Program Scope of Services - Medium Intensity - Residential Treatment Services (ASAM Level 3.3)

 

Population(s) served:
LHBHC provides care to Adults who reside in Maryland.

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Patients who are appropriate for this level of treatment:

(1) Meet the current edition of the American Society of Addiction Medicine Patient Placement Criteria for Level III.3;

(2) Are chronic alcohol or other drug dependent individuals;

(3) Do not need skilled nursing care;

(4) May have a history of multiple admissions to alcohol or drug abuse or dependence programs;

(5) May have physical and mental disabilities as a result of prolonged alcohol or other drug use; and

(6) Have been identified as individuals for whom a controlled environment and supportive therapy are necessary for an indefinite period of time.

Settings:

A clinically managed medium intensity treatment program provides a structured residential environment in combination with medium intensity treatment and ancillary services to support and promote recovery.

Hours of services:
24 hours per day

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Days of services:
Daily

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Frequency of services:
As scheduled as needed basis

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Payer sources:
Medicaid and private pay

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Fees:
Current approved Medicaid and Medicare fee schedules for Maryland

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Referral sources:
Self, walk-ins, community agencies, insurers, healthcare providers, governmental agencies

Specific services offered:
All services are rendered by independent contractors who are licensed or certified behavioral health professionals.  

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Program Services. A program shall provide the following services:

(1) An assessment within 1 week of admission;

(2) An individualized treatment plan completed and signed by the alcohol and drug counselor and patient within 3 working days of the comprehensive assessment and updated every 30 days;

(3) Alcohol and drug education;

(4) Individual counseling;

(5) Leisure and recreation counseling; and

(6) Assistance with vocational issues.

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Referral Services. The program shall offer the following services or maintain a listing of agency referral agreements for the following services:

(1) Physical examinations as determined by medical condition, within a reasonable time;

(2) Medical care;

(3) Services through the Division of Rehabilitation Services;

(4) Vocational assistance;

(5) Mental health services, which shall include, as appropriate to the severity and urgency of the patient's mental condition:

(a) Medication monitoring for patients who are admitted on or are prescribed psychotropic medications; and

(b) At least one of the following services:

(i) Services available by telephone within 8 hours of a request; or

(ii) Services available onsite or closely coordinated off-site within 24 hours of a request;

(6) Substance abuse treatment programs;

(7) Legal assistance;

(8) Family services; and

(9) Social services.

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Entry criteria:

Called Clinically Managed Population-Specific Medium Residential Services, this adult only level of care typically offers 24-hour care with trained counselors to stabilize multidimensional imminent danger along with less intense milieu and group treatment for those with cognitive or other impairments unable to use full active milieu or therapeutic community. Level 3 encompasses residential services that are described as co-occurring capable, co-occurring enhanced, and complexity capable services, which are staffed by designated addiction treatment, mental health, and general medical personnel who provide a range of services in a 24-hour treatment setting. A detailed description of the services typically offered in this level of care, the care setting and how to identify what patients would benefit best from these services based on an ASAM dimensional needs assessment, begins on page 234 of The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions (2013).

 

Transition / Exit criteria:  
Discharge/transition planning occurs throughout all phases of the program. The person served has met discharge/transition criteria when the goals of the individual plan are achieved and referral to support services is completed, when appropriate. Additionally, discharge may occur if the person no longer attends regularly or chooses not to actively participate in the program. 

Description of the program:  
Behavioral health programs are provided in a clinic, inpatient and residential setting. A wide range of services are organized within a comprehensive therapeutic environment that includes screening and assessment, diagnostic determination, individual and family counseling, consultations, medication management, crisis intervention, group counseling, client advocacy, and referral to community resources. Clients are assigned to licensed and/or certified personnel who assist in individual planning and care. Services additionally include consultation with family and/or professional care providers.

 

Philosophy of the program:
Behavioral health programs to assist persons with developing and maintaining coping skills that facilitate adjustment and integration within their living environments and community. Clients and family members are empowered to make decisions about their care with the expected outcome of an increased quality of life.  Services are designed and implemented to: support the recovery, health, or well-being of the persons or families served; enhance the quality of life of the persons served; reduce symptoms or needs and build resilience; restore and/or improve functioning; support the integration of the persons served into the community.

 

Program goals:
The overall goal of the programs is to increase the quality of life through the provision of specialized outpatient mental health services.  Specific areas of focus may include:  Recovery, Vocation/Education, Parenting, Relationships, Spirituality, Coping Skills, Anger Management, Grief and Loss.  The program seeks to achieve the following specific objectives: To improve mood and affect in daily living; To improve social, familial, and social adjustment and integration; To reduce the need for a higher level of care.

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This information is posted on the website and in brochures and is updated annually.