the  
medical necessity for continued treatment in the program and any recommended  
adjustments to the service plan.  
(12) A licensee shall comply with all requirements set forth in 42 CFR 8.  
(13) The licensee shall document in the service plan the phase the recipient is in,  
including short-term withdrawal management, long-term withdrawal management, or  
maintenance.  
(14) A licensee shall have a policy and procedure for labeling take-home medications  
that includes all of the following:  
16  
(a) The name of the medication.  
(b) The program's name, address, and phone number.  
(c) Recipient name or code number.  
(d) Medical director's name.  
(e) Directions for use.  
(f) Date to be used by.  
(g) A cautionary statement that the drug should be kept out of the reach of children.  
(15) A licensee shall have a policy and procedure to address withdrawal of a recipient  
from the program that includes all of the following:  
(a) Criteria for decreasing levels of medication and frequency of counseling.  
(b) Criteria for ending treatment when medication and counseling are no longer  
necessary.  
(c) Criteria for when medication and counseling is still necessary and the treatment at  
the program is being ended either voluntarily or involuntarily, including both of the  
following:  
(i) Documentation in the recipient record of the reasons for voluntary or involuntary  
withdrawal from the program.  
(ii) Referral options to continue treatment at another program.  
R 325.1385 Residential program requirements.  
Rule 1385. (1) Residential programs must be based on a documented assessment of a  
recipient's needs and a subsequent agreement between the recipient and the provider  
about the services to be offered.  
(2) An applicant or licensee shall employ a full-time licensed counselor, LMSW,  
licensed psychologist, or LMFT.  
(3) A licensed counselor, limited licensed counselor under the supervision of a licensed  
counselor, LMSW, limited LMSW under the supervision of a LMSW, licensed  
psychologist, limited licensed psychologist under the supervision of a licensed  
psychologist, temporary limited licensed psychologist under the supervision of a licensed  
psychologist, post-doctoral education limited licensed psychologist under the supervision  
of a licensed psychologist, LMFT, limited LMFT under the supervision of an LMFT,  
certified counselor, or limited certified counselor under the supervision of a licensed or  
certified individual listed in these rules must be available to provide counseling services  
as required in recipient service plan.  
(4) A licensee shall ensure that any licensed counselor, limited licensed counselor,  
LMSW, limited LMSW, licensed psychologist, limited licensed psychologist, temporary  
limited licensed psychologist, post-doctoral education limited licensed psychologist,  
LMFT, Limited LMFT, or certified counselor is not responsible for more than 20  
recipients.  
(5) A licensee shall ensure that a limited certified counselor is not responsible for more  
than 10 recipients.  
(6) A licensee shall have at least 1 trained staff member onsite, during all hours of  
operation, that meets the training requirements set forth in R 325.1351.  
(7) An applicant or licensee shall have a policy and procedure for the safety of the  
recipients to address recipients that leave and return to the residence. The policy and  
procedure must identify methods for searching recipients and their possessions upon their  
17  
return to the residence.  
(8) A licensee shall provide and ensure recipient participation in not less than 15 hours  
per week of support services to meet the needs of the recipients. Not less than 10 of the  
15 hours must be in the form of treatment or rehabilitation evidence-based practice or  
services. Participation must be documented in the recipient record.  
R 325.1387 Rescinded.  
R 325.1388 Residential withdrawal management program requirements.  
Rule 1388. (1) Residential withdrawal management programs must be based on a  
documented assessment of the recipient's needs and a subsequent agreement between the  
recipient and the provider about the services to be offered.  
(2) A program offering clinically managed withdrawal management services shall offer  
peer and social support services only and not offer or administer schedule II-V controlled  
substances, as classified under 21 USC 812, for the management of withdrawal, including  
methadone and buprenorphine.  
(3) A program offering medically monitored withdrawal management services shall  
offer medical and nursing care and may administer medications for the management of  
withdrawal.  
(4) A residential withdrawal management program shall meet all of the following  
requirements:  
(a) An applicant or licensee shall employ a medical director.  
(b) Before treatment, a licensee shall provide a recipient, or a person acting on the  
individual's behalf, information about all relevant, available medical treatment options  
related to the recipient’s assessment, including relevant forms of medication-assisted  
treatment, as well as the risks and benefits of each treatment option. The service plan  
must contain a written document that the recipient has been informed of the risks and  
benefits of all relevant treatment options, and identify the option selected by the recipient.  
(c) A physician, physician’s assistant, or advanced practice registered nurse shall  
review and assess each recipient upon admission and every 72 hours after the initial  
review and assessment to determine if the recipient is suitable for the services being  
offered. If a recipient is referred from a licensed acute care hospital, psychiatric unit, or  
hospital directly to a licensed residential withdrawal management program, the transfer  
documentation, including the health assessment from the transferring hospital, may be  
used as the initial assessment for admission if all of the following are met:  
(i) The transfer record must be reviewed and signed by the program’s physician,  
physician assistant, or advanced practice nurse and documented in the recipient’s record  
within 24 hours of admission.  
(ii) The transfer record must be accessible in the recipient’s record at the time of  
admission.  
(iii) The transfer record must include that the recipient was referred directly to a  
licensed residential withdrawal management program.  
(d) A licensee shall perform an initial test for opioids, benzodiazepine, methadone and  
methadone metabolites, buprenorphine and buprenorphine metabolites, barbiturates,  
amphetamines, cocaine, and other drugs based on a recipient assessment and local drug  
use pattern and trends upon admission with results documented in the recipient service  
18  
plan within 48 hours after collection of that information.  
(e) An applicant or licensee shall employ the equivalent of a full-time licensed  
counselor, LMSW, licensed psychologist, LMFT, or certified counselor.  
(f) A licensed counselor, limited licensed counselor under the supervision of a licensed  
counselor, LMSW, limited LMSW under the supervision of a LMSW, licensed  
psychologist, limited licensed psychologist under the supervision of a licensed  
psychologist, temporary limited licensed psychologist under the supervision of a licensed  
psychologist, post-doctoral education limited licensed psychologist under the supervision  
of a licensed psychologist, LMFT, limited LMFT under the supervision of an LMFT,  
certified counselor, or limited certified counselor under the supervision of a licensed or  
certified individual listed in these rules shall be available to provide counseling services  
as required in the recipient service plan.  
(g) A licensee shall ensure that any licensed counselor, limited licensed counselor,  
LMSW, limited LMSW, licensed psychologist, limited licensed psychologist, temporary  
limited licensed psychologist, post-doctoral education limited licensed psychologist,  
LMFT, limited LMFT, or certified counselor is not responsible for more than 20  
recipients.  
(h) A licensee shall ensure that a limited certified counselor is not responsible for more  
than 10 recipients.  
(5) A residential withdrawal management program offering clinically managed  
withdrawal management services shall also meet all of the following requirements:  
(a) An applicant or licensee shall have a screening and referral protocol used by a  
physician, physician’s assistant, or advanced practice registered nurse to identify and  
transfer to a medically monitored program or other appropriate setting an individual who  
meets any of the following:  
(i) Is medically unstable.  
(ii) Has a history of seizure disorder.  
(iii) Has a history of alcohol, benzodiazepine, or other sedative withdrawal related  
complications.  
(iv) Has a blood pressure measurement above or below the program’s accepted range  
for the individual.  
(v) Has current suicidal ideations or attempted suicide in the past month.  
(vi) Is pregnant.  
(b) A licensee shall have on-call, during all hours of operation, a physician, physician’s  
assistant, advanced practice registered nurse, registered professional nurse, or licensed  
practical nurse under the supervision of a registered professional nurse or physician. The  
physician, physician’s assistant, advanced practice registered nurse, registered  
professional nurse, or licensed practical nurse under the supervision of a registered  
professional nurse or physician must be available to be onsite within 30 minutes of  
notification of an emergent health concern.  
(c) A licensee shall have at least 1 trained staff member onsite, during all hours of  
operation, that meets the training requirements set forth in R 325.1351(2).  
(d) A licensee shall log all emergency transfers to another health facility, along with the  
reason for transfer. These logs must be made available to the department as requested  
during a survey or complaint investigation.  
(6) A residential withdrawal management program offering medically monitored  
19  
withdrawal management services must also meet both of the following requirements:  
(a) A licensee shall have a physician, physician’s assistant, or advanced practice  
registered nurse complete and document the medical and drug history, as well as a  
physical examination of the recipient, before administering any medications. In addition,  
any modification to medications or course of treatment must be documented in the  
recipient record and ordered by a physician, physician’s assistant, or advanced practice  
registered nurse.  
(b) A licensee shall have onsite during all hours of operation a physician, physician’s  
assistant, advanced practice registered nurse, registered professional nurse, or licensed  
practical nurse under the supervision of a registered professional nurse or physician.  
R 325.1389 Rescinded.  
PART 5: RECIPIENT RIGHTS  
R 325.1391 Recipient rights.  
Rule 1391. A recipient shall have all of the following rights:  
(a) The right to appropriate services regardless of race, color, national origin, religion,  
sex, age, mental or physical handicap, marital status, sexual preference, sexual identity,  
or political beliefs.  
(b) The right to services without being deprived of any rights, privileges, or benefits  
guaranteed by state or federal law or by the state or federal constitutions.  
(c) The right to file grievances, recommend changes in program policies or services to  
the program staff, governmental officials, or another person within or outside the  
program without program interference.  
(d) The right to review, copy, or receive a summary of his or her program records,  
unless, in the judgment of the program director, this action will be detrimental to the  
recipient or to others for either of the following reasons:  
(i) Granting the request for disclosure will cause substantial harm to the relationship  
between the recipient and the program or to the program's capacity to provide services in  
general.  
(ii) Granting the request for disclosure will cause substantial harm to the recipient.  
(e) The right to review nondetrimental portions of the record or a summary of the  
nondetrimental portions of the record if the program director determines that the action  
described under subdivision (d) of this subrule would be detrimental. If a recipient is  
denied the right to review all or part of his or her record, the reason for the denial must be  
stated to the recipient. An explanation of what portions of the record are detrimental and  
for what reasons must be stated in the recipient record and signed by the program  
director.  
(f) The right to receive services free from physical or mental abuse or neglect or sexual  
abuse from staff, including any of the following:  
(i) An intentional act by a staff member that inflicts physical injury upon a recipient or  
results in sexual contact with a recipient that includes the intentional touching of the  
recipient's intimate parts, such as primary genital area, groin, inner thigh, buttock, or  
female breast or the intentional touching of the clothing covering the immediate area of  
20  
the recipient's intimate parts, and if that intentional touching can reasonably be construed  
as being for the purpose of sexual arousal or gratification.  
(ii) A communication made by a staff member to a recipient, the purpose of which is to  
curse, vilify, intimidate, or degrade a recipient or to threaten a recipient with physical  
injury.  
(iii) A recipient suffers injury, temporarily or permanently, because the staff member or  
other person responsible for the recipient's health or welfare has been foundnegligent.  
(g) The right to review a written fee schedule in programs where recipients are charged  
for services. Policies on fees and revisions of these policies must be approved by the  
licensee and recorded in the administrative record of the program.  
(h) The right to receive an explanation of his or her bill, regardless of the source of  
payment.  
(i) The right to information concerning any experimental or research procedure  
proposed as a part of his or her treatment or prevention services, and the right to refuse to  
participate in the experiment or research without jeopardizing his or her continuing  
services. A program shall comply with state and federal rules and regulations concerning  
research that involves human subjects.  
R 325.1393 Service plan; specific recipient rights.  
Rule 1393. (1) A recipient shall be allowed to participate in the development of his or  
her service plan.  
(2) A recipient has the right to refuse treatment and to be informed of the consequences  
of that refusal. When a refusal of treatment prevents a program from providing services  
according to ethical and professional standards, the relationship with the recipient may be  
terminated by the licensee upon reasonable notice.  
(3) Unless notified in writing before admission, a recipient may utilize medications as  
prescribed by a physician.  
(4) A recipient must be informed if a program has a policy for discharging recipients  
who fail to comply with program rules and must receive, at admission and thereafter  
upon request, a notification form that includes written procedures that explain all of the  
following:  
(a) The types of infractions that can lead to discharge.  
(b) Who has the authority to discharge recipients.  
(c) How and in what situations prior notification is to be given to the recipient who is  
being considered for discharge.  
(d) The mechanism for review or appeal of a discharge decision.  
(5) A copy of the notification form signed by the recipient must be maintained in the  
recipient's case file.  
(6) The benefits, side effects, and risks associated with the use of any medications must  
be fully explained to the recipient in language that is understood by the recipient.  
(7) A recipient has the right to give prior informed consent, consistent with federal  
confidentiality regulations, for the use and future disposition of products of special  
observation and audiovisual techniques, such as 1-way vision mirrors, tape recorders,  
televisions, movies, or photographs.  
R 325.1395 Residential and residential withdrawal management programs; specific  
21  
recipient rights.  
Rule 1395. (1) In a residential and residential withdrawal management program, a  
recipient has the right to associate and have private communications and consultations  
with his or her licensed health professional, attorney, or person of his or her choice.  
(2) A program shall post its policy concerning visitors in a public place.  
(3) Unless contraindicated by program policy or an individual service plan, a recipient is  
allowed visits from family members, friends, and other persons of his or her choice at  
reasonable times, as determined by the program director or according to posted visiting  
hours. A recipient shall be informed in writing of visiting hours upon admission to the  
program.  
(4) To protect the privacy of all other recipients, a program director shall ensure, to the  
extent reasonable and possible, that the visitors of recipients will see or have contact with  
only the individual they have reason to visit.  
(5) A recipient has the right to be free from physical and chemical restraints, except  
those authorized in writing by a physician, physician’s assistant, or advanced practice  
registered nurse for a specified and limited time. Written policies and procedures that set  
forth the circumstances that require the use of restraints and designate the program  
personnel responsible for applying restraints must be approved in writing by a physician,  
physician’s assistant, or advanced practice registered nurse and shall be adopted by the  
licensee. Restraints may be applied in an emergency to protect the recipient from injury  
to self or others. The restraints must be applied by designated staff. This action must be  
reported immediately to a physician, physician’s assistant, or advanced practice  
registered nurse and reduced to writing in the recipient record within 24hours.  
(6) A recipient has the right to be free from doing work the program would otherwise  
employ someone else to do unless the work and the rationale for its therapeutic benefit  
are included in program policy or in the service plan for the recipient.  
(7) A recipient has the right to a reasonable amount of personal storage space for  
clothing and other personal property. All of these items must be returned to the recipient  
upon discharge from the program.  
(8) A recipient has the right to deposit money, earnings, or income in his or her name in  
an account with a commercial financial institution. A recipient has the right to get money  
from the account and to spend it or use it as he or she chooses, unless restricted by  
program policy or by the service plan for the recipient. A recipient has the right to receive  
all money or other belongings held for him or her by the program within 24 hours of  
discharge from the program.  
;