Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 23 - Behavioral Health Services
Rule 016.23.13-001 - Arkansas Access to Recovery Program Manual

1. Individuals with substance use disorders and their families have the right to choose recovery and the recovery-related services and supports that best meet their needs, and receive those services in their own community.

2. Client choice is enhanced by a recovery-oriented system of care that honors each client's familial, cultural, spiritual, economic, and logistical needs.

3. Individualized choice enhances client retention in treatment and strengthens client commitment to and success in recovery.

4. Participation in AR ATR is voluntary and can be terminated by the client at any time, without repercussion to the client and or family member. Participation cannot be court ordered, or required by a state agency (e.g., as a condition of parole/release or as a part of reunification with the client's child(ren).

1. Have an existing Substance Use Disorder (SUD) determined by using a standardized alcohol and drug abuse screening tool; and

2. Reside in one of the thirteen (13) covered counties (Benton, Craighead, Crawford, Faulkner, Garland, Independence, Jefferson, Lonoke, Pulaski, Saline, Sebastian, Washington, or White);* and

3. Be 18 years of age or older; and

4. Gross income at or below 200% of the Federal Poverty Level; and

5. Be a member of one of the following populations:

- 1-3 Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) convictions within the last

- 18-24 months, with the most recent conviction within the past six (6) months (Note: Does not include drug possession charges); or

- Pregnant women with SUD; or

- Combat Veteran (Army Reserve/National Guard/Activity Duty); or

- A custodial parent or custodial family member involved or at-risk of involvement with the DHS Division of Children and Family Services (DCFS) or Division of Youth Services (DYS),

1. Referral sources may be the potential client, a family member, friend, authorized representative, substance abuse or mental health treatment providers, medical professionals, state agencies, etc. The referral source accesses the referral link listed below where a list of Care Coordinators for the potential client's home county is provided, https://dhs.arkansas.gov/dbhs/atr/

2. The Potential AR ATR Client selects a Care Coordinator of their choice from the web site listing. (Each client must be offered a choice from among at least two Care Coordinators).

3. The referral source electronically selects the ATR Care Coordinator of the client's choice which will link them to an ATR Referral Form (See Forms Section: AR ATR Referral Form).

4. The Referring source will complete the ATR Referral Form and send it to the selected Care Coordinator by e-mail through the link. A copy of the Referral Form is automatically sent to the ATR Program Office.

5. The Client-Selected ATR Care Coordinator will retrieve the ATR Referral Form and accept or reject the referral. If accepted the ATR Care Coordinator will contact the potential ATR Client to schedule an ATR Assessment. If the potential client is rejected for reasons not due to eligibility by that ATR Coordinator, he/she will assist the potential client in selecting another Care Coordinator and will initiate another referral. If preferred, the referral source may make an appointment with the Care Coordinator directly while the client is present. The client-selected ATR Care Coordinator will note in the ATR referral website the results of the referral (client accepted/not accepted/ineligible) and the reason. If the ATR Electronic Referral System is not used during the referral process, it is the responsibility of the Client-Selected ATR Care Coordinator to enter the client in the electronic system and obtain a client referral number to be used when entering the client's information in the AR WITS system.

1. A cover letter listing each staff member's name and the service(s) each will provide;

2. Copies of all required documentation of qualifications for each service; and

3. ATR Provider Staff Information Sheet listing each new staff member's contact information.

1. A cover letter listing the services to be added;

2. Copies of all required documentation of qualifications for staff who will provide that service; and

3. ATR Provider Staff Information Sheet (if there is new staff not currently on the WITS System).

1. Executive Order #13520 of November 20, 2009

When the Federal Government makes payments to individuals and businesses as program beneficiaries, grantees, or contractors, or on behalf of program beneficiaries, it must make every effort to confirm that the right recipient is receiving the right payment for the right reason at the right time. The purpose of this order is to reduce improper payments by intensifying efforts to eliminate payment error, waste, fraud, and abuse in the major programs administered by the Federal Government, while continuing to ensure that Federal programs serve and provide access to their intended beneficiaries.

2. USC 18, Chapter 47

Providers and their employees/authorized representatives who knowingly and willfully:

3. The False Claims Act (FCA)

In general, the False Claims Act covers fraud involving any federally funded contract or program, with the exception of tax fraud.

A broad array of scenarios can constitute FCA violations. Some examples include the following:

- Falsification of information;

- Billing for services that were not performed or were unnecessary;

- Billing for costs not related to the grant.

The FCA includes any person who:

- Knowingly presents, or causes to be presented...a false or fraudulent claim for payment or approval;

- Knowingly makes, uses, or causes to be made or used, a false record or statement to get a false or fraudulent claim paid or approved;

- Conspires to defraud the Government by getting a false or fraudulent claim paid or approved... or

- Knowingly makes, uses, or causes to be made or used, a false record or statement to conceal, avoid, or decrease an obligation to pay or transmit money or property to the Government.

Violators are liable for a civil penalty of not less than $5,000 and not more than $10,000, plus 3 times the amount of damages which the Government sustains because of the act of that person.

FCA Violations result in disqualification from participation in Federal program for a minimum of five years; or may result in permanent exclusion if fraud is proven. Exclusion applies to participation in any Federally-funded grant, contract, or program (administered by any state or federal agency).

4. The Federal Anti-Kickback Statute

Prohibits persons or entities from knowingly or willingly soliciting or receiving remuneration, directly or indirectly, in cash or in-kind, to induce patient referrals or the purchase or lease of equipment, goods or services, payable in whole or in part by a Federal health care program.

The Act includes any offer, payment, solicitation or receipt of money, property or remuneration to induce or reward the referral of patients including, but not limited to referral fees, finder's fees, and/or excessive compensation.

5. Fraud Enforcement Reconciliation Act of 2010

Addresses Overpayment Rules / False Claims

It is unallowable for contractors to wait until end of the contract year or completion of an annual audit to reimburse the state for overpayments or false claims. Failure to reimburse the state more than 60 days past date of service is considered fraudulent claims. Triple damages applied for not only the amount of the claim but the cost of the process.

Note: For the purposes of the aforementioned statutes, the terms "knowing" and "knowingly" mean that a person, with respect to information (1) has actual knowledge of the information; (2) acts in deliberate ignorance of the truth or falsity of the information (should have known); or (3) acts in reckless disregard of the truth or falsity of the information (caused), and no proof of specific intent to defraud is required

Monitoring and Evaluation

DHS DBHS and/or its authorized representatives monitor and evaluate ATR services and providers. Monitoring and evaluation areas include, but are not limited to, client eligibility, provider eligibility, provider facilities and policies, service documentation, voucher and encounter data, provider incidents, and satisfaction surveys. DBHS or their authorized representative will conduct site visits and may talk with ATR clients and with provider staff. Providers are generally notified of planned site visits in advance but DBHS retains the right to conduct site visits at its discretion.

Providers that do not meet certification/qualification requirements as stated in the AR ATR Provider Manual and the voucher agreement may receive technical assistance from DBHS or their authorized representatives and may be required to conduct corrective action as defined in the Certification Section of this Manual. Certain violations, safety concerns, or unacceptable performance as specified below may result in termination of the provider's voucher agreement.

REMEDIES FOR UNACCEPTABLE PERFORMANCE

Acceptable performance of all provisions of the ATR Program is determined at the sole discretion of the DBHS. One or more of the following remedies may be imposed for unacceptable performance of a provision or performance indicator:

1. Type of incident

2. Exact place, time and date of the incident.

3. Name of the subject of the report, date of birth, race, sex, county of residence, responsible party and next of kin.

4. Full name of all person(s) involved including an address and a telephone number.

5. Comprehensive description of the incident.

6. Extent of injury, property loss, or damage.

7. What measures could have prevented the incident.

8. Description of any corrective action taken.

9. Outcome of the incident.

10. Person(s) notified name of agency, and time of notification.

The initial (verbal) reporting of the incident should be made to the Assistant Clinical Director:

Frank Vega, Assistant Clinical Director Office: 501-686-9875 Cell: 501-551-8266

The written report shall be faxed to:

Frank Vega, Assistant Clinical Director Arkansas Department of Human Services Division of Behavioral Health Services FAX # 501-686-9396

AND

Ann Patterson, ATR Project Director Partners for Inclusive Communities FAX# 501-501-682 -9901

DBHS researches Critical and Provider Incidents as indicated. Follow-up on reported incidents may include, but not be limited to, technical assistance, requirement of corrective action, funding repayment, voucher agreement revision or termination, or determining that no inappropriate incident occurred.

ETHICAL STANDARDS FOR ATR PROVIDERS

Provider staff and volunteers must comply with the standards listed below. Provider staff who are licensed or certified in a specific profession must comply with the code of ethics for their profession as well as with these guiding principles, whichever is the higher standard.

- ATR clients and family members are treated with honesty, dignity, and respect.

- ATR providers shall not withhold client's personal property at any time. Failure to release client's property at the time service is terminated will be constituted as exploitation of the client.

- Providers shall respect each client's right to self-development and self-direction.

- Providers respect each client's right of choice, including responsibilities for goals reached, as long as the client's choices do not cause harm to self or others.

- Providers do not abandon or neglect clients in any way, and they assist clients in proper referrals to other providers/resources when necessitated and/or indicated.

- ATR Providers will maintain client confidentiality at all times. Providers shall not provide information to any person and/or agency (to include DCFS/DYS/Arkansas Department of Corrections/AR Department of Community Corrections) without a signed consent from the client.

- Providers shall abstain from alcohol or other drug usage prior to or during the provision of ATR services.

- Providers shall not engage in any type of personal or sexual relationships with ATR clients.

- Providers do not provide services that create conflicts of interest or where conflicts of interest may likely become an issue or create dual relationships.

- Providers shall not accept commissions, gratuities, rebates, gifts, favors, or any other form of non-contract payment for ATR services.

- Providers shall not misrepresent themselves or their qualifications, licensing or other accreditation requirements, education, experience, or status.

- Providers shall not perform services outside their area of expertise, scope of practice, training, or applicable license or other accreditation by the State of Arkansas. Services provided must be listed in the provider's contract for ATR participation.

- Care Coordinators who are unable to provide services to a client must notify the referral agency within two days of referral. Direct Services providers who are unable to provide a service must notify the referring care coordinator within two days of referral.

- Providers shall not discriminate on the basis of color, age, gender, sexual orientation, national origin, socio-economic status, spiritual/faith beliefs, psychiatric or physical status, or cultural, ethnic, or racial background.

- Providers shall not participate in false or fraudulent activities including, but not limited to, submission of claims for services not rendered, submission of false data, knowingly assisting another provider to enter false claims or data, charging a client for all or any part of a service, and/or providing false representation of credentials, qualifications, insurance, or licensure/accreditation status. - Providers shall fully disclose all fees for services to clients prior to carrying out those services.

Solicitation

Providers shall refrain from solicitation of ATR clients.

1. Have an existing SUD determined by using a standardized alcohol and drug abuse screening tool; and

2. Reside in one of the 13 covered counties (Benton, Craighead, Crawford, Faulkner, Garland, Independence, Jefferson, Lonoke, Pulaski, Saline, Sebastian, Washington, or White);* and

3. Be 18 years of age or older; and

4. Gross income at or below 200% of the Federal Poverty Level; and

5. Be a member of one of the following populations:

1. Maintain all eligibility determination documentation in the client file.

2. Maintain the paper copies of the Initial GPRA Intake and GPRA 6-Month Follow-up Interview

3. Maintain documentation of referrals for non-ATR services as specified in the Recovery Support Services Plan

4. Ensure each client signs all ATR forms for which a signature is required.

5. Maintain documentation of all estimates and/or purchases from a recognized vendor, which must be on company letterhead, signed and dated by vendor and include vendor phone number and address.

6. Document any case of misuse or inappropriate use of ATR funds, including actions taken.

7. Document satisfaction survey distribution.

8. Document the distribution, including method of delivery, of incentive gift cards to the client or designee using the 6 Month GPRA Follow-Up Gift Card Receipt Form (See Forms Section of this Manual).

Voucher Process

Following the ATR Assessment with GPRA Intake Interview with the client, the Care Coordination services provider enters the referral/voucher into the AR WITS System for client selected services if they are to be funded by ATR and for future care coordination visits. The Care Coordinator may enter additional referral/vouchers or update the current voucher at a later date for ATR funded services identified with the client through on-going care coordination services.

When a referral/voucher is entered, the AR WITS System sends an electronic notification to the recovery support services and/or substance abuse treatment services provider who can choose to accept/ reject the referral. If the referral is accepted, the recovery support service and/or substance abuse treatment service provider will also need to accept the voucher. If the client is rejected, there will not be an option to accept/reject voucher. It is the responsibility of the recovery support services/substance abuse treatment services provider to monitor referrals/vouchers in the system. Recovery support services providers must accept or reject referrals/vouchers issued to them within two (2) working days. If rejected, the provider should indicate the reason for the rejection in the AR WITS System. If a service is unavailable at the time and the client agrees to be placed on a waiting list, the recovery support services provider will contact the care coordinator to advise.

It is the responsibility of the Care Coordination services provider to facilitate the client-selected referral, including contacting the provider to coordinate care. The Care Coordinator shall monitor referrals/vouchers issued and acceptance/rejection of referrals/vouchers regularly. If the referral/voucher has not been accepted or rejected within the required two working days, the Care Coordinator shall contact the provider to determine the status.

Vouchers must specify selected ATR covered services, the number of units for each vouchered service and the start and end dates (date range) of the voucher. ATR care coordination services providers may extend the voucher prior to the voucher end date, based on on-going discussion with the client and client choice. The initial voucher is valid for forty-five (45) days. Any voucher not used after thirty (30) days will be closed.

For any voucher that would put total expenditures for a specific ATR client at more than the established annual cap, the Care Coordinator must request prior approval in advance by submitting an Services Exception Request Form (See Forms Section of this Manual). A written response will be provided to the Care Coordinator within five (5) working days.

Residential Treatment services require prior written authorization before services can be vouchered. Care Coordinators must submit an ATR Services Exception Request form (to include a copy of the client's Recovery Support Plan) in advance of issuing a voucher and a copy must be retained in the Residential Treatment provider's file for review by DBHS and/or its authorized representative. Residential Treatment through the ATR program will only be authorized if all other funding sources are exhausted.

DBHS reserves the right to change the client expenditure limit or otherwise revise funding or terminate vouchers based on the availability of ATR funds.

GENERAL INFORMATION FOR

ALL ATR PROVIDERS

Encounters [Service Delivery Documentation and Billing)

The AR WITS System is an Electronic Medical Records System (EMR). Each certified independent provider or employees of certified organizations is assigned an ID and password in the AR WITS system. System security requires each individual facilitator/provider of services to log into the AR WITS system and enter their own encounters for each client and each service provided. The logon electronically signs the encounter note in the AR WITS System. It is unallowable for anyone to share their logon information or to enter encounters for someone else. Violation of this security procedure will place the provider's voucher agreement in jeopardy.

Providers (care coordination services/recovery support services/substance abuse treatment services) must document provision of ATR covered services. The documentation includes but is not limited to entering encounter information into the AR WITS System.

Note: Provider failure to follow the processes and requirements outlined below may result in delayed or denied payment or may jeopardize a provider's voucher agreement (contract). All books, records and other documents relating to ATR expenditures, services rendered or individuals served under the ATR contract for five (5) years from the date the contract expires. If an audit or investigation is pending at the end of the five year period, information must be retained until resolution of the audit, investigation. Service delivery documentation must be maintained for a period of six (6) years.

Each ATR provider must enter service delivery encounter information into the AR WITS System for the ATR covered services they provide.

- Each ATR covered service provided must be consistent with the voucher in the AR WITS system.

- Each ATR covered service provided must be documented in the AR WITS system and the provider's record system.

- An encounter must be entered into AR WITS for each ATR covered service provided. Services shall not be entered in date spans. Each individual service must be entered separately. The only exception to this rule is in the case of residential treatment and supportive transitional housing. Encounters for these services may be entered in weekly units with a maximum of seven (7) units per encounter.

- Each encounter must be entered into AR WITS within five (5) calendar days of the date the ATR covered service was provided.

- Each encounter entered into the AR WITS must be consistent with the voucher and with documentation in the provider's record system.

- For all encounters entered in the AR WITS system, the provider must enter a comment. If the provider is maintaining paper documentation, the comment must refer to the location of the notes for that encounter. If the provider is maintaining documentation in the AR WITS, the comment must contain all of the information required as specified in the Documentation Requirements Section of this Manual. For residential and transitional housing services, the comment must specify the dates covered by the encounter (e.g., 10/1/11-10/7/11 for residential treatment or supportive transitional housing; 10/1/11-10/1/11 for all other services).

ATR Documentation Requirements

Providers shall:

1. Bachelor's degree; OR

2. CADQOr

3. Currently pursuing a Bachelor's degree with two years of experience substituting for each year of education needed toward completion of the bachelor degree (documentation should include copy of current transcript and proof of experience); AND

- Documentation of experience with SUD clients;

- Documentation of training in Motivational Interviewing (may be received during the three-day mandatory training)

- Documentation of at least 6 consecutive months immediately prior to the date of application in providing referrals, linkages, and coordination of multiple services;

BRIEF INTERVENTION SUD

DEFINITION:

A short-term intervention targeted toward individuals and families that focuses on reduction of risk factors generally associated with the progression of substance use disorders. It is used to motivate the individual to seek the appropriate level of treatment or other intervention, and is accomplished through early identification of persons at risk, performing basic individual assessments and providing supportive services which emphasize short-term counseling and referral.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Brief Intervention Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification in one of the following:

- Currently licensed Physician (MD, DO)

- Currently licensed as an Advanced Practice Nurse

- Currently Licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as a Psychologist

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

ASSESSMENT-SUD

DEFINITION:

Identifies and evaluates the nature and extent of an individual's use/abuse/addiction to alcohol and/or other drugs and identifies but does not diagnose any existing co-morbid conditions. A standardized substance abuse assessment instrument approved by DBHS (such as Addiction Severity Index) is used to complete the assessment process which results in the assignment of a diagnostic impression, patient placement recommendation for treatment regimen appropriate to the condition and situation presented by the recipient, and referral into a service or level of care appropriate to effectively treat the identified condition(s).

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Assessment-SUD Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification in at least one of the following:

- Currently licensed Physician (MD, DO)

- Currently licensed as an Advanced Practice Nurse

- Currently licensed as a Physician's Assistant

- Currently Licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as a Psychologist

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

TREA TMENT PLANNING

DEFINITION:

Design or modification of a specific, individualized treatment plan for the clinical treatment for substance use disorders. The treatment plan is developed in cooperation with the client to deliver specific addiction services to the individual to restore, improve or stabilize the individual's conditions, and must be based on individualized service needs identified in the completed SUD assessment. This plan must include goals for the treatment of identified problems, symptoms, and addiction issues. The plan must identify individuals and treatment teams responsible for treatment, specific treatment modalities prescribed for the individual, and time limitations for service. This may be the initial plan for a client entering treatment, the modification of a plan for a client already in treatment and/or transitioning from one level to another, or a discharge plan that includes recovery check- ups and/or active referrals for recovery support services as needed. It is typically a scheduled service not necessarily delivered in conjunction with other treatment. This service is the "prescription" of treatment services to be provided to a client and their families.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Treatment Planning Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification one of the following:

- Currently licensed Physician (MD, DO)

- Currently licensed as an Advanced Practice Nurse

- Currently Licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as a Psychologist

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

PHARMACOLOGICAL INTERVENTIONS

DEFINITION:

Includes face-to-face medication assessment, prescription, use and review of medications to stabilize a client's substance abuse and/or co-occurring mental health disorder. This service is limited to the prescribing of psychotropic medications and those medications necessary to treat addiction-related medical conditions and medication assisted addiction treatment.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Pharmacological Intervention Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification in one of the following:

- Currently licensed Physician (MD, DO)

- Currently licensed as an Advanced Practice Nurse with prescriptive authority

- Currently licensed as a Physician's Assistant under the supervision of a licensed physical (MD or DO). {Proof of supervision must be included}

INDIVIDUAL COUNSELING-SUD

DEFINITION: Face-to-face, one-to-one, therapeutic interaction between a provider and client necessary to initiate and support the rehabilitation effort, orient the recipient to the treatment process, develop the ongoing treatment plan, augment the treatment process, intervene in a problem area, contingency management, prevent a relapse situation, continuing care or providing ongoing psychotherapy as directed by the recipient's needs.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Individual Counseling SUD Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification one of the following:

- Currently licensed Physician (MD, DO)

- Currently licensed as an Advanced Practice Nurse

- Currently Licensed Alcoholism and Drug Abuse Counselor Currently licensed as a Psychologist

Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

GROUP COUNSELING-SUD

DEFINITION: Face-to-face therapeutic interventions provided to a group of 2-12 clients on a regularly scheduled basis to improve beneficiaries' capacity to deal with problems that are a result of and/or contribute to substance abuse. The professional uses the emotional interactions of the group's members to assist them in implementing each beneficiary's master treatment plan, orient the beneficiary to the treatment process, support the rehabilitation effort, and to minimize relapse. Services are to be congruent with age, strengths, needed accommodation for any disability, and cultural framework of recipient and his/her family.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Group Counseling SUD Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification in one of the following:

- Currently licensed Physician (MD, DO)

- Currently licensed as an Advanced Practice Nurse

- Currently licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as a Psychologist

Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

INDIVIDUAL RELAPSE PREVENTION SERVICES

DEFINITION:

Educational services provided to assist client in identifying their current stage of recovery and establishing a recovery plan, including acute and post-treatment services to identify and manage relapse warning signs. This service can be provided as a stand- alone service or within any substance abuse treatment setting (outpatient, residential, detox, etc.)

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Individual Relapse Prevention Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification in one of the following:

- Currently licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as a Psychologist

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

- Currently certified as a Certified Alcohol and Drug Abuse Counselor

- Currently certified as a Counselor in Training (CIT) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPS (Certified Prevention Specialist) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPC (Certified Prevention Consultant) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a Mental Health Professional or Mental Health Para-Professional under the supervision of an LADC, AADC, or CCDP-D

GROUP RELAPSE PREVENTION

DEFINITION:

A planned program of instruction provided to 2-15 clients, designed to assist individuals in drug abuse prevention, relapse, and/or treatment. This service can be provided as a stand-alone service or within any substance use disorder treatment setting.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Group Relapse Prevention Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as a Psychologist

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

- Currently certified as a Certified Alcohol and Drug Abuse Counselor

- Currently certified as a Counselor In Training under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPS (Certified Prevention Specialist) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPC (Certified Prevention Consultant) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a Mental Health Professional or Mental Health Para-Professional under the supervision of an LADC, AADC, or CCDP-D

ALCOHOL/DRUG TESTING

DEFINITION:

Laboratory testing to collect and analyze urine, blood, saliva, or breath to determine evidence of tobacco, alcohol, and/or illicit drug use.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Any laboratory used for drug testing and analysis shall comply, if applicable, with all federal and state proficiency testing programs. Any provider conducting on-site urine testing shall comply with the Clinical Laboratory Improvement Act (CLIA) regulations.

FAMIL Y/COUPLES EDUCA TION GROUP-SUD

DEFINITION:

Face-to-face interaction between at least 2 clients and their family members/significant others to assist the whole family in identifying the client's current stage of recovery and orienting the members to the processes associated with long-term recovery, including acute and post-treatment services to identify and manage relapse warning signs and promote successful community integration

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Family/Couples Education Group-SUD Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently Licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as a Psychologist

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

- Currently certified as a Certified Alcohol and Drug Abuse Counselor

- Currently certified as a Counselor In Training under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPS (Certified Prevention Specialist) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPC (Certified Prevention Consultant) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a Mental Health Professional or Mental Health Para-Professional under the supervision of an LADC, AADC, or CCDP-D

FAMILY/MARRIAGE GROUP COUNSELING

Definition:

Face-to-face therapeutic intervention between at least 2 clients and a maximum of 9 clients and their family members/significant others to enhance family members' insight into family interactions, facilitate inter-family emotional and practical support and develop alternative strategies to address family issues, problems, and needs. Group is designed to support the rehabilitative and recovery effort and must be prescribed in the treatment plan to address familial problem or need and to achieve goals or objectives specific in the treatment plan.

Qualifications and Documentation Required:

Family/Marriage Group Counseling Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently licensed Physician (MD, DO)

- Currently licensed as an Advanced Practice Nurse

- Currently Licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

MULTI-PERSON FAMILY EDUCATION (INDIVIDUAL FAMILY)

DEFINITION:

Face-to-face interaction with an individual client and his/her family members / significant others designed to assist the family in identifying the client's current stage of recovery and orienting the members to the processes associated with long-term recovery, including acute and post-treatment services to identify and manage relapse warning signs and promote successful community integration.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Multi-person Family Education (Individual Family) Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as a Psychologist

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

- Currently certified as a Certified Alcohol and Drug Abuse Counselor

- Currently certified as a COUNSELOR IN TRAINING (CIT) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPS (Certified Prevention Specialist) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPC (Certified Prevention Consultant) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a Mental Health Professional or Mental Health Para-Professional under the supervision of an LADC, AADC, or CCDP-D

FAMILY/MARRIAGE COUNSELING

DEFINITION:

Face to face treatment provided to more than one member of a family simultaneously in the same session or treatment with an individual family member (i.e. spouse or single parent) that is specifically related to achieving goals identified on the recipients' master treatment plan. The identified recipient must be present for the service. Services are to be congruent with the age, strengths, needed accommodations for disability and cultural framework of the recipient and his/her family. These services are to be utilized to identify and address marital/family dynamics and improve/strengthen marital/family interactions and functioning in relationship to the recipient, the recipient's condition and the condition's impact on the marital/family relationship.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Family/Marriage Counseling Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently licensed Physician (MD, DO)

- Currently licensed as an Advanced Practice Nurse

- Currently Licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

RECOVERY CHECK-UP

DEFINITION:

Telephone assessment of a client's current stage of recovery post-discharge from an acute care program and their compliance with a therapeutic, individualized recovery management plan. This service is performed in collaboration with recovery care coordinator to insure appropriate needs are identified and to facilitate linkages with local recovery support services. This service may include progress monitoring and re-adjustment of the individualized recovery plan as indicated by individual circumstances.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

MuIti-person Family Education (Individual Family) Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as a Psychologist

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

- Currently certified as a Certified Alcohol and Drug Abuse Counselor

- Currently certified as a COUNSELOR IN TRAINING (CIT) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPS (Certified Prevention Specialist) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPC (Certified Prevention Consultant) under the supervision of an LADC, AADC, or CCDP-D

Currently certified as a Mental Health Professional or Mental Health Para-Professional under the supervision of an LADC, AADC, or CCDP-D

CONTINUING CARE COUNSELING

DEFINITION:

An organized service which provides on-going supportive counseling for individuals who have completed substance abuse treatment. This service cannot be provided in conjunction with Life Skills Coaching, Recovery Peer Coaching or Recovery Calls.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Continuing Care Counseling providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently licensed Physician (MD, DO)

- Currently licensed as an Advanced Practice Nurse

- Currently licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

RESIDENTIAL TREATMENT

DEFINITION:

An organized service provided by a licensed treatment program which provides a 24-hour live-in, seven-day-a-week substance abuse treatment program providing a structured recovery environment to support recovery from substance use disorders. This service may be provided to an adult or to a woman in treatment with children.

Residential Treatment services require prior written authorization before services can be vouchered. Care Coordinators must submit an ATR Services Exception Request form (to include a copy of the client's Recovery

Support Plan) in advance of issuing a voucher and a copy must be retained in the Residential Treatment provider's file for review by DBHS and/or its authorized representative. Residential Treatment through the ATR program will only be authorized if all other funding sources are exhausted.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Residential Treatment Service providers must be hold a current DBHS residential alcohol and drug abuse treatment license. A copy of the current license must be submitted to obtain certification.

OTHER EDUCA TION SERVICES-GROUP

DEFINITION:

Addresses activities of daily living such as budgeting, financial management, time management, interpersonal relations, parenting, household management, anger management, and other issues that directly link to an individual's recovery plan but are not covered under other identified Recovery Support Services and may be provided in an office or community setting to assist the individual in community integration and sustaining recovery management. This service would include at least two and no more than 12 ATR clients.

OTHER EDUCATION SERVICES GROUP:

- Employment Readiness/Training Services

Resources provided in recovery to assist in finding, improving and sustaining employment and can include skills assessment and development, job coaching, career exploration or placement, job shadowing or internships, resume writing, interviewing skills and tips for retaining employment. Other services could include training in a specific skill or vocational assessment and job referral. May include assisting the client in completing requirements prior to employment such as background checks or drug tests and assessments.

- Housing Support Services

Services include helping clients/families in locating and securing affordable and safe housing, accessing a housing referral service, relocation services, tenant/landlord counseling, repair mediation and other identified housing needs.

- Educational and Remediation Services

Supported education services may include academic counseling, assistance with academic and financial applications, and aptitude and achievement testing to assist in planning educational services and support, including for GED and college education. Services also include vocational training and education through structured sessions focusing on increasing, expanding or stabilizing the education skills of an individual. These sessions could include tutoring and other structured classes designed to present information in a group setting.

- Parenting/Child Development Education Services

Services provided in a group or experiential setting that involves clients and their family members and facilitates the instruction of promising practices or evidence-based parenting or child development knowledge and skills. Services may include teaching, monitoring, and modeling appropriate discipline strategies and techniques, providing information and advocacy on child development, age appropriate needs and expectations, and may include parent groups and other related services.

- Financial Management/Credit Counseling

Services provided by organizations that help consumers find ways to prevent overspending or repay their debt - through careful budgeting and management of money and including establishment of checking and savings account as appropriate.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Other Education Services providers must provide documented evidence of knowledge and skills in the particular area of coaching/counseling for each of the particular types of education groups for which they are applying. Documentation must include evidence of providing these types of education groups during the six consecutive months prior to becoming an ATR provider.

MEDICAL/DENTAL SCREENING

DEFINITION:

Screening and referral as needed, for primary and specialty medical or dental care. Includes screening for infectious diseases (e.g., HIV, hepatitis B and C, tuberculosis, STDs), conditions commonly associated with addiction (e.g., liver, cardiovascular disease, dental disease); and reproductive and pediatric health care needs.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Medical/Dental Screening Service providers must provide documented evidence of knowledge and skills in medical/dental screening to include documentation of providing this service during the six (6) consecutive months prior to becoming an ATR provider. A copy of the particular screening tool to be used and the process for screening a client for medical/dental referral must be included.

MEDICAL/DENTAL SERVICES

DEFINITION:

Assessment/Treatment/Re-assessment of physical or dental health care needs to address health status, illness, injury, pain, or infection.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Medical/Dental Services providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently licensed Physician (MD, DO)

- Currently licensed as an Advanced Practice Nurse (APN)

- Currently licensed as a Physician's Assistant

- Currently licensed as a Dentist (DDS)

PSYCHIA TRIC EVAL UA TION

DEFINITION:

Service to a client assessed with a substance use disorder when the client screens positive for or otherwise demonstrates need for clinical assessment for co-occurring mental health disorder.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Psychiatric Evaluation providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently licensed as a Psychiatrist

- Currently licensed as a Physician (M.D.)

- Currently licensed as an Advanced Practice Nurse (APN)

PSYCHOLOGICAL TESTING

DEFINITION:

Evaluation to assess a client with substance use disorder for co-occurring mental health or learning disorders. This includes administration, scoring, and interpretation of psychological tests developed and standardized to assist in identifying intellectual functioning, academic ability, social judgment, and personality traits to assist in accurate diagnosis and treatment based upon an individual client's ability.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Psychological Testing providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently licensed as a Psychological Examiner (LPE)

- Currently licensed as a Psychological Examiner-Independent (LPE-I)

- Currently licensed as Psychologist (LP)

MENTAL HEALTH THERAPY SERVICES

DEFINITION:

Face-to-face therapy to address mental health issues that might impact the client's life and recovery, using evidence-based approaches. The most frequent disorders are mood and personality disorders-often associated with trauma histories and Post Traumatic Stress Disorder (PTSD).

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Mental Health Therapy Services providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently licensed Physician (MD, DO)

- Currently licensed as a Psychiatrist

- Currently licensed as an Advanced Practice Nurse

- Currently licensed as Psychologist (LP)

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

- Currently licensed as a Psychological Examiner-Independent (LPE-I)

- Currently licensed as a Licensed Clinical Social Worker (LCSW),

- Currently licensed as a Licensed Professional Counselor

- Currently licensed as a Licensed Marriage and Family Therapist

- Or an Licensed Associate Counselor (LAC), Licensed Master Social Worker (LMSW) Licensed Associate Marriage and Family Therapist (LAMFT) or Psychological Examiner (LPE) under supervision

HEALTH CARE EDUCATION-GROUP

DEFINITION: Group education to address prevention and wellness, generally or regarding specific conditions such as HIV, STDs, Hepatitis, Reproductive Health Care, Tobacco Use Cessation, Child Health Supervision, Obesity, Physical Activity, etc.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Health Care Education-Group Service providers must be licensed to practice in Arkansas and must hold a current license/certification by their respective State Board of licensing/certification as follows:

- Currently Licensed Alcoholism and Drug Abuse Counselor

- Currently licensed as a Psychologist

- Currently licensed as an Advanced Alcohol and Drug Abuse Counselor

- Currently certified as a Certified Co-Occurring Disorder Professional-Diplomate Level

- Currently certified as a Certified Alcohol and Drug Abuse Counselor

- Counselor in Training (CIT) under the supervision of an LADC, AADC, or CCDP-D

- Currently certified as a CPS under the supervision of an LADC, AADC, or CCDP-D Currently certified as a CPC under the supervision of an LADC, AADC, or CCDP-D

CHILD CARE

DEFINITION:

Care and supervision provided to a client's child(ren) less than 14 years of age and for less than 24 hours per day, while the client is participating in ATR funded treatment/recovery support activities. If ATR client is not present in the building, services must be provided in a licensed child care center or school (before/day/after care) program meeting state Quality Afterschool and School-Age Programs standards-on or off-site. Staff to child ratios should be 1:3/4 for infants below 18 months; 1:6/7 for 18-36 months, 1: 8/9 for 36-60 months

Note: Client must provide evidence of application for and denial or waiting list status for state child care vouchers when a licensed child care facility is used. Documentation must be maintained in the client's file for review by DBHS and/or its authorized representatives.

QUALIFICATIONS AND DOCUMENTATIOLN REQUIRED: /. For Child Care Services provided when the ATR client is not present in the child care building:

The Child Care Services provider must be licensed by DHS to provide child care or meet afterschool quality standards.

//. For Child Care Services provided when the ATR client is present in the building and receiving ATR covered services:

The Child Care Services provider is not required to be licensed. Providers must complete a criminal background and child maltreatment registry check for each employee or volunteer that provides childcare when the provider us not licensed by DHS to provide child care. Results of the completed criminal background and child maltreatment registry must be included with the application for certification.

In addition, the provider is required to maintain a list of activities during the time in care to identify that there is a schedule/routine for children that include a variety of play/choice/learning opportunities utilizing a wide range of materials/equipment. A sample activity list must be included with the application.

While a current DHS Child Care License is not required, DBHS concurs with the following recommendations by the Division of Child Care and Early Childhood Education (DCCECE) for unlicensed Child Care Services providers:

- For care that is 2 hours or less, (DCCECE) recommends a Child Development Associate credential as a minimum.

- For child care more than 2 hours at a time, an Associate's Degree or higher in early Childhood Education, Child Development or related field is recommended.

- To promote quality child care it is recommended that caregivers meet professional development requirements such as Infant/Toddler or Preschool Frameworks, courses related to child/human development at higher education institutions, Traveling Arkansas Professional Pathways (DCCECE approved training), or Conscious Discipline.

For Child Care Services provided in an unlicensed location, DBHS reserves the right to revoke any Child Care Services certification at any time the health and safety of a child is put at risk or on-site inspection shows the location fails to meet city/state coding requirements, or there is no evidence that there is a schedule/routine for children that includes a variety of play/choice/learning opportunities utilizing a wide range of materials/equipment.

SUPPORTIVE, TRANSITIONAL, DRUG-FREE HOUSING

DEFINITION:

Transitional Living Standards (TL) - The program will apply these standards to all sites operated as Transitional Living, Group Living, Half Way House or Chemical Free Living Programs. An on-site inspection by DBHS will be conducted prior to certification approval.

Transitional Living Requirements

- Compliance with any local health and safety codes, including housing codes, fire codes, plumbing codes, and electrical codes, set by the jurisdiction(s) in which the transitional housing facility is located;

- Compliance with any state and federal health and safety codes; and

- Compliance with any local zoning ordinances; and

- Compliance with allowable ratio of transitional housing facility square footage to residents; and

- Meet the allowable ratio of bathing facilities and restroom facilities to residents.

- Maintain separate sleeping and bathing rooms for males and females.

TL1 General Requirements:

- Each client is in a residential setting with his or her own personal space that:

- Respects Privacy

- Promotes Personal Security

- Promotes Safety

- The organization provides the following community living components:

- Regular meetings between the persons served and staff.

- Opportunities to participate in typical home activities.

- Appropriate linkage when healthcare needs of the person served are identified.

- A personalized setting.

- Daily access to nutritious meals and snacks.

- The opportunity for expression of choice by the person served in regards to rooms and housemates.

- Based on the choice of the person served, opportunities to access

- Community Activities

- Cultural Activities

- Social Activities

- Recreational Activities

- Spiritual Activities

- Employment/income generating activities

- Necessary transportation

- Self-help groups

- Other activities as identified in the person's plan

- Policies related to:

- Visitors and Guests

- Pets.

- In home safety needs of persons served are addressed with respect to:

- Environmental Risk.

- Abuse and/or neglect inflicted by self or others.

- Self-protection skills.

- Medication Management

- When possible, persons served have options to make changes in their living arrangements:

- At their request.

- At the request of their families, when applicable.

- In transitional living, on periodic basis when initiated by the organization.

- Based on informed choice.

- Based on the needs of persons transitioning to other housing, there are procedures in place to assist them in securing housing that is:

- Safe

- Affordable

- Accessible

- Acceptable

- Each person served receives:

- Skill development necessary to live as independently as possible.

- Ongoing support/services as he or she explores changes in his or her living arrangements.

- Personnel are on site based on the needs of the person served, as identified in their person centered plans.

- There is a system for the on-call availability of designated personnel 24 hours a day, 7 days a week.

- In congregate housing, provisions are made to address the need for:

- Smoking or nonsmoking areas.

- Quiet areas.

- Areas for visits.

- Other issues, as identified by the residents.

- The organization assists the person served to identify and utilize available modes of transportation.

- The organization demonstrates efforts to maintain a person's residence as long as possible during temporary medical, legal, or personal absences.

- The organization provides information to residents that include:

- How to access community resources if needed.

- Safety issues related to the service delivery site.

- Access to emergency care when it is needed.

- Specific healthcare procedures and techniques.

- Contingency plans in case either the support system or the service provider is unable to deliver care.

- A review of how to deal with emergencies and evacuation from the residence.

- The organization must maintain a written policies and procedures which includes:

- Exclusion criteria for clients not appropriate for the organizations services

- Drug Testing if used by the organization

- A policy that establishes that when employment is appropriate and requires all service recipients to be gainfully employed, actively pursuing employment, or participating in vocation education/rehabilitation.

- A weekly schedule of all program services and service recipient activities for each day specifying the type of service/activity and scheduled times.

- Communication of Client rights including during orientation and evidence of review after one year of services being offered to client.

TL 2 Tobacco Products:

- The program shall have a written policy and procedure prohibiting the use of any tobacco products within the facility in accordance with the Arkansas Clean Indoor Act of 2006. If the program provides a designated smoking area it shall be located a minimum of 25 feet from any entrance to the facility and shall not be in a common area that non-smoking individuals must transverse to gain access into the facility. In addition the program shall prohibit the use of alcohol, tobacco and illicit drugs by staff which includes:

- Providing, distributing, or facilitating the access of tobacco products to clients;

- Use of tobacco products in the presence of clients or visitors; and

- Prohibits the public display of tobacco products by staff.

TL 3 Transitional Living Physical Environment:

- Programs are to ensure compliance with all local, state and federal laws and regulations regarding the condition and maintenance of its facility.

- Provide evidence of current valid certifications, which are maintained on site of all applicable buildings, fire and safety, health, and all other applicable inspections. All items of concern noted in these inspections shall immediately be addressed/corrected.

- Treatment Services may not be provided onsite unless:

- There is a separate entrance to areas in which services are rendered; and

- Services are provided in an area used exclusively for treatment.

- Facilities must provide separate bedroom and bathroom areas for males and females;

- Provide adequate barriers to divide populations; as determined by DBHS;

- Programs will maintain this separation by any means necessary including structural separation, continuous monitoring or any combination of efforts required to assure compliance with this standard.

- Window coverings to allow for privacy;

- Sufficient lighting as to avoid injury;

- Sleeping areas shall have at least:

- Fifty (50) usable square feet per person in single occupancy rooms;

- Forty-eight (48) usable square feet per person in multiple occupancy rooms;

- Individual storage for clothes and personal items.

- Plumbing must be:

- In working condition and to avoid any health threat; and

- All toilets, sinks and showers shall be clean and in working order.

- There shall be at least one toilet, one sink, and one shower or tub per every eight (8) clients.

- Clients must have access to a secure locked storage for valuables when requested.

- Separate storage areas are provided and designated for:

- Food, kitchen and eating utensils;

- Clean linens;

- Soiled linens and soiled cleaning equipment; and

- Cleaning supplies and equipment.

- Poisons, toxic materials and other potentially dangerous items shall be stored in a secure location and procedures identified for the need and use of such items.

TL 4 Facility Health and Safety Requirements:

- Maintain a suitably stocked first aid kit(s), with contents as defined in the program's policies and procedures at all sites.

- Maintain fire extinguisher(s) that are accessible, in working order and have attached documentation of annual inspection;

- Evacuation routes are prominently posted throughout all facilities;

- All exits must be clearly marked.

- The programs telephone number(s) and actual hours of operation will be posted at all public entrances.

- Conspicuous warning signs must be posted at all public entrances informing staff, volunteers, clients and visitors as to the following requirements:

- No alcohol or illicit drugs are allowed in the facilities;

- No firearms, or other dangerous weapons, are allowed in the facilities with the exception of law enforcement while in the performance of their duties; and

- The use of tobacco is not allowed in the facilities.

- A copy of compliance with law Title Vl/Title VII of the 1964 Civil Rights Law shall be prominently displayed for the viewing public.

- Programs must provide a safe and sanitary environment.

NON-MEDICAL TRANSPORTA TION SERVICES

DEFINITION:

Transportation Services for those engaged in alcohol/substance use treatment related appointments/activities (e.g. treatment, recovery check-up appointment, medical care, employment skills building, child care, or parenting service, etc.) with no other means of transportation. Can include bus passes, taxi, transportation services by private transportation agency, does not include routine transportation to and from work.

QUALIFICATIONS:

Transportation Service providers must provide proof of driver's license verification with no major violations in past three years and no more than three points in three years, insurance, and documentation of routine vehicle maintenance, and must submit specific, verifiable receipts for transportation service provided.

Documentation Required:

Certified Transportation providers must demonstrate evidence of the following personnel requirements:

- Transportation staff must meet all of the following minimum requirements prior to working with consumers:

- All vehicle operators and owners must maintain proof of financial responsibility:

- A copy of the current certificate of insurance

- A copy of the current vehicle registration

Note: The aforementioned information must be maintained in each vehicle as required by Arkansas law

- Have successfully completed drug screen within thirty (30) days of application Results of the drug screen must be submitted with the application.

- A current and valid driver's license or CDL, when appropriate;

- A signed statement attesting that the those providing transportation under this certification do not have a medical or physical condition, including vision impairment, that cannot be corrected and could interfere with safe driving, passenger assistance, and emergency treatment activity, or could jeopardize the health and welfare of a client or the general public.

- The driver has the ability to understand written and oral instructions and document services delivered.

Providers must assure:

- Maintenance of a safety checklist completed prior to transporting consumer(s) and/or travel attendants. Checklist items shall include, but not be limited to, fire extinguisher; first aid kit,

- Maintenance of service logs or trip sheets that include the date of service the consumer's name, the pick-up point and destination point for each trip, total mileage per trip, and the driver's signature.

- Transportation providers shall ensure that vehicles owned or operated by the provider are maintained according to manufacturer's recommendations.

- Transportation services shall be provided in a safe manner consistent with the regulations of the local authorities.

SPIRITUAL SUPPORT

DEFINITION:

Face-to-face counseling or spiritual guidance with the client to address spiritual issues that negatively impact recovery or that can support recovery, including, establishing/re-establishing a relationship with a higher power, acquiring skills to cope with life changing incidents, adopting positive values/principles, identifying a sense of purpose/mission for one's life, achieving serenity/peace of mind, responsible decision-making, social engagement and family responsibility.

Faith-based services include those provided to clients and using spiritual resources designed to help persons in recovery to integrate better their faith and recovery. Such services are usually provided in a religious or spiritual setting by spiritual leaders or other staff who are knowledgeable about the spiritual values of the community and are equipped to assist individuals in finding spirituality. Services include, but are not limited to, social support and community-engagement services, faith, or spiritual based activities to assist clients with drawing on the resources of their faith tradition and community to support their recovery; mentoring and role modeling; and pastoral or spiritual counseling and guidance.

QUALIFICATIONS AND DOCUMENTATION REQUIRED:

Spiritual Support Services providers must be:

- Ordained, commissioned or licensed minister or equivalent, pastor, bishop, deacon, evangelist, rabbi,

imam or other whom is give ministerial status according to the procedure followed by a particular faith's denomination; or

- An individual with an active relationship with a local religious body and with that religious body's endorsement to minister to clients and with demonstrated experience and/or education in the field of faith-based services, or

- An individual that meets traditional and recognized standards as defined within a respective Native American Tribal community and have an endorsement from that tribal community, or

- A master's level or above professional who is licensed at the independent level of practice with documented experience and/or education in spiritual counseling, and employed by a mental health clinic, group or individual private practice, hospital, or licensed substance abuse program.

SUPPLEMENTAL NEEDS

DEFINITION:

Assistance provided to ATR client to meet tangible needs that support their recovery and must address goal(s)

in the client's Recovery Support Plan. These supplemental needs are determined by the client in collaboration with their care coordinator. In order to receive supplemental needs services, a client MUST be an active ATR client for a minimum of thirty (30) days prior to receiving supplemental needs services. No other service restrictions apply to this service.

SUPPLEMENTAL NEEDS SERVICES:

Supplemental Needs Coordination Service

Coordination of supplemental needs services to include but not be limited to coordination and support of client access, purchasing of goods and services and transportation of clients to obtain supplemental services.

Clothing/Hygiene Products

This service includes clothing vouchers to be used for obtaining clothing for employment, education, and other recovery-related needs. Hygiene products related to daily needs, including soap, shampoo, toothpaste, deodorant, shaving needs, feminine hygiene products, and dental products. This service does not include perfume, cologne, nail polish, nail polish remover, make-up, hair color, electric razors, cleaning supplies or other purchases as designated by the care coordinator. Products containing alcohol are strongly discouraged.

Education

Assistance provided to clients for the purpose of completing or continuing education, such as for GED

coursework and testing, English as a second language (ESL) classes, or educational materials, books, supplies and tuition at a secondary educational institution.

Psychotropic Medication

Assistance provided to clients to purchase a 30 day supply of prescription psychotropic medications.

Documentation of medication prescription and/or pharmacy receipt indicating prescription should be maintained in the client file.

Utility Assistance

Assistance provided to clients for the purpose of past due utility assistance or deposits that assist in establishing or maintaining their residence. Client must have documentation of denial from other sources for utility assistance and documentation of utility bill and attempted payment plan. Utility Assistance can be used for past due bills that are interfering in the client's ability to obtain housing. Utility bills must be in the ATR client's name.

- Wellness

Assistance provided to clients for the purchase of items or services that support improved health. This may include an eye exam or the purchase of eye glasses/contact lenses, fitness memberships (including family memberships), smoking cessation, nutritional counseling, weight management, or nutritional assessment.

Restorative Dental Care

Restorative dental care encompasses the process of restoring missing, damaged, or diseased teeth to normal form and function, performed by general dentists.

Co-Pays

Out-of-pocket fees assessed to clients for substance use disorder treatment services or for psychotropic medications or medication assisted treatment.

Other Needs

Other instrumental needs determined by care coordinator and client such as food, assistance with legal expenses, mileage at state rate for transportation to ATR appointment by family member or other individual, automobile repair/battery/etc, or other recovery support needs as reflected in recovery care plan and approved by care coordinator.

QUALIFICATIONS:

Supplemental Needs providers may be organizations or individuals that agree to pay for a vouchered supplemental needs and then bill ATR program for encounter through VMS for reimbursement.

DOCUMENTATION REQUIRED:

A certification statement that the applicant has the financial resources to pay for supplemental needs services at time of delivery with reimbursement by ATR voucher. Statement must be signed by the organization's board chairman, president, CEO, COO, or designee (for organizations only).

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT

In August of 1996, the Health Insurance Portability and Accountability Act (HIPAA) was enacted. HIPAA requires the development and implementation of standards for the exchange, storage and handling of certain health care administrative data, security measures and privacy protections.

On August 17, 2000, the final regulations for the transactions and code sets were published, with an October 16, 2002, deadline for compliance. The final regulation for health privacy was published in December 2000. The compliance date for this regulation was April 14, 2003.

HIPAA impacts every aspect of the health care industry. To learn more about HIPAA, see the DHS link:

http://www.hipaa.state.ar.us

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Arkansas Access to Recovery Information and Rights Form

Introduction: Welcome to Arkansas Access to Recovery (AR ATR). AR ATR is a four-year Arkansas Department of Human Services (DHS), Division of Behavioral Health Services (DBHS), project funded by a grant from the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA). University of Arkansas (UAF) Partners for Inclusive Communities (Partners) works with OADAP to manage the program. ATR provides opportunities for clients through use of a voucher system to purchase ATR covered services from providers with voucher agreements with AR DHS.

ATR services are based on client needs, agency policy, and current available ATR voucher funding, and are subject to change.

Information from the ATR project will help local, state, and federal providers and funding authorities improve alcohol and drug use disorder treatment and recovery services for you and others in your community.

Data Interviews: If you consent to participate in ATR, you will be asked to take part in three GPRA data interviews that take 15 to 45 minutes each. GPRA (Government Performance Results Act) interviews ask questions about alcohol and drug use, education and employment, family and living conditions, involvement in the criminal justice system, and participation in social support and recovery groups. You will receive a $15 dollar gift card for completing the GPRA Follow-up interview. In the event that during the attempted completion of the GPRA Follow-up Interview it is discovered that you're residing in a restricted setting, by signing this consent you grant your Care Coordination provider the ability to attempt contact with you which may include disclosure to the facility at which you reside of your involvement in ATR.

Release of Information: As part of your involvement in ATR, you are authorizing contact between AR DHS and SAMHSA and each provider you're receiving services from, to obtain information necessary for ATR project management. This may include, but is not limited to, information related to fiscal reporting, quality improvement, client progress, and data collection. By signing this form you are authorizing release of information between you and AR DHS and SAMHSA. You may revoke your release of information at any time except to the extent that action has already been taken. This consent expires automatically 6 months after your final GPRA interview.

Satisfaction Survey: You will be asked to complete an ATR Client Satisfaction Survey at the time you complete the GPRA Follow-up interview.

ATR is voluntary: You can refuse to participate in ATR or leave at any time. Refusal to participate in ATR will not affect any current or future substance abuse treatment you may receive. You may refuse to answer certain questions and still participate in ATR. If you refuse to answer a question, no one associated with ATR will seek the information you did not provide from some other source. If you participate in ATR and later choose not to participate, information you already have given will remain in the project.

Risks and Confidentiality: AR DHS, UAF Partners and ATR providers take the privacy of your information seriously. ATR providers, AR DHS, UAF Partners and SAMHSA must comply with confidentiality and protected health information requirements as set forth in Federal and State Confidentiality Regulations (42 CFR, Part 2,

and the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 CFR, (160 & 164). Your records are protected and cannot be disclosed without your written consent.

Because AR ATR involves coordination of services you want, providers will ask you to sign a release of information to allow them to talk with other providers. You may revoke your release of information at any time except to the extent that action has already been taken. Generally, a program may not condition your services on whether you sign a release of information, however, in the special circumstances of the voluntary ATR project, you cannot participate if you do not sign the Voluntary Consent Form.

A unique identification number will be assigned to you as an ATR participant. Authorized representatives from AR DBHS or UAF Partners may have access to records that identify you by name. Any information you provide that is part of aggregate data given to SAMHSA will not include your name or other identifying data. If any publications or presentations result from the ATR project, you will not be identified.

As part of your involvement in ATR you will receive services from a Care Coordination provider. To assist you with your involvement in ATR and utilization of services in your recovery, Care Coordination providers establish policies and determine the appropriate use of funding (i.e. amounts, frequency, services or vendors), up to the available limits, as it pertains to your goals in recovery. Services you receive will be from a community provider as arranged by your Care Coordinator and shall not represent a conflict of interest.

Client Rights:

You have the right to:

* Appropriate and considerate care and protection

* Recognition and consideration of your cultural and spiritual values

* be told of all available ATR covered services and providers

* choose the services and providers you want from the list of available AR ATR covered services and providers

* refuse a recommended service or plan of care

* review records and information about your services

* expect providers, AR DHS, UAF Partners, and SAMHSA to keep all communications and records confidential

Maintaining Involvement:

If you do not receive at least one ATR service or participate in scheduled Care Coordination every 30 days, you will be discharged from the ATR program. By signing this form, you agree to these conditions in order to maintain involvement.

Questions: If you have questions or concerns about the ATR project, contact ATR Representative at Partners for Inclusive Communities at 501-682-9900.

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