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HomeMy WebLinkAbout112 97 QJJ.:H.i/,) l¡rw.-S, 10- 8,'11 ~¡.{1). I STATE OF WASHINGTON County of Jefferson In the Matter of Establishing A Special Revenue Fund for the Purpose of the DASA Stipend Program } } } RESOLUTION No.l12-97 WHEl&AS, the State Division of Alcohol and Substance Abuse (DASA) has held each County responsible for managing the expenditure stipend funds for rehabilitation services for indigent chemically dependent adults whose chemical dependency prevents them from maintaining gainful employment, and would benefit from treatment; and, WHEl&AS, the attached STIPEND MANAGEMENT MANUAL outlines the program's purpose, descriptions and procedures; and, WHEREAS, DASA has changed the magnitude and method in which these funds will be managed, requiring County agencies to provide beginning fund amounts from existing Substance Abuse budgets: and, WHEREAS, the Jefferson County Alcohol/Drug Center, a Division of the Jefferson County Health and Human Services Department has $1,400.00 in it's beginning/ending fund balance that can be used for this purpose, NOW THEREFORE BE IT RESOLVED, that the Board of County Commissioners of Jefferson County have determined that it is the best interest of Jefferson County that a DASA Stipend Fund be established and all revenues and expenses relating to the DASA Stipend Fund be processed through such fund, BE IT FURTHER RESOL VElJ, that the County Treasurer is hereby authorized to establish a fund known as the DASA Stipend fund (#386) with $1,400,00 received from the Jefferson County Health and Human Services Department. The County Auditor is hereby authorized to disburse funds from the established cash balance of said account as directed by the Board of coun::~::::o~:: :::::::d;lof ð i:- ' 1997. /' ,... -'-.... /~.. ~,'\J."'. rJ """ J RSONCO Y y. r ()1 ' (. :->~.~~-..>' \ B OF CO SSIO ~ [ , "; '.> ,. Damel Harpole, Merob Lorn~~, CMC 7 Clerk of the Board ~ VOL 23 . .~:.r 748 " MANUAL FOR IMPLEMENTATION OF ADATSA LIVING STIPEND MANAGEMENT 8 I. Historical Perspective When ADA TSA was created in 1987, its main goal was to provide treatment and rehabilitation services for indigent chemically dependent adults whose chemical dependency prevents them from maintaining gainful employment and would benefit from treatment. ADA TSA outpatient treatment was designed to provide sobriety maintenance skills, re-entry counseling and vocational support services. An individual eligible for these services must have been assessed and referred by an ADATSA Assessment Center. Each ADA TSA outpatient treatment patient is eligible for a living stipend. Although not considered an entitlement, the Community Service Offices (CSO) have been responsible for issuing the living stipend. Meanwhile, the Division of Alcohol and Substance Abuse (DASA) has held each county responsible for tracking the expenditure of living stipend funds. t Issues concerning the timeliness of living stipend benefits arrIVIng at the outpatient treatment provider have been problematic throughout ADATSA's existence. Staff from DASA teamed with county representatives from the Association of County Human Services (ACHS) to look at ways to improve this part of the ADA TSA system. A pilot was established and tested which gave several counties the living stipend funds directly. The pilot's biggest success was for the patients, who now received their living stipend when it was needed. The management of the living stipend funds will be the responsibility of each county beginning with the 1997 - 1999 county contracted statement of work. II. Benefits Related to County Management of Living Stipend Funds A. Stipend funds are imn1ediately available for patients. B. Increased funding flexibility; funding is interchangeable except federal outpatient treatment funds can not be used for living stipends. 1. Increased assessments. ..., Enhanced employment overlay. ,) Manual for Implementation of ADA TSA Living StIpend Management Page 1 of 28 . VOl. 23 ..r~ 749 mY'p1lOdJadamonu doc III. 3. Funding sources are interchangeable except federal outpatient treatment funds can not be used for living stipend. , ~ C. Eliminates continual "telephone tag" with cso. D. Creates incentive for patient to find employment. E. Teaches patient how to budget. F. Increased administration funding for counties. County's New RoleIDuties A. Contract for living stipend management in addition to outpatient treatment with an employment overlay. B. Manage living stipend funds. 1. Provide subcontractor's with living stipend funding equal to two months worth of stipends based on number of treatment slots provide'r has using working capital advance funds. a. Funds for living stipends must be available subcontractors for disbursement on first of each month. . to b. Working capital advance available from DASA at the beginning of each biennium. Amount of advance is equal to amount of two month's reimbursement. c. Quick turnaround time by DASA results m no financial hardship for county. 2. Reconcile stipend funding monthly on invoice from subcontractor. .., -'. Reimburse subcontractor on a monthly basis so stipend funding reserve account is replenished to amount sufficient to cover two months worth of stipends. 4. Obtain a list úom subcontractor that states patient identification code and amount of stipend each patient received each month. This list will be attached to monthly A-19 form each county submits to DASA. . Manual for Implementation of ADA TSA Living Stipend Management VOL 23. rç- 750 Page:! of 28 . . A.. mwp:aOO¡.dam.nu doc c. II Obtain reimbursement from DASA. 1. Complete A-19.. including amount stipend funds that were disbursed. 2. Attach list that outlines amount of stipend each patient received (See Section II.B(4) above). IV. CSO's New RolelDuties A. B. Issue medical cards. Issue food stamps. 1. Subcontractors must send protective payee agreement to CSO if amount of stipend patient receives is less than $339 (See page 28). c. NO involvement by CSO with stipend determination regardless of employment status. v. Subcontractors' New RolelDuties A. e B. , Continue as outpatient treatment provider. 1. Patients may receive up to 90 days of outpatient treatment within each two year eligibility period, unless an exception to policy is approved. 2. Must have patient complete release of information to referring ADA TSA assessment center at time of admission into outpatient treatment. 3. Each patient must still be evaluated at intake to determine the level of primary treatment, sobriety maintenance/re-entry services and vocational services required. 4. Services shall be delivered in accordance with a plan based on the information obtained during the intake process. Continue providing employment overlay. 1. Ensure the provision of employability assessments as well as job seeking motivation and vocational assistance services. Manual for Implementation of ADA TSA Living StIpend Management 1101. 23 :,ar..r751 Page 3 of 28 , - '. mY'o,aodiao&m&nu Ooe c. Continue to report each admission and each discharge to the referring ADA TSA Assessment Center in writing within five days of discharge using DASA approved ADMISSION/DISCHARGE VERIFICATION FORM (DSHS 14-312). (~ D. Expanded duties for protective payee overlay. 1. Establish separate checking account for living stipend funds. 2. Establish fiscal protocols to manage and track living stipend funds. a. Use of stipend funds for the protective payee's personal or business use is a crime. b. Protective payees have the responsibility to assure that the . stipend is spent on behalf of the patients. c. Maintain a simple accounting record is required and must be maintained for each patient that records check number, who check was written to, for what purpose and amount of check. 8) d. Administrative costs incurred in the performance of protective payee duties (checking account fees, postage, etc. ) is included in the treatment contract and is not be taken from the patient's living stipend. 3. Reconcile living stipend fund~ monthly (See attached sample invoice form and back-up information sheet). 4. Send a copy of protective payee agreement to CSO if amount of living stipend patient receives is less than $339 a month (See page 28). 5. The patient retains primary responsibility for reporting changes which may affect eligibility to CSO. f~ Manual for Im~lementation of ADA TSA Living Stipend Management VOl C3 :~r¡: 752 Page 4 of 28 - , " my'p'.odJaoamanu do< 6. Guidelines regarding living stipend allocation. " a. b. e 6. t. Patients participating in ADA TSA outpatient treatment may receive ]J12..1Q $339.00 per month, up to a maximum of $1,017 during the three months of outpatient treatment. If a patients starts at a time other than the first of the month, the patient's account will be credited for $339.00 with disbursement typically being pro-rated by days remaining in month. . Living stipend funds are for the purpose of providing ADATSA outpatient treatment patients.with basic needs for food, shelter, utilities, clothing and personal care items. The protective payee (P-P) has the authority and responsibility to make decisions about the expenditure of living stipend funds. Furthermore, the P-P can pay for costs to support a patient in hislher recovery. (See attached Guidelines for Stipend Expenditures). c. Housing and utility payments should be disbursed in the form of a check to the landlord or utility company upon presentation of a bill or invoice. Remaining funds can be disbursed to the patient to be used for personal needs at the discretion of the P-P depending upon the degree of patient recovery. Patients may receive up to $40.00 per month for personal incidentals. Remaining funds, if any, may be disbursed to the patient to cover other basic needs once the patient has provided a receipt but at no point shall the total disbursed exceed $339.00 per month. d. If a patient goes to work during the course of ADA TSA outpatient treatment, stipend funds may still be available to the patients to support hislher employment re-entry or education pursuits (i.e. work boots, uniforms, books, etc.). Stipend funds may be adjusted down in relationship to need and incentives (See attached form, instructions and sample). Determine amount of living stipend funds each patient receives. a. Protective Payee Agreement form completed by counselor and patient (See attached form and sample). Manual for Implementation of ADA TSA Living Stipend Management Page =- of 28 . VOL 23; I~~r 753 m"DlaDdJ.avn.nu aoe b. Stipend Funds for Patients who are Employed fonn completed by counselor with patient (See attached fonn, instructions and sample). ~~ VI. Steps to Implementation A. B. VII. Evaluate current ADA TSA system to detennine if the structure, communication netWorks and level of accountability will allow for smooth implementation. If not, make necessary adjustments during implementation. Review resource materials; draft policies/procedures and revise fonns to accommodate specific county situations. c. Establish communication netWorks (i.e. coordination meetings, memos, e- mails, etc.) to infonn all parties (CSO, treatment providers, assessment center, county staff and DASA regional administrators) of program changes and expectations of each party. D. Assure more than one person is familiar with each aspect of living stipend management in the event of staff turnover. E. Designate a "trouble-shooter" at county to problem solve and to coordinate resolution of issues that :will come up. . Policies A. Transfer Policy and Procedures (See attached). B. Unexcused Absences Policy (See attached). VIII. Program Evaluation IX A. Patient Satisfaction Survey (See attached sample survey tool). Common(v Asked Questions A. Q. "W11O benefits from this change?" . Manual for Implementation of ADA TSA Living Stipend Management Page 6 of 28 VOL 23: M,. 754 m~lp/aodi.darnanu doc e B. .e. t A. Q. A. c. D. The patients benefit the most as they no longer have to wait for their living stipend checks, creates an incentive for the patient to find employment and teaches the patient how to budget. Also, ADA TSA counselors benefits because they no longer have to spend time contacting the CSO office trying to locate living stipend checks. "Doesn't this change mean more work for the county and provider?" No (and maybe!), depending on the financial system and contract mechanism a county uses, it is estimated that county fiscal staff spend no more than five additional minutes reconciling monthly billing invoices from providers and noting the living stipend total on the A-19. While providers may spend additional time completing the protective payee fonn with the patients each month, counselors in the pilot counties indicated they are actually saving time because they no longer have to continually call the CSO or deal with hostile patients waiting for their living stipend checks. Q. "Is the patient entitled to the full $339.00 each month?" A. No, ADATSA is not an entitlement program. Therefore, ADATSA patients are not entitled to $339.00 a month. Patients nw:: receive up to $339.00 per month for basic needs including food, shelter, utilities, clothing and personal care items (see Section IV.C(S)). If these costs are less than $339.00, remaining funds can be used for other purchases that will support the patient's recovery, re-employment or education pursuits. Q. "What about patients who only participate in a partial month of treatment?" A. The patient living stipend can be pro-rated according to date patient starts treatment. To detennine the pro-rated amount, divide $339 by number of days in month and then multiple by number of days patient will be in treatment. In no case should a patient receive no than $1,017.00 during the three months a patient is in ADA TSA outpatient treatment? (See second sample of a completed protective payee agreement) Manual for Implementation of ADA TSA Living Stipend Management Page 7 of 28 I VOL 23; ,~f,C" 755 m,'p¡¡odiadamanu doc E. F. , ~ \ Q. "What can living stipends be spent on?" ", ( C A. Living stipends must used to provide patients with basic needs such a food, , shelter, utilities, clothing and personal care items. Other appropriate expenditures are those that will assist the patient in maintaining their sobriety and/or become employed (See "Guidelines for Stipend Expenditures" policy). Q. "How can counties give subcontractors funds to disburse on July I st to ADA TSA patients when counties won't get their biennial working capital advances until after the first A-19 is submitted?" A. The working capital advance is not reconciled with the state at the end of each biennium (at least not since the end of the '85 - '87 biennium). In essence, the working capital advance is "rolled over" into the following biennium, with periodic adjustments to account for increases in contract awards. No policy change is foreseen for the '97 - '99 biennium, thus you should have your advance available to disburse to your subcontractors on July 1st. e VOL 23 . ,~r;~ 756 . Manual for Implementation of ADA TSA Living Stipend Management Page 8 of 28 mv'plao~.dam.nu doc ~ \ Alcoholism and Drug Addiction Treatment a.nd Support Act (ADA TSA) Outpatient Services and Living Allowance - Pilot Division of Alcohol and Substance Abuse I-Allocates money for Treatment and Living Expenses CONTRACTS WITH I , " COUNTY - AuChotizes L.Mng ADa.vanÅ“ . Authorizestr8ltment doðIrs - Moniors tratmen prog~ PROVIDES OR CONTRACTS WITH Client , CSO Financial Services ... - , CSO Social Services ... Assessment Center ... Outpatient Chemical Dependency Treatment Services - OLItpatient VOL 23 :A~ç 757 - Determines financial eligibility - Authorizes Medical for ADA TSA outpatient clients Screens and refers to Chemical Dependency Assessment Center - Determines clinical eligibility - Notifies CSO to initiate benefits and refers to treatment - Provides treatment - Monitors progress - Protective payee for client . - Administers living allowance wp IIIcwd1 t: Ia dirt sa -4 . 3 t'2 ~ l' . ~t If)