R501. Health and Human Services, Human Service Program Licensing.
R501-21. Outpatient Treatment Programs.
R501-21-1. Authority and Purpose.
(1) Sections 26B-2-104 and 26B-2-110 authorize this rule.
(2) This rule provides the basic health and safety standards for an outpatient treatment program.
R501-21-2. Definitions.
Terms used in this rule are defined in Rules R380-600 and R501-1 and Section 26B-2-101. Additionally:
(1) "Deemed site" means:
(a) the same as defined in Section 26B-2-110; and
(b) a human services program identified by a single geographic location and linked to the parent program, if one exists.
(2) "Good standing" means the same as defined in Section 26B-2-110.
(3) "Outpatient treatment" means the same as defined in Section 26B-2-101 and includes early intervention, outpatient services, or intensive outpatient services on the American Society of Addiction Medicine (ASAM) continuum of care.
(4)(a) "Outpatient treatment program" means a group of two or more individuals, at least one of whom provides outpatient treatment, that:
(i) allows an agent, contractor, person with a financial interest, staff, volunteer, or individual who is not excluded under Subsection (4)(b) to:
(A) provide direct client services, which:
(I) includes assessment, case management, education, peer support services, screening, or transportation; and
(II) does not include office tasks unrelated to client treatment, including billing, payroll, scheduling, or standard correspondence; or
(B) manage or direct program operations, including admissions or discharge, hiring of staff, intake, or setting of fees;
(ii) is specifically required by a Department of Health and Human Services (department) contract to be licensed for outpatient treatment;
(iii) offers outpatient treatment services to satisfy criminal court requirements;
(iv) provides services requiring alcohol and drug education by the Office of Substance Use and Mental Health (OSUMH) as described in Rule R523-11; or
(v) refers clients to services that present a conflict of interest or otherwise provide an opportunity for exploitation or fraud by the referring provider, including laboratory services, private probation, housing, employment, transportation, or travel.
(b) Outpatient treatment program does not mean:
(i) a group of individuals who are exempt from individual professional licensure under Section 58-1-307;
(ii) a group of individuals who are licensed, certified, or authorized under:
(A) Title 58, Chapters 60, Mental Health Professional Practice Act;
(B) Title 58, Chapter 61, Psychologist Licensing Act;
(C) Title 58, Chapter 67, Utah Medical Practice Act; or
(D) Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or
(iii) an entity that is excluded under Section 26B-2-115.
(5) "Validated criminogenic screen" means an evidence-based tool for predicting recidivism and categorizing individuals into risk groups.
R501-21-3. Scope.
Each provider shall comply with any applicable federal, state, or local law, rule, or ordinance, including:
(1) Rule R380-80;
(2) Rule R380-600;
(3) Rule R501-1;
(4) Rule R501-14; and
(5) this rule.
R501-21-4. Administration and Direct Services.
(1) A provider shall:
(a) provide general outpatient treatment:
(i) on a weekly basis; or
(ii) only with individualized clinical justification, less than weekly;
(b) only provide intensive outpatient treatment, if offered, for:
(i) between nine and 19 hours weekly for adults; or
(ii) at least six hours weekly for youth; and
(c) ensure any client present in the facility for six or more consecutive hours:
(i) receives meals and any required medication; and
(ii) is placed in the appropriate group size, according to building capacity and a physical environment that provides for the comfort of each client.
(2)(a) An outpatient treatment provider that provides only telehealth services may apply for a single license for one centralized site to cover any telehealth services offered.
(b) An outpatient treatment provider that provides only telehealth services shall ensure that any telehealth services provided to an out of state client are done in accordance with the telehealth laws of the client's state of residence.
R501-21-5. Substance Use Disorder Treatment Programs.
(1) Each provider shall:
(a) develop and implement a plan on how to support opioid overdose reversal;
(b) maintain proof of completion of the National Survey of Substance Abuse Treatment Services annually; and
(c) ensure medical cannabis is not used as an enticement for a client or offered, referred, or recommended as treatment for substance use disorder.
(2) A provider providing medication for opioid use disorder (MOUD) shall:
(a) maintain a program-wide ratio of one counselor for every 65 clients to provide adequate substance use counseling to each client as clinically necessary; and
(b) ensure that, at least once yearly, each client sees a licensed practitioner that may prescribe controlled substances.
(3) Each MOUD provider that prescribes, administers, or dispenses methadone shall:
(a) admit a client to the program only after the completion of a face-to-face visit with a licensed practitioner authorized to prescribe controlled substances who confirms that client's opioid dependence;
(b) ensure that a licensed practitioner authorized to prescribe controlled substances approves every subsequent dose increase before the change;
(c) require each client admitted to the program to participate in random drug testing performed at least eight times a year for each client in maintenance treatment, in accordance with generally accepted clinical practice and with 42 CFR 8 (2025); and
(d) require and document at least one hour of prescribing practitioner time at the program site each month for every ten enrolled MOUD clients.
(4) Each MOUD program that prescribes, administers or dispenses methadone shall:
(a) maintain Substance Abuse and Mental Health Services Administration certification and accreditation as an opioid treatment program;
(b) employ:
(i) a licensed physician who is an ASAM-certified physician;
(ii) a prescribing licensed practitioner who can document specific training in current industry standards regarding methadone treatment for opioid addiction; or
(iii) a prescribing licensed practitioner who can document specific training or experience in methadone treatment for opioid addiction; and
(c) provide one covered provider, as defined in Section 58-17b-309.7, to dispense or administer medication for every 150 methadone clients dosing on an average of a daily basis.
(5) A provider may offer services from a mobile unit, as defined in Section 58-17b-309.7, under the provider's physical site license if:
(a) the existing licensed site provides MOUD services;
(b) the provider maintains policy and procedures in accordance with department policy applicable to a mobile unit and Rule R523-10; and
(c) the provider meets registration requirements of 21 CFR 1300, 1301, and 1304 (April 1, 2021), published by the Office of the Federal Register, incorporated by reference in this rule.
(6) An alcohol and drug education provider may only provide court-ordered education if certified to do so through the OSUMH in accordance with Rule R523-11.
(7) A licensed substance use disorder counselor (SUDC) in a substance use disorder outpatient treatment program may:
(a) collect client information;
(b) conduct the screening portion of an assessment;
(c) make level of care recommendations; and
(d) identify a substance use disorder.
(8) A SUDC may not diagnose a client.
(9) A OSUMH-certified alcohol and drug education provider shall:
(a) complete and maintain a substance use screening:
(i) for each client before providing the education course; and
(ii) that may be shared between providers with written client consent;
(b) provide a workbook to each client to keep upon completion of the course;
(c) ensure at least 16 hours of course education; and
(d) provide separate classes for adults and youth.
(10) A provider offering services to a justice-involved client shall:
(a) operate in compliance with Rule R523-3;
(b) maintain a validated criminogenic screen or risk assessment for each justice-involved client which is conducted with an accepted tool, including:
(i) Level of Service Inventory-Revised (LSI-R);
(ii) Risk and Needs Triage (RANT);
(iii) Ohio Risk Assessment System (ORAS): or
(iv) any other screen that the provider can demonstrate the validation to the OSUMH:
(c) separate clients into treatment groups according to each client's assessed level of risk;
(d) complete screenings that assess substance abuse and mental health comorbidity; and
(e) treat, or refer to another licensed department program that serves justice-involved clients to treat, an array of disorders noted in the screening.
R501-21-6. Domestic Violence Programs.
(1) A domestic violence (DV) treatment provider shall comply with generally accepted and current practices in DV treatment.
(2) A DV treatment provider shall:
(a) maintain and document cooperative working relationships with any DV shelter, treatment program, referring agency, local DV coalition, and custodial parent when the client is a minor;
(b) offer at least ten sessions of treatment for any child or victim, not including intake or orientation;
(c) if the client is a perpetrator, contact any victim, current partner, or required criminal justice referring agency; and
(d) ensure a licensed mental health therapist, as defined in Section 58-60-102, completes a DV treatment evaluation for each client who is a perpetrator that includes individualized recommendations for that client's treatment.
(3) For groups, a provider shall ensure there is at least one staff for:
(a) there is at least one staff for every eight clients in an adult treatment group for up to an hour;
(b) every ten clients in an adult treatment group exceeding one hour;
(c) every eight children in a child victim or child witness group where each child client is under 12 years old; and
(d) every ten children in a child victim or child witness group where each child client is at least 12 years old.
(4) For client safety, the provider shall:
(a) ensure that:
(i) when a client enters a DV treatment program, the staff conduct an in-depth, face-to-face interview and intake assessment to determine the client's clinical profile and treatment needs; and
(ii) when the client is a perpetrator, the evaluation described in Subsection (2)(d) counts for this intake assessment;
(b) obtain additional information for any client who is a perpetrator from any police incident report, criminal history of the client, prior treatment provider, victim, or victim advocate;
(c) when appropriate, obtain additional information for a child client from any parent, prior treatment provider, school, or the Division of Child and Family Services Child Protective Services;
(d) when any document listed in Subsections (4)(a) through (c) cannot be obtained, document the reason; and
(e) ensure that the intake assessment or evaluation described in Subsection (2)(d) includes:
(i) a profile of the frequency, severity, and duration of the DV behavior, including a summary of any psychological violence;
(ii) documentation of any homicidal, suicidal ideation and intentions, or abusive behavior toward children;
(iii) a clinical diagnosis and a referral for evaluation to determine the need for medication, if indicated;
(iv) documentation of safety planning when:
(A) the client is an adult victim, child victim, or child witness; and
(B) that client has contact with the perpetrator;
(v) documentation of a safety plan for any victim who chooses not to become a treatment client; and
(vi) documentation that appropriate measures have been taken to protect children from harm.
(5) For treatment procedures, a provider shall:
(a) create an individualized treatment plan addressing relevant treatment issues for each client;
(b) refer each client deemed not appropriate for a DV program to the appropriate resource or program, with any reason for referral documented, and notify the referred agency;
(c) provide DV counseling concurrently with, or after, other necessary treatment when appropriate;
(d) ensure that any client who is a perpetrator, or a co-perpetrator, is not provided conjoint or group therapy in the same session as any victim who has experienced violence from the perpetrator or co-perpetrator until staff has completed a comprehensive assessment to determine that:
(i) any violence between the client who is a perpetrator, or a co-perpetrator, and the victim has stopped; and
(ii) conjoint therapy is appropriate;
(e) require the client who is a perpetrator to complete at least four DV treatment sessions, unless otherwise noted in the evaluation recommendations described in Subsection (2)(d), before the provider implements conjoint therapy;
(f) implement written procedure in an efficient and timely manner to facilitate any:
(i) entry of a court-ordered defendant into treatment as a client;
(ii) notification of client compliance, participation, or completion;
(iii) disposition of a non-compliant client;
(iv) notification of the recurrence of violence; and
(v) notification of factors that may exacerbate a client's potential for violence;
(g) comply with the duty to warn, in accordance with Section 78B-3-502;
(h) document specialized training in DV assessment and treatment practices for any individual providing treatment service, including:
(i) completing 24 hours of Utah Association for Domestic Violence Treatment pre-service training;
(ii) completing 16 hours annual training after the initial training in Subsection (5)(h)(i); and
(iii) at least one hour per week of clinical supervision for any treatment staff that is not clinically licensed to discuss clinical dynamics of a case.
(6) The provider shall ensure training is documented and approved by the designated department DV specialist regarding assessment and treatment practices for treating DV victims and perpetrators.
(7) A provider shall disclose any:
(a) current department contract; or
(b) action against the contract to the Office of Licensing.
(8) A provider shall disclose any current accreditation or action against accredited status to the Office of Licensing.
R501-21-7. Requirements for Granting Deemed Status to a Mental Health or Substance Use Disorder Treatment Site.
(1) The department may grant deemed status to the site of a mental health or substance use disorder treatment provider if:
(a) the provider's license for the site is in good standing;
(b) the site only serves adults;
(c) the site currently receives accreditation from a department-approved national organization; and
(d) the provider submits the licensing documentation from the accrediting organization to the department, including any applicable:
(i) inspection record;
(ii) finding; and
(iii) corrective action plan and progress report on the site addressing any corrective action plan.
(2) A site with deemed status may opt out of a department renewal inspection.
(3) The department may investigate any complaint or incident involving a deemed site.
(4) The provider is responsible for any renewal licensing fee for each deemed site.
(5) The department shall revoke the deemed site status if:
(a) the site receives any moderate, high, or extreme noncompliance licensing violation from department;
(b) the required accreditation documentation is not submitted to the department;
(c) the accreditation documentation includes any noncompliance violation finding equal to any moderate, high, or extreme state licensing finding level; or
(d) the provider no longer receives national accreditation for the deemed site.
(6) For any provider with multiple deemed sites:
(a) each site must meet the requirements to be granted deemed status; and
(b) the revocation of deemed status for any single site does not impact the status of any other site unless any condition listed in Subsection (5) applies to the other site.
R501-21-8. Compliance.
A provider that is in operation on the effective date of this rule shall achieve compliance with this rule within 30 days.
KEY: human services, licensing, outpatient treatment programs
Date of Last Change: January 26, 2026
Notice of Continuation: February 28, 2025
Authorizing, and Implemented or Interpreted Law: 26B-2-104