R501-18-7. Direct Service

  (1) This subsection supersedes Core Rules, Section R501-2-5. The recovery residence client records shall contain the following:

  (a) name, address, telephone number, email;

  (b) admission date;

  (c) emergency contact information with names, address, email, and telephone numbers;

  (d) all information that could affect the health, safety or well-being of the client to include:

  (i) medications;

  (ii) allergies;

  (iii) chronic conditions; or

  (iv) communicable diseases;

  (e) intake documentation indicating that the client meets the admission criteria, including the following:

  (i) not currently using or withdrawing from alcohol or substances of abuse; and

  (ii) not presenting with a current clinical assessment that contraindicates this level of care.

  (f) individual recovery plan, including the signature and title of the program representative preparing the recovery plan and the signature of the client; the recovery plan shall include the following:

  (i) documentation of all services provided by the program, including a disclosure that no clinical treatment services occur on-site at the recovery residence; and

  (ii) documentation of all referred supportive services, not directly associated with the recovery residence site.

  (g) the signed written lease agreement for the recovery residence, if required;

  (h) a signed agreement indication that the client was notified in writing prior to admission regarding:

  (i) program and client responsibilities related to transportation to and location of off-site services;

  (ii) program and client responsibilities related to the provision of toiletries, bedding and linens, laundry and other household items;

  (iii) program and client responsibilities related to shopping, provision of food and preparation of meals;

  (iv) fee disclosures included Medicaid number, insurance information and identification of any other entities who may be billed for the client's services;

  (v) rules of the program;

  (vi) client rights

  (vii) grievance and complaint policy;

  (viii) critical incident reports involving the client; and

  (iv) discharge documentation.