12VAC35-105-1740 Substance abuse intensive outpatient services program criteria

1.  Mention of programming in a “structured environment.”  What does the agency identify or measure as a structured environment?

3. In number 2 there is a requirement that consultation is available within 24 hours by telephone; however, in number 3, emergency consultation is required to be available 24 hours a day.  I believe the emergency requirement is requiring instantaneous availability, but the language of number 2 convolutes the meaning of number 3 to a degree.  If the intent is instantaneous availability, it would be clarifying to say so.

12VAC35-105-1760 Substance abuse intensive outpatient services discharge criteria

2. This point allows discharge when “unable to achieve the goals of the individual’s treatment but could achieve the individual’s goals with a different type of treatment.”  Guidance requested as to how this should be measured and expectations regarding the identification of the individual’s ability to achieve goals and identification of the alternative treatment. What about discharge when an individual no longer wishes to achieve the goals of treatment?