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The Contractee shall comply with the following requirements, and all services provided and/or referrals shall be documented in the client record.
A. Contract Specific Requirements:
The Contractee shall ensure that a minimum of ___________ ( ) unduplicated clients will receive Intensive Outpatient treatment services annually.
The Contractee shall maintain an active client census of ___________ ( ) clients at all times.
The Contractee shall ensure that the average length of stay in the program is twelve (12) weeks. The Office of Clinical Services shall monitor utilization and may request clinical justification for continued stay in this level of care beyond the anticipated average length of stay.
The Contractee shall ensure that service planning and level of care placement, including length of stay and discharge/transfer planning, is determined according to The ASAM Criteria 2013, and that it is documented in the client record.
The Contractee shall ensure that all pregnant women are provided substance use disorder treatment prenatally through post-partum.
B. Admission Priority:
The Contractee shall ensure that first priority for admission to the program will be given to referrals made by the Child Protection Substance Abuse Initiative (CPSAI) substance use disorder assessor located in the DCPP Local Offices or through the SAI (Substance Abuse Initiative) Linking Initiative following established referral protocols.
The Contractee shall ensure that second priority will be given to self-referrals (walk-ins) and referrals made by other sources (Probation, court, other providers, etc.) on behalf of pregnant women or women with dependent children who are under DCPP supervision.
The Contractee shall ensure that third priority will be given to eligible pregnant women or women with dependent children who are in need of treatment and are not under DCPP supervision.
The Contractee shall ensure that pre-admission service coordination is provided in order to reduce barriers to treatment, enhance motivation, stabilize life situations, and facilitate engagement in treatment.
The Contractee shall ensure that arrangements will be made for the admission of pregnant women and other women with children who are taking prescribed medications for any reason, including the treatment of a mental health or substance use disorder.
Medication-Assisted Treatment (MAT) is the standard of care for pregnant women with opioid use disorder (OUD). (SAMHSA Treatment Improvement Protocol 43, Chapter 13). Pregnant women with OUD should not undergo opioid detoxification because of risk to the fetus. The Contractee shall ensure that pregnant women are immediately provided with or referred to comprehensive medication assisted treatment which decreases medication complications, improves pregnancy outcomes, and encourages fetal stability and growth.
MAT shall be continued throughout the pregnancy and arrangements shall be made for women who wish to continue to remain on MAT. All women will be given timely access to prenatal care either by the program or by referral to appropriate healthcare providers. (Access to MAT shall be documented in the clients file.)
C. Clinical Services:
The Contractee shall ensure that appropriate intake assessments are completed for each client and include the following:
Diagnostic assessment using a validated instrument (CAAPE or ASI completed by the CPSAI or SAI is acceptable)
DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) diagnosis
ASAM Level of Care Indicator (LOCI) (Initial LOCI completed by the CPSAI or SAI is acceptable)
The Contractee shall provide a structured schedule of intensive outpatient substance use disorder treatment services that are culturally and linguistically compatible for each woman, and which otherwise comply with the Standards For Licensure Of Outpatient Substance Abuse Treatment Facilities at N.J.A.C. 10:161B and that include:
Intensive outpatient treatment three (3) hours a day, three (3) days per week
Flexible evening and weekend treatment services shall be provided to accommodate work schedules
Evidence-based trauma informed/trauma specific treatment
A minimum of (1) one hour per week of individual counseling
Family-centered treatment services including family therapy and other supportive services
Crisis intervention awareness and capacity including thorough knowledge of available community resources to address the immediate needs of the client/family, and the ability to link consumers with needed services through affiliation agreements with community agencies
Evidence-based parenting skills group to be provided at least once per week; the evidence-based program shall be listed on the National Registry of Evidence-Based Programs and Practices ( HYPERLINK "http://www.nrepp.samsha.gov/Index.aspx" www.nrepp.samsha.gov/Index.aspx) or the California Evidence-Based Clearing House for Child Welfare ( HYPERLINK "http://cebc4cw.org/" http://cebc4cw.org/)
Structured curriculum of life skills training provided at least one (1) hour per week; topics may include but not be limited to budgeting, nutrition, child and household safety, and household management
Group counseling and didactic sessions that address gender-specific issues including, but not limited to, anger management, self-esteem, relationships, domestic violence, smoking cessation, parenting, conflict resolution and relapse prevention
Trauma screening using an evidence-based screening tool
Evidence-based trauma informed/trauma specific treatment services; the evidence-based program shall be listed on the National Registry of Evidence-Based Programs and Practices ( HYPERLINK "http://www.nrepp.samsha.gov/Index.aspx" www.nrepp.samsha.gov/Index.aspx) or the California Evidence-Based Clearing House for Child Welfare ( HYPERLINK "http://cebc4cw.org/" http://cebc4cw.org/)
Family-centered treatment services to include family therapy and other supportive services
Case management to ensure that clients and their children have access to all services described in this section and to ensure linkages, coordination and advocacy with other services and resources for pregnant, postpartum and parenting women
Housing support and assistance including, but not limited to, helping a client access transitional and/or permanent housing, developing adequate independent living skills, maintaining housing and a substance-free lifestyle
Progress notes documenting date, type and length of intervention and progress in treatment; progress notes should also include information on other case management activities such as referrals made to education or training resources or housing assistance.
Individual discharge plans shall include referrals to need-specific resources in the community, including clinical and peer recovery supports, with a scheduled appointment and a warm hand-off, to ensure continuity of care
All individual and group counseling sessions shall be documented an include clients signature in a consistent and readily accessible format
A minimum of four (4) random urine drug screens (UDS) to be performed each month. UDS collection and testing must be done under chain of custody procedures. All initial and confirmatory assays must be performed by a licensed clinical laboratory. Counseling frequency should be increased and/or referral to a more intensive treatment modality should be made if client shows positive test results. Evidence of all test results shall be maintained in the client record.
The name and contact information of the DCPP caseworker and supervisor shall be documented in the client record. Each DCPP-involved client shall sign a consent authorizing communication between the Contractee and DCPP staff regarding treatment progress and participation.
Documenting pertinent time lines affecting the family including ASFA (Adoption and Safe Families Act), court orders, and TANF (Temporary Assistance for Needy Families) restrictions and regulations should be documented and treatment benchmarks should be reflective of planning to adhere to these time frames for DCPP clients.
D. Health Services:
The Contractee shall secure medical clearance and obtain necessary releases and shall ensure that said documentation is maintained in the client record.
The Contractee shall ensure that children are referred for medical (including immunizations) and/or psychological care as needed. Documentation of referrals made for children (e.g. pediatric care, immunizations, and therapeutic intervention) with follow-up must be maintained in the client record.
The Contractee shall provide comprehensive medical services and/or referrals.
The Contractee shall ensure that emergency phone numbers are posted next to all agency phones including the number to register a complaint about a NJ substance use disorder treatment facility: 1-877-712-1868 (Toll Free, 24/7) or (609) 292-0589, 8:30 am to 4:30 pm Monday through Friday to speak to a Complaints Investigator.
E. Treatment Planning:
The Contractee shall maintain a discharge/continuum of care plan which begins at the onset of treatment and is reflected in the ongoing treatment plan.
The Contractee shall ensure treatment planning that will be family-centered and trauma-informed, provide for family input when clinically indicated, and address specific services and community support for the family.
The Contractee shall maintain an up-to-date individual treatment plan that includes goals and objectives of treatment with time frames for achievement.
The Contractee shall maintain in each client record a treatment plan and progress notes that must identify parenting issues being focused on in counseling sessions, efforts made to address them, and the clients progress toward achieving treatment goals, including child welfare needs and requirements. Progress notes must include date, type and length of intervention, and progress in treatment.
The Contractee shall ensure that treatment planning will include follow-up services, including peer recovery supports, to prevent relapse. TheContractee must coordinate with other services and resources to include continuing care for pregnant postpartum and parenting women
The Contractee shall ensure that treatment plans and treatment plan reviews include all necessary signatures.
F. Program Reporting Requirements:
The Contractee shall submit to the Department of Children and Families Contract Administrator a separate budget and expenditure report identifying expenses incurred by the program.
The Contractee shall electronically submit on an ongoing basis its monthly rosters to the Department of Children and Families Office of Clinical Services via secure file transmission protocol.
The Contractee shall enter client data into NJSAMS as required by the Standards for Licensure of Outpatient Substance Abuse Treatment Facilities at N.J.A.C. 10:161B.
G. Co-occurring Treatment Services for Mental Health Disorders:
The Contractee shall provide its policies on assessment and integrated treatment of co-occurring disorders, and its roster of staff who are qualified and designated to provide treatment (i.e. Psychiatrist, Advanced Nurse Practitioner (ANP) and/or a Psychologist), to the Department of Children and Families Office of Clinical Services.
The Contractee shall admit and treat clients with co-occurring disorders and shall provide assessment and treatment for co-occurring disorders throughout the treatment episode.
The Contractee shall not discriminate against clients who take prescribed medications for any reason, including the treatment of a mental health or substance use disorder.
The Contractee shall ensure that documentation of diagnosis and treatment for co-occurring disorders is included in the clients treatment plan.
The Contractee shall ensure that all co-occurring treatment services including assessment, medication visits, etc., are documented in the client record.
The Contractee shall ensure that the primary counselor is aware of all co-occurring treatment services provided.
H. Childcare Contractees are expected to ensure that all clients have access to childcare. Any Contractee providing childcare must abide by the following:
The Contractee shall ensure that childcare is provided either on-site or proximate to the program and that it offers a full range of services, including therapeutic childcare, developmentally appropriate intervention and recreational play while the mothers are in treatment sessions.
Off-site childcare available to mothers who are in treatment must be provided at a DCF licensed childcare facility and comply with the Child Care Center Licensing Law, N.J.S.A. 30:5B.
The Contractee shall ensure that childcare will focus on the developmental needs of the children and will include age-appropriate activities, and, where necessary, the separation of children by age group to ensure age appropriate interaction.
The Contractee shall ensure that written interagency agreements regarding the provision of childcare are developed with the off-site childcare provider(s), are kept current, and are maintained on file with the Contractee.
The Contractee shall maintain written program policies and procedures governing childcare, including those regarding child-staff ratios, the physical space (e.g. capacity, room temperature maintenance, number of separate cribs for infants and nap pads for toddlers) and child safety (e.g. safe and secure storage of hazardous materials, childproofed electrical outlets, identification of designated exits, fire extinguishers, availability of age-appropriate car seats, provision of age appropriate toys).
The Contractee shall ensure that at least one staff member certified in cardiopulmonary resuscitation (CPR) is present at all times.
The Contractee must provide clients with a written plan regarding childcare in the event of an emergency. At the time of admission, the Contractee must obtain from the client and DCPP worker the name and personal information of an individual designated to care for the clients child/children in an emergency. Written consent to notify the emergency contact must be signed by the client and the caseworker. Examples of an emergency situation include leaving treatment AMA, hospitalization, and crisis stabilization.
The Contractee must inform clients in writing that they are responsible for the direct supervision of their children when not in-group, individual or other structured treatment activities.
I. Transportation:
The Contractee shall ensure that transportation is provided as needed for each client. Transportation may be provided via agency vehicles or passes for public transportation, if available.
The Contractee shall ensure that transportation and safety precautions are provided in accordance with the State of New Jersey Laws and Regulations:
The Contractee shall maintain the motor vehicle in a safe operating condition.
The Contractee shall equip the motor vehicle with mandated safety devices and individual seat belts or safety seats for each child to use when the vehicle is in motion.
The Contractee shall ensure that the number of passengers does not exceed the seating capacity of the motor vehicle.
The Contractee shall carry liability and medical insurance. The driver shall have a valid New Jersey drivers license.
The driver or staff supervising a child(ren) in a motor vehicle shall have current first aid and CPR training.
Staff or other driver shall not leave the child unattended in the vehicle for any reason.
J. Communication and Systems Collaboration:
The Contractee shall initiate communication with the DCPP caseworker concerning clients treatment and progress within 7 days of admission to incorporate the DCPP case plan into the treatment plan; communication shall be biweekly while the client is in treatment, with more frequent communication (verbal and/or written) as needed to support coordination of case planning and treatment services.
The Contractee shall electronically submit biweekly treatment progress reports to the DCPP caseworker and casework supervisor using the report format, created by the Office of Clinical Services, via secure email.
The Contractee shall participate in meetings with DCPP and the client and/or family, including Family Team Meetings (FTMs), as clinically indicated. Documentation of meetings held, including the names of participants and their respective agencies (e.g. CPSAI, SAI, etc.), must be maintained in the client record.
The Contractee shall ensure that designated staff participate in, and present at, monthly local and state-wide DCPP/CW (Child Welfare) Substance Abuse consortia meetings.
The Contractee shall ensure that designated staff participate in meetings with the Department of Children and Families Office of Clinical Services.
The Contractee shall coordinate with DCPP to develop a Plan of Safe Care for pregnant and postpartum women. Plans of Safe Care will address the needs of the mother, infant and family to ensure coordination of, access to, and engagement in services.For a pregnant woman, the Plan shall be developed prior to the birth event whenever possible and in collaboration with treatment providers, health care providers, early childhood service providers, and other members of the multidisciplinary team as appropriate. Documentation of the Plan shall be maintained in the clients file.
The Contractee shall ensure staff is cross-trained in allied systems such as child welfare, mental health, courts, SAI, TANF, etc.
The Contractee shall ensure that all program staff successfully complete the National Center on Substance Abuse and Child Welfare (NCSACW) online tutorial Understanding Child Welfare and the Dependency Court: A Guide for
Substance Abuse Treatment Professionals
HYPERLINK "http://www.ncsasw.samhsa.gov/tutorials" http://www.ncsasw.samhsa.gov/tutorials
The Contractee shall ensure that outreach and coordination of services occurs with all systems involved with the client and her family (i.e. DCPP, SAI, courts, schools, etc.).
M. Staff Background Checks:
1. The Contractee shall conduct complete criminal background checks supported by fingerprints for all staff, volunteers, interns and any other employees routinely scheduled to work in the facility. The Contractee may use Department of Children and Families funds for this purpose. The Contractee shall enumerate these costs in its final expenditure report for the contract year.
2. The Contractee shall ensure that documentation of background checks is maintained in staff personnel files.
N. Reporting Child Abuse and Neglect:
In situations of possible child abuse or neglect, the Contractee is required to immediately report the matter to DCPP as mandated by, and in accordance with, N.J.S.A. 9:6-8.10 and 8.14, and N.J.S.A. 2C:43-3 and 43-8, and shall immediately notify local police as required by the Standards for Licensure of Outpatient Substance Abuse Treatment Facilities at N.J.A.C. 10:161B. The Contractee shall also notify the Department of Children and Families Office of Clinical Services in the following situations:
Concurrently with notification to the police and DCPP of allegations or suspicion of abuse or neglect of a clients child.
Upon termination of a staff member due to inappropriate behavior toward other staff or clients.
Upon discovering, or being notified of, alleged or suspected crimes committed by or against a client.
The Contractee shall coordinate with, and report to, DCPP as required.
O. Clinical Supervision:
The Contractee shall ensure that all program staff are qualified based on professional licensing regulations and that they are knowledgeable in the area of gender-specific treatment interventions. All credentials, training and supervision records must be maintained in the staff personnel files.
PAGE
PAGE 8
DCF FY 2019
ANNEX A
Section 2.2
DCPP Intensive Outpatient Substance Use Disorder Treatment
MOTHERS AND CHILDREN
DCF FY 2019
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