Substance Abuse Outpatient Care
|Substance Abuse Services – Outpatient-Individual Counseling
|Substance Abuse Services – Outpatient-Group Counseling
|Substance Abuse – Intake - Includes but not limited to intake into methadone or other medication-assisted treatment. May include substance abuse assessments (SASSI) by appropriately qualified personnel, although technically, a person is not in outpatient or any form of treatment at the time of the assessment.
|Medication-Assisted Detox - Includes medications such as Methadone, Subut (buprenorphine hydrochloride) and Suboxone (buprenorphine hydrochloride and naloxone hydrochloride), ORLAAM, etc.
|Substance Abuse Medication Maintenance
Health Resources and Services Administration (HRSA) Description
Substance Abuse Outpatient Care is the provision of outpatient services for the treatment of drug or alcohol use disorders.
Acupuncture therapy may be allowable under this service category only when it is part of the documented treatment plan.
Ryan White Part-B/State Services program funds may not be used to carry out the distribution or exchange of sterile needles or syringes for the use of injection of illegal substances in the state of Texas.
Activities under the Substance Abuse Outpatient Care service category include:
- Treatment of substance use disorder, including:
- Pretreatment/recovery readiness programs
- Healthy behavior promotion
- Behavioral health counseling associated with substance use disorder
- Outpatient drug-free treatment and counseling
- Medication-assisted therapy
- Neuro-psychiatric pharmaceuticals
- Relapse prevention
Services providers for Substance Abuse Outpatient Care must follow HRSA/DSHS Universal Standards 1-46 and 120-128.
Service Standards and Measures
The following standards and measures are guides to improving healthcare outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program.
Provision of Services: Support for Substance Abuse Treatment Services-Outpatient, is provided by or under the supervision of a physician or other qualified/licensed professionals. In Texas this includes a licensed chemical dependency counselor or one of the practitioners listed below who is licensed and in good standing in the State of Texas and has at least 1,000 hours of documented experience treating substance-related disorders:
Services include and are limited to:
Comprehensive Psychosocial Assessment: All clients referred to the program will have a comprehensive psychosocial assessment completed by a licensed substance use counselor or other qualified licensed professionals.
The comprehensive psychosocial assessment will be completed prior to the third counseling session and will include the following:
Approved assessment tools such as the Substance Abuse and Mental Illness Symptoms Screener (SAMISS) and Addiction Severity Index (ASI) may be used for substance use and sexual history, and the Mini Mental State Examination (MMSE) may be used for cognitive assessment. Other industry-recognized assessment tools may be used if approved by the substance abuse treatment services - outpatient provider agency.
Treatment Plan: A treatment plan shall be completed within 30 calendar days of completing a comprehensive psychosocial assessment specific to individual client needs. Treatment planning will be a collaborative process through which the provider and client develop desired treatment outcomes and identify the strategies and modalities for achieving them.
The treatment plan will include documentation of the following:
The treatment plan must be signed by the licensed substance use counselor who is providing and or supervising the service.
Progress Notes: Services will be provided according to the individual's treatment plan and documented in the client's record. Progress notes are completed for every professional counseling session and include:
Referrals: The agency will offer appropriate referrals to clients for support services as applicable to meet goals.
Discharge Planning: Discharge planning will be completed when treatment goals are met and include:
In all cases, providers/case managers shall ensure that, to the greatest extent possible, clients who leave care are linked with appropriate services to meet their needs.
Discharge: Services may be discontinued when the client has:
Note: Staff should not inactivate clients in Take Charge Texas (TCT) at the time of discharge, unless the case is being closed due to a deceased client.
Division of Metropolitan HIV/AIDS Programs, HIV/AIDS Bureau (HAB). Ryan White HIV/AIDS Program (RWHAP) National Monitoring Standards for RWHAP Part A Recipients. Health Resources and Services Administration, June 2022.
Division of State HIV/AIDS Programs, HIV/AIDS Bureau (HAB). Ryan White HIV/AIDS Program (RWHAP) National Monitoring Standards for RWHAP Part B Recipients. Health Resources and Services Administration, June 2022.
Food, Drugs, Alcohol, and Hazardous Substances, Subtitle B. Alcohol and Substance Programs, Chapter 464.
Ryan White HIV/AIDS Program. Policy Notice 16-02: Eligible Individuals & Allowable Uses of Funds. Health Resources and Services Administration, October 22 2018.