Document Description
Filename
1
Provide a complete roster of IOP clinical supervisor(s) and program staff. Include the program organization chart.
2
Provide IOP clinical supervisor and program staff job descriptions.
3
Provide verification that clinical supervisors meet licensing board standards and requirements for IOP in the most current NMAC to deliver clinical supervision.
Documentation of 1 year of supervision experience and 2 years of IOP experience prior to becoming an IOP clinical supervisor. Documentation as MAD-approved provider.
4
Provide policy and procedure that outlines how clients are assessed for eligibility based on ASAM and NMAC criteria. Also include policy and procedures for administrative discharge.
5
Provide program treatment schedules and/or calendars.
6
Provide a copy of the psycho-social assessment or diagnostic evaluation form.
7
Provide a copy of the treatment plan form.
8
Provide policy and procedure that outlines the treatment planning process including discharge planning. Include guidelines that clearly specify how treatment planning is related to clients’ goals and objectives. Specify the process for evaluating time-limited services. Include procedure for how 90-day treatment plan reviews will occur.
9
Provide policy and procedure that outlines how the provision and integration of mental health and substance abuse services are managed to include co-occurring disorders. Include in this policy how IOP will integrate with other services at the agency.
10
Include any policy and procedures of other services that are related to the IOP
11
Provide policy and procedure that support recovery and resiliency values, cultural sensitivity, and gender informed care.
12
Provide policy and procedure which demonstrates treatment planning and assessments are trauma informed.
13
Provide policy and procedure on how medication, or medication management, services are managed, in-house or through referral process. Include protocols and how the agency will comply with state facility licensure, if applicable
14
Provide copy of medication form if applicable.
15
Provide policy and procedure on drug screen protocols if applicable. Include form(s) used.
16
Provide policy and procedure that addresses crisis management. Include the crisis/safety planning process and referral process.
17
Provide policy and procedure that specifies how the agency assesses requirements for clinical supervision. Specifically, skills and training in the areas of co-occurring disorders, substance use disorders, and SMI/SED. Address state and EBP training requirements. Include how supervision is provided, frequency, number of hours, how this is documented, and how deficits in training and practice are identified and addressed in a time-limited manner for both the supervisor and the supervisee.
18
Provide copies of agency employee performance evaluation tool and the clinical supervision form.
19
Provide policy and procedure that clearly outlines the approved EBP model utilized and how this model will be evaluated according to fidelity standards.
20
Provide copy of program evaluation form and EBP fidelity tools.
21
Provide policy and procedure that specifically describes an integrated multidisciplinary team. Include frequency of team meetings, members of the team, and how the team will coordinate with other outside providers or support.
22
Provide policy and procedure that clearly outline the process for ensuring that all IOP treatment staff have been adequately trained in the EBP model. Include how staff will receive ongoing training and how skill level of trainers is evaluated.
23
Provide policy and procedure that describes how program staff are trained in culturally sensitive and trauma-informed care, crisis management and safety techniques, critical incident reporting, HIPAA, agency records management protocols, and ethics to include conflict of interest.
24
For adolescent and children’s services, provide policy and procedure to demonstrate they will conform to New Mexico Children’s Code NMSA 1978 32A-1-1 et Seq statutes and associated New Mexico Children’s Code definitions.
Specifically:
Mandatory Child Abuse and Neglect reporting
Children’s Rights and age-specific Consent for Services statutes
25
For adolescent and children’s services, provide policy and procedure to demonstrate compliance with background checks for all employees. Background checks must conform to 8.8.3 NMAC Background Check Unit background clearances and pre-hiring processes as well as 7.20.11.15.A-H NMAC Criminal Records Checks and Clearances regulatory requirements.
26
For adolescent and children’s services, provide policy and procedure to explain how treatment is developmentally appropriate and is youth and family centric and youth driven.
