A rule 25 also known as a rule 25 assessment is a clinical tool used to screen for what the medical community refers to as substance use disorders sometimes referred to as either alcoholism, addiction, substance abuse, or chemical dependency. This version of the rule 25 assessment form cannot be completed and saved electronically. Make sure to save an electronic copy of the completed document. Mobile chemical health assessment rule 25 assessment. In minnesota, the process of the assessment and the criteria the decision is based upon are governed by rule 25. Rule 25 assessment in order to receive public funding for chemical dependency treatment, an individual needs to have a chemical use assessment conducted. An assessment interview and written listing of the members specific problems related to chemical use and risk. If you are pregnant or using intravenous drugs or need help completing this application, please call 763 3241270. When you save this pdf, all attached files will be saved with it.
Rule 25 assessment providers list washington county, mn. It should be essentially the same as the information given in the reasons section after each dimension in the rule 25 assessment tool. Rule 25 assessment vrs comprehensive assesssment rule 25 9530. Burnsville pkwy, suite 100 roseville, mn 551 2675 long lake rd. Chemical health assessment rule 25 application rule 25 is state paid chemical dependency treatment funding. Alcohol, drug and other addictions minnesota department. Call 952 3611600 to access services and discuss eligibility for funding for chemical dependency treatment. Ne, suite 1 owatonna, mn 55060 5074550992 south central human relations center 610 florence avenue owatonna, mn 55060 5074512630 or 18007220590. Ch case aide compiles paperwork, submits case for opening in ssis, and.
Dakota county chemical health rule 25 assessor check list. Fax it to chemical health intake at 2188245 o r email nathan bertram. Refer a person to the rule 25 assessment number or the social service agency dhs5685 pdf in the persons county or tribe of residence. Staff can provide information on alcohol and chemical dependency, diagnostic assessment and evaluation, treatment referral services, and individual or family counseling on chemical use and abuse. Dhs2794eng dhs2794eng 12 page 1 of 2 rule 25 assessment and placement summary client name pmi assessor assessment date general guideline original update clients should be offered the least restrictive referral consistent with sound clinical judgment. Federal register premarket tobacco product applications. The states rule 25 assessment form should be only one of many chemical dependency chemical assessment tools that are used during your assessment process.
Rule 25 is state paid chemical dependency treatment funding. Chemical health crow wing county, mn official website. A new assessment is given to the offender if six months have passed since the most recent assessment or assessment update. First step in entering treatment to assess a persons drug andor alcohol use to determine if treatment is needed to determine what level of care is most appropriate to match a. A chemical dependency evaluation commonly referred to as a cd evaluation, chemical health evaluation, or rule 25 assessment is an interview conducted by a qualified evaluator. Evaluation locations rule 25 dependency assessment. Rule 25 also refers to a set of state rules shakopee assessors must follow. A rule 25 call 6122493656 for an appointment is a meeting between a medical professional and a person that may have a substance abuse or chemical dependency problem. Heres what is involved in a minnesota rule 25 assessment, along with how club recovery, a minnesota substance abuse treatment program, can help. If the assessment recommends chemical dependency treatment you may.
Call for information on assessment and program rates. Agency must submit each rule 25 assessment and all relevant documentation to the county within seven business days of the date of the assessment date. Placement summary dhs handout 4a3 circle severity ratings, do not add any narrative in the boxes send to dakota county social services. The evaluation occurs in st paul mn and assesses your overall chemical health. Download and complete a rule 25 eligibility application. Alcohol and drug abuse services washington county, mn official. The counselor gets to know you better and your situation through a structured interview.
To access services through rule 25 a person must have a rule 25 assessment and meet clinical and financial eligibility requirements. Rule 25 contracted provider brochure dakota county. Minnesota chemical health assessments hennepin county. The medical professional follows mn state guidelines, as outlined in state statute rule 25. To apply for an assessment, applications can be done by. During this appointment, you will meet with a licensed alcohol and drug counselor in hennepin county minnesota. Instructions for rule 25 assessment application rule 25 is an assessment process that consists of a chemical dependency evaluation and to determine the need for chemical dependency treatment. Referral and coordination of care at a chemical health treatment facility. Effective january 1, 2011, people will complete an. Rule 25 is the common name for chemical use assessment rule 25 by a qualified assessor to determine appropriate treatment planning decisions, a service. Chemical health rule 25 wright county, mn official.
Rule 25 assessment and eligibility process dakota county. Financially responsible persons address address, city, state, zip if different than the client. Rule 25 assessment hennepin county chemical evaluation. Those eligible for a rule 25 assessment will be given an authorization number and a list of sites where they can access an assessment. The county can assist residents with an alcoholdrug abuse health assessment process also known as rule 25, which consists of. Prior authorization form substance use disorder treatment. Walk in rule 25 assessments are available, call 612 2493656 for directions. If you are eligible, the state of minnesota will pay for you to have a chemical dependency evaluation and assessor recommended treatment. He now lives in minnesota and is an experienced rule 25 assessor based in minneapolis st paul. Licensed alcohol and drug counselors meet with individuals to assess their use of alcohol or other drugs, and to determine where their use pattern puts them on the continuum of dependency based on clinical evaluation criteria. In order to receive public funding for chemical dependency treatment, an individual needs to have a chemical use assessment conducted by a rule 25. If you feel that you are experiencing a mental health crisis.
The chemical dependency evaluator asks numerous questions about your history of alcohol and drug use and what, if any, consequences your use has caused. A case manager, agent, offender, or other source may make a request for a rule 25 chemical use assessment. The assessment lasts about an hour and includes questions about many different areas of a persons life. If you wish to apply for rule 25 funding, please complete the attached application and provide all requested verifications. It is a lengthy interview that inquires on a lot of information about your past alcohol and drug use, physical health, mental health, your interest in moderating or.
A fillable and savable version of this form is available to alcohol and drug abuse professionals. Chemical dependency nicollet county, mn official website. When a person is seeking chemical dependency treatment and needs public funding to pay for the treatment, they get a chemical use assessment. The rule 25 assessment is also referred to as a chemical health evaluation or chemical dependency assessment, which can take place inside ramsey county or in a nearby area such as minneapolis, hennepin county, anoka county, or dakota county. The rule 25 assessment will determine an individuals level of chemical dependency and recommend an appropriate level of care.
Real hope, real life, real recovery rule 25 assessments. Rule 25 risk descriptions chemical health division mn. Rule 25 eligibility application packet and privacy notice pdf. Under rule 25, an assessor gathers information about an individual and decides whether the individual needs treatment and if so, what type will be the most beneficial. Instructions for rule 25 assessment application washington county.
Owatonna, mn 55060 5078376687 mental health resources associates in psychiatry and psychology 125 landmark dr. The park avenue center offers the rule 25 on a walkin basis. A completed rule 25 form is needed for a person to enter residential and nonresidential treatment programs in the state minnesota. The county can assist people with a chemical health assessment and treatment. For more information about substance use, please visit the department of human services alcohol and drug abuse website. Your privacy rights tennessen notice information about your rights under the minnesota data practices act. Reporters notes 2009 the 2009 amendments reflect changes resulting from the adoption of the massachusetts uniform probate code. For more information or to access this service, please call 7636827400 and request to speak with a rule 25 assessment social worker. Chemical dependency evaluation essential information.
Understanding rule 25 rule 25 refers to the administrative rule that addresses chemical use assessment, administrative requirements, and appeal and fair hearing rights of the client. In minnesota, the process of the assessment and the. As a licensed, alcohol and drug abuse counselor, accurate testings assessment are recognized and accepted by the minnesota courts. Assessor assessment date general guideline this page should record a summary of the information gained from the client and collateral sources that lead to the severity rating. Community professionals interested in referring a minor for a chemical. Rule 25 is an assessment process that consists of a chemical dependency evaluation and to determine the need for chemical dependency treatment. Mhcp provider manual rule 25 process minnesota department of. Chemical health assessment rule 25 application anoka county. We offer rule 25 assessments at our hastings site located at 1294 east 18th street, hastings, mn 55033 on the veterans home campus. In order to receive public funding for chemical dependency treatment, an individual needs to have a chemical use assessment conducted by a rule 25 assessor. Dakota county contracted chemical health providers rule 25 assessment locations once you have received an eligibility number from dakota county, please contact one of the providers listed to schedule an appointment. The minnesota rule 25 assessment is a standardized process that includes a one to one session with a licensed clinician. Rule 25 assessment, rule 25 summary, or comprehensive assessment dated within 45 days of request for services and discharge summary.
A good chemical dependency assessor will also gather additional information to look out for your best interests, in order for your assessment and the recommendations to suit your. Chemical health assessment rule 25 application anoka. A rule 25 chemical use assessment is conducted with an offender seeking access to substance use disorder sud treatment services in a communitybased treatment program. To schedule an assessment please call 6514374209 and ask for the rule 25 scheduler in crp between the hours of 8. Submit either electronic or written comments on the proposed rule by november 25, 2019. Rule 25 eligibility and assessment process page 3 of 4. Individuals who are on minnesota care may access a rule 25 assessment and treatment service by calling the. All 87 minnesota counties, 11 american indian tribes, and 9 state contracted managed care organizations are mandated to provide rule 25 assessments to anyone who. State of minnesota treatment providers are required to utilize a standardized rule 25 assessment tool to determine the appropriate level of care. Visit community services customer service desk during our business hours monday through friday, 8 a.