ASAM

Question 1

ASAM Definition of Addiction

Answer 1

Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an indivdiual’s life experiences.

Question 2

What kind of care does the criteria provide?

Answer 2

Outcome-oriented, results-based care

Question 3

What is ASAM criteria used for?

Answer 3

1. Evaluating individual needs on an ongoing basis
2. Determining appropriate level of care.
3. Individualize tx
4. Create a tx plan that is client and outcomes driven
5. Meet insurance requirements for reimbursement.

Question 4

Guiding Principle of ASAM Criteria: 1

Answer 4

Admission is based on patient needs, not arbitrary prerequisites

Question 5

Guiding Principle of ASAM Criteria: 2

Answer 5

Multidimensional assessment addresses bio, psychological, social, and cultural factors that contribute to addiction/recovery.

Question 6

Guiding Principle of ASAM Criteria: 3

Answer 6

Tx plans are based on patient needs and preferences.

Question 7

Guiding Principle of ASAM Criteria: 4

Answer 7

Care is interdisciplinary, evidence-based, patient-centered, and delivered from a place of empathy.

Question 8

Guiding Principle of ASAM Criteria: 5

Answer 8

Co-occurring conditions are an expectation, not an exception.

Question 9

Guiding Principle of ASAM Criteria: 6

Answer 9

Patients move along the continuum of care based on progress, not predetermined lengths of stay.

Question 10

Guiding Principle of ASAM Criteria: 7

Answer 10

Informed consent and shared decision-making accompany tx decisions.

Question 11

3 Core Components of the ASAM Critera

Answer 11

1. Assessment standards
2. Dimensional Admission Criteria Standards
3. Continuum of care standards

Question 12

Level of Care Assessment

Answer 12

Used to determine the recommended level of care at the beginning of tx and when re-assessing for continued service or care transitions.

Question 13

The Tx Planning Assessment

Answer 13

Used to develop the individual’s treatment plan.

Question 14

Level of Care Assessment 1-5

Answer 14

Assessed first as they are used in the initial level of care recommendations.

Question 15

Level of Care Assessment 6

Answer 15

Used as part of a shared decision-making process to determine which level of care the patient is willing and able to engage in.

Question 16

Medical Necessity

Answer 16

Healthcare services or products that a prudent clinician would provide to an individual to prevent, diagnose, or treat an illness, injury, disease, or its symptoms in accordance with standards of medical practice, clinical appropriateness, and not primarily for the economic benefit of the health plans and purchasers.

Question 17

Basic Elements of Medical Necessity

Answer 17

-Reasonable
-Necessary
-Specific
-Effective
-Delivered by a skilled professional

Question 18

Utilization Management

Answer 18

Process by which payers determine whether the requested care is medically necessary based on the ASAM Criteria decision rules.

Question 19

Two Dimensions of Utilization Management Process

Answer 19

1. Dimensional Admission Criteria (used for initial clinical case review)
2. Transition and Continued Service Criteria (used for making determinations regarding when a patient should be transitioned to a more or less intensive level of care.)

Question 20

Dimensional Drivers

Answer 20

The highest severity concerns that determine the recommended level of care in the tx continuum.

Question 21

What type of care does the continuum of care promote?

Answer 21

Integrated system of care and a chronic care model.

Question 22

What are the 4 broad treatment levels in the COC?

Answer 22

Outpatient, Intensive Outpatient (IOP), residential, inpatient.

Question 23

x.1 or x.5

Answer 23

Clinically managed

Question 24

x.7 and Level 4

Answer 24

medically managed

Question 25

1.5 COE, 1.7 COE, 2.5 COE, 2.7 COE, 3.5 COE, 3.7 COE, and 4 Psych

Answer 25

Enhanced services for treating co-occurring mental health conditions.

Question 26

3.7 BIO

Answer 26

Enhanced biomedical capabilities

Question 27

Medically managed care

Answer 27

Includes medical evaluations, medications, medical monitoring, and psychosocial services to address both the medical and psychosocial aspects of SUD - providing a comprehensive, evidence-based approach to addiction tx.

Question 28

Level 4

Answer 28

Provides hospital care, including 24-hour medical management and nursing care with access to intensive care services.

Question 29

Chronic Care Model

Answer 29

Emphasizes the need for ongoing, patient-centered care. It includes tailored tx plans, community resource linkages, and evidence-based decision support.

Question 30

What percentage of individuals experience relapse in the first year of tx?

Answer 30

60%

Question 31

Recovery support services

Answer 31

Peer support, mutual support groups, recovery community organizations, and other community resources.

Question 32

What is one standard universal standard every level of care should be able to provide?

Answer 32

Overdose reversal medication, trauma-responsive practices, expectations for care coordination, and the availability of recovery support services.

Question 33

How many individuals in addiction tx settings have a diagnosed MH disorder?

Answer 33

Nearly half.

Question 34

Co-Occurring Capable

Answer 34

Assessment, triage, and symptom management support

Question 35

Co-Occurring Enhanced

Answer 35

Psychiatric oversight, integrated skilled MH interventions, higher staff to patient ratio

Question 36

Level of Care Assessment

Answer 36

Collecting just enough info to recommend an appropriate level of care and support initiation of tx for immediate needs.

Question 36

Treatment Planning Assessment

Answer 36

A comprehensive biopsychosocial assessment to inform longer-term tx planning.

Question 37

Reassessment for Tx Plan Review

Answer 37

Repeated assessments to support tx plan updates, outcome-based care, and inform level of care transitions.

Question 37

When does the tx planning assessment occur?

Answer 37

Post-admission and is updated throughout the course of tx as needed based on reassessments and Tx Plan reviews.

Question 38

Recommendations for an Effective Assessment

Answer 38

1. Maintain a nonjudgmental mindset.
2. Use open-ended questions.
3. Build a therapeutic alliance.
4. Recognize different levels of readiness.
5. Consider unique experiences and world views.
6. Respect autonomy.

Question 39

What do you do if the level of care is not available?

Answer 39

Recommend an alternative that can safely and effectively meet the needs, typically involving a more intensive level of care.

Question 40

Dimension 1

Answer 40

Intoxication, Withdrawal, and Addiction Medicine

Question 41

Care coordination for Dimension 1

Answer 41

Med-adherence support, patient navigation services, addressing psychosocial issues that impact engagement in care, educational services, and care coordination.

Question 42

Dimension 2

Answer 42

Biomedical Conditions

Question 43

COWS

Answer 43

Clinical Opioid Withdrawal Scale

Question 44

CIWA-Ar

Answer 44

Clinical Intoxication Withdrawal Assessment for Alcohol Revised