007.25.95 Ark. Code R. 004

Current through Register Vol. 49, No. 10, October, 2024
Rule 007.25.95-004 - Bureau of Alcohol and Drug Abuse Prevention Rules and Regulations

INTRODUCTION

The Arkansas Department of Health, Bureau of Alcohol and Drug Abuse Prevention (ADH-ADAP or ADAP) is the single state agency responsible for developing and promulgating standards, rules and regulations for alcohol and other drug abuse prevention and treatment functions within the State, and operation of a comprehensive management evaluation and community research process for the allocation of resources. It is the primary point of contact in the state for the award of federal funds to be used in alcohol and other drug abuse prevention and treatment programs in the state.

It is determined that in order to combat the abuse and misuse of alcohol, tobacco and other potentially harmful drugs, a comprehensive prevention and treatment strategy must be developed in Arkansas. This strategy shall include the development and administration of a wide range of activities and campaigns deemed effective and tailored to the needs of Arkansas citizens.

MISSION

To help Arkansas Citizens live productive lives free from the abuse of alcohol; tobacco and other drugs.

MAJOR GOALS

1. To act as a strong advocate for comprehensive alcohol, tobacco and other drug abuse, education, intervention, prevention and treatment services in Arkansas and to assure that these programs are identified and presented to lawmakers and to key decision makers.
2. To assure the provision of comprehensive treatment and prevention services to citizens of Arkansas who have an alcohol, tobacco and/or other drug abuse problem or potential problem.
3. To assure that comprehensive services are tailored to the specific needs of individuals within each county and region of the State.
4. To assure that all services provided for the alcohol and drug abuser meet minimum standards required for quality care.
5. To allocate limited dollars to local communities in the most cost efficient and cost effective process available.
6. To coordinate with other State agencies and voluntary agencies to assure maximum utilization of available resources and services.
7. To provide comprehensive educational and training resources that are responsive to the changing and diverse needs of alcohol, tobacco and drug abuse clients in Arkansas. .
8. To provide a focus for the enhancing of criminal justice linkages with the substance abuse treatment system.

PHILOSOPHY AND PROGRAM POLICY

The philosophy and program policy of the ADAP recognizes that:

1. Even though there are generally accepted solutions to the problems of alcohol, tobacco and other drug abuse, local communities, problems and needs must be considered when determining successful preventive approaches.
2. Effective alcohol, tobacco and other drug abuse prevention and treatment activities must have local citizen input, community support, and community involvement.
3. An effective prevention plan must provide opportunities for persons to become functional and productive citizens, either through treatment, information, education, or alternative activities. All activities are important in effective prevention.
4. . Effective prevention programs cannot rely on a-singlescairce of support but must utilize local resources such as existing sources of supportive services, community programs, neighborhood organizations and social services.
5. In order to assist local communities in the development of alcohol, tobacco and other drug abuse prevention activities, the ADAP must first assist the community by generating community awareness of alcohol, tobacco and other drug abuse problems. This includes an understanding of the nature and extent of the alcohol, tobacco and other drug abuse problem, the deeper issues underlying the problem, and. the need for efforts to deal with the problem.
6. Any activity or program funded by the ADAP must be consistent with the goals established by the ADAP; however, funding requirements must be flexible to allow a responsiveness to individual community needs.
7. Alcohol, tobacco and/or other drag abuse may reflect or contribute to underlying individual and/or community problems; the most successful prevention measures are those that deal with helping a person in the development of his inner resources (feelings, attitudes, values clarification, communication skills, etc.) so that he can deal more effectively with his role in life.
8. Alcohol, tobacco and other drug abuse are problems found in rural areas as well as metropolitan areas. Programs should be available to rural and small communities.
9. State level responsibilities to alcohol, tobacco and other drug abuse prevention activities in Arkansas shall be in management, coordination and technical assistance areas. Delivery of direct services shall be through the administration of the Benton Detoxification Services Center, providing services statewide, and the Supervised Treatment and Education Program (S.T.E.P.), providing assessment and drug treatment diversion to first time non-violent offenders.
10. State level responsibilities to all funded community-based treatment and prevention programs in management, coordination and technical assistance areas shall include

' financial monitoring, evaluation, training, statewide dataTetrieval-and analysis,

Licensure and technical assistance.

11. The ADAP shall develop a Request for Proposal (RFP),. Request for Application (RFA) and Progress Report (PR) system to be used in the awarding of funds.
12. The ADAP shall assure that all availability of funding announcements, press releases, RFPs, etc. will include a statement indicating the percentage of federal funds involved in the program.
13. All procurement transactions shall be conducted in a manner to provide, to the maximum extent practicable, open and free competition.
14. The ADAP shall afford an opportunity to an applicant to appear before the Alcohol and Drug Abuse Coordinating Council in matters of the award of funds, review of an application, or adjustment to an existing contract or grant.
15. The ADAP shall not enforce or develop a policy or guideline for the awarding of

.. contracts or grants, .or to continue to disburse.funds, which, it Icnowingly finds to be in conflict with any state or federal rule or regulation.

16. The ADAP shall not approve for funding any application which does not comply with the ADAP policies and procedures.
17. The ADAP shall present the Policies and Procedures Manual affecting all contracts and grants to the Alcohol and Drug Abuse Coordinating Council for review and advice -prior to its implementation. The Policies and Procedures Manual will be reviewed and updated at least annually.
18. The ADAP shall present applications/proposals for service delivery which are awarded by the ADAP to the Alcohol and Drug Abuse Coordinating Council for review and advice. This procedure does not apply to administrative contracts such as equipment purchases, newspaper contracts, training contracts, planning contracts or pilot projects.
19. The ADAP shall develop licensure standards for all funded and non-funded treatment programs. All alcohol/other drug abuse/addiction treatment programs must comply with the ADAP standards. The ADAP shall accept the licensure/accreditation/certification of hospital-based alcohol and other drug abuse programs by the Arkansas Department of Health, the Joint Commission on Accreditation of Hospital Organizations (JCAHO), or the Commission on Accreditation of Rehabilitation Facilities (CARP). The ADAP shall also accept certification of Community Mental Health Centers by the Arkansas Division of Mental Health Services.
20. The ADAP shall encourage development of standards for alcohol and drug abuse professionals in the state.
21. The ADAP shall develop a management information system for all programs, whereby the ADAP can conduct program planning activities.
22. The ADAP shall allocate funds inrach areaxrf the state-based on federal mandates, special projects and a needs hased funding formula.
23. The ADAP shall allocate regional funding according to the following program categories: Treatment, Prevention and Education.
24. The ADAP shall initiate, if funds are available, the development of pilot projects in treatment, prevention and education which shall be evaluated for future development of model programs and activities.
25. The ADAP shall assist local communities in securing all available financial assistance for provision of treatment and prevention activities.
26. The ADAP may coordinate with any public or private agency or organization which can assist in collecting data on incidence and prevalence of alcohol and other drug abuse.
27. Information on alcohol and other drugs should be presented in a clear, unbiased and - factual method. .The ADAP -believes "scare.tactics",areaninappropriate mechanism for conveying information to the general public.
28. The ADAP and its funded contract/grant providers shall complete the Certification

Regarding Lobbying statement for contracts of $100,000 or more. This certification assures that no federal funds have been paid or will be paid for the purposes of lobbying in connection with the awarding of any Federal contract, grant, loan, cooperative agreement, and the extension,-renewal; amendment or modification of any Federal contract, grant, loan or cooperative agreement.

29. The ADAP shall not use Substance Abuse Prevention and Treatment (SAPT) Block Grant funds to carry out any program of distributing sterile needles for the hypodermic injection of any illegal drug or distributing bleach for the purpose of cleansing needles for such hypodermic injection.
30. The ADAP shall not carry out any testing for the etiologic agent for acquired immune deficiency syndrome unless such testing is accompanied by appropriate pre-test counseling and appropriate post-test counseling.
31. It is the policy of the ADAP and the State of Arkansas that the unlawful manufacture, distribution, dispensation, possession or use of a controlled substance in a state agency's workplace is prohibited.
32. Prevention programs shall emphasize zero tolerance of illicit drug use by all persons and the use of alcohol and tobacco by youth.
33. Prevention is based on the knowledge that alcohol and other drug abuse is a multifaceted, complex problem, and that alcoholism and other drug addiction is a primary, progressive but treatable disease.

PREVENTION PHILOSOPHY AND POLICIES

1. Prevention is the use of planned activities to reduce the risk that individuals will experience alcohol or drug-related problems in their lives.' It is a positive; proactive - -' approach that attempts to influence individuals before thcearliest onset of such problems.
2. Prevention begins within communities - helping individuals to learn that they can have an impact in solving their local problems and setting local norms. Prevention emphasizes collaboration and cooperation, both to conserve limited resources and to build on existing relationships within the community. Community groups are routinely used to explore new, creative ways to use existing resources.
3. Prevention is part of a broader health promotion effort, based on the knowledge that addiction is a primary, progressive, chronic, and fatal disease. As such, it focuses on helping people develop new, more positive views of themselves. It is aimed at both users and non-users, with a goal to helping community members to achieve healthier life-styles.
4. Community activities sometimes incorporate intervention activities, which attempt to assist individuals who have already begun inappropriate use of alcohol or other drugs. Intervention may include referring to diagnostic or treatment centers.
5. Comprehensive prevention efforts target many agencies and systems, and use many strategies in order to have the broadest possible impact; Therefore, evaluation is .. -crucial in order for communities to identify their successful efforts and-to modify or abandon their unproductive efforts.
6. The overall goal for prevention is the developmentof healthy, responsible, productive citizens who will be unlikely to experience alcohol or drug-related problems in their lives,
7. Prevention emphasizes zero tolerance of illicit drug use by all persons and the use of alcohol and tobacco products by youth.
8. Building coordinated prevention efforts that offer multiple strategies, provide multiple points of access and coordinate and expand citizen participation in community activity is a most promising approach to preventing alcohol and other drug problems.
9. The ADAP supports an holistic approach to drug,- alcohol, and other education including health education, self-appreciation and personal development for grades kindergarten through 12.
10. The ADAP supports development of alcohol and other drug abuse education in schools. It is the philosophy of ADAP that effective education is dependent upon quality teacher training.
11. Prevention programs approved for funding must identify a target population; must develop a program in response to the target population; must assure adequate measures to involve the target group; must have short and long term objectives; and must have an adequate evaluation methodology to reflect accomplishment-of short and long term objectives.
12. The ADAP'shall ericoiirageall primary prevention programs to become self-sustaining after initial funding.

POLICIES AFFECTING TREATMENT AND REHABILITATION

1. The ADAP shall develop a plan for each area of the State which shall include the present funding, utilization and need.
2. The ADAP shall determine a plan for allocations of funding, (i.e., Federal mandates, special projects and a statewide funding formula, etc.).
3. The ADAP will purchase outpatient and residential alcohol and other drug abuse j treatment services within a reasonable ceiling rate. Subordinate services may be

I purchased within a separate ceiling rate.

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4. The ADAP supports the concept that non-medical as well as medical treatment models are viable and effective approaches in providing quality care.
5. Successful treatment and rehabilitation must utilize the total range of services which the individual can appropriately and productively use in the recovery process.
6. While client work may be an important part of the recovery process, the program should develop policies which safeguard the client from inappropriate work, ensure the voluntary nature of work assignments, and meet Department of Labor guidelines.
7. Isolated program components, (i.e., detoxification, outreach) shall not be funded without assurance that primary and subordinate services are provided.
8. The ADAP shall not initiate, encourage, or approve the development nor funding of programs seeking to provide treatment by modifying behavior through the use of psychosurgery, aversion therapy, or chemotherapy as a primary treatment method.
9. The ADAP shall serve as the State Methadone/LAAM (Levo-Alpha-Acetyl-Methadol) Authority and shall develop standards, provide coordination and oversight of all methadone/LAAM program applications, exemptions, waivers, monitoring and closings in coordination and cooperation with the various federal agencies having regulatory oversight for methadone/LAAM programs.
10. The ADAP shall require that each funded treatment program coordinate services with criminal justice systems within their service area.
11. The ADAP shall require that funded treatment programs provide priority admission in the following order:
(1) Court ordered clients,
(2) Clients with the greatest clinical need,
(3) If all clients awaiting admission have relatively the same clinical need, Injection Drug Users (IDU), and Pregnant clients are given priority,
(4) Clients from the catchment area specified by ADAP,
(5) Clients from the State of Arkansas, and
(6) Clients from other states.
13. The ADAP shall require that treatment programs provide treatment services, within fourteen (14) days of receipt of request for admission. Interim services (see Definitions, Section 7.03) will be provided for IDU and pregnant clients until the time of admission. /
14. The ADAP shall require that funded treatment programs be designated as receiving facilities for voluntary admissions and involuntary commitments in compliance with Act 1268 of 1995 as amended. Non-funded treatment programs may be designated as receiving facilities at their request.

POLICIES AFFECTING FUJVPING

1. The ADAP shall make funds available for the delivery of services through funding mechanisms known as contracts and/or grants.
2. The ADAP shall not approve an application which is not consistent with its funding plan and allocations approved by the Alcohol and Drug Abuse Coordinating Council.
3. Allocated funding for programs which do not demonstrate the ability to utilize at least 90% of the programs' funds may be reallocated to other programs based on need and overutilization of funds. Evaluation of utilization shall be done quarterly throughout the fiscal year.
4. Priority for expanded level programming shall be given to the following programs:
A. Programs which are requesting expansion of their services and/or which have demonstrated full utilization of existing funds.
B. Programs which provide specialized services as identified by the ADAP (e.g., pregnant women, women with children, adolescents, high-risk youth, etc.)
5. Unexpected and/or unallocated funding that becomes available during the fiscal year, but which will not be continued in subsequent fiscal years, may be allocated to programs which are overutilizing funds or to activities which will not be ongoing programs.
6. The ADAP reserves the right to reduce the funding of any contract/grant due to the poor performance of the contractor/grantee in fulfilling contractual obligations. Indicators of poor performance which may result in a reduced contract/grant include, but are not limited to, the following:
A. An unsatisfactory Progress Report or failure to comply with standards as outlined in the Proposal Development Guidelines.
B. Chronic or severe problems with ADMIS reporting.
C. Late submittal of financial audit.
D. An unsatisfactory services-to-billing audit.
E. An unsatisfactory client records review.
F. Failure to comply with standards necessary to meet licensure requirements.

POLICIES AFFECTING MONITORING

1. The ADAP will review all contracts and grants for utilization and overall effectiveness and performance. The review will include but not be limited to the following:
A. A site visit at least annually.
B. Desk review of ADMIS, audits, program, incident and expenditure reports, etc.

POLICIES AFFECTING PLANNING AND COORDINATION

1. - The ADAP .shall develop an annualstate-planfor the-delivery of. alcohol and other drug abuse services.
2. The ADAP shall do planning on a regional basis or as special needs dictate.
3. The ADAP shall involve special interest groups and professions in the planning process.
4. The ADAP shall develop formal written coordination agreements with other Bureaus of the Department of Health as appropriate. Agreements may be developed: with state -governmental units which have some involvement in the areas of alcohol and other drug abuse.

POLICIES AFFECTING SPECIAL EMPHASIS PROGRAM DEVELOPMENT

1. The ADAP shall place a high priority on programming for pregnant women and women with dependent children.
2. The ADAP may plan and develop special emphasis programs for special population groups which include, but are not limited to, the elderly, youth, women and other minorities.
3. Any action strategy designed by ADAP will be to expand and coordinate with existing programs to assure that needs of special groups are met.

POLICIES REGARDING FEDERAL FUNDING REQUIREMENTS

The ADAP and its program providers shall adhere to the following federal funding mandates:

1. Substance Abuse Prevention and Treatment (SAPT) Block Grant:
A. At least 35 % of the SAPT Block Grant shall be spent for alcohol services.
B. At least 35% of the SAPT Block Grant shall be spent for drug services.
C. At least 20% of the SAPT Block Grant shall be spent for prevention services.
D. At least 5 % of the SAPT Block Grant shall be spent on HTV Early Intervention Services.
E. SAPT Block Grant funds shall be spent for services to women, with emphasis on speciality services for pregnant women and women with children according to a formula provided by the Center for Substance Abuse Treatment.
F. No more than 5% of the SAPT Block Grant may be spent on administration.
G. Maintenance of Effort. Section 1916(c)(ll))(A) of the SAPT regulations provides that the State agrees to maintain State expenditures for alcohol, drug abuse, TB and HTV services at a level equal to not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying to receive block grant payments.
2. Drug-Free Schools and Communities Act (DFSCA):
A. Not more than 42.5% shall be spent for general programs.
B. Not less than 42.5 % shall be spent for programs serving High-Risk Youth (HRY). Programs designated and funded as HRY shall serve no less than 90% HRY population.
C. Not less than 10% shall be spent for drug abuse resistance education program. Not less than 5 % shall be spent for the replication of successful drug education programs.
E. Not more than 2.5 % may be spent from the general program portion for the administration of the DFSCA program.
3. All subgrantees shall-adhere to the cost principles set forth in the U. S. Office of Management and Budget (OMB) Circular A-122 (Cost Principles for Non-Profit Organizations) or Circular A-87 (Cost Principles for State and Local Governments), as applicable, in the use of ADAP funds.
1.00INTRODUCTION
1.01PURPOSE.

This manual provides information on the conduct of programs and activities related to the treatment and prevention of alcohol and other drug abuse in the State of Arkansas, and which have funds provided by the Department of Health, Bureau of Alcohol and Drug Abuse Prevention (ADAP). It provides guidance to prospective applicants about the steps in making application for such funds, and guidance to contractors/grantees, hereinafter referred to as "Providers," on their responsibility for accounting for such funds, reporting on progress, and observing applicable laws and regulations.

1.02 SCOPE

The provisions of this manual are applicable to all ADAP operations, including contract and grant applications administered by the ADAP.

1.03WHERE TO OBTAIN INFORMATION AND ASSISTANCE

Persons needing help in using this manual should contact the ADAP. The functional Organizational Chart shown on the following page may help in that endeavor. A new applicant should contact the Director, Treatment Services, the Director, Prevention Services, or that person's designee, for assistance.

1.04AVAILABILITY OF FUNDS

Although it is the intent of the ADAP to address as many of the approaches to treatment and prevention as may be brought to it, applicants and providers should be aware that there is no certainty that funds will be available for every program and every proposed project however worthwhile. Projects selected for funding may be limited geographically and numerically so that the awards will have a measurable impact on the State. Furthermore, it is also possible that funds .may, not be available for the continuation of every contract/grant, even if approved for the first year.

1.05MANUAL CONTENT AND ORGANIZATION The following sections of this manual will cover: Contract/grant specifications and the application process Financial administration

General Procedures

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2.00CONTRACT/GRANT SPECIFICATIONS AND THE APPLICATION PROCESS
2.01PROJECTS CONSIDERED ELIGIBLE FOR FUNDING BY THE ADAP:

- Federal and state laws and regulations-designate certain categories which the ADAP may address. An appropriate Request for Proposal (RFP), Request for Application (RFA), or Progress Report (PR) application will be developed for each category. The RFP, RFA, or PR will include requirements and instructions for the applicant. The categories are as follows:

2.011Treatment and Rehabilitation. Any program that delivers alcohol and/or other drug abuse treatment services to a defined client population.

The intent of the program of treatment services is to insure the restoration of a client to the fullest physical, mental, social, vocational, and economic usefulness of which he or she is capable. Rehabilitation may include, but is not limited to, residential and outpatient counseling, medical treatment, psychological therapy, occupational training, job counseling, social and domestic rehabilitation and education.

2.012Primary Prevention. Primary prevention programs are those directed at individuals who have not been determined to require treatment for substance abuse. Such programs are aimed at educating and counseling individuals on such abuse and providing activities to reduce the risk of such abuse. Primary prevention includes a broad array of prevention activities and services including such activities and services to discourage'the use of alcoholic beverages and tobacco products by minors. These activities and services must be provided in a variety of settings for both the general population, as well as targeted sub groups who are at high risk for substance abuse. A variety of strategies, as appropriate for each target group, shall be used. These include, but are not limited to the following:
(1) Information Dissemination;
(2) Education;
(3) Alternative Activities;
(4) Problem Identification and Referral;
(5) Community Based Processes;. and
(6) Environmental Changes. See. - . ___

Definitions, Section 7.015.

2.013Intervention." The intervention process consists of those purposeful activities by which persons or segments of the environment strengthen the individual and his/her environment to interrupt existing harmful alcohol and/or drug addictive behavior in a manner intended to bring about a positive change. The intervention process normally consists of identifying people with a problem; documentation of problem behavior; confrontation of the individual with a problem; referring the individual to those who can help; and follow-up to assure that the intervention has affected a positive change. Examples include COA (Children of Alcoholics) Groups, Diversion classes, Individual assessment and referral assistance, Employee Assistance Programs, Intervention teams, Student Assistance Programs, DWI Programs, Hot Lines.
2.014Data. Research and Analysis. Approaches to and mechanisms for the collection of data on alcohol and other drug abuse in the state or local area; also the development of systems to evaluate the data for use in planning processes for Arkansas alcohol and other drug trearmentand prevention services.
2.015Training. Includes training of workers in alcohol or other drug treatment, prevention or intervention programs, and training of professionals and paraprofessionals in local communities including physicians, teachers, law enforcement, etc.
2.02ELIGIBLE APPLICANTS
2.021 Non-profit corporations
2.022 Local Education Agencies
2.023 Local units of government
2.024 Public and private non-profit service agencies
2.025 All applicants for funding must provide IRS Certification of their 501(c)3 status as an eligible entity.

Applications must be made by an official authorized to sign for the eligible applicant.

2.03PROHIBITIONS ON FUND USE

Applications will not be considered for programs using any procedures which seek to provide treatment by modifying behavior by means of psychosurgery, aversion therapy, or chemotherapy (except as a part of routine clinical care). This does not apply to those programs of behavior modification which involve environmental changes or social interaction where no medical procedures are used.

2.031Prohibitions on Substance Abuse Prevention and Treatment (SAPT) Block Grant Funds. The State shall not use SAPT Block Grant funding to carry out any projects which include (1) the exchange of sterilized needles for hypodermic injection of any illegal drug, or (2) distribution of bleach.

SAPT Block Grant funds may not be used to (1) provide inpatient services; (2) make cash payments to intended recipients of health services; (3) purchase or * improve land, construct or permanently improve (other than minorremodeling) any building or other facility, or purchase major medical equipment; (4) satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; or (5) provide financial assistance to any entity other than a public or non-profit private entity.

2.032Prohibitions on DOE Drug-Free Schools and Communities Act Funds. Programs receiving U.S. Department of Education Drug-Free Schools and Communities Act High Risk Youth funds shall be used for direct services to a target population of not less than 90% High Risk Youth. A High Risk Youth is defined as an individual who is at high risk of becoming or has been a drug or alcohol abuser, and who must meet at least one of the following criteria:
1) A school dropout:
2) Is economically disadvantaged;
3) Is a victim of physical, sexual or psychological abuse;
4) Has experienced mental health problems;
5) Has experienced long term physical pain due to injury;
6) Has become pregnant;
7) Is a child of an alcohol or other drug abuser;
8) Has committed a violent or delinquent act;
9) Has attempted suicide;
10) Has experienced repeated failures in school;
11) Is in a Juvenile Detention Facility.

All recipients of these funds must also follow the guidelines for administration as described in the Education Department General Administrative Regulations (EDGAR) and National Regulatory Guidelines (NGR).

2.04APPLICATION SUBMISSION AND PROCEDURES
2.041ADAP Guidelines. The application must comply with state and federal guidelines and must be consistent with established priorities of the ADAP for the prevention and reduction of alcohol and other drug abuse.
2.042Confidentiality Requirements. The treatment services applicant must certify his familiarity and agreement to comply with the confidentiality requirements of 42 CFR, Part 2, which prohibit the unlawful disclosure of client records or any other client identifying information by alcohol or other drug abuse programs which are partially or totally funded by Federal funds, and/or licensed by the ADAP.
2.043Assurances and Certifications. The applicant must include assurances and certifications as required by the ADAP regarding affirmative action (including those for the disabled), civil rights, client rights, equal employment opportunities, compliance with the Fair Labor Standards Act, Americans with Disabilities Act (ADA) and other state and federal laws.

The applicant must include assurances and certifications regarding compliance with applicable policies initiated by the Department of Health. The ADAP is responsible for notifying all applicants and recipients of funding of these policies.

2.044ADAP Access to Records. The applicant must allow access to all records related to the grant or contract at the ADAP's request. ADAP assures compliance with all state and federal requirements regarding confidentiality.
2.045Financial Disclosure. The applicant must provide financial disclosure for the total agency, if part of a larger organization, if so requested by the ADAP.
2.046Processing. Deadlines-for submission of thefinal- application must be observed to receive consideration for review.

The applicant is required to submit sufficient copies of the RFP, RFA, or PR, as designated in the Specifications Sheet of the RFP, RFA, or PR.

2.047Qualifications of Proposals. Late Proposals, and Withdrawals of Proposals
1.Any proposal received at the ADAP after the exact time specified for the receipt will not be considered for that funding period unless:
a. It was sent by registered or certified mail not later than the fifth calendar day prior to the date specified for receipt of offers (e.g., an offer submitted in response to a solicitation requiring receipt of offers by the 20th of the month must have been postmarked by the 15th of the month or earlier; if mailing arrangements will not provide a postmark, you are advised to use certified or registered mail);

Proposals sent by Overnight or Express mail that arrive after the deadline specified will not be accepted for review.

b. It was sent by mail and it is determined by the ADAP that the late receipt was due solely to mishandling by the ADAP after receipt at the ADAP, or
c. It is the only proposal submitted.
2. The only acceptable evidence to establish:
a. The date of mailing of a later proposal or modification sent either by registered mail or certified mail is the U. S. Postal Service postmark on the wrapper or on the original receipt from the U.S. Postal Service. If neither postmark shows a legible date, the proposal or modification of proposal shall be deemed to have been mailed late. (The term "postmark" means a printed, stamped, or otherwise placed impression that is readily identifiable without further action as having been supplied and affixed on the date of mailing by employees of the U.S. Postal Service.)
b. The time of receipt at the ADAP is the time-date stamp on the proposal or other documentary evidence of receipt maintained by the ADAP.
3. Proposals may be withdrawn by written or telegraphic notice received at any time prior to award. Proposals may be withdrawn in person by an applicant or his authorized representative, provided his identity is made known and he signs a receipt for the proposal prior to award.
4. The normal revisions of proposals by applicants selected for discussion during the usual conduct of negotiations with such applicants will not be considered as late proposals or late modifications. The applicant will be notified by the ADAP as to the need for revisions or corrections. Revisions or corrections may be required in response to reviews by the ADAP and/or the Alcohol and Drug Abuse Coordinating Council.
5. Proposals submitted in response to an RFP, RFA or PR are subject to the provisions of the Freedom of Information Act.
6. The ADAP will evaluate program proposals in accordance with the criteria set forth in the RFP, RFA, or PR instructions.
7. The ADAP reserves the right to make an award without further discussion of the proposal received. Therefore, it is important that the proposal be submitted initially on the most favorable terms from both the programmatic and cost standpoints. After submission of proposals and closing thereof, no information will be released until after the award.
8. The ADAP reserves the right to reject any or all proposals received. It is understood that the proposal will become part of the official file on this matter without obligation to the ADAP.
9. Unnecessarily elaborate brochures or other presentations beyond that sufficient to present a complete and effective proposal are not desired. Elaborate art work, 'expensive visual and other presentation aides are neither necessary nor wanted.
10. If human subjects are involved or at risk in the proposed project, the following notice is applicable and Form HHS-596 (rev. 5/80), entitled "Protection of Human Subjects," or equivalent form, must be completed and certified, in accordance with the requirements of the Federal Regulations on the Protection of Human Subjects ( 45 CFR 46) and the instructions contained therein.
11. Proposals or additions to proposals will not be accepted via a facsimile machine (FAX).
2.05APPEAL PROCESS FOR ADVERSE ACTION

An appeal process is available to provide a mechanism by which a provider or grant applicant may appeal adverse action by the Bureau of-AlGofaokand Drug-Abuse Prevention relating to a program/contract/grant. Complaints which solely assert an objection to federal or state laws or regulations are not subject to appeal under this.procedure.

When a provider or grant applicant wishes to appeal an action by the ADAP, he/she may do so by submitting a written request to the Chairperson, Alcohol and Drug Abuse Coordinating Council. The request must be received by the Chairperson no later than thirty days from the date of receipt of notification of the adverse action by the provider or grant applicant.

The notice of appeal must contain:

1. A statement of the specified action which is being appealed.
2. The reason the provider/grant applicant believes the action was incorrect.
3. The specific relief requested.

When a request for appeal is received, the Chairperson of the Alcohol and Drug Abuse Coordinating Council will initiate the process by establishing a date for hearing the complaint.

An appeal of the decision by the Alcohol and Drug Abuse Coordinating Council may be made to the Director, Arkansas Department of Health. The request must be made within thirty days of receipt of notification of the Coordinating Council decision. The notice of appeal must contain the information specified in items 1, 2, and 3 above.

2.06PREREQUISITES FOR FUNDING OF THE APPLICATION

A proposed program cannot be considered for funding without the following prerequisites. Applicants should review the Request for Proposal, Request for Application or Progress Report for the prerequisites specific to the program for which-they are making application. Compliance with the following does not, however, guarantee funding.

2.061Administrative and Fiscal Structure, The applicant must be responsible to an administrative and fiscal structure, capable of administering an alcohol or other drug treatment or prevention project.
2.062Clear Purpose. The purpose, objectives and scope of the project must be clear.
2.063.Specific. Measurable Goals. The applicant must establish specific, attainable, measurable goals and objectives. These must be capable of being evaluated. Programs will be required to participate in theADAP Evaluation System, including client, program and financial management review, and site visits by ADAP staff.
2.064Referral Arrangement. The applicant for treatment and rehabilitative services must have written referral agreements with local or state agencies which may provide supportive services to the clients served in the proposed program or which may refer potential clients to the proposed program. These arrangements refer to formal written referral agreements signed by both parties and not to support letters.
2.065Community Support and Assistance. There must be validated evidence for the need for such a program with adequate community support to insure continuation after termination of the contract/grant funding. Such support must consist of -definedoffers of support .and-assistance, andmust be clearly documented giving details of the plan for continuation. These should include but are not limited to: volunteers, funding and equipment donations from community groups (e.g., churches, civic organizations), participation by local units of government, participation by private industry or business. The ADAP must be assured that services do not duplicate existing effective and efficient programs.
2.07CONTINUATION SUPPORT POLICY

Funding of a project does not imply approval for subsequent years.

2.08AWARD PERIOD

Grant awards are usually made for a twelve month period, normally coinciding with the state or federal fiscal year. Contracts or grants may be made for shorter periods after the start of the fiscal year.

2.09GRANT NEGOTIATION AND APPROVAL PROCESS
1. Application is received by the Bureau's Office of Financial Management and Compliance (OFM&C) after approval by the ADAP Alcohol and Drug Abuse Coordinating Council.
2. Notice of Grant Award is prepared by the Office of Financial Management and Compliance within seven working days of approval by the ADAP Alcohol and Drug Abuse Coordinating Council.
3.00CONTRACT AND GRANT FINANCIAL PROVISIONS
3.01AWARD INSTRUMENTS

The ADAP uses twcftypes of award instruments: Grant- an award of financial assistance to an eligible recipient. Such awards may be subject to certain terms and covenants and may be conditional upon delivery of specified goods or services. Contract - a_binding agreement between ADAP and the provider for the procurement of program or project related goods or services. Procurement contracts are subject to the requirements of the STATE ACCOUNTING PROCEDURES MANUAL. The grant or contract may specify the catchment area for provision of services.

3.02PAYMENT METHOD

The ADAP uses both advance payment and reimbursement. Advance payment may_be made to grantees prior to the actual delivery of goods or services. At the discretion of the Coordinator, Office of Financial Management and Compliance, advance payment may be made for the full amount of the grant or in monthly or quarterly installments. The decision to make advances is based on the federal cash management requirements, the need of the project or program for start-up cash, the availability of money, sound business practices, and such other considerations as required. Reimbursement payment is made to contractors and may be made to granteesaccoTding to the specificterms of the agreement subsequent to the actual delivery of goods or services.

3.03GENERAL CONSIDERATIONS

All subgrantees shall adhere to the cost principles set forth in the U.S. Office of Management and Budget (OMB) Circular A-122 (Cost Principles for Non-Profit Organizations) or Circular A-87 (Cost Principles for State and Local Governments) or its successors, and applicable cost principles duly promulgated by the Department of Health. All providers shall adhere to generally accepted accounting principles and/or applicable industry accounting -principles established by the American Institute of Certified Public Accountants and the Comptroller General of the United States of America.

3.04REASONABLE AND NECESSARY

All rates of payment or costs must be reasonable and necessary to ensure the provision of quality services. Under no circumstances shall the Department of Health be liable for payment in excess of the maximum contract/grant liability or for payment in excess of the ADAP rates where applicable. The ADAP does not enter into open-ended agreements with no limitations on the total liability to the State or Federal Government.

At the beginning of each grant period, treatment providers will submit to ADAP an estimated cost for each service. If payment is also received from the client or other resources, in no event should payment collected from a client or other resource and from the ADAP exceed the providers estimated cost for each service. If the provider receives a late or unexpected payment from an insurance or other third party on a client for services previously billed to ADAP, the ADAP must be reimbursed for the previously billed costs. This can usually be done as an adjustment to the current month's billing.

3.05RATE CHARACTERISTICS

Payment to providers is made on a prospective basis. Prospective payment means that the payment for goods or services is final payment regardless of the actual cost to the provider.

3.06BASIS OF RATE ESTABLISHMENT

" Rates of payment for the procurement of goods or services ased'on the following:

1. Prospective, ADAP rates: Rates are established solely by reference to the rate schedule approved by the ADAP. The method used to determine the rates of

-" payment maybe based on an average-or on a predetermined percentile of the '

actual costs of a base year, or of estimated costs for the program period. The ,. ,, method may be based on a formula describing'historical or estimated costs behavior in the comprehensive program environment. Alternately, the method of rate setting may be any other such method which yields rates which are reasonable and necessary to ensure the provision of quality services. The rates may from time to time be adjusted to reflect the effects of inflation by reference to the Consumer Price Index or to an appropriate industry price index.

2. Prospective, budget based: Rates are established on the basis of the provider's estimated costs. This method may be required in the absence of applicable ADAP established rates or for proposed rates which fall below 85% of the ADAP established rates.
3. Prospective, non-budget based: Rates are established on any such other method (e.g., statewide or regionwide cost/rate analysis of similar projects or program environments) which provide for reasonable and necessary rates.
3.07ADAP ESTABLISHED RATES

The ADAP will periodically establish rates for reimbursable services which have been determined to be reasonable and necessary to ensure the provision of quality treatment services in the general statewide treatment environment (i.e., medical models, residential treatment models, community mental health centers). A thirty, day advance written notice will be provided when new rates are established.

3.08TREATMENT SERVICE CAPACITY

Treatment programs shall provide treatment services, if ADAP funding is available, within fourteen days of receipt of request for admission. Interim services (see Definitions Section, 7.03) will be provided for IDU and pregnant clients until the time of admission.

Treatment programs must notify ADAP when they reach 90% of their capacity to admit individuals to their program.

If funded, subordinate care costs or allocations may be less than but may not exceed 33% of any grant for alcohol funding (i.e., ADAP adult treatment, SSBG adult treatment, adolescent treatment, etc.), or 33% of any grant for drug funding awarded to any treatment provider.

3.09PROVISION OF SERVICES

No client may be refused treatment services due solely to an inability to pay so long as the provider has available ADAP funds. When a provider has exhausted the reimbursable amount of their contract, clients may be refused due to inability to pay.

3-10FUNDING UTILIZATION

If utilization of total funding by category falls below 90% at the end of each quarter, at the option of the Director of the ADAP, funding may be reduced or deobligated from the provider's project or program and included in a pool for reallocation. Awards of reallocated monies shall be at the discretion of the ADAP Director.

...........The provisions of this section are not intended to establistrbifiing quotas for services, nor to determine the manner in which the provider shall earn income. At the discretion of the Director of the ADAP, billing quotas or limits may be implemented for service allocations if ;

'necessary to ensure the achievement of program goals-and objectives or if mandated by federal regulation or law.

Providers are encouraged to continue to submit bills for services provided to ADAP-eligible clients even after all ADAP funding is exhausted. ADAP may include over-utilization statistics or unpaid bills on file in awarding certain types of funds (see Section 5.0123).

3.11AUDIT
3.111Independent Audit: An annual audit for the fiscal period of the provider contract/grant shall be conducted by a Certified Public Accountant and shall be prepared to the generally accepted governmental audit standards as determined by the American Institute of Certified Public Accountants, the Comptroller General of the United States, United States General Accounting Office (GAO), and the United States Office of Management and Budget (OMB).

All subrecipients, regardless of organizational structure, receiving $25,000 or more in aggregate federal assistance for the contract/grant period will be audited in accordance with the provisions of the Office of Management and Budget (OMB) Circular A-128 and/or A-133.

A copy of the audit must be submitted to ADAP within 120 days of the end of the fiscal period. In the case of a contract/grant which ends or is terminated prior to the end of the fiscal period, a short period audit is required.

The independent audits will be reviewed forcompliance with program - - - - - -

requirements. If the audit reveals that the program is not in compliance, the ADAP will determine the steps necessary for the corrective action, notify the provider accordingly, and advise the provider of available administrative appeal procedures.

3.112Audit/Review Performed By ADAP: There must be maintained within the state agency administering the program the authority and responsibility for overall supervision, control and oversight of program activities. Therefore, in the best interest of the providers and the State, circumstances may indicate a need for various other types of audit activities. Such audits may encompass a variety of procedures including, but not limited to, service to billing reviews, limited financial management audits, management reviews and special investigations.

ADAP audits include, but are not limited to, the review and examination of documents, records, reports, systems, internal controls and accounting and financial procedures pertaining to the grant/subgrant, for one or more of the following purposes:

1. To ascertain whether the statements contained within an independent audit present fairly the financial position and results of financial operations in accordance with Generally Accepted Accounting Principles;
2. To determine the mathematical accuracy of the financial transactions;
3. To ascertain whether all financial transactions-have been properly recorded;
4. To confirm that eligible clients received reimbursable services in

-'" " ** 'J accordance with the agreement j* '

5. To investigate reported irregularities of the program involving the provider, its staf£ or Board of Directors; and
6. To determine compatibility with Federal and State laws, regulations and guidelines.
3.113.Audit Settlement: If the independent audit or AD AP review/audit results in a repayment due to ADAP, the provider will choose, upon the approval of the ADAP Director, either of the following recoupment methods;
1. Payment in full to ADH-ADAP within 90 days;
2. Negotiated recoupment schedule with installments deducted from payments made by ADAP to the provider.
3.12USE OF FUNDS - SPECIFIC REQUIREMENTS
3.121Restrictions. Contract/grant funds may be used specifically and only for the direct costs attributable to the execution of the particular alcohol or other drug abuse related program as approved by the ADAP and as detailed in the individual contract/grant. Also, services may only be provided in a catchment area as determined by the ADAP.
3.122Transfer of Funds. Contract/grant funds may not be transferred, consigned, assigned, or used to subcontract for services without the prior written consent of -the Director, ADAP.
3.123Replacement of Other Funds. No funds allocated from contract/grant funds will be used to supplant or otherwise replace funds which may be available from other federal, state, or local sources for the purchase of services, supplies, equipment, etc.
3.124Deviation from Budget. Contract/grant funds cannot be spent in any category other than that specified in the contract/grant. The ADAP recognizes, however, that situations may arise which will cause some deviation from the approved budget of a program. If such a situation arises, the provider must submit in writing to the ADAP the amounts of funds which are to be transferred between budget categories, and must show the revision by line item amounts.

This must be done before liabilities are incurred. The ADAP budget form must be used to show the transfer of funds. Also, any changes in the approved equipment list included in the funding application must have a similar written request made before the change can be made. In no case are changes effective without the written approval of the ADAP. A formal letter must accompany the budget revision giving justification for the changes. Approval will not be given retroactively.

3.125Retention of Financial Records. Records of the provider, including books of original entry, source documents, supporting accounting transactions, the general ledger, subsidiary ledgers, personnel and payroll records, cancelled checks, and related documents and records, to include electronic files, must be retained for a period of three years, with the following qualifications:
(1) the records shall be retained beyond the three-year period if audit findings have not been resolved,
(2) if the program is closed out, all records concerning the contract shall be transferred to the ADAP,
(3) the retention period starts from receipt of the final billing and/or expenditure report.
3.126Third Party Reimbursement - Treatment. Treatment programs supported with funds from the ADAP for the delivery of alcohol and other drug abuse services are expected to develop, to the extent possible, independence from ADAP support. Therefore, these projects will be encouraged and assisted in the development and use of alternate funding sources to supplement or replace ADAP support where possible. These funding sources include third-party payers, other available federal, state, local and private funds, and beneficiaries who are able to pay. (See Section 3.04) .

Where third-party payers, including government agencies, are authorized or under legal obligation to pay all or a portion of charges for health care services, all such sources must be billed for covered services and every effort must be made to obtain payment. The provider must have an operative procedure for identifying all persons served who are eligible for third party reimbursement.

Where a significant percentage of the cost of care and services provided by the project is to be reimbursed by a third party, there should be a written agreement with such third party.

3.127Third Party Reimbursement - Prevention. The ADAP encourages Prevention z programs to access additional funding sources, however, full time equivalent prevention staff paid with ADAP contract funds shall not charge for those contracted services. If an honorarium is received, see Section 3.16, Program Income.
3.128Deobligation of Funds. All contracts/grants shall automatically be deobligated 60 days following the end of the award period. Bills, not to exceed the amount of the obligated funds, submitted after the contract is deobligated may be paid after review and approval by the Coordinator, Office of Financial Management and Compliance. Such relief may be granted for any reasonable explanation of the delay if allowable by any federal regulations affecting the funding. Providers with unexplained delays or willful negligence in timely billing will not be granted relief from the deobligation requirement.
3.129Selected Items of Cost
3.1291Equipment.-Equipment is personal tangible property with a total acquisition price of $50.00 or more and useful life of at least one year. Only equipment listed in the contract/grant approved budget may be purchased. This must be done at cost equal to or less than the price listed in the original contract/grant. Unexpended funds at the end of a contract/grant period may not be used to purchase or lease items of capital expense such as office furniture and equipment to include typewriters, calculators, adding machines, copy equipment, mimeograph duplication machines, postage meters, VCR, TVs, camcorders, stereo equipment, or films, without special approval from the Coordinator, Office of Financial Management and Compliance. Equipment used as match must be cost incurred, during the contract/grant period. All equipment purchased with federal and local match dollars within the contract/grant period must be inventoried and reported to the ADAP within 30 days after the contract/grant ends.

The ADAP shall discourage the funding of programs whose major purpose is the purchase of equipment (i.e., films, audio-visual, recreational equipment, etc.). Approval shall be given only if the program is able to adequately justify that the application is for a total program which shall be assisted through the purchase of equipment. The ADAP shall not furnish equipment which will be used to supplement programs funded for purposes other than alcohol and other drug primary prevention, education, treatment or intervention.

A.Bidding. All renovation and purchases of equipment, supplies or services must be done in accordance with State Contract Bidding Procedures, and reported to the ADAP before final purchase is made Basically, the-following guidelines apply.
1. Commodity over $2,000 (known as Formal Bid). The provider must (1) develop specifications for each item bid, (2) mail an invitation to bid to all eligible prospective bidders, (3) make an insertion in a newspaper with statewide circulation, not less than five nor more than thirty days prior to the opening date, (4) post bid forms on a "Bid Notice Board," and (5) open and tabulate bids at the time and date indicated.
2. Commodity of $500 to $2,000 (Quotation Bid). The provider must (1) obtain at least three bids, (2) receive all bids at least one day prior to the date of purchase and (3) have the bids recorded and signed by the person receiving them.
3. Commodity of $500 or less - No bids are necessary. The best judgment of the agency purchasing official should be used.
4. Note that in any case where other than the low bid is to be purchased, a full letter of justification must be sent to the ADAP.
B.ADAP Retention of Ownership. All equipment purchased by any program with contract/grant funds are the property of the Department of Health, Bureau of Alcohol and Drug Abuse Prevention and must be returned to the ADAP if for any reason the program is terminated or ceases to function as an alcohol or other drug related program or operate according to the specified guidelines of the grant. Such equipment, however, may remain with the provider after the contract/grant period as long as the program continues in operation. The program must assure, in writing, each year that the program will continue to serve the population designed in the original grant application. Failure to do so will result in return of property to ADAP.
C. " Inventory Requirements, Under a line item cost reimbursement contract/grant, all equipment purchased with contract/grant funds remain the property of the ADAP and must be kept on the inventory list. Each item shall be affixed with an identification tag provided by the ADAP.

The program should provide the ADAP with an inventory list of all equipment costing over $250.00 purchased with contract/grant funds. The list should include a description of the item and its serial number. This equipment is the property of ADAP and within 48 hours of the program's closing, all equipment shall be returned to the ADAP.

3.1292Travel. (Applies to line item cost reimbursement contracts/grants only.) Reimbursement for travel expenses will be made only if specified in the contract/grant. Reimbursement will be made for mileage only, and at a rate not to exceed the rate established by the Chief Fiscal Officer of the State of Arkansas, (currently 25 cents per mile) based on the shortest highway distance. Reimbursement for meals, lodging, fees, etc., will not be allowed unless specified in the program contract/grant. In such cases, the prevailing state rate of reimbursement will apply. Out-of-state travel must have prior approval from the ADAP to be eligible for reimbursement except for travel into Texarkana, Texas, Memphis, Tennessee or similar such immediate border areas.
3.1293Insurance. Treatment programs funded by the ADAP shall be required to have a liability program thatprovides for the protection of the-physical and financial resources of the program, coverage of the building and equipment and coverage of its clients, staff and general public. If the program is part of a governmental agency, in lieu of liability insurance, the program must have other appropriate means of protection for the items specified above.
3.130Program Implementation Requirements. Contracts/grants must be implemented within the time authorized by ADAP (90 days from date of award or approved project start date). Contracts/grants not implemented within this time frame will be deobligated unless the approved applicant can justify to both the ADAP Director and to the ADAP Alcohol and Drug Abuse Coordinating Council why this action should not occur. Deobligated funds will revert to the ADAP.
3.13ALLOWABLE COSTS

The following is a general guideline. Federal and State regulations specific to the program -" being "funded may differ. Seethe RFP/RFA-or Progress Report for exceptions.

3.131Salaries and Fringe Benefits; The costs of salaries are allowable to the extent that compensation of each employee is (1) reasonable and necessary, (2) comparable to that paid for similar work in the labor market and (3) supported by time-records. NOTE: Budgeted positions which are vacant should be filled within sixty (60) days of the effective date of the contract, or the cost removed from the budget.

FICA, life and health insurance, unemployment coverage, worker's compensation, retirement and pension plans are allowable if reasonable and made available to all employees in the program.

The cost of housing and/or food is allowable only if it is part of an employee's compensation because of required attendance at the facility.

Fringe benefits for volunteers are not allowable; however, they may be reimbursed for expenses directly related to the program.

3.132Maintenance and Operation
3.132.1Accounting and Auditing: The expense of establishing and maintaining accounting and other information systems required in the performance of the contract is an allowable expense. The cost of the required annual independent audit is also allowable.
3.132.2Advertising: Costs are allowable for recruitment of personnel, * procurement of scarce items and'disposal of scrap or surplus-material.
3.132.3Bonding and Insurance: The costs of bonding and insurance are allowable if in accordance with sound business practice and the rates are competitive.
3.132.4Building Space and Related Facilities: Costs associated with building space and related facilities used for the benefit of the program are allowable. Funds may not be utilized for the purchase, construction or permanent improvement (other than minor remodeling) of any building.
3.132.5Communications: Allowable costs include (1) Telephone costs for local and long-distance calls, service charges, installation costs, and similar expenses. (2) Postage used in the office for communication related to the program.
3.132.6Depreciation and Use Allowance: A_depreciation schedule should be available and supported by adequate records and inventory.
3.132.7 v Equipment Expenditures: Expenditures for equipment costing less than $500 or with a useful life of less than two years are allowable. If the total costs of all components of a system (such as for

......... computers or stereos) is S500 or more,"it must be considered a capital expense (see 3.14).

3.132.8Equipment Rental: The cost of rental equipment is allowable. Lease-purchase of equipment must be recovered through depreciation.
3.132.9Field Trips: The cost of educational and recreational outings for clients, including the cost of admission, transportation (if not provided for under another line item), snacks, beverages, and food costs directly associated with field trips are allowable.
3.132.10Food Service Supplies: Costs of supplies (such as plates, silverware, etc.) directly associated with the provision of meals to clients is allowable.
3.132.11Freight: Costs incurred for freight, postage, and other transportation costs directly relating to goods purchased, delivered or moved from one location to another are allowable.
3.132.12Indirect Costs: See Item 3.17
3.132.13Inspections: The cost of required inspections such as health and fire inspections, is allowable if such inspections are not available without charge.
3.132.14Insurance: See Bonding and Insurance
3.132.15Lease Costs: See Rental Costs
3.132.16Maintenance and Repair: Costs incurred for necessary maintenance, repair or upkeep of property, including motor vehicles.
3.132.17Materials and Supplies: The cost of materials and supplies necessary to carry out the objectives of the program is allowable. This line item should be broken into the following categories: Office Supplies (paper, folders, ink, pencils, etc.), Janitorial Supplies (brooms, mops, soap, etc.); Program Supplies (classroom materials, etc.). (See Section 4.09 and 4.10 regarding audio-visuals, books, tapes, etc.).
3.132.18Meetings and Conferences: See Training
3.132.19Memberships: The cost of membership in trade, technical, and professional organizations is allowable if:
(1) related to the cost of the program;
(2) is for provider membership;
(3) cost is reasonable; and
(4) not for membership in an organization which devotes a substantial part of its activities to influencing legislation.
3.132.20.Postage: See Communications
3.132.21Printing and'Reproduction: Costs for printing" and reproduction services necessary for the program, including but not limited to forms, reports and manuals is allowable.
3.132.22Public Information Costs: Costs for pamphlets, news releases, and -; - other forms of information services are allowable when the primary purpose of such activities is to inform the public about the availability of services. (Prior approval from ADAP is required. See Section 4.08 for additional information.)
3.132.23Rental Costs: Rental costs are allowable to the extent they are reasonable and necessary and the provider does not gain a material equity in the property.
3.132.24Subcontracted Services: May be allowable:
(1) Based on services rendered in relation to the contract;
(2) the necessity of contracting for the services;
(3) the past pattern of such costs;
(4) whether contracting is more economical than service performed by employee;
(5) the qualifications of the individual or firm and fees charged; and
(6) written contractual agreement for services. (Also see Section 4.07.)
3.132.25Subscriptions or Reference Materials: The cost of books and subscriptions to trade, business or professional periodicals is allowable when related to and subscribed for the program.
3.132.26 Taxes: In general, tax payments which the program is legally required to pay are allowable. (See Section 3.14 - 9).
3.132.27Training. Meetings. Conferences: In-service training is allowable . where the primary purpose is the dissemination of technical information of direct benefit to the program. Costs may include

meals, transportation, lodging; registration fees, materials, etc. The cost may not exceed allowable limits for State employees on State business.

3.132.28Travel: Costs are allowable for mileage, lodging, meals and related items incurred by employees who travel on official program business. The maximum allowable may not exceed limits for State employees on official business. In no case may funds be used to pay for employees' travel between the place they are employed and their residence without prior approval from ADAP.
3.132.29Utilities: The cost of utilities is allowable.
3.14UNALLOWABLE COSTS

The following costs are unallowable:

1. Bad Debts
2. Bidding and Proposal Costs
3. Capital Expenditures (unless-specifically approved bytheiunding source
4. Capital Payments (mortgage payments, investments, etc.)
5. Contingency Funds
6. Contributionsand Donations
7. Deposits (for utilities, etc.)
8. Entertainment (This is not intended to apply to clients receiving socialization services with meals, congregate meal services, or field trips.)
9. Fines and Penalties
10. Interest and Other Financing Cost
11. Legal Services
12. Line Item Overages
13. Lobbying
15. Organization Costs (incorporation fees, fund raising costs, etc.)
16. Profits and Losses on Disposition of Capital Assets
17. Purchase or Improvement of Land or Buildings
18. Severance Pay
3.15CASH DEPOSITORIES

The ADAP does not impose contract or grant requirements which;

1. Require the provider to use a separate bank account for the deposit of grant funds or reimbursement funds.
2. Establish any eligibility requirement for banks or other financial institutions in which providers deposit funds.
3.16PROGRAM INCOME

Program income means gross income earned from activities part or all of the cost of which is borne as a direct cost by a contract or grant. It includes but is not limited to such income in the form of fees for services performed during the award period, proceeds from sale of tangible or.. real property, usage or rental fees, and patent or copyright royalties. If income meets this definition, it shall be considered program income regardless of the method used to calculate the -amount paid to the provider - whether, for example, by a cost reimbursement method or fixed price arrangement.

Program income may be retained by the provider only if allowed by the federal funding source and specifically authorized in writing by the ADAP, If retention of program income is approved it must be deducted from the funded amount or, if approved by ADAP, used for costs which are in addition to allowable costs of the program but support the objectives of the funded program.

3.17REIMBURSEMENT

No payment can be made until a completed W-9 is on file with the Arkansas Department of Health. The W-9 must reflect the legal name of the entity and the full mailing address for receipt of warrants. Any change in the name and address requires the completion and submission of a revised W-9.

3.171Billing. All funding requests are submitted on the appropriate forms provided by the ADAP. These must be for the actual units of service delivered or expenses incurred, if budget based, for the month not to exceed the limits of the contract/grant nor the ADAP ceiling rates for the fixed price contracts/grants.
3.172Billing for Services. All reimbursement requests for any treatment service must be reconciled with the Client Logs (ADAP-6) for the particular report month. When

- -j - the amount requested for these services cannot be reconciled with what appears on the ADAP-6 and correction or clarification cannot be made by telephone, the -

..... " request will be returned immediately to the provider for correction and resubmission. If the reimbursement request does correspond with the ADAP-6, the Office of Financial Management and Compliance will forward for payment.

3.173Professional Requirements to Provide Subordinate Services. Only services by physicians, psychiatrist, psychological examiners, clinical psychologists, psychiatric registered nurses and laboratories are considered to be eligible for billing as Subordinate Services. If any agency wishes to request an exception for another category or staff member, then such a request for reimbursement for any such service must be made in writing and written approval must be received from the Director, ADAP, prior to billing for such services.
3.174Billing Due Dates - Reimbursement Requests. All programs are required to submit their requests for reimbursement or expenditures monthly to be postmarked no later than the seventh of the month.
3.18UNEXPENDED FUNDS

Any ADAP funds over 10% remaining at the end of a contract/grant period must be returned to the ADAP. A written request to retain unexpended funds (including budget) may be -addressed to the ADAP Director. If approved, these funds may be retained by the contractor/grantee. A request for retention of funds 10% and under shall be addressed in writing (including budget) to the Coordinator, Financial Management and Compliance Section.

3.19INDIRECT COST

Indirect cost shall be allowable only when special approval is given, in writing, from the . Director, ADAP. Generally this shall not exceed 10%. Indirect costs are costs incurred by an organization that are not readily identifiable with a particular project or program but are necessary to the operation of the organization and the performance of its program.

A copy of the Federally approved indirect cost rate, or a cost allocation showing the items and expense included and the method used to equitably distribute the cost should be maintained by the provider.

4.00GENERAL REQUIREMENTS
4.01ACCESSIBILITY OF FACILITIES

Facilities, programs, and services-supported-inpart or in whole with funds provided by the ADAP will be so located as to be readily accessible, available, and responsive to the needs of the population to be served without discrimination because of sex; race, disability, age, religion, color, national origin, or duration of residence. Services for alcohol and other drug abuse prevention or treatment will be actively publicized so as to be generally known to the population to be served.

4.02EQUAL OPPORTUNITY

Equal employment opportunity will be assured by all programs. Discrimination in any aspect of personnel administration based on race, sex, age, color, national origin, religion, disability or political affiliation is prohibited except where age, sex, or physical requirements constitute a bona fide occupational qualification. No qualified applicant will be denied employment in a position wholly or partly supported by funds provided by the ADAP solely on the basis of a prior history of alcohol or drug dependence. An Affirmative Action Plan shall be prepared and retained for review.

4.03LICENSURE

All persons, partnerships, associations or corporations establishing, conducting, managing, or operating an alcohol and drug abuse treatment program must be licensed by the Bureau of Alcohol and Drug Abuse Prevention as provided by Act 173 of 1995

4.04TREATMENT REQUIREMENTS
4.041Basic Requirements. All prospective contractors/grantees for funds for treatment programs are obligated to be familiar with, and comply with, the provisions of all pertinent state, federal, and local regulations governing the activities of treatment programs." In addition, providers should be aware that programs are subject to the requirements of the ADAP Licensure Standards Manual for Alcohol and Other Drug Abuse/Addiction Treatment Programs. Providers are advised to review thoroughly the Licensure Standards package for those specific requirements (see item 4.03)

The ADAP will not award funds to programs who fail to meet other licensure laws. For example, any treatment program that provides residential or similar services to adolescents must also comply with the applicable licensure requirements mandated by the Department of Human Services, Division of Children and Family services (DCFS).

4.042Client Records. Treatment facilities are required to establish a uniform client record system to document and monitor client care. These client records will conform to the requirements established in the ADAP Licensure Standards.
4.043Retention of Client Records. The provider shall retain all records and other documents relating to services rendered and the individuals in receipt of the services for a minimum of three (3) years from the expiration of the agreement for the purpose of client follow-up, evaluation of the program and for completion of compliance reviews in progress at that time.
4.044Confidentiality. Confidentiality of alcohol/drug abuse client records shall be assured by the provider and shall be in accordance with all pertinent state and federal regulations. Existing federal iaw (42 CFR; Part 2) provides for safeguarding files or any other client identifying information from access by any unauthorized individuals, and requires that records be maintained in a secure manner All records, however, are subject to review by the ADAP at any time for the purpose of monitoring proper execution of the contract/grant, and must be made available to ADAP upon request.
4.045Client Input. Each program will develop and implement a procedure whereby persons served by the program can provide input on the operation and services of the program.
4.046Client Grievance Procedures. Each program shall develop and implement a procedure whereby persons served by the program can communicate a grievance against that program and the means whereby the program will respond to the grievance. The program will also develop and implement a procedure that documents the mechanism whereby persons served by the program are informed of this procedure.
4.05ON FILE REQUIREMENTS
4.051Items Required On File with ADAP. As applicable to-particular programs, the following items are required to be provided to the ADAP for file, prior to approval for funding.
1. A current list of Board of Directors, including names, addresses, telephone numbers, date of appointment, length of term, and identification of officers. The Board should represent the gender, ethnic and economic-level population distribution of the entire geographic area to be served.
2. A description of volunteers including numbers used in the program, a summary of qualifications for the duties to be performed, and methods of recruitment.
3. A copy of the bond for the bookkeeper or accountant. Note that this must be provided prior to the effective date of the contract/grant.
4. A copy of the Articles of Incorporation
5. Current referral agreements with local human service providers.
6. A narrative history of the program and current organizational chart.
7. Listing of program personnel.
8. The goals, objectives and target groups of the program for the current contract/grant year.
9. Evaluation Methodology.
10. Treatment Approaches and Philosophies.
11. Current subcontractors and cooperative agreements.
12. Geographic area of service; program hours of-operation; client/staff ratio; and facility capacity according to local fire, health and safety standards.
13. Admission criteria.
14. Assurances of Section 504 and Americans with Disabilities Act compliance.
15. Annual assessment of program progress.
4.06PARTICIPATION IN CONFERENCE

The provider must participate in a minimum of one local or statewide sponsored coordinating conference, training seminar, or training workshop as so directed by the ADAP if deficiencies are identified which require specific training.

4.07SUBCONTRACTED SERVICES
4.071Restriction of Services. Unless-subcontracted services are specifically identified in the program contract/grant, they may not be paid for from contract/grant funds.
4.072Other Agency Subcontractor: -If a subcontractor is employed-full-time by another agency or group, a letter of permission must be obtained from the regular employer and approved by the ADAP prior to utilization in the funded program.
4.073Subcontract Requirements. All subcontractors are subject to the same requirements as the prime contractor/grantee. Subcontract arrangements must contain, at a minimum, the following conditions.
1. A statement describing the particular services to be provided.
2. A statement setting forth the number of hours or description of other rate computation which the consultant has agreed to provide.
3. A statement of the amount of compensation to be paid.
4. A clear understanding that the fee-for-services, or other compensation is available only from the funded program and not from the ADAP or other program participants.
5. Provision for termination of the contract if the above requirements are not met.
4.08ADVERTISING AND PUBLICITY

Contract/grant funds or matching funds to be spent for advertising or publicity must be clearly identified in the program contract/grant line item budget and the advertising or publicity materials must have prior written approval of the ADAP before implementation. All publicity and advertising materials, releases, etc., must identify the program as an affiliate of the Bureau of Alcohol and Drug Abuse Prevention. In addition, treatment programs shall conduct an active publicity campaign for alcohol and other drug abuse treatment utilizing all available public service announcements in the local news media.

4.09AUDIO-VISUAL MATERIALS

All audio-visual materials used by the project must have prior content approval from the, Director, Prevention Services before purchase-obligation is incurred. Review copies must, where feasible, be furnished to the ADAP.

4.10BOOKS. TAPES. FILMS AND OTHER LITERATURE

All books, tapes, films, and other literature must have prior content approval from the Director, Prevention Services at the ADAP before purchase obligation is incurred. Review copies must, where feasible, be furnished to the ADAP.

4.11VOLUNTEERS

If volunteer services are included in the terms of the contract/grant, the provider is responsible for the overseeing of the volunteers and for the monitoring of services provided by these individuals.

4.12TERMINATION

Either party has the right to terminate a contract/grant on 30-day written notice to the other party. Termination may also result by failure of the provider to meet contractual or grant obligations.

5.00SPECIFIC REQUIREMENTS
5.01ALCOHOL/DRUG TREATMENT CONTRACT/GRANT REQUIREMENTS
5.011Compliance With Funding Criteria. All prospective applicants for treatment funds for the initiation and/or the continuation of treatment programs must comply with current, applicable state and federal regulations. See Section 4.04 of this manual for specific program requirements. Providers will submit financial and program reports as required by ADAP according to established schedules.
5.012Maintenance of Minimum Capacity. Each treatment program receiving funds from the ADAP must meet minimum performance levels as identified in the current contract/grant.
5.0121Minimum Requirement. All treatment programs must maintain 90% minimum capacity as identified in the current contract/grant.
5.0122Failure to Maintain Minimum, If the provider has not met the required performance levels, the ADAP shall either terminate the contract/grant or reduce the minimum capacity and funding.
5.0123Operation Above Capacity. If the provider has consistently operated above the contracted level of performance and reported those services on ADMES, the ADAP may increase, contingent upon receiving a request from the provider, and upon funds being available, the level of funding and program performance for a specified period.
5.013ADMIS Compliance. All alcohol and other drug abuse.treatment and . rehabilitation programs in Arkansas are required to report client-related data in accordance with the requirements of the current ADMIS. For ADAP funded programs, failure to report may result in the suspension or loss of ADAP required licensure. For acute care, hospital based and.other non-funded alcohol and drug abuse treatment programs, failure to report may result in notification to the Arkansas Department of Health, Division of Health Facility Services of failure to comply with requirements of Act 25 of 1991. Licensure awarded automatically pursuant to Section 4 (a) and (c) of Act 173 of 1995 shall not be affected by failure to report.
5.014Report Requirements
5.0141ADMIS Billing Reports. All funded treatment programs are required to submit their requests for reimbursement on a monthly basis. At minimum, providers are to submit the ADAP-5 and ADAP-6 to be postmarked by the seventh (7th) day of each month. All clients must be reported, not just clients for which reimbursement is requested.
5.0142ADMIS Client Reports. A complete package of ADMIS Client Reports must be submitted by all treatment programs, to be.postmarked by the seventh (7th) day of each month.
5.0143Other Reports. There may be occasions where separate, additional reports are needed from a provider. The ADAP reserves the right to make such requests.
5.02PRIMARY PREVENTION. EDUCATION. INTERVENTION CONTRACT/GRANT

REQUIREMENTS

All prospective applicants must comply, with ADAP procedures and the appropriate RFP.,, or-RFA format when making application. The-services to be provided must reflect and promote ADAP's basic policies and philosophies regarding that service category. Community acceptance of; commitment 1o, and involvement with the program are necessary-elements. The program should compliment and support the local treatment and rehabilitation services. Contract/grant awards reflect only a one year funding period. Special short-term programs may be funded and may require special application and reporting procedures.

5.021Compliance with Funding Criteria. All prospective applicants for the initiation and/or the continuation of a Prevention, Intervention or Education Program must comply with current, applicable state and federal regulations. Specific compliance requirements for each type of program are specified in the individual contract/grant and applicable sections of this manual.
5.022ADMIS Compliance. Any program receiving funds for prevention, intervention or education is required to participate in the Alcohol/Drug Management Information System (ADMIS). A signed Statement of Agreement shall be obtained from each

.. .applicant .prior, to approval of funding.-Failure J:o report on. ADMIS may result in suspension of the current contract/grant.

5.023Report Requirements
5.0231Billing Reports. All prevention, intervention and education programs are required to submit their requests for reimbursement or reports of expenditures on a regular basis. The actual time periods are specified in the individual contract or grant.
5.0232Program Reports. All prevention, intervention and education programs are required to submit reports of progress, including level of activity on a regular basis as identified in the individual contract or grant.
5.0233Other Reports. The provider shall submit separate additional reports as requested by the ADAP.
6.00DIRECT SERVICES
6.01DETOXIFICATION SERVICES CENTER- *

Direct services are provided by the Benton Detoxification Services Center. The program is two weeks long, providing medical detoxification from alcohol and other drugs of abuse, counseling, referral and follow-up.

6.011Admission Criteria. Individuals seeking admission shall be at least 18 years of age and a resident of the State of Arkansas.
6.012Types of Admission:
6.012.1Voluntary Admission. Individuals seeking admission will sign in voluntarily.
6.012.2Court Ordered Admission. Any person having a reason to believe that an addicted person is homicidal, suicidal or gravely disabled may file a petition with the Clerk of the Probate Court to have that person involuntarily committed under the guidelines described within Act 10 of the 1989 Third Extraordinary Session.
6.013Reasons Individuals Are Denied Admission
6.013.1Disciplinary Discharge. Clients given a disciplinary discharge or who leave prior to the discharge date are ineligible for readrnission for one year except in case of a medical emergency.
6.013.2Within Three Months of Discharge. Clients seeking readrnission within three months after discharge are ineligible for admission, except in case of a medical emergency.
6.02SUPERVISED TREATMENT AND EDUCATION PROGRAM (S.T.E.P.)

Direct services are provided by the Supervised Treatment and Education Program (S.T.E.P.) This is adrug diversion court with an ADAP assessment component (Central Intake Unit) and a treatment program grantee component.

6.021Admission Criteria. Detailed admission criteria has been developed by the court in conjunction with the Prosecuting Attorney and Public Defender's offices. However, in general, admission is restricted to non-violent, first time offenders who have a need for alcohol/drug treatment.
7.00DEFINITIONS

The definitions provided here are intended to assist the reader in understanding some major terms and documents as used routinely by the ADAP. The list is not all inclusive. The reader is referred to the ADAP licensure Standards, the ADMIS Manual, the Request for Proposal (RFP), Request for Application (RFA), or Progress Report (PR) package of instructions, and to the appropriate contract or grant document for further clarification or specific project areas.

7.01LICENSURE STANDARDS FOR ALCOHOL AND/OR OTHER DRUG ABUSE/ADDICTION TREATMENT PROGRAMS. Those Licensure Standards which were developed and revised by the ADAP and the ADAP Standards Review Committee, they contain criteria by which treatment programs are reviewed in the Licensure process.
7.02ALCOHOL/DRUG MANAGEMENT INFORMATION SYSTEM (ADMIS). A data collection system developed and operated by the ADAP to be used in alcohol and drug abuse treatment programs. Reporting under this system is a requirement in accordance with Act 25 of 1991 and applies to all alcohol and drug treatment programs operating in the State of Arkansas.
7.03INTERIM SERVICES Interim substance abuse services means services that are provided until an individual is admitted to a substance abuse treatment program. At a minimum, interim services include counseling and education about HIV and tuberculosis (TB) about the risks of needle-sharing, the risks of transmission to sexual partners and infants, and about step that can be taken to ensure that HIV and TB Transmission does not occur, as well as referral for HIV or TB services if necessary. For pregnant women, interim services also include counseling on the effects of alcohol and drug use on the fetus, as well as referral for prenatal care.
7.04PRIMARY PREVENTION STRATEGIES
7.041Information Dissemination: This strategy provides awareness and-knowledge of the nature and extent of alcohol, tobacco and drug use, abuse and addiction and their effects on individuals, families and communities. It also provides knowledge and awareness of a available prevention programs and services. Information dissemination is characterized by one-way communication from the source to the audience, with limited contact between the two. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following:
(1) clearinghouse/information resource center(s);
(2) resource directories;
(3) media campaigns;
(4) brochures;
(5) radio/TV public service announcements;
(6) speaking engagements;
(7) Health fairs/health promotion; and
(8) information lines.
7.042 Education: This strategy involves two-way communication and is distinguished from the Information Dissemination strategy by the fact that interaction between the educator/facilitator and the participants is the basis of its activities. Activities under this strategy aim to affect critical life and social skills, including decision-making, refusal skills, critical analysis (e.g. of media messages) and systematic judgment abilities. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following:
(1) classroom and/or small group sessions (all ages);
(2) parenting and family management classes;
(3) peer leader/helper programs;
(4) education programs for youth groups; and
(5) children of substance abusers groups.
7.043Alternatives This strategy provides for the participation of target populations in activities that exclude alcohol, tobacco and other drug use. The assumption is that constructive and healthy activities offset the attraction to, or otherwise meet the nBedsusnalry-fiiied by alcohol, obacco and other drugs and would, therefore, minimize or obviate resort to the latter. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following:
(1) drug free dances and parties;
(2) youth/adult leadership activities;
(3) community drop-in centers; and
(4) community service activities.
7.044Problem Identification and Referral: This strategy aims at identification of those who have indulged in illegal/age-inappropriate use of tobacco or alcohol and those individuals who have indulged in the first use of illicit drugs in order to assess if their behavior can be reversed through education. It should be noted, however, that this strategy does not include any activity designed to determine if a person is in need of treatment. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following:
(1) employee assistance programs;
(2) student assistance programs; and
(3) driving while under the influence/driving while intoxicated education programs.
7.045 - Community-Based Process: This strategy aims to .enhance the ability of the community to more effectively provide prevention and treatment services for alcohol, tobacco and drug abuse disorders. Activities in this strategy include organizing, planning, enhancing efficiency and effectiveness of service implementation, inter-agency collaboration, coalition building and networking. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following:
(1) community and volunteer training, e.g., neighborhood action training, training of key people in the system, staJo7officials training;
(2) systematic planning;
(3) multi-agency coordination and collaboration;
(4) accessing services-and funding; and
(5) community team-.. building.
7.046Environmental: This strategy establishes or changes written and unwritten community standards, codes and attitudes, thereby influencing incidence and prevalence of the abuse of alcohol, tobacco and other drugs used in the general -population. -This strategy is divided into two subcategories to permit distinction between activities which center on legal and regulatory initiatives and those which relate to the service and action-oriented initiatives. Examples of activities conducted and methods used for this strategy shall include (but not be limited to) the following:
(1) promoting the establishment and review of alcohol, tobacco and drug use policies in schools;
(2) technical assistance to communities to maximize local enforcement procedures governing availability and distribution of alcohol, tobacco and other drug use;
(3) modifying alcohol and tobacco advertising practices; and
(4) product pricing strategies.
7.05PROGRESS REPORT (PR). That process by which current contracted providers of prevention or treatment services are evaluated, and their grant is either renewed, not renewed, or renewed pending contingencies placed by the ADAP Alcohol and Drug Abuse Coordinating Council; This process involves submitting to the ADAP a document which reports the activities of the provider during the current grant period, and outlines a proposed program for the upcoming grant period. Other performance indicators such as licensure visits, service-to-billing audits, case reviews, and ADMIS reporting are taken into account during this process.
7.06REGIONAL ALCOHOL AND DRUG DETOXIFICATION (RADD) -

The Regional Alcohol and Drug Detoxification (RADD) Program will consist of an evaluation and three levels of service:

(1) Medical Detoxification,
(2) Observation and
(3) Regional Alcohol and Drug Detoxification Services. An individual-presenting for detoxification will be-evaluated by a Regional Detoxification Specialist. The-RADD evaluation is a process to assist in the evaluation and placement in the appropriate level of service, and may include the administration of standardized screening or assessment instruments. At a minimum the following information will be gathered:
(1) vital signs,
(2) presenting symptoms,
(3) substance abuse history,
(4) social/economic history.

Based upon the RADD evaluation, a determination of the appropriate level of service will be made:

1. Clients in an acute phase of withdrawal will be referred to the appropriate medical facility for medical detoxification. Upon discharge from the medical facility, the client will be returned to the AOD treatment facility and placed in residential treatment followed by continued care. . * --
2. Clients who are in mild withdrawal will be placed in the Observation level of the RADD program. 'Following discharge from observation, the client will be placed -in residential treatment followed by continued care.
3. Clients who exhibit no apparent signs of withdrawal will be placed in RADD Services (residential treatment followed by continued care): ...
7.061Continued Care - The component of the treatment process which assures the provision of a continued contact with-the client The continued care plan will follow the termination of services from the primary care modality (medical detoxification, observation and RADD services), designed to support and to -increase the,gains made to date in the treatment process. The continued care plan development will start prior to discharge and when possible involves participation of the client's significant others. At a minimum this will include participation in at least four (4) outpatient group counseling sessions and involvement in community based support groups.
7.062Medical Detoxification - Includes 24-hour medically supervised care in a hospital setting or medical model facility. Includes a short-term treatment (3 days), during which time prescribed medication is used to restore physiological functioning after it has been upset by toxic agents, including alcohol. Service shall be under the supervision and guidance of a licensed physician. Service is allowable when:
(1) an integral but subordinate part of the outpatient or residential service,
(2) necessary for the client to receive the residential or outpatient services, and
(3) determined to be needed on a case by case basis. A unit of service is a day.
7.063Observation. - Includes monitoring on a 24-hourspertiay basis of a client who is undergoing mild withdrawal in a residential/live in setting. Monitoring will consist of taking the client's vital signs jsv.ery .two hours, or more frequently if indicated, until results remain within the normal range for at least four hours. Vital signs will be-taken by a staff member trained and certified by the. ADAP. The facility shall establish approved emergency medical procedures. These services shall be available should the client's condition deteriorate and emergency procedures be required. A unit of service is one day.
7.064Regional Alcohol and Drug Detoxification Services (RADD Services)- A one time charge per admission for a client presenting themselves for medical detoxification from substance abuse. The RADD services process will provide the client with up to three days residential treatment with a continued care plan which will include up to four outpatient group counseling sessions. All or part of these services may be provided to individualize the treatment to meet the client's needs. A unit of service will include the following;
(1) initial evaluation,
(2) referral to the appropriate leveKof detoxification services,
(3) up ±o-three days residential treatment, and
(4) continued care including up to four outpatient groups.
7.065Regional Detoxification Specialist - A person trained and certified by the Bureau of Alcohol and Drug Abuse Prevention.. Training will, provide competency at a minimum, in the following areas:
(1) taking of vital signs,
(2) evaluation of . presenting symptoms and compiling an accurate substance abuse history,
(3) certification in cardiopulmonary resuscitation (CPR),
(4) certification in a First Aid course,
(5) training in diffusing hostile situations, and
(6) knowledge of alternate social, rehabilitative and emergency referral resources.
7.07REIMBURSABLE TREATMENT SERVICES
7.071.Residential Service - Includes care provided to a medically or socially diagnosed - alcohol/drug dependent client who is not ill enough to need admission to a hospital, but who has need of more intensive care in the therapeutic setting with supportive living arrangements. This service shall include at a minimum, intake, screening, individual and group therapy, room and board. Residential service is a comprehensive service and is intended to include all services, excluding subordinate units, provided to residential clients. A daily client schedule should reflect a minimum of five hours of structured activity related to treatment. A unit of service is one day.
7.072Outpatient Service - Includes care provided to a medically or socially diagnosed alcohol/drug dependent client in an outpatient environment. Outpatient service may be provided on an individual, group, and/or family basis; it may also include -partial day treatment. A unit of service is one hour.
7.073Partial Day Treatment - Includes care provided to a medically or socially diagnosed alcohol/drug dependent client during any part of the 24-hour day for a minimum of four and one-half hours per day. Services may include counseling, occupational therapy, recreational therapy and a meal. This unit of service is available for outpatient clients only. A unit of service is one day.
7.074Intensive Outpatient Service - Aholistic approach in working with alcohol and drug treatment clients, including injection drug users (IDU), using many different -f

-treatment methods: This willmelude-assessment services for the purpose of developing a treatment plan that will focus on, but is not limited to the following:

(1) substance abuse counseling,-education, referral, monitoring
(2) services to family arid significant others;
(3) mental health, medical issues;
(4) vocational, educational; and,
(5) relapse prevention and aftercare. Sessions are held at least three (3) times per week. A unit of service is at least three (3) consecutive hours of outpatient service.
7.075Assessment - A one time charge per client per admission which includes the administration of an interview to provide information on the client, the client's alcohol/drug taking history, employment history, family background, prior treatment episodes, etc. This may include the administration of standardized screening or assessment tools, such as the Compass, ASI, DAST, ADS, etc.
7.08REQUEST FOR PROPOSAL (RFP) OR REQUEST FOR APPLICATION (RFA). That process by which potential providers of a particular service submit a proposal/application to the ADAP in which specific administrative and procedural information about the particular program is included. This is a competitive process whereby the applicant with the most effective project which most closely fits with the original request is awarded funds.
7.09SUBORDINATE SERVICES
7.091Medical Detoxification - Includes 24-hour medically supervised care in a hospital setting or medical model facility. Includes a short-term treatment (3-7 days), during which time prescribed medication is used to restore physiological functioning after it has been upset by toxic agents, including alcohol. Service shall be under the supervision and guidance of a licensed physician. Service is allowable when:
(1) an integral but subordinate part of the outpatient or residential service;
(2) necessary for the client to receive the residential or outpatient services; ad
(3) determined to be needed on a case by case basis. A unit -of service is a day.
7.092Residential Detoxification - Includes the availability of 24-hours per day medical (physician/nurse) care services to clients while undergoing detoxification in a residential/live-in setting. Medical care services must include physician/nurse-patient contact and physician's/nurse's review of the patient's progress at least once per 24-hour period. Service is allowable when:
(1) an integral but subordinate part of the outpatient or residential service;
(2) necessary for the client to receive the residential or outpatient service; and,
(3) determined to.be needed on a case by case basis. A unit of service is one day.
7.093Drug Testing - Includes screening for any type of drug. Drug testing is reimbursable only when given in conjunction with basic treatment services. A unit of service is one test for one type of drug. A maximum of three tests per admission are reimbursable.
7.094Other Supportive Medical - Includes care for a medically or socially diagnosed alcohol/drug dependent client which has been prescribed by a licensed medical practitioner operating within the scope of medical practice as defined by State law, and which is provided by or under the direct supervision of such a medical practitioner or other health professional licensed by the State or accredited by the appropriate professional organization. Medical services are allowable when:
(1) an integral but subordinate part of the residential service;
(2) specifically defined as a -componentirfthe-service-being-received by the client; and,
(3) determined to be - needed on a case by case basis and is not available through Title XVHI or Title XDC.

Services may include:

A.Medical Historv/Phvsical: Initial medical history and physical examination by a licensed medical practitioner. A unit of service is a one-time charge per client per admission.
B.Medical Maintenance: Necessary medical care by a licensed medical practitioner. A unit of service is generally considered one visit by the medical practitioner to the facility or by the client to the practitioners office. This service is limited to two visits per client per admission and available only to clients while in residential treatment.

Additional services rnay be allowed with prior approval by the ADAP and on a case-by-case basis.

7.095Psychiatric Evaluation - Includes a review and evaluation of a client's social. history, test data and other pertinent information for diagnostic purposes with a . written narrative report by a psychiatrist licensed by the State of Arkansas. A unit of service is a one time charge per client per admission, no matter how many evaluations are performed.
7.096Psychological Evaluation - Includes a review and evaluation of a client's social history, test data and other pertinent information for diagnostic purposes with a written narrative report by a psychologist licensed by the State of Arkansas. A unit of service is a one time charge per client-per admission, no matter how many-evaluations are performed.
7.097Psychological Testing - Includes a full battery of recognized psychological tests designed to provide a comprehensive assessment of a client's intelligence, achievement, personality, organic-perceptual, and vocational aptitude and/or interest. Testing shall be done by persons licensed to perform such testing. A unit of service is a one time charge per client per admission, no matter how many tests are given.
7.098Pay Care

Full Time: Care provided for 32 hours or more per week in periods of less than 24-hours per day to enable the parent(s) to attend treatment or treatment-related seed services.

Part-Time: Care provided for less than six hours a day, five days a week or less to enable the parent(s) to attend treatment or treatment-related services.

Other services may be established as needed and defined in the appropriate RFP/RFA or Progress Report.

007.25.95 Ark. Code R. 004

6/16/1995