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Supervisor SACOT/IOP LCAS Supervisor Residential/Group/SACOT/IOP

2 months ago

Pembroke, United States Southeastern Integrated Care LLC Full time
Job Description*SIGN ON BONUS*

Summary:

The Supervisor/ is responsible for the supervision and management of team operations and staffing for SACOT/SAIOP/MOUD treatment services. The Supervisor ensures that services are provided to the members served to meet the clinical needs of each recipient through direct and indirect interventions in accordance with DHHS Clinical Coverage Policy 8A. The Supervisor oversees and assures the program integrity of SACOT/SAIOP/MOUD services as outlined below.

Essential Duties and Responsibilities:

  • The clinical supervisor must provide individual therapy and group for recipients served by the team.
  • Behavioral interventions such as modeling, behavior modification, and behavior rehearsal.
  • Designates the appropriate team staff so that specialized clinical expertise is applied as clinically indicated for each recipient.
  • Implementation and monitoring of ASAM levels of care, Matrix Model, Illness Management and Recovery, MOUD, Dimensions of Wellness and Cognitive Behavioral Therapy
  • Provides, coordinates, and oversees initial assessment and ongoing assessment of the recipients clinical needs.
  • Develops and implements individualized supervision plans for team members.
  • Provides clinical supervision of all members of the team for the provision of this service.
  • Determines team caseload by the level of acuity and the needs of the individual served.
  • Facilitates weekly team meetings.
  • Monitors and evaluates the services, interventions, and activities provided by the team.
  • Provide clinical expertise and guidance to the members in the teams interventions with the recipient.
  • Development of relapse prevention and disease management strategies to support recovery.
  • Psychoeducation for the recipient, families, caregivers, and/or other individuals involved with the recipient about the recipients diagnosis, symptoms, and treatment.
  • Performs Intensive Case Management functions of linking and arranging for services and referrals.
  • Participates in the initial PCP and revision of the Person-Centered Plan (PCP) as needed.
  • Ensure and monitor the implementation of the PCP.
  • Spends time at the location where services are being performed as specified in the service definition for that service.
  • Participates in a first responder on-call system available to consumers and/or his/her natural support network on a 24/7/365 basis; coordinates first response resources according to consumer needs and the PCP.
  • Works closely with other clinical/professional staff to maintain communication and provide feedback, standardize procedures, and expedite PCP implementation.
  • Conducts and supervises formal investigations into incidents/allegations of abuse, neglect, exploitation, or other circumstances that may present a risk to the safety and health of the person supported.
  • Ensures that all initial and reauthorizations for services occur in a timely fashion.
  • Provides timely and accurate information when requesting authorizations from the LME/MCO/Statewide Vendor and follows up on each request for authorization modified, not approved, and/or not responded to.
  • Notifies appropriate parties upon the denial/modification of continued services and provides person-supported/guardian DMA-approved appeal policies and materials.
  • Monitors utilization of service to ensure that it is effective, appropriate, and within the limits set forth in both rules, PCP, and the service authorization.
  • Coordinates transition to another level/type of care for the person supported.
  • Coordinates and oversees the discharge planning process including the development of a discharge plan initially upon admission and a discharge summary with follow-up resources at the conclusion of services.
  • Facilitates relationships and serves as a link between the company, consumer, guardians, local agencies, and the community.
  • Drafts responses to and implements changes required by Medicaid, the Department of Facility Services, and/or other regulatory agencies.
  • Performs all other duties as reasonably required and assigned.
  • Practices standard medical precautions by understanding and utilizing personal protective and safety equipment.
  • Ensures confidentiality regarding sensitive and protected information.
  • Ensures individual rights to privacy and protected health information for the person supported.
  • Maintaining records, charting each individual, and reporting unusual and critical incidents in a professional, timely manner (within 24 hours).
  • Familiarization with medications used by the client and policies. regarding medication administration.
  • Represent the company in a positive manner, reflective of the companys mission, at all times.
  • Ensures confidentiality regarding sensitive and protected information.
  • Ensures individual rights to privacy and protected health information for the person supported.
  • Ensures service, agency, LME/MCO, state and/or federal documentation requirements and timelines such as NCTOPPs, PCPs/ITRs, and reminders relative to Clinical Monthly Summaries, Discharge Summaries, and Aggregate Reports.
  • Completes Intake Packets for any of the referrals that the office receives.
  • Accurately document all billable encounters into Southeastern Integrated Cares EMR (electronic medical record) system within 24 hours. Any corrections will be entered within 24 hours of being notified.
  • Other duties as assigned.
  • In addition, the employee must participate in all required training and education as mandated by the specific service line and clinical coverage policy.

Program Integrity:

SACOT/SAIOP integrated with MOUD are the most comprehensive, structured, and clinically intense ambulatory services for the treatment of substance use disorders/addiction.

The integrity of these services is dependent on quality clinical interventions, scheduled duration of interventions, and frequency of care weekly. These are the vital components of care.

Therefore, key quality metrics driving program integrity include milieu, pharmacological interventions, frequency of each episode of care and duration of each episode of care

PROGRAM INTEGRITY includes:

1. Structure/ time/ content of all groups and services
2. Expectations regarding attendance, drug testing (medication monitoring), LOS and hours per week
3. Expectations regarding use - limitations around harm reduction and relapse
4. Program safety - constant client observation, engagement, surveillance while on campus
5. Documentation quality tied to PCP goals, interventions provided, response to interventions
6. Expected KPIs - duration and frequency of care, admitted clients per week, relapse rate/positive urine screening, ED, or hospitalizations-clinical stability

Harm Reduction, albeit controversial does have a role in the continuum of interventions for the treatment of substance use disorder and addiction, however harm reduction is defined as reducing the severity of the outcomes of behaviors, IE death, overdose, infection, and DOES NOT directly address the biopsychosocial and spiritual aspects of the brain diseases of substance use disorder and addiction. Therefore, harm reduction does not appropriately overlay on intensive treatment services such as SACOT/SAIOP which are designed to change behavior, thinking, and beliefs.

When a client is unable to maintain abstinence during ambulatory treatment, it is called relapse, and appropriate treatment revisions and interventions must be made to assist the client in working toward the biopsychosocial and spiritual changes needed for ongoing and continued recovery. Therefore, use during intensive treatment must be addressed as a relapsing issue.

ASAM defines SACOT and SIOP services from a threefold perspective or what we can call the three components of treatment.

TIME: Like all medical treatment protocols, frequency and duration are treatment is critical. In SACOT and SAIOP, duration or time spent on clinical interventions per episode of care, inclusive of group counseling, individual counseling, psycho educational counseling, therapeutic recreation/socialization interventions, etc. is equivalent to the dose or intensity of a medication. Frequency of episodes of care, or times attended weekly, is equivalent to any prescription for medical care that clearly outlines how often the medication, procedure, etc. should be administered. Frequency and duration both are critical components in the structure of SACOT and SAIOP, the integrity of the intervention and combined help determine a length of stay. Honoring LOS and therefore duration of each episode and frequency of those episodes is a key component for clients to process the beginning and end of each phase of treatment. Care is not arbitrary; LOS is not arbitrary. Recognizing the unique characteristics of each level of care in treatment is vital for a robust therapeutic experience for clients

MILIEU- This is the structure/environment that is established to allow for quality, best practice, standards of clinical practice/interventions to be provided including the use of SAMHSA Illness, management and recovery practices (IMR), Eight Dimensions of Wellness, MATRIX model, Integrated Treatment for Co-Occurring Disorders, Relapse Prevention, Motivational Interventions, 12 Step Integration, Disease Management, Cognitive Behavioral Therapy, Family Systems, etc.

PSYCHOTROPIC/PHARMOLOGICAL/PROCEDURE Management- The use of medications for opioid use disorder, or alcohol abuse disorder, stimulant use disorder, or co-occurring use disorders is critical as a bridge (short term and on occasion long term) to recovery and adherence to the other facets of clinical interventions inclusive of SACOT and SAIOP. In addition, procedures like acicular acupuncture can be incorporated into care.

SACOT- ASAM 2.5 minimum 5 days a week of care, preferably 6 (FREQUENCY) with minimum of 4 hours a day, taper up if needed to 6 hours daily (DURATION)- minimum of 20 hours of care a week, preferably 25 -30 which is standard with commercial payers THIS IS A PARTIAL HOSPITLIZATION MODEL. Anticipated LOS is 60 to 120 days per clinical coverage guidelines

SAIOP-ASAM 2.1 minimum 3 days a week of care, preferably 4-5 initially (FREQUENCY), with a minimum of 3 hours a day, preferably 4 hours daily initially (DURATION)- minimum 9 hours a week, preferably 12-15 hours up to 19 per week, with no more than 48 hours between episodes/events of care- Anticipated LOS is 30-90 days per clinical coverage guidelines

Recommended schedule of care to assure duration, frequency and milieu are adequately provided

The below structured schedule allows for the services to be more clients driven as opposed to program driven, i.e., more flexibility on delivering care to the client - allowing for both frequency and duration along with achieving specific objectives to be the measures of success as opposed to completing a program.

The structure (bones) of the program included a:

  • Monday - Friday schedule eventually Saturdays as well
  • 6 hours a day of services plus lunch i.e., 10-4pm and an evening IOP 6-9
  • Each service/even was broken into one-hour segments
  • Two services running concurrently at a time (allowing for 20 patients to be seen)
  • Services included one therapy group- theme focused, one psych educational group - dimension focused, and one therapeutic activity group - i.e., mediation, art therapy, Rec therapy, team building (gym across street) etc. PER three-hour block
  • This model allows for SACOT/SAIOP to operate simultaneously with duration and frequency changing as client progresses in treatment. This also allows for the clients to attend at various times of the day, as long as they receive their prescribed clinical interventions

EXAMPLE TREATMENT SCHEDULE DAILY

10 AM

  1. Therapy group
  2. Psych Educational group

11 AM

  1. Activity Group 1
  2. Activity Group 2

12 PM

  1. Therapy group
  2. Psych Educational group

1 -130 Pm lunch

1:30 PM

  1. Therapy group
  2. Psych Educational group

2:30 PM

  1. Activity Group 1
  2. Activity Group 2

3:30 PM

  1. Therapy group
  2. Psych Educational group

  • This is staffed accordingly to assure two professionals in their designated role/ discipline where available per one hour segment
  • Supervisor/Team Lead will pinch hit for two to three groups a week allowing some additional non-Clinical time for their direct care providers
  • Embedded throughout the day would be individual sessions as needed, family sessions as needed, pharmacological management, and medication monitoring
  • Care management services, appointments to DSS, etc. are services provided in addition to onsite therapeutic interventions, to assure the integrity and quality of services, and are not billed as part of the duration and frequency of outlined care. Peer Support Services as outlined in clinical coverage policy 8G can be provided to SACOT/SAIOP clients as long as services are not at the same time of day as scheduled SACOT/SAIOP intervention/events

The model requires between 2.5 FTE direct care staff and a Team LEAD. Additional per diem staff as needed to adhere to clinical coverage policy guidelines inclusive of peer support specialists, paraprofessionals, etc.

1 Team Lead- LCAS onsite

1 40 hours CSAC, CADC, etc.

1 40-hour social worker/QP

.5 FTE or 20 hours of activity therapist times. Need two individuals each working about 10 hours or so a week

Supervisory Responsibilities:

The team leader supervises all members of the team demonstrating the knowledge, skills, and abilities for this role as required by the population and age served.

Qualifica...