ANNEX A1 DMHAS ASAM SERVICE DESCRIPTIONS Please Carefully Review

annex a1 dmhas asam service descriptions please carefully review the service descriptions that are included in the dmhas ffs initiativ

ANNEX A1
DMHAS ASAM SERVICE DESCRIPTIONS
Please carefully review the Service Descriptions that are included in
the DMHAS FFS Initiatives in this Annex A1 contract section. Initial
the boxes below to identify the ASAM Level/s of Care for which your
agency is renewing its contract. Agency must be licensed for the ASAM
level/s of care provided under this contract. Only those services
initialed will signify the services to be provided in this contract
period.
ASAM Levels of Care
Please initial the appropriate box
Outpatient
Intensive Outpatient
Partial Care
Short Term Residential
Long Term Residential
Halfway House
Detoxification
Medically Monitored Inpatient Detoxification
I understand and agree to deliver the services according to the
contract Document Annex A1. I have reviewed these contract
requirements with our agency staff and affirm that our agency policies
and procedures support adherence to these requirements. I understand
that our agency will be monitored by DMHAS for adherence to these
contract requirements.
Agency Name: ________________________________
Federal ID: _________________________
Signature Date
______________________________________
Print Name Title
DEFINITIONS OF SUBSTANCE USE TREATMENT COMPONENTS
Counseling/Therapy Services
Individual Counseling Session:
Counseling provided on an individual basis to clients with a substance
use diagnosis which includes therapeutic and supportive interventions
designed to: motivate the client for recovery from addictive disease,
facilitate skills for the development and maintenance of that
recovery, improve problems solving and coping skills, and develop
relapse prevention skills. Session content and structure are designed
in accordance with client’s treatment. Individual counseling can be
delivered by a CADC, an alcohol and drug counselor intern or
credentialed intern under the supervision of a qualified clinical
supervisor per N.J.A.C. 13:34C-6.2, or by a New Jersey licensed
behavioral health professional who is also credentialed to provide
therapy in accordance with the DMHAS Service Descriptions. 1 hour = 1
unit
Individual Therapy Session:
The treatment of an emotional disorder, including a substance use
disorder, as identified in the DSM through the use of established
psychological techniques and within the framework of accepted model of
therapeutic interventions such as psychodynamic therapy, behavioral
therapy, gestalt therapy and other accepted therapeutic models. These
techniques are designed to increase insight and awareness into
problems and behavior with the goal being relief of symptoms, and
changes in behavior that lead to improved social and vocational
functioning, and personality growth. Individual Therapy must be
provided by: Licensed Clinical Psychologist, Certified Nurse
Practitioner-Psychiatric and Mental Health (CNP-PMH), Advanced
Practical Nurse-Psychiatric and Mental Health (APN-PMH), Licensed
Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC),
or Licensed Marriage and Family Therapist (LMFT). 1 hour = 1 unit.
Group Counseling:
Counseling provided on a group basis to clients which uses group
processes and supports to: motivate the client for recovery from
addictive disease, facilitate skills for the development and
maintenance of that recovery, improve problems solving and coping
skills, improve intra and inter personal development and functioning,
and develop relapse prevention skills. Session content and structure
are designed in accordance with client’s treatment plan. Group
counseling can be delivered by a CADC, an alcohol and drug counselor
intern or credentialed intern under the supervision of a qualified
clinical supervisor per N.J.A.C. 13:34C-6.2, or by a New Jersey
licensed behavioral health professional who is also credentialed to
provide therapy in accordance with the DMHAS Service Descriptions. 1
hour= 1 unit
Family Counseling:
Counseling provided to the family unit, with or without the client
present, to impart education about the disease of addiction, elicit
family support for the client’s treatment, encourage family members to
seek their own treatment and self-help, assess the clients environment
during or after treatment and to assess the client’s functioning
outside of the treatment environment. Family counseling can be
delivered by a CADC, an alcohol and drug counselor intern or
credentialed intern under the supervision of a qualified clinical
supervisor per N.J.A.C. 13:34C-6.2, or by a New Jersey licensed
behavioral health professional who is also credentialed to provide
therapy in accordance with the DMHAS Service Descriptions. 1 hour =1
unit
Family Therapy:
Treatment provided to a family utilizing appropriate therapeutic
methods to enable families to resolve problems or situational stress
related to or caused by a family member’s addictive illness. In this
service, the family system is the identified client and interventions
are targeted to system change. Family and Individual Therapy must be
provided by: Licensed Clinical Psychologist, Certified Nurse
Practitioner-Psychiatric and Mental Health (CNP-PMH), Advanced
Practical Nurse-Psychiatric and Mental Health (APN-PMH), Licensed
Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC),
or Licensed Marriage and Family Therapist (LMFT). 1 hour = 1 unit.
Psycho-education
Psycho-education is the education of a client in way that supports and
serves the goals of treatment.
Didactic Session:
Group session that involves teaching people about the disease of
addiction, how to treat it, and how to recognize signs of relapse so
that they can get necessary treatment and support services. 1 hour = 1
unit
Family Education and Information:
Family Education and Information is the education of the family in a
way that services the goals of the identified client. Family Education
and Information involves teaching family members of identified clients
about the disease of addiction, how the disease affects the family,
how to support the client’s recovery and how to find services and
treatment for the family members. 1 hour = 1 unit
OUTPATIENT SUBSTANCE USE TREATMENT
Level 1
In addition to the DMHAS Service Requirements stated in the Division
of Mental Health and Addiction Services (DMHAS) Network Annex A,
Outpatient Substance Use Treatment contractees shall comply with the
following parameters.
Definition: Outpatient Substance Use Treatment is provided in a DMHAS
licensed outpatient facility which provides regularly scheduled
individual, group and family counseling services for less than nine
(9) hours per week. Services may be provided to patients discharged
from a more intensive level of care, but are not necessarily limited
to this population. Twelve (12) Step Meetings or other Self-Help
Meetings cannot be counted as billable Counseling Services. This care
approximates ASAM PPC-2R Level 1 care.
Counseling/Therapy Services:
*
Individual: in a full session, this includes face-to-face for one
(1) hour.
*
Individual: in a half-session, this includes face-to-face for
thirty (30) minutes.
*
Group: minimum sixty (60) minutes of face to face contact.
*
Family: in a full session for one (1) hour or a half-session for
thirty (30) minutes. To be included during course of treatment as
clinically indicated.
Psycho-education:
*
Didactic sessions.
*
Family education and information sessions as clinically indicated.
INTENSIVE OUTPATIENT SUBSTANCE USE TREATMENT
Level II.I
In addition to the DMHAS Service Requirements stated in the Division
of Mental Health and Addiction Services (DMHAS) Network Annex A,
Intensive Outpatient Substance use Treatment contractees shall comply
with the following parameters.
Definition: Intensive Outpatient (IOP) Substance use Treatment is
provided in a licensed IOP facility which provides a broad range of
highly intensive clinical interventions. Services are provided in a
structured environment for no less than nine (9) hours per week.
Request for more than twelve (12) hours per week of services must be
pre-approved by initiative case manager or DMHAS staff. A minimum of
three (3) hours of treatment services must be provided on each
billable day to include one individual counseling session per week.
IOP treatment will generally includes intensive, moderate and
step-down components. Twelve (12) Step Meetings or other Self-Help
Meetings cannot be counted as billable services. This care
approximates ASAM PPC-2 Level II.I care.
Counseling/Therapy Services:
*
Individual: One hour per week minimum.
*
Group: Six (6) hours per week minimum.
*
Family: To be included during course of treatment as clinically
indicated.
Psycho-education:
*
Didactic sessions: 2 hours/week minimum.
*
Family education and information sessions as clinically indicated.
PARTIAL CARE SUBSTANCE USE TREATMENT
Level II.5
In addition to the DMHAS Service Requirements stated in the Division
of Mental Health and Addiction Services (DMHAS) Network Annex A,
Partial Care Substance use Treatment contractees shall comply with the
following parameters.
Definition: Partial Care Substance use Treatment is provided in a
licensed Partial Care facility which provides a broad range of highly
clinically intensive interventions. Services are provided in a
structured environment for no less than 20 hours per week. A minimum
of four (4) hours of treatment services must be provided on each
billable day to include one individual counseling session per week.
Lunch is not a billable hour. Twelve (12) Step Meetings or other
Self-Help Meetings cannot be counted as billable services. Programs
have ready access to psychiatric, medical and laboratory services.
This care approximates ASAM PPC-2 Level II.5 care.
Counseling/Therapy Services:
*
Individual: 1 hour/week minimum.
*
Group: 8 hours/week minimum.
*
Family: To be included during course of treatment as clinically
indicated.
Psycho-education:
*
Didactic sessions: 3 hours/week minimum.
*
Family education and information sessions as clinically indicated.
CLINICALLY MANAGED LOW-INTENSITY RESIDENTIAL TREATMENT
HALFWAY HOUSE SUBSTANCE USE TREATMENT
Level III.1
In addition to the DMHAS Service Requirements stated in the Division
of Mental Health and Addiction Services (DMHAS) Network Annex A,
Clinically Managed Low Intensity Residential Substance use Treatment
Halfway House Substance use Treatment contractees shall comply with
the following parameters.
Definition: Halfway House Substance use Treatment is provided in a
licensed residential facility which provides room, board, and services
designed to apply recovery skills, prevent relapse, improve emotional
functioning, promote personal responsibility and reintegrate the
individual into work, education and family life. Halfway house
services must be physically separated from short term and long term
program. In addition, clinical services must be separate from short
term and long term residential services. This modality includes no
less than 5 hours per week of counseling services. A minimum of 7
hours per day of structured activities must be provided on each
billable day. (Note: Self-help meetings may be included as part of
structured activities. This care approximates ASAM PPC-2 Level III.1
care.
Medical Services: Must be provided as per licensing requirements.
Counseling/Therapy Services:
*
Individual: 1 hour/week minimum.
*
Group: 3 hours/week minimum.
*
Family: To be included during course of treatment as clinically
indicated.
Psycho-education:
*
Didactic sessions: 1 hours/week minimum.
*
Family education and information sessions as clinically indicated.
Structured Activities: 7 hours a day required. Example of activities:
a.
Counseling Services
b.
Psycho-education
c.
Employment
d.
Vocational Training
e.
Recovery Support Services
f.
Recreation
CLINICALLY MANAGED HIGH-INTENSITY RESIDENTIAL TREATMENT
LONG TERM RESIDENTIAL SUBSTANCE USE TREATMENT
Level III.5
In addition to the DMHAS Service Requirements stated in the Division
of Mental Health and Addiction Services (DMHAS) Network Annex A,
Clinically Managed High Intensity Residential Substance use Treatment
Long Term Residential Substance use Treatment contractees shall comply
with the following parameters.
Definition: Long Term Residential Substance use Treatment or
Therapeutic Community is provided in a licensed long term residential
facility which provides a structured recovery environment, combined
with professional clinical services, designed to address addiction and
living skills problems for persons with substance use diagnosis who
require longer treatment stays to support and promote recovery. (Note:
Self-help meetings may be included as part of structured activities.)
Long Term Residential includes no less than 8 hours per week of
counseling services on at least five (5) separate occasions. A minimum
of 7 hours per day of structured activities must be provided on each
billable day. Intervention focuses on reintegration into the greater
community with particular emphasis on education and vocational
development. This care approximates ASAM PPC-2 Level III.5 care.
Medical Services: Must be provided as per licensing requirements.
Counseling/Therapy Services:
*
Individual: 1 hour/week minimum.
*
Group: 5 hour week minimum.
*
Family: To be included during course of treatment as clinically
indicated.
Psycho-education:
*
Didactic sessions: 3 hours/week minimum.
*
Family Education and Information sessions as clinically indicated.
Structured Activities: 7 hours a day required. Example of activities:
a.
Counseling Services
b.
Psycho-education
c.
Vocational Training
d.
Recovery Support Services
e.
Recreation
MEDICALLY MONITORED INTENSIVE INPATIENT TREATMENT
SHORT TERM RESIDENTIAL SUBSTANCE USE TREATMENT
Level III.7
In addition to the DMHAS Service Requirements stated in the Division
of Mental Health and Addiction Services (DMHAS) Network Annex A,
Medically Monitored Intensive Inpatient Substance Use Treatment Short
Term Residential Substance Use Treatment contractees shall comply with
the following parameters.
Definition: Short Term Residential Substance Use Treatment is provided
in a licensed short term residential facility which provides a highly
structured recovery environment, combined with a commensurate level of
professional clinical services, designed to address specific addiction
and living skills problems for persons who are deemed amenable to
intervention through short-term residential treatment. Short Term
Residential treatment must include no less than 12 hours per week of
counseling services on at least 6 separate occasions. A minimum of 7
hours of structured programming must be provided on a billable day.
(Note: Self-help meetings may be included as part of structured
activities.) This care approximates ASAM PPC-2 Level III.7 care.
Medical Services: Must be provided as per licensing requirements.
Counseling/Therapy Services:
*
Individual: 2 hour/week minimum.
*
Group: 10 hours/week minimum (4 sessions).
*
Family: To be included during course of treatment as clinically
indicated.
Psycho-education:
*
Didactic sessions: 8 hours/week minimum.
*
Family Education and Information sessions as clinically indicated.
Structured Activities: 7 hours a day required. Example of activities:
a.
Counseling Services
b.
Psycho-education
c.
Vocational Training
d.
Recovery Support Services
e.
Recreation
MEDICALLY MONITORED INPATIENT DETOXIFICATION
Level III.7D
In addition to the DMHAS Service Requirements stated in the Division
of Mental Health and Addiction Services (DMHAS) Network Annex A,
Medically Monitored Inpatient Detoxification Substance Use Treatment
contractees shall comply with the following parameters.
Definition: Medically Monitored Inpatient Detoxification is an
organized service delivered by medical and nursing professionals,
which provides 24-hour medically supervised evaluation and withdrawal
management in a permanent facility with inpatient beds. Services are
delivered under a defined set of physician-approved policies and
physician monitored procedures for clinical protocols. This level
provides care to patients whose withdrawal signs and symptoms are
sufficiently severe to require 24-hour medical monitoring care.
Detoxification includes 2 hours per week of counseling services.
(Note: Self-help meetings may be included as part of daily activities)
This care approximates ASAM PPC-2 Level III.7D care.
Medical Services: Must be provided in the facility under the
supervision of a Medical Director. All other licensing requirements
for medical services must be followed.
Counseling/Therapy Services:
*
Individual: 1 hour/week minimum.
*
Group: 1 hour/week.
Psycho-education:
*
Minimum of two hours per detox episode.
MEDICALLY MONITORED INPATIENT DETOXIFICATION ENHANCED
111.7D Enhanced
In addition to the DMHAS Service Requirements stated in the Division
of Mental Health and Addiction Services (DMHAS) Network Annex A,
Medically Monitored Inpatient Detoxification Enhanced Substance use
Treatment contractees shall comply with the following parameters.
Description: Medically Monitored Inpatient Detoxification Enhanced is
an organized service delivered by medical and nursing professionals,
which provides 24-hour medically supervised evaluation and withdrawal
management in a permanent facility with inpatient beds. Services are
delivered under a defined set of physician-approved policies and
physician-monitored procedures for clinical protocols. This level
provides care to patients whose withdrawal signs and symptoms are
sufficiently severe enough to require 24-hour medically monitored
care. Detoxification includes substance use assessment, medication
monitoring and two (2) hours per week of counseling services. (Note:
Self-help meetings may be included as a part of daily activities)
This care approximates ASAM PPC-2 Level III.7D care but enhances that
level to include the ability to treat the following: 1) individuals
with co-occurring disorders; 2) pregnant women; 3) poly-addicted
persons, including those addicted to benzodiazepines; 4) individuals
who may or may not be on opiate replacement therapy; and 5) clients
with non–life-threatening medical condition(s) that do not require the
services of an acute care hospital.
In order to accommodate this increased acuity in patients being
treated in this service, the facility must have an affiliation
agreement and procedures in place with an acute care hospital that
ensures the seamless transfer of the patient to the acute care
setting, if clinically necessary.
Required Staff: Must be provided in the facility under the supervision
of a Medical Director. All other licensing requirements for medical
services and co-occurring services must be followed.
Required Medical Services:
*
Full medical assessment.
*
Ongoing medical services including medication monitoring.
*
Pregnancy test for all women.
*
24 hour nursing services.
*
24 hour access to physician.
Counseling Services:
*
Individual counseling: 1 hours/week minimum.
*
Group Sessions: 1 hour/week.
Psycho-education:
*
Minimum of two hours per week.
Co-occurring Services included as part of this service:
*
Case Management.
*
Medication Monitoring.
FFS Contract Annex A1 – SFY 2015-2016 Page 1
Department of Human Services
Division of Mental Health and Addiction Services
Revised March 2014 Posted: March 2014
Effective: July 1, 2014