AD 66 GT006307DOC DHSCMHPAD 66 Amendment Exemption Final.DOC by longze569

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									AD 66/2007-2009
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Service Name:      CONTINUUM OF CARE SERVICES

Service ID Code: A&D 66


I.   Service Description

     Continuum of Care Services (A&D 66) are services delivered to individuals
     who have lost control of their use of alcohol or other drugs. The purpose of
     A&D 66 Services is to assist individuals in recovering from alcohol abuse or
     other drug dependency. A&D 66 Services consist of case management,
     clinical care and continuing care delivered when therapeutically necessary
     and consistent with the clinical need of the individual. For purposes of A&D
     66, case management, clinical care and continuing care have the following
     meanings:

     Case Management services are flexible, community-based and client-
     oriented services that enhance the scope of the addiction treatment and
     recovery continuum by providing the individual with a single point of contact
     for multiple health and social service systems and assisting the individual in
     advocating for his or her needs. Case management services assist the
     individual with needs that generally are thought to be outside the realm of
     substance abuse treatment. Case management services also assist individuals
     transitioning from community settings to residential care and from residential
     care back to community settings.

     Clinical Care services are assessment, counseling and treatment services,
     meeting the Standards for Outpatient and Residential Alcohol and Drug
     Treatment Programs (set forth in OAR 415-051-0000 through 415-051-0155,
     as such rules may be amended from time to time).

     Continuing Care services are services provided to individuals in treatment to
     sustain their commitment to recovery and consist of ongoing intermittent
     contact by the individual with a treatment Provider including, but not limited
     to, telephone outreach, participation in individual or group counseling, self
     help groups and programs, and transitional housing.




AD 66 GT0063-07                                                   Approved 03/23/2007
AD 66/2007-2009
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     A&D 66 Services are provided at one of the following levels of care as
     therapeutically necessary and consistent with the clinical need of the
     individual:

     Level I (Outpatient) Non-residential treatment services provided to the
     individual in regularly scheduled face-to-face therapeutic sessions. This level
     of service consists of 1-6 hours per week of face-to-face therapeutic sessions
     for adolescents and 1-9 hours per week for adults. Such services may include
     individual, group and family counseling, as well as long-term support for
     relapse prevention. The services may also include medically prescribed
     pharmacological agents, i.e., methadone, level-alpha-acetyl-methadol
     (LAAM), etc.

     Level II (Intensive Outpatient) This level of service affords the individual
     the opportunity to remain in his or her existing environment (social, familial,
     vocational), while still benefiting from a therapeutic, structured program. It is
     a non-residential service consisting of at least nine hours of face-to-face
     contact per week for adults and at least six hours of face-to-face contact per
     week for adolescents who meet the administrative rule placement
     requirements for this level of care. Some Level II Providers may provide
     evening services, day treatment services, or partial hospitalization. Such
     Services may include individual, group and family counseling, as well as
     medically-prescribed pharmacological agents.

     Level III Non-medical Detoxification This level of service provides twenty-
     four hour observation, monitoring and treatment for individuals who are
     suffering from alcohol or other drug intoxication or withdrawal.

     Subject to the preference for pregnant women and intravenous drug users
     described in Exhibit G, Required Federal Terms and Conditions, County must
     give preference in A&D 66 service delivery to persons referred by DHS and
     persons referred by Drug Courts within County’s service area.

II. Performance Standards and Quality Measures

     Providers of A&D 66 Services funded through this Contract must also have a
     current license issued by the Department in accordance with OAR 415-012-
     0000 through 415-012-0090. Providers of A&D 66 Continuing Care Level I


AD 66 GT0063-07                                                     Approved 03/23/2007
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     and II Services funded through this Agreement must comply with OAR 415-
     051-0000 through 415-051-0155 and OAR 415-020-0000 through 415-020-
     0090, as such rules may be revised from time to time. Providers of A&D 66
     Continuing Care Level III Services funded through this Agreement must
     comply with OAR 415-050-0000 through 415-050-0095, as such rules may
     be revised from time to time.

     With respect to each individual that Provider serves with funds provided
     under this Agreement, Provider shall deliver all A&D 66 Services
     therapeutically necessary for the individual from the date Provider begins
     serving the individual through the date set forth in the Financial Assistance
     Award.

     A Provider may not use A&D 66 funds provided under this Agreement to
     deliver A&D 66 Continuing Care Level I or Level II services to any individual
     enrolled in the Oregon Health Plan for chemical dependency benefits.
     Providers must refer such individuals to their managed care plan for A&D 66
     Services.

     The quality of the A&D 66 Services supported with funds provided under this
     Agreement will be measured in accordance with the criteria set forth below.
     These criteria are applied on a countywide basis each calendar quarter (or
     portion thereof) during the period for which the funds are awarded for A&D
     66 Services under this Agreement. County must develop and implement
     quality assurance /quality improvement processes to improve, progressively
     as measured by the criteria set forth below, the quality of A&D 66 Services
     supported with funds provided under this Agreement. The Department may
     recommend additional actions to improve quality.

     Access: Access is measured by Department as the percentage of adult
     County residents estimated by Department surveys to need treatment who are
     enrolled in A&D 66 Services.

     Engagement: Engagement is measured by Department as the percentage of
     adults receiving A&D 66 Services with funds provided through this
     Agreement who enter treatment following positive assessment. .




AD 66 GT0063-07                                                    Approved 03/23/2007
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     Retention: Retention is measured by Department as the percentage of
     individuals receiving A&D 66 Services with funds provided through this
     Agreement who are actively engaged in treatment for 90 days or more.

     Reduced Use: Reduced use is measured by Department as the percentage of
     adults engaged in and receiving A&D 66 Services with funds provided
     through this Agreement who reduce their use of alcohol or other drugs during
     treatment, as reported in CPMS upon termination of treatment.

     Completion: Completion is measured as the percentage of individuals
     engaged in and receiving A&D 66 Services with funds provided through this
     Agreement who complete two thirds of their treatment plan and are not
     abusing alcohol or other drugs at the time services are terminated.

III. Special Reporting Requirements
     All individuals receiving A&D 66 Services with funds provided under this
     Agreement must be enrolled in CPMS, and the individual’s CPMS record for
     A&D 66 Services must be maintained, as specified in Department’s CPMS
     manual.
IV. Financial Assistance Calculation and Disbursement Procedures
     A. Calculation of Financial Assistance. The funds awarded for A&D 66
        services are intended to be general financial assistance to the County for
        A&D 66 services. Accordingly, the Department will not track delivery
        of A&D 66 services or service capacity on a per unit basis, so long as the
        County offers and delivers A&D 66 services as part of its CMHP. Total
        Department financial assistance for all A&D 66 Services delivered under
        a particular line of the Financial Assistance Award shall not exceed the
        total funds awarded for A&D 66 Services as specified in that line of the
        Financial Assistance Award.
     B.   Disbursement of Funds. Unless a different disbursement method is
          specified in that line of the Financial Assistance Award, Department will
          disburse the funds awarded for A&D 66 Services in a particular line of
          the Financial Assistance Award, to County in substantially equal
          monthly allotments during the period specified in that line of the
          Financial Assistance Award, subject to the following:



AD 66 GT0063-07                                                   Approved 03/23/2007
AD 66/2007-2009
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          1.      Department may, at is discretion, adjust monthly allotments to meet
                  cash flow requirements for continued delivery of A&D 66 services.

          2.      Department may, at its discretion, adjust monthly allotments to
                  reflect changes in the funds awarded for A&D 66 services on that
                  line of the Financial Assistance Award as a result of amendments to
                  the Financial Assistance Award.

     C.   Agreement Settlement. Agreement Settlement will be used to confirm
          the offer and delivery of A&D 66 Services by County as part of its
          CMHP, based on data properly reported in CPMS or through other
          reports required or permitted by this Service Description or an applicable
          Specialized Service Requirement.




AD 66 GT0063-07                                                      Approved 03/23/2007

								
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