3.1 ASAM Treatment Levels of Care Services All services must be evidence-based, trauma-informed or trauma-enhanced, and value-driven, with clearly documented goals, outcomes, and measurable results. Services shall align with the Eight Dimensions of Wellness and evaluate the need for treatment across all levels of care to ensure compliance with ASAM criteria. When appropriate, residents shall be referred to more intensive or specialized services. Each service shall use an integrated treatment approach supported by a comprehensive, individualized treatment plan that addresses substance use, mental health, and medical needs, including infectious disease testing and counseling or referral (HIV/AIDS, Hepatitis B and C). Services must also address residents’ social needs and be capable of tailoring treatment to specific populations, such as those who are deaf or hard of hearing, and to diverse cultural, ethnic, and life circumstances. 3.1.1 Adult Inpatient Withdrawal Management (Detox) - Adult (18 and over), 3.7-WM ASAM Criteria medically monitored inpatient withdrawal management, requiring 24-hour nursing care with physician availability and 16-hour per day counselor availability; or Hospital-based Withdrawal Management (Detox) Adult (18 and over), 4.0-WM ASAM Criteria; medically managed intensive inpatient services, requiring 24-hour nursing care with physician availability and 16-hour per day counselor availability for severe and unstable withdrawal that cannot be clinically managed in ASAM Criteria 1, 2 or 3. Services must include: a) Provide physical withdrawal management (detoxification) for all substances b) Evaluate and address psychosocial and biomedical issues c) Address co-occurring medical and psychiatric conditions d) Offer engagement and stabilization that fosters readiness for entry into substance use treatment such as short-term rehab or long-term rehab e) Make appropriate referrals and linkages to address the whole health care needs of residents 3.1.2 Adult Short Term Residential (Inpatient Rehab) - Adult (18 and over), medically monitored intensive inpatient services 3.7 ASAM Criteria; 24-hour nursing care with physician availability for significant problems in Dimension 1 (Acute Intoxication and/or Withdrawal Potential), Dimension 2 (Biomedical Conditions and Complications) or Dimension 3 (Emotional, Behavioral or Cognitive Conditions and Complications); 16 hour per day counselor availability. Services must include: a) Evaluate and address psychosocial and biomedical issues b) Address co-occurring medical and psychiatric conditions c) Offer engagement and stabilization that fosters readiness for entry into the next level of care such as long-term rehab; halfway house or outpatient services d) Make appropriate referrals and linkages to address the whole health care needs of residents e) Offer or connect residents to community-based recovery support services 3.1.3 Adult SUD/COD Intensive Outpatient/Standard (Traditional) Outpatient - Adult (18 and over), Intensive Outpatient (IOP) 2.1 ASAM Criteria, 9 hours or more hours of service per week to treat multidimensional instability; and Standard/Traditional Outpatient 1.0 ASAM Criteria; less than 9 hours of service per week for recovery or motivational enhancement therapies/strategies. Services must include: (i) Screening and assessment sufficient to screen for, and rule in or out, substance-related disorders (ii) Individual counseling (iii) Group counseling (iv) Family counseling (v) Psychoeducation (iv) Case Management: o Case planning o Linkage o Advocacy o Monitoring 3.1.4 Women’s Halfway House - Adult Female (18 and over); 3.1 ASAM Criteria; clinically managed low-intensity residential, 24-hour structure with available trained personnel; at least 5 hours of clinical service per week. Services must include: a) Evaluate and address psychosocial and biomedical issues b) Address co-occurring medical and psychiatric conditions c) Offer engagement that fosters recovery d) Make appropriate referrals and linkages to address the whole health care needs of residents e) Offer or connect residents to community-based recovery support services 3.1.5 Men’s Halfway House - Adult Male (18 and over); 3.1 ASAM Criteria; clinically managed lowintensity residential, 24-hour structure with available trained personnel; at least 5 hours of clinical service per week. Services must include: a) Evaluate and address psychosocial and biomedical issues b) Address co-occurring medical and psychiatric conditions c) Offer engagement that fosters recovery d) Make appropriate referrals and linkages to address the whole health care needs of residents e) Offer or connect residents to community-based recovery support services All ASAM level of care treatment services mentioned above may provide specific and/or enhancement services. Specific and/or enhancement services are in addition to above mentioned proposed services (specific and/or enhancement category cannot be an existing service in an ASAM level of care treatment service modality); enhancement services may not be utilized if a funding stream is available for this service, or to supplement any other funding stream.
