The following are comments and concerns regarding the new, Part 822 draft regulations raised at the monthly, clinical review/quality improvement meeting of ATPA held on January 11th, 2013:
- “Telepractice services may be provided.” Could this include other forms of evolving online services (e.g., email/text-based sessions, videoconferenced sessions, etc.)? What CPT codes would we use for these services? Must they be a certain duration?
- How do these new regulations follow the “golden thread” formulation of gold standard treatment? The new regulations seem to be moving away from this plan (i.e., no comp evals., no medical screening required)
- Treatment plans completed no later than 21 days or 5th visit, whichever occurs first. For someone attending intensive outpatient services, the treatment plan could be due before the second week of treatment not allowing ample time to know the client’s case well. Is this ample time to adequately assess and develop a recovery plan? May lead to cookie-cutter, generic treatment plans. We think 21 days is sufficient, but remove the 5th visit stipulation.
- Having treatment plan reviews signed by the medical director is difficult and time consuming.
- There must be “an adequate number of counselors” to carry out objectives of program. This ambiguity leads to too much subjectivity both by programs and by OASAS in determining proper outcomes. Specifically state the program outcomes by which OASAS would flag a program.
- “Extended care” is unclear. Are these patients considered discharged? Are they readmitted as extended care patients? Do they continue to need treatment plan reviews?
- Criteria for discharge is ambiguous. Please define “stabilized”. What are the specific “remission criteria for a substance use disorder”? Is this related to a duration free from substances? What specifically does it mean to “attain necessary support for long-term remission”?
- Each employee to have a training plan. Can OASAS provide us with some direction or a format for this?
- Have authorized staff for administering a Narcan emergency overdose prevention kit. Is this really necessary for non-OTP programs? Would we need an authorized staff available during all clinic hours?
The Addiction Treatment Providers Association (ATPA) is composed of licensed and proprietary agencies within New York State that do not receive any deficit-funding from OASAS. Learn more about us at http://www.atpanys.org.
Nick Lessa, LCSW-R, MA, CASAC
Chair of the Clinical Review Committee