Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This amendment removes the reference to the
department's Trauma Initiative Core Competency Model, adds a clarifying
statement regarding the provision of FDA-approved medications for opioid use
and other substance use disorders, and updates the address for the American
Society of Addiction Medicine.
(1) Program Requirements. In order to be
certified by the department to provide CSTAR services the organization must-
(A) Comply with 9 CSR 10-7, 9 CSR 10-5, and 9
CSR 30-3, as applicable;
(B) Be
accredited to provide substance use disorder treatment services by Commission
on Accreditation of Rehabilitation Facilities (CARF) International, The Joint
Commission, Council on Accreditation, or other entity recognized by the
department;
(C) Have the capacity
to collect, analyze, and report outcome and other data related to the
population served to the department in accordance with established
protocol;
(D) Incorporate
evidence-based, best, and promising practices into its service array.
1. At a minimum, the organization shall
employ or have a formal contract with the following:
A. Licensed and credentialed professionals
with expertise and specialized training in the treatment of trauma-related
disorders
B. Licensed and
credentialed professionals with expertise and specialized training in the
treatment of co-occurring disorders (substance use and mental
illness);
C. Licensed prescribers to
provide FDA-approved medications which can be provided in an outpatient setting
for the treatment of opioid use and other substance use disorders (methadone
must be provided by a certified opioid treatment program). Long-term
medications shall be offered and prescribed, as medically
appropriate;
D. Certified Peer
Specialists who have completed department-approved training and
credentialing;
E. Clinical staff who
have completed department-approved training on smoking cessation;
F. Clinical staff who have completed
department-approved training on suicide prevention;
and
(E) Have
clinical staff who are trained and qualified to utilize The ASAM
Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring
Conditions, 2013, hereby incorporated by reference and made a part of
this rule, published by and available from The American Society of Addiction
Medicine, 11400 Rockville Pike, Suite 200, Rockville, MD 20852, (301)
656-3920. This rule does not incorporate any subsequent
amendments or additions to this publication.
(2) Other Applicable Program Requirements. A
CSTAR program shall meet the following additional requirements when the
department determines they are applicable:
(A) Services offered on a residential basis
shall comply with requirements for residential treatment; and
(B) Requirements as a specialized program for
adolescents or as a specialized program for women and children shall be met,
where applicable.
(3)
Medicaid Eligibility. An organization must be certified as a CSTAR program to
qualify for Medicaid reimbursement for delivery of substance use disorder
treatment services to eligible persons.
(A) A
CSTAR program shall comply with applicable state and federal Medicaid
requirements.
(B) If there is a
change in the Medicaid eligibility or financial status of a person served, the
individual shall not be prematurely discharged from the CSTAR program or
otherwise denied CSTAR services. The program shall-
1. Continue to provide all necessary and
appropriate services until the individual meets treatment plan goals and
criteria for discharge; or
2.
Transition the individual to another provider and document in the individual
record there is continuity of clinically appropriate treatment
services.
(C) A CSTAR
program acknowledges and accepts that not all required services may be
reimbursed by Medicaid.
(4) Temporary Waiver. Upon the effective date
of this rule, the department will grant a one- (1-) year waiver from the
requirements specified in subsections (1)(B) and (1)(E) of this rule to
programs that have a current and valid CSTAR contract with the department and
continue to meet certification and contract requirements.
(A) Waivers shall be temporary and time
limited.
1. The initial waiver period of one
(1) year may be renewed or extended by the department annually
thereafter.
2. The total period of
waiver shall not exceed three (3) years unless otherwise determined by the
department.
*Original authority: 630.050, RSMo 1980, amended 1993,
1995; 630.655, RSMo 1980; and 631.010, RSMo
1980.
