RELATES TO: KRS 222.460-222.475
NECESSITY, FUNCTION AND CONFORMITY: EO 2004-726, effective July
9, 2004, reorganized the Cabinet for Health Services and placed the Department
for Behavioral Health, Developmental and Intellectual Disabilities within the
cabinet.
KRS 194.050 and
222.460
to
222.475
authorizes the cabinet to promulgate administrative regulations governing the
gathering of information on clients discharged from publicly funded chemical
dependency treatment agencies and the format of reports of this information to
the cabinet in order to assess treatment effectiveness.
Section 1. Definitions.
(1) "Agency" is defined in
KRS
222.005(2) and receiving
state or federal funds.
(2)
"Client" means an individual on whom a record or chart has been opened by an
agency or subcontractor of an agency and for whom a treatment plan has been
prepared for a primary substance abuse problem. Clients receiving only DUI
education services, DUI assessment services or Clients receiving only
detoxification services during the treatment episode are excluded from the
definition.
(3) "Client identifier"
means a unique code used by agencies and the department to identify clients in
a departmental data set.
(4)
"Commissioner" means the Commissioner of the Department for Behavioral Health,
Developmental and Intellectual Disabilities Services, or designee.
(5) "Department" means the Department for
Behavioral Health, Developmental and Intellectual Disabilities Services within
the Cabinet.
(6) "Discharge" means
a date which is ninety (90) days following the last date on which a client
received a treatment service from the agency.
(7) "Division" means the Division of
Behavioral Health within the Department for Behavioral Health, Developmental
and Intellectual Disabilities Services.
(8) "Evaluator" means the independent
organization determined by the department to be qualified to conduct an outcome
study.
(9) "Instrument" means the
electronically-recorded baseline survey tool adopted for use in the
study.
(10) "Outcome study" means a
department defined study of clients to assess their progress twelve (12) months
after discharge from substance abuse treatment.
Section 2. Agency Responsibilities.
(1) An agency shall explain the purpose,
design, and procedures of the outcome study to the client.
(2) An agency shall ask the client to
participate in the outcome study. An agency shall obtain informed consent from
the client who agrees to participate. An agency shall allow the client the
right to refuse to participate without risk of penalty or effect in the
delivery of treatment services.
(3)
An agency shall use the instrument required by the department to gather client
information upon admission to treatment in an agency. The instrument shall be
administered to the client within seventy-two (72) hours of admission to a
residential or transitional care program, or within three (3) visits to
outpatient or intensive outpatient care program.
(4) An agency shall:
(a) Report by the tenth of each month
admission information gathered using the instrument to the evaluator using a
specified electronic data format; and
(b) Gather and report informed consent,
assent, and parental consent forms to the evaluator by the tenth of the month
following the month of discharge.
(5) An agency shall designate a coordinator
for the study and shall notify the division and the evaluator in writing of the
name of the designated coordinator.
Section 3. Evaluator Responsibilities.
(1) The evaluator shall receive and process
the outcome study data generated by each agency.
(2) The evaluator shall monitor compliance
with the reporting requirements and advise the agency and the division when
corrective action is necessary.
(3)
The evaluator shall provide all necessary training of agency and department
staff in regards to the outcome study and its administration.
(4) The evaluator shall provide ongoing
technical assistance to the agency and the division in regards to the outcome
study and its administration.
(5)
The evaluator shall provide reports to the division on a quarterly basis of
summaries of admission and discharge information gathered from the agencies.
The evaluator shall also respond to specific data analysis requests by the
division.
(6) The evaluator shall
provide the division with copies of data files containing the collected
admission and discharge information.
(7) The evaluator shall produce and provide
to the division an annual report on the outcome study which includes the
elements required by
KRS
222.475.
(8) The evaluator shall provide security for
all paper and electronic records which it holds in order to prevent
unauthorized access to confidential client information.
(9) All paper and electronic records remain
the property of the division and shall be maintained by the evaluator until
disposal is directed by the division.
(10) The evaluator shall be responsible for
any necessary revision of forms, software design, protocols, and procedures
which govern the outcome study and its implementation.
(11) The evaluator shall contact a
statistically valid representative sample of clients for each agency following
the client's discharge from substance abuse treatment.
(a) The follow-up contact shall be one (1)
year from the date of discharge.
(b) The methods of contact may include
telephone, mail, and face to face interview.
(c) Each selected client shall be asked to
answer a series of standard questions on a survey instrument designed to
measure certain treatment outcomes.
Section 4. Confidentiality. The evaluator and
the agency shall follow the standards protecting and guiding confidentiality of
client identifiable information as found in
908
KAR 1:320. Confidential record of treatment for
federally assisted alcohol and other drug abuse programs.
Section 5. Monitoring and Penalties for
Noncompliance.
(1) The division shall monitor
compliance of the evaluator and the agency.
(2) If an agency is determined to be
noncompliant with any of the provisions of the administrative regulation, its
state substance abuse payments, if any, shall be held by the department as
provided in
KRS
222.470 until the agency has met the
requirements.
(3) A determination
to hold payment shall be made by the commissioner.
(4) A notice of the determination shall be
sent to the agency thirty (30) days prior to its implementation.
(5) Notice of determination. A notice of
determination shall be in writing, mailed to the agency, and contain the
following information:
(a) The reason for the
determination;
(b) The effective
date of the determination; and
(c)
The agency's hearing rights in accordance with Section 6 of this administrative
regulation.
Section
6. Appeal of Penalties for Noncompliance.
(1) An agency may appeal any determination
made by the department in the application of the provisions of Section 5(2) and
(3) of this administrative regulation.
(2) A written notice of appeal shall be
submitted to the commissioner no later than thirty (30) days after an agency
has been notified of a determination affecting payment. The notice of appeal
shall:
(a) Specify the determination being
appealed;
(b) Specify the reasons
the agency believes the determination is unwarranted;
(c) Include any documentation the agency
considers relevant to support the appeal; and
(d) Specify an alternative determination that
should be made.
(3) The
commissioner shall cause the appeal to be reviewed and evaluated with
consideration of the provisions of applicable laws and regulations.
(4) The commissioner shall issue a written
decision including findings of fact and conclusions on the appeal no later than
thirty (30) days after receipt of a notice of appeal unless the commissioner
determines that a conference may result in a mutually satisfactory resolution
of the appeal.
(5) If the
commissioner determines that a conference shall be held, the commissioner shall
schedule a conference no later than thirty (30) days after receipt of a notice
of appeal or at a later time agreeable to the commissioner and the
agency.
(6) The conference shall be
conducted according to the following procedures:
(a) The commissioner shall preside over the
conference.
(b) The conference
shall be recorded and a transcription made.
(c) The agency, or the agency's authorized
representative may present any oral arguments or documentation which he
considers relevant to support the contention that the department should not
take the appealed action or should rescind an action already taken.
(d) Department staff who are knowledgeable of
applicable laws and regulations shall explain the department's determination
and may present any documentation which supports the department's determination
or which demonstrates if the department's determination and actions are
consistent with applicable laws and administrative regulations.
(e) If the appealed determination is based
upon reports provided by persons other than department employees, those
individuals may attend the conference, explain the reports and the basis of
those reports.
(f) The commissioner
may question any of the participants and may permit any questions or discussion
among participants if that will contribute to a decision on the appeal
consistent with applicable laws and regulations.
(7) If an agency conference is held the
commissioner shall issue a written decision on the appeal no later than thirty
(30) days after the agency conference. The written decision shall include
findings of fact and conclusions.
(8) If an agency disagrees with the
commissioner's decision on an appeal he shall have the right to an
administrative hearing.
(9) The
agency may appeal the decision (and underlying program issue) by submitting a
request for an administrative hearing to the commissioner within thirty (30)
days after receipt of the decision.
(10) The commissioner shall forward the
request to the Office of Personnel and Budget, Administrative Hearing Branch
within five (5) working days of receipt.
(11) The scope of the administrative hearing
shall be restricted to the issues raised pursuant to this administrative
regulation.
(12) The administrative
hearing shall be in accordance with KRS Chapter 13B.
Section 7. Material Incorporated by
Reference.
(1) The following forms from the
University of Kentucky Center for Drug and Alcohol Research are hereby
incorporated by reference:
(a) Baseline
Survey Instrument (Electronic Format) (March 15, 1996 edition);
(b) Baseline Survey Instrument (Optical Scan
Format) (March 15, 1996 edition);
(c) Consent to Participate in a Treatment
Outcome Study (April 18, 1996 edition);
(d) Parental Consent for a Minor to
Participate in a Treatment Outcome Study (April 18, 1996 edition);
(e) Assent to Participate in a Treatment
Outcome Study (April 18, 1996 edition); and
(f) Follow-Up Contact Survey Instrument
(Telephone Script) (March 15, 1996 edition).
(2) Copies of the incorporated material may
be inspected, copied or obtained at the Department for Behavioral Health,
Developmental and Intellectual Disabilities, 275 East Main Street, Frankfort,
Kentucky 40621, 8 a.m. through 4:30 p.m., Monday through Friday.