	Services for Substance Use Conditions

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

PA-SA 2: Assessment

Individuals participate in a comprehensive, integrated, strengths-based, culturally responsive assessment to determine an appropriate level of service.

Interpretation: Assessments are based on standardized instruments or protocols, such as the Addiction Severity Index, Treatment Services Review, or the American Society of Addiction Medicine (ASAM) patient placement criteria.

Note: Refer to the Assessment Matrix for additional assessment criteria. The elements of the matrix can be tailored according to the needs of specific individuals or service design.

PA-SA 2.01

Personnel who conduct assessments are qualified by training, skill and experience and can recognize individuals and families with special needs.

PA-SA 2.02

The information gathered for assessments is strengths-based, integrated, comprehensive, directed at concerns identified in initial screenings, and limited to material pertinent for meeting service requests and objectives.

PA-SA 2.03

Standardized criteria are used to match the needs of the individual and his or her family with the level and intensity of services provided.

Interpretation: Recognized, standardized criteria may include those published by ASAM, the Institute of Medicine (IOM), criteria required by federal or state oversight authorities, or criteria required for participation in managed care delivery systems.

Research Note: The level and intensity of services should be appropriately matched to the client’s needs and stage of recovery and be flexible over time as client needs change. Literature indicates that effective programs use a stage-wise treatment system. Stages of treatment include: engaging the client, persuading the client to develop the motivation to become involved in treatment, supporting the client through active treatment, and preventing relapse.

PA-SA 2.04

An integrated assessment includes:

a thorough alcohol and drug use history;
an evaluation of co-occurring mental health and medical problems;
medical and dental history;
a family history, including any history of family violence and alcohol and other drug use problems;
information about how the service recipient’s alcohol and other drug problems affect, and are affected by, his/her family; and
recommendations for treatment services.

Interpretation: Personnel who conduct assessments may substitute a standardized assessment instrument for the requirements cited above if the assessment includes a summary statement that integrates the available information about the person and his or her family and the demonstrated need for service. Assessments are completed within timeframes established by the agency and are updated periodically.

PA-SA 2.05

Assessments are conducted in a culturally responsive manner, and:

identify resources that can increase service participation and achievement of agreed-upon goals; and
address issues of special relevance to various groups, such as women, older adults, or adolescents, as applicable.

Interpretation: Culturally responsive assessments can include attention to geographic location, language of choice, and the person’s religious, racial, ethnic, and cultural background. Other important factors that contribute to a responsive assessment include attention to age, sexual orientation, and developmental level.

PA-SA 2.06

Engagement and assessment are characterized by:

sensitivity to the willingness of the individual and family to be engaged;
a non-threatening manner;
respect for the individual’s autonomy and confidentiality;
flexibility; and
persistence.

PA-SA 2.07

Unmet medical needs identified in the assessment are addressed directly or through an established referral arrangement and can include:

medical detoxification;
medication monitoring and management;
physical examinations or other physical health services;
laboratory testing and toxicology screens; and
other diagnostic procedures.

Interpretation: The nature of problems resulting from substance use conditions requires medical services to be available. Such services need not be provided by the agency, but the results of medical screens, tests, and services will be documented in the case record and incorporated into service planning and monitoring.

Treatment Services are expected to have on staff, or available through a formal consulting arrangement, a licensed physician or other qualified health practitioner with substance use training and experience. All other services must have, at minimum, a formal referral relationship with a licensed physician or other qualified health practitioner with substance use training and experience to whom individuals believed to be dependent on alcohol or other drugs may be referred.

Clinical personnel coordinate services when an individual receives medical treatment from a private physician. For example, a physician may refer the individual to the agency for counseling or relapse prevention. In such cases, the agency is not responsible for addressing the medical aspects of treatment, but must coordinate services with the physician.

NA The agency provides Co-Dependency Counseling only.

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	PURPOSE: Individuals who participate in Services for Substance Use Conditions on an on-going basis improve social, emotional, psychological, cognitive, and family functioning, and attain the recovery they seek.

RELATED FILES


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	FAMILY Two or more people who consider themselves family and who assume obligations, functions, and responsibilities generally essential to healthy family life. Child care and child socialization, income support, long-term care, and other caregiving are among the functions of family life. The definition of "family" will rest with an individual's indication of who plays a family member role, including current or former foster family, adoptive family, extended family members, fictive kin, or significant others. Organizations that believe family is the central constellation in a child's life, and that family attachments are of primary importance for human development, will strive to work with professional staff to develop a common understanding of "family."


	ASSESSMENT An evaluation, which utilizes professional expertise and skills in the collection and analysis of data to understand and describe the nature of service needs of an individual, family, or group. Assessment, as in needs assessment, is also used to determine priorities of program planning and service development for the organization as a whole. See also DIAGNOSIS.


	PROTOCOLS Instruments and procedures used to accomplish a particular goal, activity, or purpose.


	CRITERIA Systematically developed, objective, and quantifiable statements used to assess the appropriateness of specific decisions, services, and outcomes.


	PERSONNEL The body of employees and/or volunteers that carries out the organization's tasks under the organization's administration and/or supervision. This definition does not include foster parents who are specifically referenced in relevant standards


	TRAINING Instruction so as to make fit, qualified, or proficient in a skill or body of knowledge.


	SPECIAL NEEDS A designation used in reference to conditions or characteristics of a person that reflect a need for special care, services, or treatment. When the term is used in the context of adoption services, special needs refers to conditions that make a child harder to place for adoption. This includes children who are members of sibling groups, older children, children with disabilities, children of certain racial /ethnic backgrounds, etc. When the term is used in the context of foster care it refers to the need for a higher degree of specialized case services and attention due to mental and physical disabilities. When the term is used in the context of out-of-school time services, a child or youth may have special physical, behavioral, medical, emotional, or cognitive needs that should be addressed or accommodated. The term is also used in other contexts. See also DEVELOPMENTAL DISABILITIES.


	OBJECTIVE A sub-goal stated in operational terms, i.e., a statement that makes clear what expected results are to be measured or assessed.


	PROGRAM A system of services offered by an organization. For example, an organization providing a mental health service may offer several mental health programs to different populations, e.g., a mental health program for adolescent teens. The word "program" can be used interchangeably with the word "service" or to describe specific programs.


	CLIENT See service recipient.


	EVALUATION The review and assessment of organizational operations, programs and services.


	SERVICE RECIPIENT The individuals, groups, organizations, or communities that use, receive, or benefit from programs and services. Service recipients can include consumers, patients, family members, legal guardians, advocates, public/private organizations, employers, and purchasers. All are regarded as significant stakeholders served in a variety of agencies and practice settings.


	CONFIDENTIALITY An ethical and practice principle that requires the protection of information shared within a professional-client relationship. An organization that upholds confidentiality prohibits personnel from disclosing information about persons served without their written consent.


	DETOXIFICATION The process by which drugs or other harmful substances are removed from a person's body for a time period sufficient to restore adequate physiological and psychosocial functioning.


	MEDICATION A prescribed or over-the-counter drug that is injected, taken orally, applied topically, or otherwise administered.


	MONITORING An evaluation involving a periodic review of consumer services, organizational activities, or conduct. Specifically, monitoring is an activity of case coordination, whereas more broadly, monitoring is an evaluation technique used in overall quality assurance.


	SCREEN A preliminary test administered to a client to determine whether he/she meets eligibility criteria for the services offered by an organization.


	CASE RECORD A written compilation that describes the client and the services delivered. Records can be in hard copy and/or electronic format. The case record can be used as a source of information for quality improvement or other evaluation activities, for research purposes, or to demonstrate accountability to funding bodies.


	PLANNING The process of specifying objectives, evaluating the means for their achievement, and exercising deliberate decision making about appropriate courses of action.


	CLINICAL PERSONNEL Qualified and trained professionals who provide the treatment services of an organization. Clinical personnel who assume case responsibilities must meet the applicable regulatory requirements and the minimum standards set by their respective professional organizations. Clinical personnel generally include clinical social workers (MSW or DSW/PhD in social work), clinical or counseling psychologists (PhD or PsyD), psychiatric nurses (MSN), certified marriage or family therapists, certified pastoral counselors, and board eligible or certified psychiatrists. Where additional disciplines or degrees are acceptable, it is stated in the standard for each service section. "Clinical personnel" and "mental health personnel" may be used interchangeably.


	PREVENTION Actions taken to minimize and/or eliminate social, psychological, or other conditions. Prevention can occur at the individual, group, community, and societal levels and enhances opportunities to achieve positive fulfillment.


	CASE A general term used to designate clients (including individuals, families, and groups) served by an organization for purposes of monitoring the provision of services. A foster care case is generally based on the placement of an individual child, although casework for the child may include services to the child's family. A child protective services case is based on an entire family household if a family assessment model is used; otherwise a case is defined as a child.