Chapter 3 : Section 7.3

Adult Behavioral Health and Substance Abuse Services

Procedures

Behavioral Health Services

To access behavioral health services for adults through the adult’s RBHA or TRBHA:

• meet with a Unit Psychological Consultant to obtain recommendations and guidance prior to referring an adult for a psychological evaluation, bonding assessment/best interest evaluation, individual or group counseling, PhD counseling, substance use disorder assessment or treatment, and Clinically Supervised Parenting Time;

• assist the adult to apply for general mental health or SMI services through a Application for Benefits found online (Health-e-Arizona Plus) or by contacting the adult’s ACC plan or local RBHA/TRBHA;

• request the adult to sign the Department’s Authorization to Disclose Health Information (CSO-1038A) and the provider’s consent for release of assessment and treatment information so that information can be shared for continuity of care; and

• provide the unit consultation summary and referral questions or focus areas to the service provider.

To access DCS-funded behavioral health services:

• meet with a Unit Psychological Consultant to obtain recommendations and guidance prior to referring an adult for a psychological evaluation, bonding assessment/best interest evaluation, individual or group counseling, PhD counseling, substance use disorder assessment or treatment, and Clinically Supervised Parenting Time;

• request approval for recommended services according to the Service Referral Approval Matrix;

• request the adult to sign the Department’s Authorization to Disclose Health Information (CSO-1038A) and the provider’s consent for release of assessment and treatment information so that information can be shared for continuity of care; and

• complete the New Service Request and attach all required documents.

If a parent has identified a non-RBHA and non-DCS funded behavioral health service provider through private insurance or another funding source, the DCS Specialist shall:

• meet with a Unit Psychological Consultant to obtain recommendations and guidance about the adult’s behavioral health service needs and areas of focus;

• request the adult to sign the Department’s Authorization to Disclose Health Information (CSO-1038A) and the provider’s consent for release of assessment and treatment information so that information can be shared for continuity of care; and

• provide the unit consultation summary and referral questions or focus areas to the service provider.

Contact the ACC plan, RBHA, TRBHA and privately funded providers to request:

• initial treatment plans;

• monthly treatment reports; and

• information necessary to assess parent progress toward behavioral goals.

Invite the behavioral health provider to all case plan staffings.

Arizona Families FIRST Substance Use Assessment and Treatment Services

Arizona Families F.I.R.S.T. (Families in Recovery Succeeding Together) (AFF) provides timely and accessible family-focused, evidence-based, trauma-informed substance use disorder assessment, treatment, and recovery services to parents, caregivers, youth, and families to promote family stability, self-sufficiency, caregiver protective capacities, and child safety and permanency, with a preference for reunification with a child’s birth family.

AFF substance use services are coordinated and provided through a statewide continuum of services including:

• comprehensive assessment;

• stabilization;

• early intervention services;

• outpatient services;

• partial hospitalization (intensive outpatient);

• residential treatment;

• medication-assisted treatment;

• auxiliary services and case coordination; and

• recovery maintenance services.

The following individuals are eligible for AFF services:

• A parent, guardian, or custodian of a child named in a Report as a victim of abuse or neglect; or the parent, guardian or custodian of another child residing in the household of alleged maltreatment; whose substance use is a significant barrier to maintaining, preserving, or reunifying the family.

• Other adults in the home of the parent, guardian, or custodian (as described above) whose substance use is a significant barrier to maintaining, preserving, or reunifying the family.

• A child in out-of-home care who is in the temporary custody of the Department, adjudicated dependent, or the subject of a Voluntary Placement Agreement, and whose behavior indicates a need for substance use assessment, treatment or recovery.

• Young adults participating in Extended Foster Care whose behavior indicates a need for a substance abuse assessment, treatment or recovery.

• A child in a family that is receiving in-home case management services from DCS, and whose behavior indicates a need for substance use assessment, treatment, or recovery to prevent entry or re-entry into out-of-home care.

For information regarding AFF services and supports for children and young adults, see Behavioral Health and Substances Abuse Services for Children and Youth Adults and Services and Supports to Prepare Youth for Adulthood.

If the Family Functioning Assessment indicates that an adult’s substance use may be a danger in the home or is diminishing a caregiver’s protective capacity, the DCS Specialist shall consult with a Unit Consultant to determine if the adult should be referred to the AFF Program for initial outreach and comprehensive assessment. The Unit Consultant will provide guidance about the need for AFF services and focus of treatment.

The AFF provider will conduct a comprehensive assessment to determine appropriate interventions and treatment. If a substance use concern is identified through the assessment, the AFF provider will identity the recommended level of care and coordinate services that are appropriate.

Request that the adult signs the Authorization to Disclose Health Information (CSO-1038) and the provider’s release of information so that substance abuse assessment and treatment information can be shared with the Department and other interested parties. See What Child Safety Specialists Should Know About Substance Abuse Confidentiality for more information on confidentiality related to substance abuse assessment, treatment and client records.

While the adult is receiving AFF services, the DCS Specialist shall:

• provide information about services to the client and family, and encourage participation;

• help the client and provider to identify family and supportive people to participate in education, treatment, and recovery services with the client;

• invite the AFF provider to TDM meetings, Service Planning meetings (such as for SENSE services), and Case Plan Staffings;

• review the AFF provider’s monthly progress report and problem-solve with the provider any barriers to service delivery; and

• submit the service request for drug testing and manage any proposed changes in frequency of drug testing.

Contact the AFF Service Coordinator at fcs@azdcs.gov for assistance related to the provision of substance use assessment and treatment services.

If the adult wishes to use a different behavioral health or substance abuse treatment provider, assist in identifying another provider that can best meet their substance abuse treatment needs. Request that the adult sign a release of information to allow exchange of information between the provider and the Department. Upon receiving the release of information, begin communication with this provider and provide any documentation that would be helpful in ensuring the assessment is complete and able assist the adult in reaching the necessary behavioral change goals. See the AFF service guide for additional information.

DCS Case Management During Adult Behavioral Health and Substance Use Disorder Services

The assigned DCS Specialist shall:

• maintain primary case management responsibility (Family Function Assessment, making referrals to DCS funded services, monitoring timely services, reviewing provider reports, referring for the recommended drug testing, etc.);

• make DCS records available to the behavioral health providers, complying with confidentiality requirements;

• invite the service providers to all case plan staffings; and

• participate in all treatment staffings or Adult Recovery Team (ART) meetings.

Documentation

File a copy of the completed Authorization to Disclose Health Information CSO-1038 in the hard copy case record and as an Artifact in Guardian.

When parental substance abuse is a barrier to maintaining or reunifying the family, document the occurrence of substance abuse in the Family Functioning Assessment.

Include the Behavioral Health and/or AFF substance abuse provider on the Attachment A for reports to the Juvenile Court.

File documentation received from the provider in the hard copy file and as an Artifact in Guardian.

Maintain the referral, assessment, provider monthly reports, service-planning documents, and other information received in the case record.

Document the progress made toward achieving behavioral goals and outcomes specified in the case plan using Notes.

Effective Date: April 1, 2021

Revision History: November 30, 2012, February 1, 2021