Section 164.423 - Program Components(A) Residential rehabilitation programs for adults, regardless of program model, shall: (1) provide daily clinical services to improve residents' ability to structure and organize the tasks of daily living and recovery;(2) advocacy and ombudsman services to support residents in obtaining needed resources and services and actively promote residents' interests; and(3) directly connect the resident to substance use disorder treatment or community support services upon discharge.(B)Transitional Support Services. Residential rehabilitation programs based on a Transitional Support model shall provide: (1) at a minimum, four hours of nursing services available each day;(2) case management services;(3) a dedicated staff member to provide transportation services available at least 12 hours per day, seven days per week; and(4) health monitoring, education and crisis services.(C)Social Model Recovery Homes. Residential rehabilitation programs based on a Social Model shall provide: (1) individual treatment plans developed by residents with assistance within the first 30 calendar days of residence;(2) planned program activities to stabilize and maintain the stability of the resident's substance dependence symptoms and to help the resident develop and apply recovery skills; and(3) case management and support to promote successful involvement in regular, productive daily activity, such as work or school, and, as indicated, successful reintegration into family and community living.(D)Recovery Homes. Residential rehabilitation services based on a Recovery Home model shall provide: (1) planned daily clinical program activities to stabilize the resident's substance dependence symptoms and to help the resident develop and apply recovery skills;(2) counseling and clinical monitoring by qualified staff to promote successful involvement in regular, productive daily activity, such as work or school, and, as indicated, successful reintegration into community living;(3) a range of cognitive and motivational therapies on a group and individual basis; and(4) a daily schedule of services designed to develop and apply recovery skills.(E)Therapeutic Communities. Residential rehabilitation services based on a Therapeutic Community model shall provide:(1) daily clinical services to promote the residents' ability to develop and practice pro-social behaviors;(2) planned daily clinical program activities to stabilize and maintain stabilization of the resident's substance dependence symptoms and to help the resident develop and apply recovery skills;(3) counseling and clinical monitoring by qualified staff to promote successful involvement in regular, productive daily activity, such as work or school, and, as indicated, successful reintegration into family and community living;(4) a range of cognitive and motivational therapies on a group and individual basis;(5) motivational enhancement and engagement strategies appropriate to the resident's stage of readiness to change; and(6) planned community reinforcement designed to foster pro-social values and group living skills.(F)Co-occurring Enhanced Residential Services. Residential rehabilitation services based on a Co-occurring Enhanced Services model shall be delivered by appropriately credential medical staff who are available to assess and treat co-occurring disorders and to monitor the patients' administration of medication in accordance with a physician's prescription, as well as provide: (1) staffing patterns that include appropriately credentialed mental health professionals, who are able to assess and treat co-occurring disorders with the capacity to involve addiction trained psychiatrists or in coordination with community physicians for review of treatment as needed;(2) planned daily clinical program activities constituting at least five hours a week of professionally directed treatment designed to stabilize and maintain the resident's substance dependence symptoms and to help the resident develop and apply recovery skills;(3) counseling and clinical monitoring by qualified staff to promote successful involvement in regular, productive daily activity, successful reintegration into community living;(4) a range of cognitive and motivational therapies on a group and individual basis, where the goals of such therapies pertain to both the substance use disorder and any mental health disorder;(5) a daily schedule of self-help, health education, relapse and overdose prevention and recovery maintenance education as well individual and group services designed to develop and apply recovery skills;(6) trauma-informed care, with an emphasis on individual choice and decision making, including trauma screening in all assessments and access to trauma specific services;(7) specific medication education and management services; and(8) Recovery Support services, referral, and engagement.(G) Programs may provide services through telemedicine where appropriate and at the discretion of the program director, based on federal guidance.Amended by Mass Register Issue 1482, eff. 11/11/2022.