Ryan White Program Substance Abuse Treatment Outpatient Standards May 2016

Similar documents
SUBSTANCE ABUSE SERVICES-OUTPATIENT

Behavioral Health Concurrent Review

Behavioral Health Initial Review Form

Rule 31 Table of Changes Date of Last Revision

LOUISIANA MEDICAID PROGRAM ISSUED: 08/24/17 REPLACED: 07/06/17 CHAPTER 2: BEHAVIORAL HEALTH SERVICES APPENDIX B GLOSSARY/ACRONYMS PAGE(S) 5 GLOSSARY

907 KAR 1:044. Coverage provisions and requirements regarding community mental health center behavioral health services.

Ryan White Part A Quality Management

Region 1 South Crisis Care System

907 KAR 15:080. Coverage provisions and requirements regarding outpatient chemical dependency treatment center services.

Mental Health Outpatient Treatment Report form

Clinical Criteria Inpatient Medical Withdrawal Management Substance Use Inpatient Withdrawal Management (Adults and Adolescents)

State of Connecticut REGULATION of. Department of Social Services. Payment of Behavioral Health Clinic Services

Ryan White Part A. Quality Management

4.401 Substance Use Partial Hospitalization Program (Adults and Adolescents)

Chapter 2 Provider Responsibilities Unit 6: Behavioral Health Care Specialists

number: parent/guardian:

Ryan White Part A. Quality Management

CCBHC Standards of Care

CHILDREN'S MENTAL HEALTH ACT

o Recipients must coordinate these testing services with other HIV prevention and testing programs to avoid duplication of efforts.

Clinical Utilization Management Guideline

Division of Mental Health, Developmental Disabilities & Substance Abuse Services NC Mental Health and Substance Use Service Array Survey

HIV HEALTH & HUMAN SERVICES PLANNING COUNCIL OF NEW YORK Mental Health Service Directive - Tri-County Approved by the HIV Planning Council 3/31/16

RULES OF THE TENNESSEE DEPARTMENT OF MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

RULES OF THE TENNESSEE DEPARTMENT OF MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

Welcome to the Webinar!

Florida Medicaid. Behavioral Health Community Support and Rehabilitation Services Coverage Policy. Agency for Health Care Administration [Month YYYY]

Acute Crisis Units. Shelly Rhodes, Provider Relations Manager

UCARE MODEL OF CARE SUMMARY FOR MH-TCM (February 2009)

Covered Service Codes and Definitions

Dialectical Behavioral Therapy (DBT) Level of Care Guidelines

MENTAL HEALTH SERVICES

Assertive Community Treatment (ACT)

PART 512 Personalized Recovery Oriented Services

STANDARDS OF CARE HIV AMBULATORY OUTPATIENT MEDICAL CARE STANDARDS I. DEFINITION OF SERVICES

Tennessee Health Link Guidelines: Adults Medical Necessity Criteria-Final

9/13/2016. ASAM Criteria and Levels of Care. Why a Continuum of Care. and. Substance Use. Co-Occurring Disorders. Guiding Principles

HCMC Outpatient Mental Health Programs. External Referral Form

THE ADDICTION AND RECOVERY TREATMENT SERVICES PROGRAM (ARTS) PROVIDER MANUAL

PROFESSIONAL DISCLOSURE STATEMENT and INFORMATION REGARDING CLINICAL SUPERVISION SERVICES REV /29/2014. Contact Information

ALCOHOL AND/OR OTHER DRUG PROGRAM CERTIFICATION STANDARDS

Behavioral Health Services

Specialty Behavioral Health and Integrated Services

CHAPTER 24 ACCREDITATION OF PROVIDERS OF SERVICES TO PERSONS WITH MENTAL ILLNESS, MENTAL RETARDATION, AND DEVELOPMENTAL DISABILITIES PREAMBLE

Using Innovation to Maximize Behavioral Health Accommodations. Regions Hospital Case Study

MAGELLAN UNIVERSAL SERVICES LIST - Includes Preferred HIPAA Compliant Codes. UB-04 Revenue Codes

I. Description. Triage Counseling is an individual level intervention that establishes a direct link between primary. Rural

Planned Respite Referral Application

STATE OF CONNECTICUT. Department of Mental Health and Addiction Services. Concerning. DMHAS General Assistance Behavioral Health Program

RULES OF THE TENNESSEE BOARD OF NURSING CHAPTER ADVANCED PRACTICE NURSES & CERTIFICATES OF FITNESS TO PRESCRIBE TABLE OF CONTENTS

Bulletin. DHS Provides Policy for Certified Community Behavioral Health Clinics TOPIC PURPOSE CONTACT SIGNED TERMINOLOGY NOTICE NUMBER DATE

Name: Intensive Service Array Responsible Department: Lane County Health and Human Services- Trillium Behavioral Health

907 KAR 10:014. Outpatient hospital service coverage provisions and requirements.

WYOMING MEDICAID PROGRAM

PURPOSE: In accordance with SB362, Seven Hills Hospital has a documented staffing plan in place which adequately meets the needs of our patients.

Florida Medicaid. Behavioral Health Therapy Services Coverage Policy. Agency for Health Care Administration [Month YYYY] Draft Rule

RYAN WHITE HIV/AIDS PROGRAM SERVICES Definitions for Eligible Services

DEPARTMENT OF REHABILITATION STUDIES

ALCOHOL AND/OR OTHER DRUGPROGRAM CERTIFICATION STANDARDS. Department of Health Care Services. Health and Human Services Agency. State of California

IDAHO SCHOOL-BASED MENTAL HEALTH SERVICES (EFFECTIVE JULY 1, 2016) PSYCHOTHERAPY & COMMUNITY BASED REHABILITATION SERVICES (CBRS)

What type of institutional or programmatic accreditation is required?

Service Array: Mental Health Medicaid Specialty Supports and Services Descriptions Note:

Outpatient Services - Federal Mental Health Parity (FMHP) Outpatient Outlier Model Refresher. Mini Webinar Series June 2011

Children Come First Covered Services Fee Schedule

Drug Medi-Cal Organized Delivery System

201 KAR 35:070. Supervision experience.

PROPOSED REGULATION OF THE BOARD OF EXAMINERS FOR MARRIAGE AND FAMILY THERAPISTS AND CLINICAL PROFESSIONAL COUNSELORS. LCB File No.

UTILIZATION MANAGEMENT POLICIES AND PROCEDURES. Policy Name: Substance Use Disorder Level of Care Guidelines Policy Number: 7.08

256B.0943 CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.

Medicaid Rehabilitation Option Provider Manual

Family Medicine Residency Behavior Medicine Rotation Elly Riley, DO

HEALTH SERVICES POLICY & PROCEDURE MANUAL

Aurora Behavioral Health System

[ ] POSITIVE SUPPORT STRATEGIES AND EMERGENCY MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS.

Mental Health Certified Family Peer Specialist (CFPS)

NURSE MONITORING PROGRAM HANDBOOK

Corporate Medical Policy

HIPAA Privacy Rule and Sharing Information Related to Mental Health

Behavioral Health Services

State-Funded Enhanced Mental Health and Substance Abuse Services

Minnesota Board of Behavioral Health and Therapy

INTEGRATED CASE MANAGEMENT ANNEX A

It is the policy of Sacramento County MHP that a Core Assessment be completed for all clients.

Macomb County Community Mental Health Level of Care Training Manual

Indianapolis Transitional Grant Area Quality Management Plan (Revised)

Department of Vermont Health Access Department of Mental Health. dvha.vermont.gov/ vtmedicaid.com/#/home

State Recognition of the CPRP Credential

DRAFT. An Introduction to The ASAM Criteria for Patients and Families. What is The ASAM Criteria?

Oregon Health Authority DIVISION OF MEDICAL ASSISTANCE PROGRAMS Medicaid Policy & Program Section

Level 2.1- Intensive Outpatient Services (IOP)

GUIDELINES FOR SCORING INDIVIDUAL RECORDS. Y = Meets Standard N = Does Not Meet Standard. N/A = Not Applicable

Aurora Behavioral Health System

MEDICARE COVERAGE SUMMARY: HOME HEALTH PSYCHIATRIC CARE MEDICARE COVERAGE SUMMARY

Medicaid Rehabilitation Option Services

A Review of Current EMTALA and Florida Law

Behavioral Health Services ( )

TACT Target Population Youth Must Meet the Following Criteria? (Please check all that apply.)

Mental Health Psychiatry, SPOE, SPOA, BILT, PROS, Alcohol & Substance Abuse

Outpatient Behavioral Health Basics 1

APPENDIX B. Physician Assistant Competencies: A Self-Evaluation Tool

Transcription:

Ryan White Program Substance Abuse Treatment Outpatient Standards May 2016 Purpose Substance Abuse Treatment Outpatient Standards are to ensure that uniformity of service exists in Minnesota such that the consumers of a service receive the same quality of service regardless of where or by whom the service is provided. MN Rule 31 (9530.6405-9530.6505) requirements will be used as standards, in program monitoring, and in quality management. If an agency is unable to meet a particular standard, the agency must document why the standard was unable to be met and explain the steps it is taking to meet that standard. The purpose of substance abuse treatment outpatient standards is to address and stabilize substance abuse issues so that a person is able to engage in and maintain participation in HIV medical care. HRSA Definition: Substance Abuse Outpatient Care is the provision of outpatient services for the treatment of drug or alcohol use disorders. Support for Substance Abuse Treatment Services-Outpatient, provided by or under the supervision of a physician or other qualified/licensed personnel; may include use of funds to expand HIV-specific capacity of programs if timely access to treatment and counseling is not otherwise available. Services limited to the following: Pre-treatment/recovery readiness programs Harm reduction Mental health counseling to reduce depression, anxiety and other disorders associated with substance abuse Outpatient drug-free treatment and counseling Opiate Assisted Therapy Neuro-psychiatric pharmaceuticals Relapse prevention Limited acupuncture services with a written referral from the client s primary health care provider, provided by certified or licensed practitioners wherever State certification or licensure exists Services provided must include a treatment plan that calls only for allowable activities and includes: o The quantity, frequency, and modality of treatment provided o The date treatment begins and ends o Regular monitoring and assessment of client progress o The signature of the individual providing the service and or the supervisor as applicable Substance Abuse Treatment Outpatient Standards Page 1 of 6 5/2016

Program Guidance: Acupuncture therapy may be allowable under this service category only when, as part of a substance use disorder treatment program funded under the RWHAP, it is included in a documented plan. Syringe access services are allowable, to the extent that they comport with current appropriations law and applicable HHS guidance, including HRSA- or HAB-specific guidance. CAREWare Units of Service: Substance Abuse Treatment Outpatient: Comprehensive Chemical Health Assessment Group Substance Use Counseling Individual Substance Use Counseling Treatment Referral and Coordination Standard Measure Data Source Government Regulations 1. Eligible services will meet all applicable statutory and administrative rule practice requirements that apply to Minnesota-licensed chemical dependency detoxification and treatment programs. Chemical dependency treatment licensing requirements include, but are not limited to Minnesota Rule 31 (9530.6405-9530.6505). 1. Compliance with all appropriate regulatory agencies. 1. File review/site visits Chemical Health Assessment 2.1 Assessment of functioning, including: current and historical chemical use; withdrawal symptoms; acute symptoms/withdrawal potential; biomedical complications and conditions; emotional, behavioral, cognitive conditions and complications; readiness for change; relapse, continued use, and continued problem potential; recovery environment; and criteria for diagnosis (see Rule 25 assessment.) 2.1 Charts will include current chemical health needs; medical history including substance use, determination of need for medical evaluation, and results of medical evaluation if applicable; screening to identify service recipients risk for TB infection. Rule 25 or equivalent. 2.1-2.3 File Review/Site Substance Abuse Treatment Outpatient Standards Page 2 of 6 5/2016

Standard Measure Data Source 2.2 Basic medical history, including substance usage, a determination of the necessity of a medical evaluation, and a copy, where applicable of the results of the medical evaluation. 2.2 Documentation of basic medical history and a copy of medical evaluation in client chart. Treatment Plan 3.1: A written treatment plan must be developed in conjunction with referral and coordination of services with the participation and agreement of the client or guardian. 3.2 Treatment plan will reflect the assessment. Client must have an active role in determining the goals and activities. Treatment plan will be signed by service staff or supervisor. 3.1-3.2 Client chart will include documentation of signed treatment plan. The signature of the individual providing the service and or the supervisor as applicable. 3.1-3.2 File Review/Site Referral and Coordination 4.1 A client who is identified in need of treatment receives referral and coordination. 4.2 Program shall identify, network, and establish referrals agreements with treatment programs outside of the Ryan White System. This does not preclude making a referral to a treatment program where there is no formal agreement. 4.3 Program staff will assess for and address client barriers to making the treatment appointments. Coordinate additional services when applicable. 4.1 Referral and coordination occurs as a result of the Chemical Health Assessment. 4.2 List of referrals and signed agreements. 4.3 Documentation of referral and coordination to additional services, including medical case management, food, medical transportation, etc., 4.1-4.3 File Review/Site Substance Abuse Treatment Outpatient Standards Page 3 of 6 5/2016

Standard Measure Data Source Individual and Group Counseling Curriculum 5. In addition to education around the topics covered in the assessment, agency will have a written curriculum as guidance for individual and group level education: - reducing HIV transmission risks including partner testing - preventing STIs - the benefits of treatment and information on how to access and retain care - available resources to help with HIV treatment and prevention - PrEP - Understanding lab values and medication regimen - Personal HIV disclosure 5. Curriculum approved by Ryan White Program. 5. File review/site Substance Abuse Treatment Outpatient Standards Cultural Competency 6. Agency must have a policy that outlines staff experience and training requirements around the provision of culturally competent services to PLWHA and the diverse communities served. 6. Policy in program files 6. File Review/Site Provider Qualifications 7.1 Provider staff, will be licensed as an LADC, or meet the exceptions to license requirements in 148F.11 7.1-7.3 Policy in program files 7.1-7.3 File Review/Site 7.2 Provider staff will have knowledge of chemical health and HIV related topics, the skills and abilities to provide education and one or more of the following: Bachelor s degree in a Human Service field Substance Abuse Treatment Outpatient Standards Page 4 of 6 5/2016

Registered Nurse Master s /Bachelor s degree in a non-human Service field and 2 years HIV experience A 2 year associates degree in a Human Service field and 2 years of relevant HIV experience. 4 years of HIV prevention or service delivery or relevant experience. 7.3 Supervision will be provided by a physician or other qualified/licensed personnel. Supervisor requirements; Be a licensed alcohol and drug counselor or other qualified professional as determined by the Board Have three years of experience in providing alcohol and drug counseling Have received a minimum of 12 hours of training in clinical and ethical supervision. This can include continuing education courses, workshops, or college courses To supervise applicants completing their 2,000 hours of supervised practice for licensure, you need to be an approved supervisor. You do not need to be an approved supervisor if you are supervising a temporary permit holder. To supervise a temporary permit holder you need to either be a licensed alcohol and drug counselor or other licensed professional practicing under Minnesota Statutes section 148F.11. Substance Abuse Treatment Outpatient Standards Page 5 of 6 5/2016

Standard Measure Data Source Quality Assurance/Quality Improvement 8. A process for quality monitoring is in place that addresses: Compliance with Universal Standards for Ryan White Programs and Substance Abuse Treatment Outpatient service specific standards Responsibility and accountability for implementation of quality improvement strategies 8. Quality improvement plan in place; ongoing documentation and reporting of program outcomes evaluation measures. Programs will meet the Universal Standards for Ryan White Funded Programs which can be found on the following link: Universal Standards_updated 052913_final.docx 8. Outcomes Evaluation data submitted on schedule specified by Data and Outcomes coordinator. Annual audit and site visit documentation, including review of a sample of client records. Issues identified in meeting Outcomes goals and Universal Standards are addressed in annual Quality Improvement Plan. Substance Abuse Treatment Outpatient Standards Page 6 of 6 5/2016