Wyo. Code R. 048-0077-1
Effective Date: 04/09/2020 to 09/18/2024
Rule Type: Superceded Rules & Regulations
Reference Number: 048.0077.1.04092020
The Wyoming Department of Health (Department) promulgates these Rules under 2012 Wyoming Session Laws 93-94 (ch. 26, § 48b, n.7) and Wyoming Statutes 7-13-1605, -1613; 9-2-102, -106, -2701; and 35-1-620(b).
(a) This Chapter establishes the Department's authority to promulgate these Rules related to mental health and substance use disorder services, the definitions of terms used in these Rules, the standards incorporated by reference in these Rules, and other general provisions.
(b) This Chapter applies to all chapters promulgated under these Rules.
(a) The terms used in these Rules possess their standard meaning in healthcare, unless otherwise defined by the Department.
(b) The following definitions apply to these Rules:
(i) 'Administrator' means the Senior Administrator of the Wyoming Department of Health, Behavioral Health Division, as well as the Senior Administrator's designees.
(ii) 'Behavioral health services' means mental health or substance use disorder treatment services and supports provided to persons with mental illness and/or substance use disorders.
(iii) 'Bio-psychosocial and spiritual needs' means the biological, psychological, social, and spiritual needs of a client, which play a significant role in a behavioral health disorder and contribute to the client's functioning.
(iv) 'Certification' means a process to formally recognize that a provider has met the requirements of these Rules to provide substance use disorder treatment services to court ordered individuals or behavioral health services purchased by the Department.
(v) 'Community mental health or substance use disorder treatment center' means a provider that:
(A) Is licensed to conduct business in the State of Wyoming;
(B) Is governed by a citizen board;
(C) Has a local identity;
(D) Participates as a member of the community;
(E) Is responsive to community needs;
(F) Provides affordable, accessible, and effective services that address individual needs and that are available to all persons who need services, regardless of the ability to pay for services; and
(G) Provides a comprehensive range of services for persons with behavioral health disorders including specialized services for the priority populations.
(vi) “Core behavioral health services” means mental health outpatient services, substance use disorder outpatient services, community housing services, residential treatment services, crisis stabilization services, withdrawal management services, and other relevant services as determined by the Department.
(vii) “Corrective action” means a necessary change in provider policy or practice that is a result of a complaint, an investigation process, site visit findings, or noncompliance with a contract provision, a resolution plan, or these Rules.
(viii) “Court Supervised Treatment panel” or “CST program panel” means the panel authorized under the Court Supervised Treatment Programs Act, W.S. 7-13-1605(d).
(ix) “Court Supervised Treatment program” or “CST program” means the program authorized under the Court Supervised Treatment Programs Act, W.S. 7-13-1601 to -1616.
(x) “Court Supervised Treatment provider” or “CST treatment provider” means the provider of substance use disorder treatment services for a CST program.
(xi) “Court Supervised Treatment program team” or “CST program team” means the CST team authorized under W.S. 7-13-1609(a).
(xii) “Department” means the Wyoming Department of Health, Behavioral Health Division.
(xiii) “Driving under the influence/minor in possession services” or “DUI/MIP services” means assessment and education services for persons arrested for driving under the influence or minor in possession of illegal substances.
(xiv) “Emergency services” means direct contact with a person in a mental health crisis as an intervention to prevent escalation of the crisis and to triage the person into needed services.
(xv) “Engagement services” means face-to-face staff contact, which may include delivery through telehealth, with an individual who is waiting to be admitted into treatment for the purpose of maintaining the individual’s motivation and to help prepare them for treatment.
(xvi) “Evidence-based practice” means a behavioral health intervention that:
(A) Shows statistically significant effectiveness through empirical research in treating specific problems and populations;
(B) Is consistent with relevant clinical expertise; and
(C) Considers client preferences and values.
(xvii) “Executive director” means the individual responsible for the overall management of a provider. The term encompasses other titles including, but not limited to, chief executive officer, sole proprietor, president, or program administrator.
(xviii) “Governing board” means the board of directors of a private nonprofit corporation, a community board as defined in W.S. 35-1-613(a)(i), or a public agency as defined in W.S. 35-1-613(a)(vi).
(xix) “Intensive outpatient program” or “IOP” means structured substance use disorder and mental health treatment programming consisting primarily of counseling and education. IOP is more intensive than outpatient counseling, less intensive than residential care and can function as a step-down from residential care.
(xx) “Intervention services” means skilled treatment services indicated by client need, which include, individual and group counseling, family counseling, educational groups, skills training, occupational and recreational therapy, medication assisted treatment, and psychotherapy.
(xxi) “Medication assisted treatment” or “MAT” means the use of medications, excluding those used for detoxification, which are used in combination with counseling and behavioral therapies to support recovery and provide a whole-person approach to the treatment of substance use disorders. Medications utilized in MAT include buprenorphine (Suboxone® and Subutex®), acamprosate, naltrexone, disulfiram, and others approved by the Food and Drug Administration (FDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA).
(xxii) “Multi-county consortium” means a formal agreement between two or more providers in different counties to share funding, administrative support, clinical staff, or other resources to ensure a continuum of service availability and increase cost effectiveness.
(xxiii) “National accreditation” means accreditation issued by The Joint Commission (TJC), the Commission on Accreditation of Rehabilitation Facilities (CARF), or National Integrated Accreditation for Healthcare Organizations (NIAHO).
(xxiv) “Ombudsman program” means a program which advocates for the rights of individuals by investigating and resolving problems and grievances, providing information, and working with institutions, organizations, and agencies to increase the effective provision of services to the people they serve.
(xxv) “Peer specialist” means a person who is or has been a recipient of services for serious mental illness or substance use disorder treatment, who is credentialed by the Department or a national accrediting organization, and employed by a provider. The term encompasses other titles including recovery coach, recovery specialist, job coach, peer wellness coach, peer mentor, and peer advocate.
(xxvi) “Promising practice” means an administrative or clinical practice that has some scientific research or data showing positive outcomes but does not have enough evidence to support generalizable conclusions.
(xxvii) “Provider” means a provider of behavioral health services funded by the Department or a provider of substance use disorder services to persons referred or ordered to receive services by a court.
(xxviii) “Qualified clinical staff” means persons who are licensed or certified in Wyoming to practice:
(A) As a mental health or addictions professional under the Wyoming Mental Health Professions Licensing Act, W.S. 33-38-101 to -113;
(B) Psychology under W.S. 33-27-113 to -123;
(C) Medicine under the Medical Practice Act, W.S. 33-26-101 to -703; or
(D) As an Advanced Practice Registered Nurse under the Wyoming Nurse Practice Act, W.S. 33-21-119 to -157 or the Advanced Practice Registered Nurse Compact, W.S. 33-21-301 to -302.
(xxix) “Quality of care review” means review by the client’s treatment team of clinical documentation for the purpose of reviewing the client’s progress in treatment and the services provided to ensure the most appropriate level of care is provided, to coordinate needed services outside the provider, and for internal quality assurance.
(xxx) “Recovery supports” means non-clinical provider-sponsored activities and services which advance a sense of hope, complement and support treatment, increase and sustain treatment engagement, improve outcomes, and enhance recovery. Generally, recovery supports are developed and conducted by persons who are in recovery. Recovery supports do not include 12-Step meetings.
(xxxi) “Residential treatment services” means services provided in a free-standing or hospital-based facility, which provides room and board, and which operates twenty-four (24) hours per day, seven (7) days per week. A residential treatment facility provides evaluation, a planned regimen of treatment services including the staff-monitored administration of prescribed medication, and other supports as indicated by the client’s treatment plan.
(xxxii) “Resolution plan” means a written plan to implement corrective actions identified by the Department to achieve measurable improvements in efficiency, effectiveness, performance, accountability, outcomes, or other indicators.
(xxxiii) “SAMHSA” means the Substance Abuse and Mental Health Services Administration within the United States Department of Health and Human Services.
(xxxiv) “Service area” means a single county, multiple counties, or a region, designated by the Department to serve as the geographic area in which contracted services are to be provided.
(xxxv) “These Rules” means all chapters promulgated under Rules, Wyoming Department of Health, Mental Health & Substance Abuse Services.
(xxxvi) “Withdrawal management” means an organized service delivered by appropriately trained staff and which includes supervision, observation, and support for clients who are intoxicated or experiencing withdrawal.
(a) For any code, standard, rule, or regulation incorporated by reference in these Rules:
(i) The Department has determined that incorporation of the full text in these Rules would be cumbersome or inefficient given the length or nature of the Rules;
(ii) The incorporation by reference does not include any later amendments or editions of the incorporated matter beyond the applicable date identified in subsection (b) of this section; and
(iii) The incorporated code, standard, rule, or regulation is maintained at https://health.wyo.gov/behavioralhealth/mhsa/ and is available for public inspection and copying at cost at the same location.
(b) Each code, standard, rule, and regulation incorporated by reference in these Rules is further identified as follows. The Department incorporates by reference:
(i) Rules, Office of Administrative Hearings, General Agency, Board or Commission Rules, Ch. 2 (2017), which the Department refers to as the “OAH Contested Case Rules” under Chapter 2 of these Rules and may be found at: http://rules.wyo.gov;
(ii) American Society of Addiction Medicine (ASAM), The ASAM Criteria: Treatment for Addictive, Substance-Related, and Co-Occurring Conditions (David Mee-Lee ed., 3d ed. 2013), which the Department refers to as the “ASAM Criteria” under Chapter 2 of these Rules and may be found at http://www.asam.org/publications/the-asam-criteria/text;
(iii) Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment, Technical Assistance Publication (TAP) Series 21-A: Competencies for Substance Abuse Treatment Clinical Supervisors (2013), which the Department refers to as the “SAMHSA TAP 21-A” under Chapter 2 of these Rules and may be found at http://store.samhsa.gov/product/TAP-21-A-Competencies-for-Substance-Abuse-Treatment-Clinical-Supervisors/SMA13-4243;
(iv) Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment, Treatment Improvement Protocol (TIP) Series 44: Substance Abuse Treatment for Adults in the Criminal Justice System (2013), which the Department refers to as “SAMSHA TIP 44” under Chapter 2 of these Rules and may be found at http://store.samhsa.gov/product/TIP-44-Substance-Abuse-Treatment-for-Adults-in-the-Criminal-Justice-System/SMA13-4056; and
(v) Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment, Treatment Improvement Protocol (TIP) Series 47: Clinical Issues in Intensive Outpatient Treatment (2013), which the Department refers to as “SAMSHA TIP 47” under Chapter 2 of these Rules and may be found at https://store.samhsa.gov/product/TIP-47-Substance-Abuse-Clinical-Issues-in-Intensive-OutpatientTreatment/SMA13-4182.