APPLICATION PROCESS

The preparation stage is the time to review and prepare all required documents. The required documents are forms, policies and acknowledgments that must be submitted with the organizations application.

1. Completed Provider Application
   • The application is online through the MCRSP Website. Please make sure all fields are filled out. If the second line of your address is not filled in, the application will not send. If you do not have anything to enter on this address line, please put in “n/a”.
2. Completed Self-Assessment Checklist
   • The self-assessment checklist can be downloaded from MCRSP website.
3. Mission Statement (Standard 1A1a)
   • The programs mission statement but must reflect a commitment to those served and identify the population served which, at a minimum, includes persons in recovery from a substance use disorder.
4. Vision Statement (Standard 1A1b)
   • A good vision statement is a God-sized goal that you are striving to reach, such as “A world without hunger.”
5. Legal business entity documentation (Standard 1A2a)
   • All documents showing program in compliance with state and local business requirements. Please include your certificate of good standing from the Missouri Secretary of State’s office and any Fictitious Names utilized by your organization.
6. Documentation of applicable insurance coverage (Standard 1A2b)
   • Policy showing property insurance if property is owned; renter’s insurance if it is leased. Each property location must be listed on the certificate of coverage. Policy must also show adequate liability insurance. Please have your agent or insurance agent issue the certificate to MCRSP as a third-party interest, 1305 Southwest Blvd., Suite D, Jefferson City, MO 65109. This way MCRSP will be notified by your insurance company is the coverage lapses or is renewed.
7. Written permission from property owner (if applicable) (Standard 1A2c)
   • This a letter from the landlord or statement in the lease that gives you permission to run a recovery house on the premises. If you own the property, a statement of fact is needed.
8. Non-Discriminatory Affidavit (Standard 1A2d)
   • A statement attesting to compliance with nondiscriminatory state and federal requirements.
9. Signed Housing Compliance Agreement, which includes attestations to all of the NARR standards, including Marketing Material (Standard 1A2e)
   • The Housing Compliance Agreement is available below. In addition, applicant should meet the marketing standard by supplying the following:
     • Any brochure or pamphlets program used to inform potential residents of their program.
     • List your website
     • Statements should not be made that cannot be adequately supported with data. Use of “success rates” should be avoided unless it can be backed up.
10. Background Check Policy on All Staff that Interacts with Residents (Standard 1A2f)
    • Policy showing all employees and volunteers have a background check with a minimum of a record check through the Family Care Safety Registry in Jefferson City, Missouri.
11. Policy on Paid Work Agreements (if applicable) (Standard 1A2g)
    • A written policy and forms on a paid work agreement. A paid work agreement is any agreement where the resident is paid by the program to perform a duty. The policy must outline how much the resident will be paid; how the resident be paid; and accounting system of the paid work agreement.
    • The policy must show the paid work is voluntary and that no discrimination will occur if resident does or does not participate.
12. Staff Never Involved in Resident’s Finances (Standard 1A2h)
    • Policy showing staff not lending or borrowing money, or other transactions involving property or services, except that the operator may make agreements with residents with respect to payment of fees. Staff can, at a minimum, assist a resident with budgeting.
13. Code of Ethics (Standard 1A2i)
    • A policy and practice that provider has a code of ethics that is aligned with the NARR code of ethics. These can be found on MCRSP’s website. Every operator must sign and attest to the MCRSP Code of Ethics, along with staff and volunteers.
14. Assurances Form (Standard 1A2j)
    • The assurances form can be found below. Multiple houses can be placed on a form.
15. Resident Informed of all Fees and Charges (Standard 1A3a)
    • Program form that informs applicants of all fees and charges in advance of becoming a resident.
16. Resident Informed of Refund Policy (Standard 1A3c)
    • Form showing the program’s refund policy. This can form can be incorporated with the form that informs resident of fees and charges.
17. Policy and Practice on Payments from 3^rd Party Payers (Standard 1A3d)
    • Policy on how a resident is informed of a third-party payment and how third-party payments will possibly be refunded.
18. Collection of Resident Data (Standard 1A4a)
    • Policy on what and how resident’s information is collected. The policy should also relate what is done with the information.
19. Resident Rights; Resident Notification and Agreement; House Rules and Resident Agreement documentation (Standard 1B5a)
    • These are blank forms that the resident would sing upon entering the program.
    • Residents’ rights must be posted in the residence. Resident rights forms can also be obtained from the Missouri Department of Mental Health.
20. Resident Notification on Abandoned Personal Property (Standard 1B5a)
    • This is a policy regarding property left by a resident. How many days does the resident have to remove property before it is forfeited?
21. Confidentiality Policy and Procedure (Standard 1B6 – three standards in this section)
    • Policies on keeping residents records secure with limited access to authorized staff and within the confine of federal, state, and local confidentially laws.
    • Example of release signed by resident upon entering the program.
22. Grievance Policy and Procedure (Standard 1C7b)
    • Program’s grievance policy for residents can be found below. This also needs to be posted in the residence.
23. MCRSP Grievance Policy and Procedure with agency signature and dated. (Standard 1C7b)
    • The MCRSP grievance policy can be download from the website. It must be signed by the program head and submitted. This also must be posted in the recovery home where residents have access to it.
24. Written Responsibilities, Role Description, Guidelines, and/or Feedback for Residence Leaders. (Standard 1C8b)
    • Written descriptions of all residence leaders.
25. Culturally Responsive and Competent (Standard 1D11b)
    • This is a policy acknowledging cultural responsiveness and how the program confirms training.
26. All staff positions are guided by written job descriptions that reflect recovery (Standard 1D12– three standards in this section)
    • Job descriptions for all staff to include position responsibilities; eligibility; knowledge, skills, and abilities; certification/licenses; facilitate access to local community-based resources.
27. Provide Social Model-Orientated Supervision of Staff (Standard 1D13 – three standards in this section)
    • Program’s polices for ongoing performance development and acknowledging staff achievements and professional development.
28. Alcohol and Illicit Drug Policy and Procedure (Standard 2F16a)
    • Policy prohibits the use of alcohol and/or illicit drug use or seeking by staff or residents.
29. List of Prohibited items and Procedure for Associated Searches by Staff (Standard 2F16b)
    • Program list of contraband items and procedure for if/how staff can search.
30. Policy for Drug Screening and/or Toxicology Protocols (Standard 2F16c)
    • Policy on when and how you drug or alcohol test.
31. Over-the-Counter and Prescribed Medication Policy and Procedure (Standard 2F16d)
    • Policy on over-the-counter medication and prescription medication usage and storage.
32. Policy to Encourage Resident’s responsibility for own Health and Safety (2F16e)
    • Policy requiring residents to take responsibility for their health and safety.
33. Policy regarding Smoke-Free Living Environment (Standard 2F18a)
    • Policy describing the program’s non-smoking policy and/or designating smoking areas outside the residence.
34. Policy Regarding Exposure to Bodily Fluids and Contagious Disease (Standard 2F18b)
    • Policy regarding the exposure or spillage of bodily fluids.
    • Policy on contagious diseases and house protocol.
35. Emergency Contact Information Form (Standard 2F19b)
    • Emergency contact information form and written criteria on where it is kept and who has access to it.
36. Naloxone Accessibility and Training Documentation (Standard 2F19d)
    • Policy showing Naloxone is accessible in the residence and staff and residents are trained in using it.
37. Documentation Promoting Meaningful Activities (Standard 3G20a)
    • Policy on work or volunteer; social recovery activities; and daily or weekly programming.
38. Personal Recovery Plan Documentation (Standard 3G21a)
    • A sample of recovery plan or goal settings
39. Written Criteria and Guidelines for Peer Leadership and Mentoring (Standard 3G21c)
    • Policy setting criteria and guidelines for peers and mentors.
40. Resident Weekly Activities Schedule (Standard 3G23a)
    • A sample of weekly schedule.
41. Good Neighbor Policy (Standard 4J30 – three standards in this section)
    • Policy on handling neighbors’ concerns; the procedure for residents to provide contact information to neighbors; and how staff and residents are orientated to how to greet and interact with neighbors.
42. Courtesy Rules (Standard 4J31 – two standards in this section)
    • Policies that address common complaints such as smoking; loitering; lewd or offensive language; and cleanliness of property. Policy will include parking courtesy rules.

For any questions please contact the MCRSP Housing Director.