As used in this part:

1. (1)

   1. (A) “Addiction Severity Index (ASI)” means a semi-structured assessment instrument designed to be used with clients presenting for substance abuse treatment.

   2. (B)

      1. (i) It covers seven (7) important areas of a client’s life:

         1. (a) (a) Medical;
         2. (b) (b) Employment/support;
      2. (c) (c) Drug and alcohol use;

      3. (d) (d) Legal;

         1. (e) (e) Family/social;
         2. (f) (f) Opinions about alcohol and drug use; and
         3. (g) (g) Psychological.
      4. (ii) The instrument documents lifetime difficulties in these seven (7) areas and focuses on difficulties in the thirty (30) days prior to assessment;
2. (2) “Administrative detoxification” means the gradual, medically controlled withdrawal of methadone;

3. (3) “Admission” means the point in an alcohol or drug abuser’s relationship with the program at which the:

   1. (A) Intake process has been completed; and
   2. (B) Individual is entitled to receive services;

4. (4)

   1. (A) “Aftercare” means the component of the treatment program which ensures the provision of continued contact with the client following the termination of services from a primary care modality, designed to support and to increase the gains made to date in the treatment process.
   2. (B) Aftercare plan development should start prior to discharge but is not implemented until discharge;
5. (5) “Alcohol and Drug Management Information System (ADMIS)” means the management information system for the collection and reporting of client-related data prescribed by the state;
6. (6) “Alcohol or drug abuser” means a person who voluntarily uses alcohol or other drugs in such a way that their social or economic functioning is disrupted;
7. (7) “Alcohol or drug addict” means a person who is physically and/or psychologically dependent on alcohol or other drugs and has little or no control over the amounts consumed, leading to substantial health endangerment, or social functioning disruption and economic functioning disruption;
8. (8) “Applicant” means any individual who has applied for admission to a treatment program, but is not yet admitted to the program;
9. (9) “Applicant screening” means the act of determining eligibility for treatment;
10. (10) “Assessment” means the process of collecting sufficient data to enable evaluation of an individual’s strengths, weaknesses, problems, and needs so that a treatment plan can be developed;
11. (11) “Chief executive officer” means the individual appointed by the governing board to set in behalf of the overall daily management of the organization;
12. (12) “Client” means an individual who has an alcohol or other drug abuse problem, for whom intake procedures have been completed, who is admitted to the program, and remains active in the treatment provided by the program, and has not been discharged;
13. (13) “Counselor” means an individual who, by virtue of education, training or experience, provides treatment, which includes advice, opinion, or instruction to an individual or in a group setting to allow opportunities for a person to explore their problems related directly or indirectly to alcohol and/or other drug abuse or dependence;
14. (14) “Definitive laboratory results” means confirmatory tests conducted by a National Institute of Drug Abuse (NIDA)-certified laboratory;
15. (15) “Detoxification” means the withdrawal of a person from a physiologically addicting substance;
16. (16) “Detoxification treatment for opioid dependence” means the dispensing of a narcotic drug in decreasing doses to an individual to alleviate adverse physiological and psychological effects of withdrawal from the continuous or sustained use of a narcotic drug and as a method of bringing the individual to a narcotic drug-free state within such period;
17. (17) “Direct care” means any individual who provides chemical dependency education or counseling of treatment related activities;
18. (18) “Documentation” means the provision of written, dated, and authenticated evidence, signed by person’s name and title, to substantiate compliance with standards, e.g., minutes of meetings, memoranda, schedules, notices, announcements;
19. (19) “Emergency admission” means an admission that does not meet the intake process due to the extreme nature of the circumstances involved;
20. (20) “Emergency care” means a network of services that provides all persons having acute problems related to alcohol and other drug use and abuse readily available diagnosis and care, as well as appropriate referral for continuing care after emergency treatment;
21. (21) “Family” means individuals as defined by law, or significant others that claim relationship to the client;

22. (22)

    1. (A) “Fiscal management system” means the procedures that provide management control of the financial aspects of program operations.
    2. (B) Such procedures include cost accounting, program budgeting, materials purchasing, and client billing standards;
23. (23) “Governing board” means that person or persons with the ultimate authority and responsibility for the overall operation of the program;
24. (24) “Intake” means the process of collecting and assessing information to determine the appropriateness of admitting an individual in an alcohol and drug abuse treatment program;
25. (25) “Licensure” means the process by which the Office of Alcohol and Drug Abuse Prevention determines if a person, partnership, association, or corporation may operate an alcohol and drug abuse treatment program;
26. (26) “Licensure Standards for Alcohol and/or Other Drug Abuse Treatment Programs” means the standards developed by the Office of Alcohol and Drug Abuse Prevention, with which licensed treatment programs shall comply;
27. (27) “May” means a term in the interpretation of a standard to reflect an acceptable method that is recognized but not necessarily preferred;

28. (28)

    1. (A) “Medical Director” means a physician licensed to practice medicine in the State of Arkansas who assumes responsibility for the administration of medical services performed by the program, ensuring that the program is in compliance with federal, state, and local laws and regulations.
    2. (B) In an opioid treatment program, the Medical Director assumes the responsibility regarding the medical treatment of narcotic addiction with a narcotic drug;
29. (29) “Methadone hydrochloride” means an opioid, a synthetic opiate, that is primarily used for the treatment of narcotic addiction in detoxification or maintenance programs;
30. (30) “Narcotic dependent” means an individual who physiologically needs an opiate or a synthetic opiate to prevent the onset of signs of withdrawal;
31. (31) “NCPI” means the Crisis Prevention Institute’s training in nonviolent crisis prevention and intervention;

32. (32)

    1. (A) “Observation detoxification” means monitoring on a twenty-four-hour-per-day basis of a client who is undergoing mild withdrawal in a residential/live-in setting.

    2. (B)

       1. (i) Monitoring will consist of taking the client’s vital signs.

       2. (ii) Vital signs will be taken by a staff member trained and certified by:

          1. (a) (a) The Office of Alcohol and Drug Abuse Prevention;
          2. (b) (b) A medical doctor;
       3. (c) (c) A registered nurse;

       4. (d) (d) A licensed psychiatric technical nurse; or

          1. (e) (e) A licensed practical nurse.

    3. (C)

       1. (i) The facility shall establish approved emergency medical procedures.
       2. (ii) These services shall be available should the client’s condition deteriorate and emergency procedures be required;
33. (33) “Opioid maintenance” means the dispensing of methadone for more than one hundred eighty (180) days in the treatment of an individual for dependence on opiates;

34. (34) “Opioid treatment program” means an entity that:

    1. (A) Administers or dispenses an approved narcotic drug to a narcotic addict for maintenance or detoxification treatment;
    2. (B) Provides a comprehensive range of medical and rehabilitative services;
    3. (C) Is approved by the State Methadone Authority (SMA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT);
    4. (D) Is registered with the United States Drug Enforcement Administration to use a narcotic drug for the treatment of narcotic addiction; and
    5. (E) Is open at least six (6) days a week;
35. (35) “Outpatient program” means a non-live-in program offering treatment or rehabilitation services to alcohol or drug abusers on a scheduled or nonscheduled basis;
36. (36) “Outpatient service – family” means counseling provided in an outpatient environment to a substance abuse client and family members or significant other;
37. (37) “Outpatient service – group” means counseling provided in an outpatient environment to more than one substance abuse client;
38. (38) “Outpatient service – individual” means care provided to a substance abuse client in an outpatient environment;

39. (39)

    1. (A) “Outreach public education and information” means the dissemination of relevant information specifically aimed at increasing the awareness, receptivity, and sensitivity of the community and stimulating social action to increase the services provided for people with problems associated with the use of alcohol and/or other drugs.

    2. (B) It also includes the process of reaching into a community systematically for the purpose of:

       1. (i) Identifying persons in need of services;
       2. (ii) Informing individuals and their families as to the availability of services;
       3. (iii) Locating additional services; and
       4. (iv) Enhancing the entry into the service delivery system;

40. (40)

    1. (A) “Partial day treatment” means care provided to a substance abuse client who is not ill enough to need admission to medical detoxification or observation detoxification, but who has need of more intensive care in the therapeutic setting.

    2. (B)

       1. (i) This service shall include at a minimum:

          1. (a) (a) Intake;
          2. (b) (b) Individual and group therapy;
       2. (c) (c) Psychological education;

       3. (d) (d) Case management; and

          1. (e) (e) One (1) hot meal per day.
       4. (ii) Partial day treatment shall be a minimum of four (4) hours per day for five (5) days per week.

       5. (iii) In addition to the minimum services, treatment may include:

          1. (a) (a) Drug testing;
          2. (b) (b) Medical care other than detoxification; and
       6. (c) (c) Other appropriate services;
41. (41) “Presumptive laboratory results” means screening test results that have not been confirmed by a National Institute of Drug Abuse (NIDA)-certified laboratory;
42. (42) “Program” means an individual, partnership, corporation, association, government subdivision, or public or private organization that provides treatment services;
43. (43) “Program component” means a category into which a specific group of interrelated services can be classified, e.g., outpatient care;

44. (44) “Program sponsor” means a person, or representative of an organization, who is:

    1. (A) Responsible for the operation of a program and who assumes responsibility for its employees, including practitioners, agents, or other persons providing services at the program; and
    2. (B) Knowledgeable of substance abuse treatment issues;

45. (45)

    1. (A) “Progress note” means that portion of the client’s case which describes the progress of the client and his or her current status in meeting the goals set in the treatment plan, as well as describing the efforts of staff members to help the client achieve those stated goals.
    2. (B) Progress notes also include documentation of those events and activities related to the client’s treatment;
46. (46) “Referral agreement” means a written document defining a relationship between the program and an outside resource for the provision of client services not available within the alcohol and/or other drug abuse treatment program;
47. (47) “Regional Alcohol and Drug Detoxification (RADD) services” means a process providing the client with up to three (3) days detoxification services and aftercare plan;

48. (48)

    1. (A) “Regional detoxification specialist” means a person trained and certified by the Office of Alcohol and Drug Abuse Prevention.

    2. (B) Training will provide competency, at a minimum, in the following areas:

       1. (i) Current regional alcohol and drug detoxification services program policies and procedures;

       2. (ii) Taking of vital signs, such as:

          1. (a) (a) Temperature;
          2. (b) (b) Pulse;
       3. (c) (c) Respiration; and
       4. (d) (d) Blood pressure;
       5. (iii) Evaluation of presenting symptoms and compiling an accurate substance abuse history;
       6. (iv) Current certification in cardiopulmonary resuscitation (CPR);
       7. (v) Current certification in a first aid course;
       8. (vi) Current nonviolent crisis intervention certification in defusing hostile situations; and
       9. (vii) Knowledge of alternate social, rehabilitation, and emergency referral resources;

49. (49)

    1. (A) “Rehabilitation” means the restoration of a client to the fullest physical, mental, social, vocational, and economic usefulness of which he or she is capable.

    2. (B) Rehabilitation may include, but is not limited to:

       1. (i) Medical treatment;
       2. (ii) Psychological therapy;
       3. (iii) Occupational training;
       4. (iv) Job counseling;
       5. (v) Social and domestic rehabilitation; and
       6. (vi) Education;

50. (50)

    1. (A) “Residential program” means a twenty-four-hour, seven-day-per-week, nonmedical, live-in facility offering treatment and rehabilitation services to facilitate the alcohol and/or other drug abuser’s ability to live and work in the community.
    2. (B) Includes care provided to a substance abuse client who is not ill enough to need admission to medical detoxification or observation detoxification, but who has need of more intensive care in the therapeutic setting with supportive living arrangements.

    3. (C)

       1. (i) This service shall include at a minimum:

          1. (a) (a) Intake;
          2. (b) (b) Individual and group therapy;
       2. (c) (c) Case management; and
       3. (d) (d) Room and board.

       4. (ii) In addition to the minimum services, residential service may include:

          1. (a) (a) Drug testing;
          2. (b) (b) Medical care other than detoxification; and
       5. (c) (c) Other appropriate services;
51. (51) “Services” are program components rendered to clients which shall include, but are not limited to, medical evaluations, counseling, and rehabilitative and other social programs, such as vocational and educational guidance or employment placement, which shall support the client in becoming a productive member of society;
52. (52) “Shall” means a term used to indicate a mandatory statement, the only acceptable method under the present standards;
53. (53) “Significant other” means an individual who has an intimate relationship with another but who is not related by heredity or law;

54. (54)

    1. (A) “Specialized Women’s Services (SWS)” means, at facilities designated as SWS, a unit of service will be one (1) day for a family.
    2. (B) A family is considered one (1) mother and up to two (2) children below the age of seven (7).

    3. (C) Services at a minimum include:

       1. (i) Case management;
       2. (ii) Alcohol and other drug treatment;
       3. (iii) Child care;
       4. (iv) Transportation;
       5. (v) Medical treatment;
       6. (vi) Housing;
       7. (vii) Education/job skills training;
       8. (viii) Parenting skills;
       9. (ix) Aftercare;
       10. (x) Family education and support; and
       11. (xi) House rules;
55. (55) “Staff” means any individual who provides services to the program on a regular basis as a paid employee;
56. (56) “Standards” means the specifications representing the minimal characteristics of an alcohol and/or other drug abuse treatment program, which are acceptable for the licensing of a program;
57. (57) “State Authority (SA)” means the director, or designee, of the Division of Aging, Adult, and Behavioral Health Services of the Department of Human Services, Office of Alcohol and Drug Abuse Prevention, or its successor;
58. (58) “State opioid treatment authority” means the director, or designee, of the Arkansas Department of Human Services, Division of Aging, Adult, and Behavioral Health Services, Office of Alcohol and Drug Abuse Prevention, or its successor;

59. (59)

    1. (A) “Structured treatment” means an activity facilitated by:

       1. (i) A staff member;
       2. (ii) An appropriate volunteer; or
       3. (iii) A representative from an outside agency.
    2. (B) Client meditation and study groups are not structured treatment;

60. (60)

    1. (A)

       1. (i) “Substance abuse treatment” means a process whereby services are provided to an individual with the intent of the cessation of harmful or addictive use of alcohol and/or other drugs.
       2. (ii) Treatment must include, but should not be limited to, counseling.
    2. (B) Treatment promotes the ultimate goal of the individual reaching their fullest physical, mental, social, vocational, and economic capabilities possible;
61. (61) “Take-home medication” means those doses of methadone consumed by the client under conditions of no direct observation by a medical provider;
62. (62) “Treatment plan” means a written plan developed after assessment, which specifies the goals, activities, and services appropriate to meet the objective needs of the client;
63. (63) “Treatment program” means any program that delivers alcohol and/or other drug abuse treatment services to a defined client population;
64. (64) “Treatment staff” means the group of personnel of the alcohol and/or other drug abuse treatment program, which is directly involved in client care or treatment;
65. (65) “Update” means a dated and signed review of a report, plan, or program with or without revision;

66. (66)

    1. (A) “Volunteer” means any person who of their own free will provides goods or service without any financial gain.
    2. (B) Volunteers may not supplant paid staff; and
67. (67) “Working agreement” means a written contract, letter of document, or other document that defines the relationship.