Ala. Admin. Code r. 580-9-44-.14

Current through Register Vol. 43, No. 1, October 31, 2024

Section 580-9-44-.14 - Level 0.5: Early Intervention

(1) Rule Compliance. Each Level 0.5 Early Intervention Program shall comply with the following rules and the rules specified in this chapter.

(a) Operational Plan. The entity shall develop, maintain and document implementation of a written operational plan that defines its Level 0.5 Early Intervention Program. The program description shall comply with all of the requirements specified in 580-9-44-.13 and the following additional specifications:

1. Location. The entity shall specifically identify and describe the setting in which Level 0.5 Early Intervention services shall be provided. Services may be provided in any appropriate setting that protects the client's right to privacy, confidentiality, safety and meets the DMH facility certification standards as appropriate to the location. Service locations may include traditional clinical offices and behavioral health sites, residences, schools, shelters, work sites, community centers and other locations as pre-authorized by DMH.

(i) Adolescent Specific Criteria.

(I) Location. Shall not provide services in locations that would require shared services or significant contact with individuals receiving treatment for substance use disorders.

2. Admission Criteria. The entity shall develop, maintain, and document implementation of written criteria for admission to its Level 0.5 Outpatient Program, as according to 580-9-44-.13(9), and the following criteria:

(i) The entity's admission criteria shall specify the target population for Level 0.5 services to include, at a minimum, individuals whose problems and risk factors appear to be related to substance use, but do not meet the diagnostic criteria for a substance-related disorder as defined in the current Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.

(ii) The entity shall provide written documentation in individual case records that each client admitted to receive Level 0.5 Early Intervention Services meets the most current edition of the ASAM Patient Placement Criteria diagnostic and dimensional criteria for this level of care.

(iii) Adolescent Program Specific Criteria. The entity shall provide written documentation in individual case records that each adolescent admitted to receive Level 0.5 Early Intervention services meets the most recent edition of the ASAM Patient Placement Criteria adolescent diagnostic and dimensional criteria for this level of care.

3. Core Services. Each Level 0.5 Early Intervention Program shall demonstrate the capacity to provide a basic level of skilled services appropriate to the needs of its clientele:

(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:

(I) Case planning.

(II) Linkage.

(III) Advocacy.

(IV) Monitoring.

4. Service Intensity. The entity shall document that the amount and frequency of services is established on the basis of the unique needs of each client served.

5. Documentation: In addition to meeting the requirements of 580-9-44-.13(21), an individualized progress note shall be recorded for each service provided in Level 0.5.

6. Support Systems.

(i) At a minimum, the Early Intervention Program shall develop, maintain and document implementation of written policies and procedures which govern the process used to ensure the availability of and provide referrals as needed for:

(I) Treatment of substance use disorders.

(II) Medical, psychological or psychiatric services, including assessment.

(III) Community social services.

(ii) The entity shall maintain up-to-date, written Memorandums of Understanding, Collaborative Agreements or Referral Agreements as applicable.

7. Program Personnel. Each Level 0.5 Early Intervention Program shall employ an adequate number of qualified individuals to carry out personalized care for its clientele and to meet the program's goals and objectives.

(i) Every client in a Level 0.5 Program shall be assigned to a specific Primary Counselor for care management.

8. Training. The entity shall provide written documentation that all Level 0.5 Program personnel satisfy the competency and training requirements as specified in 580-9-44-.02(3).

9. Service Intensity: The entity shall document that the amount and frequency of Level 0.5 Early Intervention Services are established on the basis of the unique needs of each client served.

10. Length of Service: The entity shall provide written documentation that the duration of treatment in each Level 0.5 Program shall vary as determined by:

(i) The client's ability to comprehend the information provided and use that information to make behavior changes; or

(ii) The appearance of new problems which require another modality of service.

11. Service Availability: The entity shall provide written documentation describing the process utilized to establish the hours of service availability for its Level 0.5 Early Intervention Program. At a minimum, this process shall:

(i) Include consideration of the needs of the target population, including work, school and parenting responsibilities.

(ii) Not be based solely on standard eight (8) to five (5), Monday through Friday office hours.

Ala. Admin. Code r. 580-9-44-.14

New Rule: Filed January 26, 2012; effective March 1, 2012.

Amended by Alabama Administrative Monthly Volume XLI, Issue No. 04, January 31, 2023, eff. 3/17/2023.

Author: Substance Abuse Services Division

Statutory Authority:Code of Ala. 1975, § 22-50-11.