Current through Register Vol. 49, No. 9, September, 2024
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.
i
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.
1.00
INTRODUCTION
1.01
PURPOSE.
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.
1.03
WHERE 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.
1.04
AVAILABILITY 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.
1.05
MANUAL 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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here to view image
2.00
CONTRACT/GRANT SPECIFICATIONS AND THE APPLICATION
PROCESS
2.01
PROJECTS
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:
2.011
Treatment 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.
2.012
Primary
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.
2.013
Intervention."
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.
2.014
Data. 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.
2.015
Training.
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.
2.02
ELIGIBLE
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.
2.03
PROHIBITIONS 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.
2.031
Prohibitions 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.
2.032
Prohibitions 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).
2.04
APPLICATION SUBMISSION AND
PROCEDURES
2.041
ADAP 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.
2.042
Confidentiality 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.
2.043
Assurances 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.
2.044
ADAP 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.
2.045
Financial
Disclosure. The applicant must provide financial disclosure for
the total agency, if part of a larger organization, if so requested by the
ADAP.
2.046
Processing. 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.
2.047
Qualifications 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).
2.05
APPEAL 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.
2.06
PREREQUISITES 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.
2.061
Administrative 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.
2.062
Clear 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.
2.064
Referral 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.
2.065
Community 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.
2.07
CONTINUATION SUPPORT POLICY
Funding of a project does not imply approval for subsequent
years.
2.08
AWARD 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.
2.09
GRANT NEGOTIATION
AND APPROVAL PROCESS1.
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.
3.00
CONTRACT AND GRANT FINANCIAL
PROVISIONS
3.01
AWARD 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.
3.02
PAYMENT 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.
3.03
GENERAL
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.
3.04
REASONABLE 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.
3.05
RATE
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.
3.06
BASIS 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.
3.07
ADAP 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.
3.08
TREATMENT 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.
3.09
PROVISION 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.
3-10
FUNDING
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).
3.11
AUDIT
3.111
Independent
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.
3.112
Audit/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.
3.12
USE OF FUNDS - SPECIFIC
REQUIREMENTS
3.121
Restrictions. 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.
3.122
Transfer 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.
3.123
Replacement 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.
3.124
Deviation 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.
3.125
Retention 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.
3.126
Third 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.
3.127
Third 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.
3.128
Deobligation 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.
3.129
Selected Items of
Cost
3.1291
Equipment.-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.
3.1292
Travel.
(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.
3.1293
Insurance. 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.
3.130
Program 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.
3.13
ALLOWABLE 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.
3.131
Salaries 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.
3.132
Maintenance and
Operation
3.132.1
Accounting 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.
3.132.2
Advertising:
Costs are allowable for recruitment of personnel, * procurement of scarce items
and'disposal of scrap or surplus-material.
3.132.3
Bonding and
Insurance: The costs of bonding and insurance are allowable if in
accordance with sound business practice and the rates are
competitive.
3.132.4
Building 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.
3.132.5
Communications: 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.
3.132.6
Depreciation 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).
3.132.8
Equipment
Rental: The cost of rental equipment is allowable. Lease-purchase
of equipment must be recovered through depreciation.
3.132.9
Field 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.
3.132.10
Food Service Supplies: Costs of supplies (such as
plates, silverware, etc.) directly associated with the provision of meals to
clients is allowable.
3.132.11
Freight: Costs incurred for freight, postage, and
other transportation costs directly relating to goods purchased, delivered or
moved from one location to another are allowable.
3.132.12
Indirect
Costs: See Item 3.17
3.132.13
Inspections: The cost of required inspections such as
health and fire inspections, is allowable if such inspections are not available
without charge.
3.132.14
Insurance: See Bonding and Insurance
3.132.15
Lease
Costs: See Rental Costs
3.132.16
Maintenance and
Repair: Costs incurred for necessary maintenance, repair or upkeep
of property, including motor vehicles.
3.132.17
Materials 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.).
3.132.18
Meetings and Conferences: See Training
3.132.19
Memberships: 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
3.132.21
Printing
and'Reproduction: Costs for printing" and reproduction services
necessary for the program, including but not limited to forms, reports and
manuals is allowable.
3.132.22
Public 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.)
3.132.23
Rental 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.
3.132.24
Subcontracted 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.)
3.132.25
Subscriptions 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).
3.132.27
Training. 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.
3.132.28
Travel: 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.
3.132.29
Utilities: The cost of utilities is
allowable.
3.14
UNALLOWABLE
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
3.15
CASH 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.
3.16
PROGRAM 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.
3.17
REIMBURSEMENT
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.
3.171
Billing. 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.
3.172
Billing 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.
3.173
Professional 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.
3.174
Billing 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.
3.18
UNEXPENDED 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.
3.19
INDIRECT
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.
4.00
GENERAL
REQUIREMENTS
4.01
ACCESSIBILITY 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.
4.02
EQUAL
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.
4.03
LICENSURE
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
4.04
TREATMENT
REQUIREMENTS
4.041
Basic 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).
4.042
Client
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.
4.043
Retention 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.
4.044
Confidentiality. 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.
4.045
Client 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.
4.046
Client
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.
4.05
ON FILE REQUIREMENTS
4.051
Items 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.
4.06
PARTICIPATION 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.
4.07
SUBCONTRACTED
SERVICES
4.071
Restriction of Services. Unless-subcontracted services
are specifically identified in the program contract/grant, they may not be paid
for from contract/grant funds.
4.072
Other 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.
4.073
Subcontract 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.
4.08
ADVERTISING 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.
4.09
AUDIO-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.
4.10
BOOKS. 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.
4.11
VOLUNTEERS
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.
4.12
TERMINATION
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.
5.00
SPECIFIC REQUIREMENTS
5.01
ALCOHOL/DRUG TREATMENT
CONTRACT/GRANT REQUIREMENTS
5.011
Compliance 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.
5.012
Maintenance of Minimum Capacity. Each treatment
program receiving funds from the ADAP must meet minimum performance levels as
identified in the current contract/grant.
5.0121
Minimum
Requirement. All treatment programs must maintain 90% minimum
capacity as identified in the current contract/grant.
5.0122
Failure 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.
5.0123
Operation 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.
5.013
ADMIS 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.
5.014
Report
Requirements
5.0141
ADMIS 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.
5.0142
ADMIS 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.
5.02
PRIMARY 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.
5.021
Compliance 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.
5.022
ADMIS 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.
5.023
Report
Requirements5.0231
Billing 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.
5.0232
Program
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.
5.0233
Other
Reports. The provider shall submit separate additional reports as
requested by the ADAP.
6.00
DIRECT SERVICES
6.01
DETOXIFICATION 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.
6.011
Admission
Criteria. Individuals seeking admission shall be at least 18 years
of age and a resident of the State of Arkansas.
6.012
Types of
Admission:
6.012.1
Voluntary Admission. Individuals seeking admission
will sign in voluntarily.
6.012.2
Court 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.
6.013
Reasons Individuals Are
Denied Admission
6.013.1
Disciplinary 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.
6.013.2
Within Three Months of
Discharge. Clients seeking readrnission within three months after
discharge are ineligible for admission, except in case of a medical emergency.
6.02
SUPERVISED 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.
6.021
Admission
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.
7.00
DEFINITIONS
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.
7.01
LICENSURE 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.
7.02
ALCOHOL/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.
7.03
INTERIM
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.
7.04
PRIMARY PREVENTION STRATEGIES
7.041
Information
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.
7.043
Alternatives
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.
7.044
Problem 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.
7.046
Environmental:
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.
7.05
PROGRESS 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.
7.06
REGIONAL 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): ...
7.061
Continued 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.
7.062
Medical 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.
7.063
Observation. -
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.
7.064
Regional 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.
7.065
Regional 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.
7.07
REIMBURSABLE
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.
7.072
Outpatient
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.
7.073
Partial 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.
7.074
Intensive 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.
7.075
Assessment - 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.
7.08
REQUEST
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.
7.09
SUBORDINATE
SERVICES
7.091
Medical 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.
7.092
Residential 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.
7.093
Drug 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.
7.094
Other 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.
7.095
Psychiatric
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.
7.096
Psychological 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.
7.097
Psychological
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.
7.098
Pay
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.
