PURPOSE: This rule describes personnel policies and procedures for Opioid Treatment Programs, Substance Use Disorder Treatment Programs, Comprehensive Substance Treatment and Rehabilitation Programs (CSTAR), Gambling Disorder Treatment Programs, Institutional Treatment Centers, Substance Awareness Traffic Offender Programs (SATOP), Required Education Assessment and Community Treatment Programs (REACT), Community Psychiatric Rehabilitation Programs (CPRP), and Outpatient Mental Health Treatment Programs.

1. (1) Policies and Procedures. The organization shall maintain personnel policies, procedures, and practices in accordance with local, state and federal laws and regulations.

   1. (A) The policies and procedures shall include written job descriptions for each position, provisions for annual written performance reviews with all employees, and a current table of organization reflecting each position and, where applicable, the relationship to the larger organization of which the program or service is a part.
   2. (B) Policies and procedures shall be consistently and fairly applied in the recruitment, selection, development, and termination of staff.

2. (2) Qualified and Trained Staff. Qualified staff shall be available in sufficient numbers to ensure effective service delivery. The organization shall establish, maintain, and implement a written plan for professional growth and development of staff.

   1. (A) The organization shall ensure staff possess the training, experience, and credentials to effectively perform their assigned services and duties.

      1. 1. All individuals holding a position within the organization

shall complete orientation and training within the first thirty (30) days of employment in order to be knowledgeable in core competency areas. Staff who are promoted or transferred to a new job assignment shall receive training and orientation to their new responsibilities within thirty (30) days of actual transfer.

1. (B) Within the scope of their position in the organization, staff shall have a working familiarity with core competencies prior to performing their job as follows:

   1. 1. Know the organization’s population served, scope of

program, mission, vision, and policies and procedures;

1. 2. Understand and perform respective job assignments;
2. 3. Abide by applicable regulations for rights, ethics,

confidentiality, corporate compliance, and abuse and neglect;

1. 4. Know agency protocols for responding to emergencies

at the program or while providing services in the community, including protocols for infection control and agency procedures to maximize safety for individuals served, staff members, and the public.

1. (C) A background screening shall be conducted for all staff in accordance with 9 CSR 10-5.190.
2. (D) Qualifications and credentials of staff shall be verified prior to employment, including primary source verification.
3. (E) Clinical supervision of direct service staff shall be provided on an ongoing basis to ensure adequate supervisory oversight and guidance, particularly for staff who lack credentials for independent practice in Missouri.

4. (F) Training and continuing education opportunities are available to all direct service staff in accordance with their job duties and any licensing or credentialing requirements.

   1. 1. All staff who provide services or are responsible for the

supervision of persons served shall participate in at least thirtysix (36) clock hours of relevant training during a two (2)-year period. A minimum of twelve (12) clock hours of training must be completed annually.

1. 2. Training shall assist staff in meeting the needs of

persons served, including persons with co-occurring and trauma-related disorders.

1. 3. The organization shall maintain a record of participation

in training and staff development activities.

1. (G) When services and supervision are provided twentyfour (24) hours per day, the organization maintains staff on duty, awake, and fully dressed at all times. A schedule or log is maintained which accurately documents staff coverage.

1. (3) Ethical Standards of Behavior. Staff shall adhere to ethical standards of behavior in their relationships with individuals being served.

   1. (A) Staff shall maintain an objective, professional relationship with individuals being served at all times.
   2. (B) Staff shall not enter dual or conflicting relationships with individuals being served which might affect professional judgment or increase the risk of exploitation.
   3. (C) The organization shall establish policies and procedures regarding staff relationships with individuals currently being served and individuals previously served.
   4. (D) The organization shall establish policies and procedures regarding staff use of social media, including how violations of the procedures will be managed.
   5. (E) The organization shall establish standards of conduct for volunteers and students, as applicable.

2. (4) Volunteers. If the organization uses volunteers to assist with service delivery, it shall establish and consistently implement policies and procedures to guide the roles and activities of volunteers in an organized and productive manner. The agency shall ensure volunteers are qualified to provide the services rendered, have a background screening in accordance with 9 CSR 10-5.190, and receive orientation, training, and adequate supervision.

   1. (A) Orientation shall occur within thirty (30) days of the individual’s volunteer work with the organization including, but not limited to:

      1. 1. Client rights, confidentiality policies and procedures,

and abuse, neglect, and misuse of funds as defined in 9 CSR 10-5.200;

1. 2. Emergency policies and procedures of the program;
2. 3. Philosophy, values, mission, and goals; and
3. 4. Other topics relevant to their assignment(s).

1. (5) Practicum/Intern Students. If the organization uses practicum/intern students in a department-funded program, he/she must be enrolled and participating in an accredited college/university in a field of study including, but not limited to, social work, psychology, sociology, or nursing.

   1. (A) The student and agency must have a written plan documenting the following:

      1. 1. Name of the student, educational institution, and

degree program;

1. 2. Brief description of the status of the student with respect

to degree completion including semester/hours remaining, projected completion date, and time period of the practicum or internship;

1. 3. A job description of the specific role of the student with

respect to the program and population served;

1. 4. A specific plan for supervision of the student including

name and title of the direct supervisor. The plan must detail the frequency and duration of the supervision activities including the scope of case/record reviews, the location of the supervisor with respect to the service delivery locations, and emergency backup supervision arrangements; and

1. 5. A list of the specific services the agency has approved the

student to deliver. Students cannot deliver services reimbursed by Medicaid unless they meet the provider eligibility requirements through prior experience and education.

1. (B) The student must have a letter from their academic advisor attesting to their qualifications and eligibility for the proposed practicum.

2. (C) The student must be under the close supervision of the direct clinical supervising professional of the agency. The person providing the supervision must be qualified to provide the services they are supervising.

   1. 1. A student who provides counseling services must be in a

master’s program or above and be approved for the practicum by the college/university.

1. 2. To provide case management, community support, and

other support services, a student must be in the final year of a bachelor’s program or an associate program approved by the department.

1. 3. A student may be assigned a limited caseload based on

background and prior experience.

1. (D) The agency shall ensure students have a background screening in accordance with 9 CSR 10-5.190 and receive orientation and training consistent with the organization’s policies for new employees.

2. (E) Service delivery by the student must be documented according to department standards and policy.

   1. 1. All documentation of billable services must be reviewed

and countersigned by an individual who meets department criteria for a qualified mental health professional or supervisor of counselors, a community support specialist, or case manager, as appropriate.

1. 2. Services shall be billed using appropriate existing

service codes and reimbursed at the established contract rate for the anticipated degree, unless a distinct student rate has been established for the service. AUTHORITY: sections 630.050 and 630.055, RSMo 2016.* Original rule filed Feb. 28, 2001, effective Oct. 30, 2001. Amended: Filed Aug. 28, 2002, effective April 30, 2003. Amended: Filed Nov. 5, 2018, effective June 30, 2019. *Original authority: 630.050, RSMo 1980, amended 1993, 1995, 2008 and 630.055, RSMo 1980.