Human Services, Substance Abuse and Mental Health

Section R523-20-11

Division Rules of Administration

Notice of Proposed Rule

(Amendment)

DAR File No.: 34726
Filed: 04/27/2011 05:07:34 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This amendment will no longer require substance abuse contractors and subcontractors to use the Addiction Severity Index (ASI). The ASI no longer meets the industry's standard of care, so changes to this rule help ensure the latest technology is being used to identify the severity of substance use problems for those receiving public substance abuse services.

Summary of the rule or change:

The use of the ASI as the assessment instrument to determine the degree of severity of a substance abuse problem is no longer required. The division now requires a thorough eight dimension bio-psycho-social-cultural assessment of each client to determine the degree of severity of their substance abuse problem. Also, the requirement of at least one staff member for each contractor and subcontractor being trained in the proper use of the ASI and ASAM instruments has been removed.

State statutory or constitutional authorization for this rule:

• Subsection 62A-15-105(2)

Anticipated cost or savings to:

the state budget:

Amendments to this rule are associated with agencies providing direct services to individuals in the public substance abuse services system. The state will not receive a cost increase or savings through these changes because all direct services to individuals are provided by local governments, businesses and small businesses.

local governments:

The division has determined that local governments contracting to provide public substance abuse services will receive a cost savings associated with the use of less time, by not requiring their staff to conduct an additional assessment on every client in order to meet a division mandate. There is no way of calculating the actual cost savings, but there is an assumption that an enhanced efficiency savings will exist. The required bio-psycho-social-cultural assessment that is replacing the ASI is already a component of current practice, but the required eight dimensions that are specifically mandated will slightly increase the overall time commitment that does not exist in current practice. This time increase is not anticipated to out step the time savings in eliminating the ASI. There will not be a cost savings associated with use of the ASI because it is in public domain and has no fee associated with its use by agencies. The same type of cost savings will be realized by not requiring that at least one staff member is trained in proper use of the ASI.

small businesses:

The division has determined that small businesses subcontracting to provide public substance abuse services will receive a cost savings associated with the use of less time, by not requiring their staff to conduct an additional assessment on every client in order to meet a division mandate. There is no way of calculating the actual cost savings, but there is an assumption that an enhanced efficiency savings will exist. The required bio-psycho-social-cultural assessment that is replacing the ASI is already a component of current practice, but the required eight dimensions that are specifically mandated will slightly increase the overall time commitment that does not exist in current practice. This time increase is not anticipated to out step the time savings in eliminating the ASI. There will not be a cost savings associated with use of the ASI because it is in public domain and has no fee associated with its use by agencies. The same type of cost savings will be realized by not requiring that at least one staff member is trained in proper use of the ASI.

persons other than small businesses, businesses, or local governmental entities:

The division has determined that businesses subcontracting to provide public substance abuse services and individuals receiving public substance abuse services will receive a cost savings associated with the use of less time, by not requiring staff to conduct an additional assessment on every client in order to meet a division mandate. There is no way of calculating the actual cost savings, but there is an assumption that an enhanced efficiency savings will exist. The required bio-psycho-social-cultural assessment that is replacing the ASI is already a component of current practice, but the required eight dimensions that are specifically mandated will slightly increase the overall time commitment that does not exist in current practice. This time increase is not anticipated to out step the time savings in eliminating the ASI. There will not be a cost savings associated with use of the ASI because it is in public domain and has no fee associated with its use by agencies. The same type of cost savings will be realized by not requiring that at least one staff member is trained in proper use of the ASI.

Compliance costs for affected persons:

There will be no fiscal obligations associated with implementation of these amendments for local governments, businesses or other individuals. The amendments to this rule remove additional burdens of assessment from contractors and subcontractors in the public substance abuse treatment delivery system that will provide a cost savings.

Comments by the department head on the fiscal impact the rule may have on businesses:

After careful review, the Department of Human Services has determined that this rule will have an incalculable financial savings on businesses in the State of Utah. This savings is associated with the use of less time, by not requiring staff to conduct an additional assessment on every client in order to meet a division mandate, and by not requiring that at least one staff member is trained in proper use of the ASI.

Palmer DePaulis, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Human Services
Substance Abuse and Mental Health
195 N 1950 W
SALT LAKE CITY, UT 84116

Direct questions regarding this rule to:

• Thom Dunford at the above address, by phone at 801-538-4519, by FAX at 801-538-9892, or by Internet E-mail at tdunford@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

06/14/2011

This rule may become effective on:

06/21/2011

Authorized by:

Lana Stohl, Director

R523. Human Services, Substance Abuse and Mental Health.

R523-20. Division Rules of Administration.

R523-20-11. Use of Standard Criteria.

(1) [The assessment instrument that a]All contractors and subcontractors must [use to determine the degree of severity of a substance abuse problem shall be the Addiction Severity Index, (ASI)]conduct a thorough bio-psycho-social-cultural assessment of each client to determine the degree of severity of their substance abuse problem. This assessment must evaluate the client's status in a minimum of the following dimensions:

(a) substance abuse status;

(b) treatment history;

(c) legal status;

(d) educational and employment status;

(e) family and social status;

(f) mental health/psychiatric status;

(g) cultural status; and

(h) readiness to change.

(2) The placement decisions for all patients treated in programs funded by or contracting with the Division of Substance Abuse and Mental Health or subcontracted to any local authority shall be based upon the placement criteria developed by the American Society of Additive Medicine (ASAM).

(3) Documentation of the use of ASAM placement criteria must be included in each patient's record.

[ (4) At least one staff member for each contractor and subcontractor shall be trained in the proper use of the ASI and ASAM instruments. This training must be documented in individual personnel files.

]

KEY: substance abuse, financing of programs, service continuum, assessment instruments

Date of Enactment or Last Substantive Amendment: [December 29, 2009]2011

Notice of Continuation: June 5, 2007

Authorizing, and Implemented or Interpreted Law: 62A-15-105(5)