PART I - Department of Behavioral Health and Developmental ...

Substance Abuse Intensive Outpatient Package: (SA Adolescent Day Treatment)6. Individual Counseling7. Group Counseling (including psycho-educational groups focusing, relapse prevention and recovery)8. Family Counseling/Psycho-Educational Groups for Family Members9. Structured Activity SupportsThese services are to be available at least 5 days per week to allow youth’s access to support and treatment within his/her community, school, and family. These servicesare to be age appropriate and providers are to use best/evidenced based practices for service delivery to adolescent consumers. Intense coordination with schools andother child serving agencies is mandatory. This service promotes resiliency and recovery from substance abuse disorders incorporating the basic tenets of clinicalpractice. These services should follow Adolescent ASAM Level Guidelines. These guidelines are as follows: II.1 (at least 6 hours of structured programming per week);II.2 (at least 9 hours per week); II.3 (at least 12 hours per week); II.4 (at least 15 hours per week); and II.5 (at least 20 hours of structured activity per week). Themaximum number of units that can be billed differs depending on the individual service. Please refer to the table below or in the Mental Health and Addictive DiseaseOrientation to Authorization Packages Section of this manual.A consumer may have variable length of stay. The level of care should be determined as a result of consumers’ multiple assessments. It is recommended that individualsattend at a frequency appropriate to their level of need. Ongoing clinical assessment should be conducted to determine step down in level of care.AdmissionCriteriaContinuingStay CriteriaDischargeCriteria1. A DSM IV diagnosis of Substance Abuse or Dependence or substance- related disorder with a co-occurring DSM IV-TR diagnosis of mental illness and2. Consumer meets the age criteria for adolescent treatment; and3. Youth’s biomedical conditions are stable or are being concurrently addressed (if applicable) and one or more of the following:a. Youth is currently unable to maintain behavioral stability for more than a 72 hour period, as evidenced by distractibility, negative emotions, or generalized anxiety orb. Youth has a diagnosed emotional/behavioral disorder that requires monitoring and/or management due to a history indicating a high potential for distracting theindividual from recovery/treatment, orc. There is a likelihood of drinking or drug use without close monitoring and structured supportd. The substance use is incapacitating, destabilizing or causing the individual anguish or distress and the individual demonstrates a pattern of alcohol and/or drug usethat has resulted in a significant impairment of interpersonal, occupational and/or educationalSee also Adolescent ASAM Level II continued service criteria1. Youth continues to meet admission criteria 1, 2, and/or 3 or2. Youth is responding to treatment as evidenced by progress towards goals, but has not yet met the full expectation of the objectives or3. Youth begins to recognize and understand his/her responsibility for addressing his/her illness, but still requires services and strategies to sustain personal responsibilityand progress in treatment or4. Youth recognizes and understands relapse triggers, but has not developed sufficient coping skills to interrupt or postpone gratification or to change related inadequateimpulse control behaviors or5. Youth’s substance seeking behaviors, while diminishing, have not been reduced sufficiently to support function outside of a structure treatment environmentAn adequate continuing care or discharge plan is established and linkages are in place; and one or more of the following:1. Goals of the treatment plan have been substantially met; or2. Youth’s problems have diminished in such a way that they can be managed through less intensive services; orFY2013 Provider Manual for Community Behavioral Health Providers Page 55