This rule provides guidelines and requirements applicable to service providers under direct contract with the Department or service providers under subcontracts with a Managing Entity.
    (1) Unless specifically authorized otherwise in advance by the Department, service providers shall only use the following Substance Abuse and Mental Health (SAMH) Covered Services to report contracted or subcontracted substance abuse and mental health services.
    (a) Aftercare,
    (b) Assessment,
    (c) Care Coordination,
    (d) Case Management,
    (e) Community Action Treatment (CAT),
    (f) Comprehensive Community Service Team,
    (g) Crisis Stabilization,
    (h) Crisis Support/Emergency,
    (i) Day Care,
    (j) Day Treatment,
    (k) Drop-In/Self Help Centers,
    (l) Florida Assertive Community Treatment (FACT) Team,
    (m) HIV Early Intervention Services,
    (n) Incidental Expenses,
    (o) Information and Referral,
    (p) In-Home and Onsite,
    (q) Inpatient,
    (r) Intensive Case Management,
    (s) Intervention,
    (t) Medical Services,
    (u) Medication-Assisted Treatment,
    (v) Mental Health Clubhouse Services,
    (w) Outpatient,
    (x) Outreach,
    (y) Prevention – Indicated,
    (z) Prevention – Selective,
    (aa) Prevention – Universal Direct,
    (bb) Prevention – Universal Indirect,
    (cc) Recovery Support,
    (dd) Residential Level I,
    (ee) Residential Level II,
    (ff) Residential Level III,
    (gg) Residential Level IV,
    (hh) Respite Services,
    (ii) Room and Board with Supervision Level I,
    (jj) Room and Board with Supervision Level II,
    (kk) Room and Board with Supervision Level III,
    (ll) Room and Board with Supervision Level IV,
    (mm) Short-term Residential Treatment,
    (nn) Substance Abuse Inpatient Detoxification,
    (oo) Substance Abuse Outpatient Detoxification,
    (pp) Supported Employment,
    (qq) Supportive Housing/Living,
    (rr) Treatment Accountability for Safer Communities (TASC), and
    (ss) Any other SAMH Covered Services the department may establish pursuant to subsection (2) of this rule, to ensure adequate provision of service.
    (2) The department may establish additional SAMH Covered Services for statewide use as necessary to ensure the adequate provision of services to individuals. At a minimum, the department shall notify affected parties of the department’s intended action and provide an opportunity to comment at least 30 days prior to the establishment of a temporary SAMH Covered Service.
    (3) Measurement Standards for Covered Services.
    (a) Measurement standards document the amount of service delivery, regardless of the method of payment for the service provided pursuant to contracts with SAMH-Funded Entities. The following common measurement definitions shall apply to each SAMH Covered Service as specified in subsection (4) of this rule:
    1. Direct Staff Hour.
    a. This measure equals the actual time a staff person:
    (I) Is available at the work site to perform assigned tasks, or
    (II) Spends in face-to-face or direct telephone contact with an individual receiving services or a collateral contact where the contact is documented in the individual’s service record, or
    (III) Spends on activities directly associated with an individual receiving services, including case staffings and travel time if the travel is integral to a Covered Service allowable under this rule.
    b. This measure may also include telephone contact with parents or teachers and actual time spent in a courtroom or juvenile detention facility on behalf of a child or adult.
    c. Covered Services that are measured by this standard shall be reported on the basis of utilization, except for the following SAMH Covered Services, which shall be paid on the basis of availability.
    (I) Paragraph (4)(h), Crisis Support/Emergency,
    (II) Paragraph (4)(o), Information and Referral; and,
    (III) Paragraph (4)(oo), Substance Abuse Outpatient Detoxification.
    2. Non-Direct Staff Hour.
    a. This measure indicates the time spent on activities that cannot be directly associated with an individual or group of individuals receiving services, but are integral to the program and described in the program description. This includes preparation for services and travel time, if travel is integral to a Covered Service allowable under this rule.
    b. Covered Services that are measured by this standard shall be reported on the basis of utilization, except paragraph (4)(i), Drop-in/Self Help Centers, which shall be reported on the basis of availability.
    3. Day.
    a. This measure is determined by one of the following:
    (I) The service provider’s capacity to provide an actual bed for a period of twenty-four hours to individuals eligible for SAMH-funded services, or
    (II) A day in which an individual receiving services is physically present at the midnight census, including the day the individual is admitted and excluding the day the individual is discharged.
    b. Covered Services that are measured by this standard shall be reported on the basis of utilization, except for the following:
    (I) Paragraph (4)(g), Crisis Stabilization,
    (II) Paragraph (4)(mm), Short-term Residential Treatment; and,
    (III) Paragraph (4)(nn), Substance Abuse Inpatient Detoxification.
    4. Dosage.
    a. This measure equals one dose of clinically prescribed medication received by an individual participating in programs under the Medication-Assisted Treatment Covered Service.
    b. Dosage shall be reported on the basis of utilization.
    (b) Covered Services reported on the basis of utilization require the service to be provided to or on behalf of an eligible individual, or by the commitment of actual direct or non-direct staff hours.
    (c) Covered Services reported on the basis of availability require the service to be available for use, regardless of whether the service is actually used by an individual. Availability shall not include staff time spent serving a Medicaid eligible individual for a Medicaid eligible service, or staff time spent in another program or Covered Service other than the specific availability-based service in which they are listed on the duty roster.
    (d) Definition of Hour.
    1. Hourly units of measure are based upon the actual time spent providing services to or on behalf of an individual or individuals, rounded to the nearest fifteen-minute interval. The cumulative, rounded number of minutes shall be divided by sixty to derive the number of hourly units.
    2. When intermittent services are provided to or on behalf of a specific individual during a single calendar day, the actual cumulative time spent providing the service during that day shall be rounded to the nearest fifteen-minute interval.
    3. For the Case Management Covered Service defined in paragraph (4)(d) of this rule, if the time interval required by Medicaid is different than described above, a service provider may use the Medicaid time interval instead.
    (e) Covered Services measured in terms of hours or days:
    1. Shall not include the time direct service delivery staff are:
    a. Absent from the work place, or
    b. Attending training or orientation, unless the training or orientation is specifically required in contracts or subcontracts.
    2. Shall include time direct service delivery staff spend administering individual functional assessments and individual satisfaction surveys.
    (4) The descriptions, applicable programs, measurements standards, and data elements for SAMH Covered Services are as follows:
    (a) Aftercare.
    1. Description – Aftercare activities occur after a treatment level of care is completed and include activities such as supportive counseling, life skills training, and relapse prevention for individuals with mental illness or substance use disorders to assist in their ongoing recovery. Aftercare services help individuals, families, and pro-social support systems reinforce a healthy living environment.
    2. Programs – Community Mental Health and Community Substance Abuse.
    3. Measurement Standard – Direct Staff Hour, as defined in sub-sub-subparagraph (3)(a)1.a.(III) of this rule.
    4. Data Elements:
    a. Service Documentation – Activity Log:
    (I) Covered Service,
    (II) Staff name and identification number,
    (III) Recipient name and identification number,
    (IV) Service date,
    (V) Duration,
    (VI) Service (specify),
    (VII) Group Indicator; and,
    (VIII) Program.
    b. Audit Documentation – Recipient Service Chart:
    (I) Recipient name and identification number,
    (II) Staff name and identification number,
    (III) Service date,
    (IV) Duration; and,
    (V) Service (specify).
    (b) Assessment.
    1. Description – This Covered Service includes the systematic collection and integrated review of individual-specific data, such as examinations and evaluations. This data is gathered, analyzed, monitored and documented to develop the person’s individualized plan of care and to monitor recovery. Assessment specifically includes efforts to identify the person’s key medical and psychological needs, competency to consent to treatment, history of mental illness or substance use and indicators of co-occurring conditions, as well as clinically significant neurological deficits, traumatic brain injury, organicity, physical disability, developmental disability, need for assistive devices, physical or sexual abuse, and trauma.
    2. Programs – Community Mental Health and Community Substance Abuse.
    3. Measurement Standard – Direct Staff Hour, as defined in sub-sub-subparagraph (3)(a)1.a.(II) of this rule.
    4. Data Elements:
    a. Service Documentation – Service Ticket:
    (I) Recipient name and identification number,
    (II) Staff name and identification number,
    (III) Service date,
    (IV) Duration,
    (V) Covered Service,
    (VI) Service (specify); and,
    (VII) Program.
    b. Audit Documentation – Recipient Service Chart:
    (I) Recipient name and identification number,
    (II) Staff name and identification number,
    (III) Service date,
    (IV) Duration; and,
    (V) Service (specify).
    (c) Care Coordination.
    1. Description – Care Coordination is a time-limited service that assists individuals with behavioral health conditions who are not effectively engaged with case management or other behavioral health services and supports for a successful transition to appropriate levels of care. Once engagement in the necessary community-based services is verified, care coordination services are terminated.
    2. Programs – Community Mental Health and Community Substance Abuse.
    3. Measurement Standard – Direct Staff Hour, as defined in sub-sub-subparagraph (3)(a)1. of this rule.
    4. Data Elements:
    a. Service Documentation – Activity Log:
    (I) Covered Service,
    (II) Staff name and identification number,
    (III)