Policies and Procedures, Quality Assurance and Technical Assistance
 |
 |
|||||||||||||||||||||||||||||||||||||
|
Welcome to the Substance Use Disorder Treatment and Recovery Services (SUDS) Webpage for the Quality Assurance Office of Alameda County Behavioral Health (ACBH). The Quality Assurance Office offers intensive training and technical assistance for Alameda County contracted SUDS providers with a primary focus on supporting Drug Medi-Cal certification and documentation efforts. We also provide assistance on other aspects of quality improvement and integration to enhance provider treatment and recovery services in the new climate of health care reform. Keep in Touch We encourage you to check back regularly for updates. Additionally, please email the QATA@acgov.org and provide us with your name, agency and email address so that you can be added to our Distribution List for memos and important information. We are here to assist: The ACBH Quality Assurance team is available to provide technical assistance (TA) to ACBH contract providers. If you have questions about SUD or MH policies and procedures, i.e., clinical documentation, grievances, privacy, security, etc. please email the ACBH Quality Assurance Technical Assistance inbox at QATA@acgov.org. Quick Links:
Medical Necessity for SUD Services DMC-ODS services must be medically necessary. Pursuant to W&I Section 14059.5(a), for individuals 21 years of age or older, a service is “medically necessary” or a “medical necessity” when it is reasonable and necessary to protect life, to prevent significant illness or significant disability, or to alleviate severe pain. For individuals under 21 years of age, a service is “medically necessary” or a “medical necessity” if the service is necessary to correct or ameliorate screened health conditions. Consistent with federal guidance, services need not be curative or completely restorative to ameliorate a health condition, including substance misuse and SUDs. Services that sustain, support, improve, or make more tolerable substance misuse or a SUD are considered to ameliorate the condition and are thus covered as EPSDT services. (Section 1396d(r)(5) of Title 42 of the United States Code; W&I Section 14059.5(b)(1)). No Wrong Door As part of the CalAIM initiative and to reduce access barriers, any Medi-Cal beneficiary can receive an assessment for determination of DMC-ODS services. Even if the beneficiary ends up not meeting DMC-ODS criteria, assessment services in good faith are allowed. Access Criteria for DMC-ODS Adolescent beneficiaries are eligible for DMC-ODS services even if they do not meet criteria for substance use disorder diagnosis. Services may be provided for both early intervention/preventative purposes as well as for treatment purposes. For adult beneficiaries, a substance use disorder diagnosis is required to receive treatment services after the initial assessment has been completed. Alcohol and Drug Counselor Requirements There are three approved organizations that DHCS recognizes as accredited to register and certify alcohol and other drug counselors in California. For more information regarding the educational requirements for becoming an alcohol and other drug counselor in California, please contact any of the certifying organizations listed at the DHCS webpage for Counselor Certification: Counselor Certification Organizations. Substance Use Disorder-Behavioral Health Policies & Procedures
| ||||||||||||||||||||||||||||||||||||||
 |
 |
|||||||||||||||||||||||||||||||||||||