DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

BUREAU OF COMMUNITY AND HEALTH SYSTEMS

SUBSTANCE USE DISORDER SERVICES PROGRAM

Filed with the secretary of state on June 3, 2026

These rules become effective immediately after 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 325.1302, R 325.1303, R 325.1304, R 325.1305, R 325.1307, R 325.1323,

R 325.1351, R 325.1353, R 325.1361, R 325.1363, R 325.1365, R 325.1375, R 325.1381,

R 325.1383, R 325.1391, and R 325.1393 of the Michigan Administrative Code are

amended, 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) “Certified counselor” means an individual who is employed or volunteers to work by

providing counseling to recipients, and who is certified as an alcohol and drug counselor

by an organization approved or recognized by the department.

(f) “Complaint investigation” means a visit or an inspection of a licensee based on a

complaint with an allegation of noncompliance or violation of the public health code, the

mental health code, or these rules.

(g) “Counseling services” means services that include behavioral health counseling by a

health professional as defined in these rules in a substance use disorder services program.

December 5, 2025

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(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 on request.

(k) “Follow-up” means activities designed for a screening, assessment, referral, and

follow up program to determine the present status of individuals 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 the individual’s 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 the individual’s 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 the individual’s 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 the individual’s 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 to an applicant or licensee to evaluate compliance

with the public health code, the mental health code, or these rules.

(t) “Limited certified counselor” means an individual who is employed or who volunteers

to work providing counseling to recipients, 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.

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(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 substance use disorder services 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

methadone 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) “Pharmacist” means an individual licensed to engage in the practice of pharmacy

under article 15.

(aa) “Physician” means an individual licensed to engage in the practice of medicine or

the practice of osteopathic medicine and surgery under article 15.

(bb) “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.

(cc) “Public health code” means the public health code, 1978 PA 368, MCL 333.1101 to

333.25211.

(dd) “Recipient” means an individual who receives services from a licensed substance

use disorder services program in this state.

(ee) “Regional entity” means an agency designated by this state to coordinate substance

use disorder services in a specified region.

(ff) “Residential program” means a substance use disorder services program offering a

residential setting that is staffed and provides substance use disorder treatment or

rehabilitation services onsite.

(gg) “Residential withdrawal management program” means a substance use disorder

services program in a residential setting offering either clinically managed or medically

monitored withdrawal management services for the purposes of detoxification.

(hh) “Staff” means an individual who is not a recipient and who works, with or without

remuneration, for a licensed substance use disorder services program.

(ii) “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.

(jj) “Substance use disorder services program” or “program” means a non-governmental

or private individual or entity offering or purporting to offer substance use disorder

treatment and rehabilitation services that include methadone programs, residential

programs, and residential withdrawal management programs.

(kk) “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.

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R 325.1302 Certified counselor; limited certified counselor.

Rule 1302. A certified counselor or a limited certified counselor may provide alcohol

or drug counseling to recipients in, but not limited to, a substance use disorder services

program licensed by the department under part 62 of the public health code, MCL

333.6230 to R 333.6251. A certified counselor or limited certified counselor who offers

alcohol counseling or drug counseling and who does not provide other counseling

services under any other circumstances is not licensed under part 181 of the code unless

otherwise provided by law.

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 mobile unit, must be made on the

most recent applicable form authorized and provided by the department.

(2) An individual 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 both of the following are met:

(a) The individual is offering psychological, medical, or social services within the scope

of the individual’s 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.

(5) The department shall conduct a prelicensure survey and make a determination on an

application within 3 months after an application is considered complete. A prelicensure

survey is required for residential programs, residential withdrawal management programs,

and methadone programs. Only an application review is required for any other program.

(6) On 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.

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(d) Program service categories authorized are any of the following:

(i) Methadone program.

(ii) Residential program.

(iii) 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 must 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 mobile unit; requirements; review process;

approval.

Rule 1304. (1) Before operation of a 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) An application for a mobile unit must be approved if the mobile unit satisfies all of

the following requirements:

(a) The parent organization is a licensed methadone program.

(b) The mobile unit shall return each night to the licensed.

(c) The total number of mobile units does not exceed 3 for the parent organization.

(4) A licensee shall post the mobile unit license in a conspicuous area for public view.

(5) For purposes of these rules and all compliance purposes, a 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 on 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 license must

be closed. This closure of a license is not subject to appeal.

(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.

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Rule 1307. (1) A prelicensure survey is scheduled and announced.

(2) All other licensure surveys and complaint 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.

(6) The department may forego a licensure survey and conduct a desk review if the

circumstances do not require an on-site visit.

SUBPART C: ENFORCEMENT AND HEARING

R 325.1323 Notification of revocation of license or nonrenewal of license; compliance

conference; opportunity to appeal.

Rule 1323. (1) When the department determines that a licensee has committed an act or

engaged in conduct or practices that warrants the revocation of a license or the denial to

renew a license, the department shall issue a notice of intent that includes all of the

following:

(a) The reason or reasons for the revocation of a license or the denial to renew a license.

(b) The date, time, and location for a compliance conference. The compliance conference

must take place at least 45 days after the date of the notice of intent.

(c) Guidance to the licensee that a written appeal of the notice of intent must be submitted

to the department within 30 days after the date of the notice of intent for the compliance

conference to occur.

(2) The department shall send the notice of intent to the licensee by certified mail with

return receipt requested.

(3) If a licensee does not submit a written appeal of the notice of intent within 30 days after

the date of the notice of intent, the department may revoke or not renew the license. This

action on the license is final and is not subject to administrative appeal.

(4) If a licensee submits a timely appeal of the notice of intent, the department shall hold

the compliance conference as indicated in the notice of intent. The licensee shall be afforded

an opportunity to show compliance with all lawful requirements for a license.

(5) If a licensee does not demonstrate compliance at the compliance conference or the parties

are unable to resolve the issues at the conference, the department shall request a formal hearing

pursuant to sections 71 to 92 of the administrative procedures act of 1969, 1969 PA 306, MCL

24.271 to 24.292, and part 1 of the Michigan administrative hearing system administrative

hearing rules, R 792.10101 to R 792.10137.

(6) This rule does not apply when there is failure to renew a license under R 325.1305.

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PART 3: SUBSTANCE USE DISORDER SERVICES PROGRAM REQUIREMENTS

SUBPART A: ADMINISTRATION

SUBPART B: STAFFING

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) 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, including monitoring of self-

administration of medications such as infusion and injection medications. If the program

has medical staff who are licensed to administer infusion and injection medications,

training must include administration and monitoring of infusion and injection medications.

(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.

(4) An applicant or licensee shall maintain training records for each staff member.

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

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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 counterparts of these organizations in

this state, 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) A licensee shall maintain a staffing log that documents the dates and times when the

medical director and other physicians, physician assistants, and nurse practitioners under

the direction of the medical director are working at the licensed site location. A staffing

log must be retained for 1 year.

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:

(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.

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(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 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 programs must include all of the following:

(a) Medical history and physical examination.

(b) Medication records that include the medication name, dose, route of administration, date,

time, and the individual who administered the medication.

(c) Documentation of the recipient’s ability to self-administer medications, as appropriate,

and a record of each incident when a staff member accepts or rejects a supply of recipient

medications filled by a non-program pharmacy or destroys discontinued, outdated, or

deteriorated recipient medications.

(3) The recipient record for residential withdrawal management or methadone must

include all of the following:

(a) Medical history and physical examination.

(b) Physician, physician’s assistant, or advanced practice registered nurse orders.

(c) Physician, physician’s assistant, or advanced practice registered nurse progress notes.

(d) Nurse notes.

(e) Medication records that include the medication name, dose, route of administration, date,

time, and the individual who administered the medication.

(f) For residential withdrawal management programs, documentation of the recipient’s

ability to self-administer non-substance use disorder (SUD) treatment medications, as

appropriate, and a record of each incident when a staff member accepts or rejects a supply of

recipient medications filled by a non-program pharmacy or destroys discontinued, outdated,

or deteriorated recipient medications.

R 325.1363 Service plan.

Rule 1363. (1) Based on 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:

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(a) The conclusion of the next session attended by the recipient for counseling services.

(b) Twenty-four hours for methadone, residential, and residential withdrawal

management programs.

(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 on 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 counseling services 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.

(c) Include referrals for services that are not available in the program, such as referrals to

external providers or contractors to provide recipient services in the program or appropriate

transportation to an off-site location during the stay including for the administration of

infusion or injection medications.

(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.

Rule 1365. 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.

SUBPART E: SUPPLIES AND PHYSICAL PLANT

R 325.1375 Security of controlled substances, medications, and dispensing area.

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Rule 1375. (1) An applicant or licensee offering treatment and rehabilitation services shall

have a policy and procedure to maintain secured and, if necessary, climate-controlled

storage and dispensing areas for controlled substances and medications.

(2) The policy and procedure must identify who and when authorized staff are allowed

access to secured and, if necessary, climate-controlled storage and dispensing areas and

when recipients are allowed access to dispensing area.

(3) The policy and procedure must be reviewed and documented annually by the program

director and updated as necessary.

PART 4: SPECIAL REQUIREMENTS BY SERVICE CATEGORIES

R 325.1381 Counseling service requirements.

Rule 1381. Counseling 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.

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.

(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 shall 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

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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.

(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 treatment to date and any recommended

adjustments to the service plan.

(12) A licensee shall comply with all requirements set forth in 42 CFR 8.

(13) A 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:

(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 maintained 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.

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 disability, marital status, sexual preference, sexual identity, or

political beliefs, as well as the use of a prescribed non-SUD medication for withdrawal

management, or a condition that can be self-managed, which includes, but is not limited

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to, self-administering pharmacotherapy for hemophilia, or managed effectively by an

external provider.

(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 individual within or outside the

program without program interference.

(d) The right to review, copy, or receive a summary of the individual’s 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 the individual’s 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 on 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 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 individual responsible for the recipient's health or welfare has been found negligent.

(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 the individual’s bill, regardless of the source of

payment.

(i) The right to information concerning any experimental or research procedure proposed

as a part of the individual’s treatment services, and the right to refuse to participate in the

experiment or research without jeopardizing the individual’s 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.

14

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 on reasonable notice.

(3) A recipient has the right to maintain an active ongoing non-SUD treatment prescribed

by a physician. A recipient may receive or self-administer appropriate medications,

including infusion or injection medications, as prescribed by a physician. If an individual

has documentation from a physician to self-administer prescribed medication, then the

recipient shall be allowed to self-administer. If a recipient cannot administer the

individual’s own medication, the program shall ensure that medication is administered by

or under the supervision of personnel who are qualified and trained either from the facility

or through referral to an external provider. If a recipient has a physician order for a

medication that is part of an active, on-going non-SUD treatment plan and filled by an

outside pharmacy, the recipient shall be allowed to bring the medication into the program,

provided the facility’s medical staff can ensure the integrity of the prescription, and that

the medication is sealed, not tamper evident, and not expired.

(4) A recipient shall be informed if a program has a policy for discharging recipients who

fail to comply with program rules and shall receive, at admission and on 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.