Structured Outpatient Addiction Program. (SOAP) - clinically intensive, structured day and/or evening substance use disorder services. These programs can be utilized as a transition service in the continuum of care for an Enrollee being discharged from Acute Substance Use Disorder Treatment, or can be utilized by individuals, who need Outpatient Services, but who also need more structured treatment for a substance use disorder. These programs may incorporate the evidence-based practice of Motivational Interviewing into clinical programming to promote individualized treatment planning. These programs may include specialized services and staffing for targeted populations including pregnant women, adolescents and adults requiring 24-hour monitoring and must be licensed by the Department of Public Health. Transitional Support Services (TSS) for Substance Use Disorders (ASAM Level 3.1) – Beginning no sooner than January 1, 2019 as directed by EOHHS, 24-hour short term intensive case management and psycho-educational residential programming with nursing available for Enrollees requiring short-term placements. Enrollees with co- occurring disorders receive coordination of transportation and referrals to mental health providers to ensure treatment for their co-occurring psychiatric conditions. TSS programs must be licensed by the Department of Public Health. APPENDIX B – COVERED SERVICES DEFINTIONS Exhibit 3: Expansions of Services Durable Medical Equipment (DME) - Environmental Aids and Assistive/Adaptive Technology Durable Medical Equipment – Training in Usage, Repairs, and Modifications Personal Assistance Services – Cueing and Monitoring APPENDIX B – COVERED SERVICES DEFINTIONS Exhibit 4: New Community-based Services Day Services that provide for on-site structured day activity typically for Enrollees with pervasive and extensive support needs who are not ready to join the general workforce. Such day services are individually designed around Consumer choice and preferences with a focus on improvement or maintenance of the person’s skills and their ability to live as independently as possible in the community; Such services often include assistance to learn activities of daily living and functional skills; language and communication training; compensatory, cognitive, and other strategies; interpersonal skills; prevocational skills; and recreational/socialization skills. Home Care Services provided within the Enrollee’s home or in the community. Such services include several types of home supports, inc...
Structured Outpatient Addiction Program. (SOAP) ‑ clinically intensive, structured day and/or evening substance use disorder services. These programs can be utilized as a transition service in the continuum of care for an Enrollee being discharged from Acute Treatment Services for Substance Use Disorders, or can be utilized by individuals, who need Outpatient Services, but who also need more structured treatment for a substance use disorder. These programs may incorporate the evidence‑based practice of Motivational Interviewing into clinical programming to promote individualized treatment planning. These programs may include specialized services and staffing for targeted populations including pregnant women, adolescents and adults requiring 24‑hour monitoring and must be licensed by the Department of Public Health. Transitional Support Services (TSS) for Substance Use Disorders (ASAM Level 3.1) – Beginning no sooner than January 1, 2022 as directed by EOHHS, 24‑hour short term intensive case management and psycho‑educational residential programming with nursing available for Enrollees requiring short‑term placements. Enrollees with co‑occurring disorders receive coordination of transportation and referrals to Behavioral Health Providers to ensure treatment for their co‑occurring psychiatric conditions. TSS programs must be licensed by the Department of Public Health. Appendix B – Covered Services Defintions Exhibit 3: Expansions of Services These expanded services are broader in scope than those described in Appendix B, Exhibit 1. Durable Medical Equipment (DME) – Environmental Aids and Assistive/Adaptive Technology Assistive/Adaptive Technology (AT) are devices (including devices that are not primarily used for a medical purpose), equipment, accessories, products, and/or methods, whether acquired commercially off the shelf, modified, or customized, that are used to increase, maintain, or improve the functional capabilities, mobility, communication, and overall independence of individuals with disabilities. These items may have uses beyond those determined Medically Necessary.
Structured Outpatient Addiction Program. (SOAP) - clinically intensive, structured day and/or evening substance use disorder services. These programs can be utilized as a transition service in the continuum of care for an Enrollee being discharged from Acute Substance Abuse Treatment, or can be utilized by individuals, who need Outpatient Services, but who also need more structured treatment for a substance use disorder. These programs may incorporate the evidence-based practice of Motivational Interviewing into clinical programming to promote individualized treatment planning. These programs may include specialized services and staffing for targeted populations including pregnant women, adolescents and adults requiring 24-hour monitoring.
