Except for those providing laboratory services, all contracted providers shall meet the following requirements:

1. (a) The contracted provider shall develop a recovery plan with each eligible recipient:

   1. (1) The recovery plan shall be developed with participation from the eligible recipient or, if the eligible recipient does not participate in its development, shall contain a written explanation as to why the eligible recipient did not participate; and (2) The recovery plan shall reflect:

      1. (A) The eligible recipient's preferences, interests, strengths and areas of health;
      2. (B) Specific outcomes that the eligible recipient desires related to the eligible recipient's preferences, interests, strengths and areas of health;
      3. (C) Activities, supports and covered behavioral health services that may assist with the achievement of the eligible recipient's desired outcomes;
      4. (D) Regularly scheduled review and, if necessary, revision of the recovery plan; and(E) Review by, and signatures of the eligible recipient, counselor or clinician responsible for the development of the recovery plan with the eligible recipient, and his or her supervisor if the counselor or clinician is not licensed or certified.

2. (b) The contracted provider shall develop a discharge plan with each eligible recipient:

   1. (1) The discharge plan shall be developed with participation from the eligible recipient or, if the eligible recipient does not participate in its development, shall contain a written explanation as to why the eligible recipient did not participate; and (2) Discharge plan review: Contracted providers are required to participate in a discharge plan review for all eligible recipients admitted into the following covered behavioral health services:

      1. (A) Acute psychiatric hospitalization;
      2. (B) Medically managed inpatient detoxification;
      3. (C) Medically monitored residential detoxification;
      4. (D) Intensive residential treatment; and(E) Intermediate or long-term treatment or care.

3. (c) Except when the eligible recipient leaves the facility unexpectedly, the contracted provider shall contact the designated agent to request a discharge review not more than two (2) business days, and not less than four (4) hours, before the eligible recipient's scheduled departure:

   1. (1) Reviews of unexpected discharges shall be conducted not later than one (1) business day following the date of the eligible recipient's discharge. If an eligible recipient leaves a facility but is expected to return, the contracted provider may delay the discharge review until either the eligible recipient returns or a decision is made to discharge the eligible recipient. The contracted provider shall conform with generally accepted standards of professional practice regarding the duration of time such contracted provider shall delay a discharge decision for an eligible recipient who left the program unexpectedly and has not returned; and (2) The discharge plan review for an eligible recipient shall include the following:

      1. (A) Identifying information;
      2. (B) DSM-IV discharge diagnosis;
      3. (C) Progress made toward the accomplishment of treatment objectives;
      4. (D) Clinical presentation at the time of discharge, including such items as his or her mental status and response to treatment;
      5. (E) Clinical risk and relapse potential;
      6. (F) Medication(s) used during the present treatment episode;
      7. (G) Circumstances of discharge, including whether the eligible recipient left upon completion of treatment or under some other discharge status and the details of that status;
      8. (H) Involvement in recovery and discharge planning;
      9. (I) Details of the discharge or aftercare plan or both for the eligible recipient, including the level of care recommended by the discharging contracted provider and details of arrangements made to secure that care;
      10. (J) Living arrangement(s) and address upon discharge; and(K) Arrangements for any medication(s) that may be needed by the eligible recipient following discharge.

(Adopted effective December 7, 2009)