1_-_SOW_2017.pdf

STATEMENT OF WORK

(SOW)

COMMUNITY TREATMENT SERVICES

JANUARY 2017

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TABLE OF CONTENTS

CHAPTER ONE: INTRODUCTION

1.1 Purpose and Scope

1.2 The Bureau’s Commitment

1.3 Evidence-Based Practices

CHAPTER TWO: STAFFING

2.1 Staffing

2.2 Contractor Licensure

2.3 Background Information

CHAPTER THREE: SERVICES

3.1 Treatment Services

3.2 Treatment Referral and Authorization

3.3 Intake Screening

3.4 Clinical Assessment

3.5 Counseling Services

3.6 Transportation

CHAPTER FOUR: SUBSTANCE USE SERVICES

4.1 Substance Use Individuals

4.2 Description of Substance Use Service Line Items

CHAPTER FIVE: MENTAL HEALTH SERVICES

5.1 Mental Health Individuals

5.2 Description of Mental Health Service Line Items

CHAPTER SIX: SEX OFFENDER SERVICES

6.1 Sex Offender Individuals

6.2 Description of Sex Offender Service Line Items

CHAPTER SEVEN: TREATMENT DOCUMENTATION

7.1 Treatment Documentation

7.2 Clinical Assessment Reports

7.3 Clinical Treatment Plan

7.4 Monthly Progress Reports

7.5 Termination Report

7.6 Clinical Interventions

CHAPTER EIGHT: BILLING

8.1 Billing

CHAPTER NINE: STAFF TRAINING

9.1 Training

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CHAPTER TEN: STANDARDS OF CONDUCT

10.1 Contractor’s Employee Standards of Conduct

10.2 Sexual Abuse Information

10.3 Prison Rape Elimination Act

10.4 Drug Free Workplace

CHAPTER ELEVEN: ADMINISTRATION

11.1 Facility Requirements

11.2 Contractor Licensure/Certification

11.3 File Maintenance

CHAPTER TWELVE: COMMUNICATION

12.1 Partnerships

12.2 Accountability

CHAPTER THIRTEEN: BUREAU ADMINISTRATION OF CONTRACT

13.1 Bureau Inspection of Services (Monitorings)

13.2 Repeat Deficiencies

13.3 Contractor Evaluation

CHAPTER FOURTEEN: DEDUCTION AND REIMBURSEMENTS

14.1 Deduction and Reimbursements

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LIST OF ATTACHMENTS

Stages of Change ................................................................................................................... A-1 The Eight Criminal Thinking Patterns .................................................................................... A-3 Eight Attitudes of Change ....................................................................................................... A-4 Criminal Thinking Patterns ..................................................................................................... A-5 Rational Thinking Errors ........................................................................................................ A-6 Rational Self-Analysis ............................................................................................................ A-8 Rational Self-Analysis Example ............................................................................................. A-9

Staff Training Form ................................................................................................................ B-1 Treatment Services and Accountability Log ........................................................................... B-2 Inmate Trip Ledger ................................................................................................................. B-3 Treatment Referral and Authorization .................................................................................... B-4 Initial Contact Report .............................................................................................................. B-5 Authorization of Release of Information (BP-528) ................................................................ B-6 Agreement to Participate in Community Transition Program (BP-750) ................................ B-7 Behavior Notification.............................................................................................................. B-8 PREA Report ......................................................................................................................... B-9 Treatment Plan – Substance Use ........................................................................................... B-11 Monthly Progress Report – Substance Use ........................................................................... B-13 Termination Report – Substance Use ................................................................................... B-15 Treatment Plan – Mental Health ........................................................................................... B-17 Monthly Progress Report – Mental Health ........................................................................... B-19 Termination Report – Mental Health .................................................................................... B-21 NCIC Check Form (BP-660) ................................................................................................ B-23

REFERENCED PROGRAM STATEMENTS

Program Statement 4100.05, Bureau of Prisons Acquisition Policy

Program Statement 3735.04, Drug Free Workplace

Program Statement, 5270.09, Inmate Discipline Program iv

EXPLANATION OF TERMS

“Contractor” means “the total contractor organization or a separate entity of it, such as an affiliate, division, or plant, that performs its own purchasing.” “Contractor” and “treatment provider” are considered synonymous and are used interchangeably throughout the document.

Subcontractor. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor

• Americans with Disabilities Act (ADA)

• Cognitive-Behavioral Therapy (CBT)

• Community Treatment Oversight Specialist (CTOS)

• Community Treatment Services (CTS)

• Contract Line Item Number (CLIN)

• Contracting Officer (CO)

• Correctional Management Plans (CMP)

• Court Services and Offender Supervision Agency (CSOSA)

• Evidence-Based Practices (EBPs).

• Federal Acquisition Certification Contracting Officer’s Representative (FAC COR)

• Health Insurance Portability and Accountability Act of 1996 (HIPAA)

• Presidential Executive Orders (EOs)

• Prison Rape Elimination Act of 2003 (PREA)

• Residential Reentry Center (RRC)

• Statement of Work (SOW)

• Supervisory Community Treatment Coordinator (SCTC)

• U.S. Probation Office (USPO)

CHAPTER ONE: INTRODUCTION

1.1 PURPOSE AND SCOPE. The purpose of this Community Treatment Services (CTS)

Statement of Work (SOW) is to outline the Government's technical requirements for contractors who provide substance use, mental health, and/or sex offender treatment services to Federal inmates in the custody of the Bureau of Prisons (Bureau), residing in a Residential Reentry Center (RRC) or on Home Confinement (HC).

1.1.1 On occasion, the U.S. Probation Office may seek to use the same services for individuals under U.S. Probation Office supervision. The Supervisory Community Treatment Coordinator (SCTC) must approve these placements. The contract requirements set forth in this document prevail and Bureau personnel remain the primary contract administrators.

1.1.2 The scope includes community substance use, mental health, and sex offender treatment services for Federal inmates nationwide. All services and programs must comply with this SOW; the U.S. Constitution; all applicable Federal, state, and local laws and regulations; applicable Presidential Executive Orders (EOs); all applicable case laws, consent decrees, and court orders. The contractor must comply with and carry out any applicable changes to Bureau policy, Department of Justice (“DOJ”) regulations, Congressional mandates, Federal law, or EOs.

1.1.3 The Bureau reserves the right to enter into negotiations with the contractor to change the conditions or procedures in this SOW and the contract.

1.1.4 The Bureau reserves the right to have various staff monitor contract performance. The Bureau reserves the right to conduct announced and unannounced inspections of any part of the contractor’s operation at any time and by any reasonable method to assess contract compliance. The Bureau, or other appropriate agency, may investigate any incident pertaining to the performance of this contract. The contractor must comply and cooperate with the Bureau, or other appropriate agency, on all investigations, monitoring visits, inspections, and inquiries.

1.1.5 The contractor will submit any request for contract modifications through the Federal Acquisition Certification Contracting Officer’s Representative (FAC COR) for approval.

1.2 THE BUREAU’S COMMITMENT. The Bureau is committed to providing quality, evidence-based psychological treatment to all individuals in transition to the community in need of services. Bureau Psychology Treatment Programs (PTPs) are based on the most recent research and evidence-based practices, ensuring effective treatment programs. These evidence-based treatment practices lead to:

• the reduction of misconduct;

• the reduction of substance use, relapse, and recidivism;

• the reduction of future sexual offending;

• an increase in the level of functioning for individuals with mental illness and behavioral disorders;

• an increase in the level of the individual’s stake in societal norms; and

• an increase in participation in standardized community transition/aftercare treatment programs.

1.2.1 Community treatment increases the likelihood of reentry success and increases the public’s health and safety.

1.3 EVIDENCE-BASED PRACTICES (EBPs). EBPs are empirically supported interventions proven to deliver positive outcomes. The Bureau’s PTPs are unified clinical services and activities organized to treat complex psychological and behavioral problems.

The Bureau has chosen cognitive-behavioral therapy (CBT) as a theoretical model to guide psychological service delivery because of its proven effectiveness. Empirical support for CBT’s effectiveness is noted both in the treatment of mental disorders and criminal thinking patterns. Therefore, CBT is used to address two components of the Psychology Services mission: mental health care and reentry services. The Bureau seeks community-based treatment providers that adhere to CBT or another evidence-based programing compatible with CBT (e.g. Motivational Interviewing, Rational Emotive Behavior Therapy, and Dialectical Behavior Therapy).

1.3.1 According to the CBT model, a person’s feelings and behaviors are influenced by his or her perceptions and core beliefs. By assisting individuals to perceive events objectively and modify their irrational beliefs, the model anticipates a person may become more successful in achieving pro-social goals.

1.3.2 CBT combines different treatment targets and specific conforming behaviors, focusing on an individual’s:

• core beliefs;

• intermediate beliefs;

• current situation;

• automatic thoughts; and

• the effect these thoughts and beliefs have on an emotional, behavioral and psychological level.

1.3.3 As an example, ongoing criminal behavior is conceived, supported, and perpetuated by a set of habitual thinking errors: both criminal thinking and cognitive thinking errors.

Using CBT, individuals are taught to replace those thinking errors with pro-social thinking. Such thinking supports behaviors that are consistent with the norms of a law-abiding community. (See attachments)

1.3.4 The Bureau has found these objectives significantly decrease recidivism. Therefore, the contractor is required to possess:

• a treatment philosophy and techniques that directly work in conjunction with the identified Bureau program philosophy for substance use and mental health;

• documented experience working with a criminal justice population and an understanding of the criminal justice system;

• a treatment philosophy and techniques that directly work in conjunction with the identified Bureau program philosophy for sex offenders;

• professional standards as specified in the “Practice Standards and Guidelines” issued by the Association for the Treatment of Sexual Abusers (ATSA) www.atsa.com;

• past experience, preferred two (2) year minimum, working with a sex offender population and an understanding of the criminal justice system.

1.3.5 Sex Offender Specific Treatment: The Bureau does not compel individuals receiving sex offender treatment to reveal the identity of past victims. The contractor shall not act in any manner which coerces them to reveal the names or identities of past victims. The contractor shall encourage disclosure of past thoughts, feelings and behaviors to foster the development of treatment initiatives consistent with the Good Lives Model and CBT.

Treatment is designed and offered to promote personal development, resulting in public safety, and is not to be conceptualized as an investigative function.

CHAPTER TWO: STAFFING

2.1 STAFFING. All new treatment providers providing direct clinical services for the

Bureau must be approved by the Bureau prior to providing services. The contractor shall hire key personnel to be approved by the Bureau to meet SOW requirements. The contractor will identify the key personnel by name, position, and responsibility. The contractor will staff all key personnel positions throughout the performance of the contract. The contractor will notify the Bureau in writing if any key personnel vacate a position permanently and indicate when an equivalent replacement will be made. The replacement staff must be equivalent in credentials and experience. The notification to CTS will occur within three calendar days of the vacancy. The Bureau reserves the right to pursue contractual remedies if the contractor cannot provide a staff member with equivalent credentials and experience to the staff that were originally approved at contract award.

2.1.1 The Prime Contractor shall notify the FAC COR and CO in advance of executing any subcontract or modification, including the following information:

• a description of the services to be subcontracted;

• identification and selection of the proposed subcontractor.

2.1.2 Treatment services must continue despite staff absences (e.g.: vacation, sick leave). The contractor is responsible for providing services with Bureau approved equally credentialed, staff for key personnel during these instances.

2.1.3 The contractor shall establish limits on caseload size to ensure effective treatment. Group sessions shall not exceed twelve (12) individuals for substance use or mental health treatment, or ten (10) individuals for sex offender treatment, unless Bureau staff authorizes a temporary increase. The contractor must justify the caseload size based on the number of individuals to be served, program design, characteristics and needs of the population served to include gender concerns and other factors.

2.1.4 The contractor shall provide bilingual services for non-English speaking individuals, through use of bilingual staff, approved language line or approved interpretive services, as long as there is a need for these services.

2.2 CONTRACTOR LICENSURE. The contractor shall ensure all personnel providing direct clinical services for the Bureau are fully licensed/certified clinicians to practice independently (i.e., without direct supervision) as required by the state authority where the services are being provided. All licenses must be current. Contractors shall forward documentation no later than 30 days after the license expiration date showing a renewed or current license.

2.2.1 The Bureau reserves the right to exclude any clinician who has pending allegations of misconduct, previous disciplinary actions, or who is currently being investigated by the Bureau’s Office of Internal Affairs, the DOJ Inspector General’s Office, or the applicable state or national licensing board(s). The contractor is responsible for reporting to the

Bureau any pending investigations or sanctions involving staff providing services under the contract.

2.2.2 At no time will direct clinical services be provided to by personnel not authorized to conduct such services by the licensing authorities in the state where the services are provided. At no time will personnel who do not meet the minimum state requirements be considered to provide direct clinical services for the Bureau.

2.2.3 If interns or trainees are used to provide direct clinical services for the Bureau, they shall adhere to all state requirements to conduct such services (i.e., education, experience, and clinical supervision). Interns or trainees must also work directly (i.e., in the same room) with a licensed staff member when providing direct clinical services. At no time should direct clinical services be provided by personnel not authorized by the state licensing authorities where the services are provided. A provisional license is not acceptable as a license. National or regional certification boards that issue credentials not specifically granted authority to license treatment practitioners in a given state cannot be utilized to satisfy the licensing requirement. State license reciprocity agreements are acceptable if the appropriate documentation is submitted and approved by the state authority (i.e., International Certification and Reciprocity Consortium).

2.2.4 If a state requires a practitioner to obtain a specific license/certification to provide substance use, mental health or sex offender treatment services, then this supersedes any other certifications or credentials. However, a specific license/certification is not required if the state where services are provided allows psychologists, licensed social workers, licensed professional counselors, etc. to conduct such services.

2.2.5 The contractor must ensure fully licensed staff provides services in accordance with all state licensing requirements.

2.2.6 Practitioners performing assessments or psychiatric evaluations:

• are licensed to conduct psychological or psychiatric evaluations in the state where services are being rendered; and

• meet the standards of practice established by their state’s professional regulatory board.

2.2.7 The contractor must have a qualified practitioner (i.e. Physician, Physician Assistant, Advanced Practice Registered Nurse Practitioner/Specialist) with prescriptive authority who meets the standards of practice established by his/her state’s professional regulatory board to provide medication monitoring. The individual’s license must be in the state in which service is provided and the license must be submitted with the quote.

2.2.8 If the provider plans to use telepsychiatry services, the qualified practitioner must be approved to provide services by CTS. The telehealth system must meet HIPAA guidelines and Bureau telehealth security criteria. If telepsychiatry is used, an approved clinician or healthcare staff member must be physically present with the patient for the duration of the session.

2.3 BACKGROUND INFORMATION. All contract employees must be approved by the

FAC COR before they have any contact with Federal inmates or related documentation.

This includes all employees, subcontractors, volunteers, and interns who have access to personally identifiable information, treatment records, contract documentation, billing invoices, or any other Federal inmate information.

2.3.1 After the contractor determines that a person is appropriate for employment or volunteer work with Federal inmates, the contractor will request a background check by the FAC

COR.

2.3.2 The contractor will submit to the FAC COR all relevant information, including a completed and signed NCIC Check form and driver’s license. This begins the background check process. The information provided on the form includes full name, all aliases used, date of birth, place of birth, sex, race, and social security number. The contractor shall notify this person that a National Crime Information Center/National Law Enforcement Telecommunication System (NCIC/NLETS), fingerprints (if applicable), criminal records and other appropriate background checks will be processed by the Bureau to verify this information.

2.3.3 Contract staff shall not begin working with Federal inmates prior to obtaining clearance from the FAC COR. The FAC COR may grant the person clearance to work with Federal inmates after the NCIC/NLETS check is conducted and the results of the check are appropriate.

2.3.4 If the NCIC/NLETS check results in a negative finding, an additional background check may be initiated, to include a request for the fingerprints from the proposed employee.

The FAC COR may authorize the contractor to obtain fingerprints of their employee and forward the fingerprint cards to the Bureau. In this instance, the final approval or disapproval by the FAC COR will follow the FAC COR's receipt of the fingerprints or other background checks.

2.3.5 The contractor shall understand that granting final approval shall not occur until after the FAC COR receives a response(s) from the background checks and these checks yield acceptable results. This action does not prevent, preclude, or bar the withdrawal or termination of any prior clearance or approval by the FAC COR at any time during the term of the contract.

2.3.6 The contractor shall verify the training and experience of all staff. This verification includes credentials for all professional staff. The contractor shall document verification in the personnel file and make it available to CTS staff during inspections. The contractor shall voucher potential employees through reference and employment checks.

The contractor shall document information regarding reference and employment checks in the employee's personnel file.

2.3.7 There may be occasions when an individual is prohibited from working with Federal inmates by the Bureau. If the contractor wishes to appeal the decision, the contractor may appeal the decision by submitting a written justification to the SCTC for the individual to be approved to work with Federal inmates. The SCTC will review the appeal and make a determination to grant or deny the appeal.

2.3.8 Contractors must adhere to the Residency Requirement Clause. The clause applies to all employees, volunteers, interns, and subcontractors working with Federal inmates as follows:

DOJ CONTRACTOR RESIDENCY REQUIREMENT BUREAU OF PRISONS

(JUNE 2004)

For three (3) of the five (5) years immediately prior to submission of an offer/bid/quote, or prior to performance under a contract or commitment, individuals or contractor employees providing services must have:

1. Legally resided in the United States (U.S.);

2. Worked for the U.S. overseas in a Federal or military capacity; or

3. Been a dependent of a Federal or military employee serving overseas.

If the individual is not a U.S. citizen, they must be from a country allied with the U.S. The following website provides current information regarding allied countries:

http://www.state.gov/s/l/treaty/collectivedefense/

CHAPTER THREE: SERVICES

3.1 TREATMENT SERVICES. All treatment services must be provided face-to-face, other than pre-approved tele-psychiatry, and require in-person clinical interactions between a client and an appropriately licensed and Bureau approved staff member. The interactions shall be deliberate and based on a cognitive-behavioral approach that has been demonstrated to effectively change behavior.

3.1.1 The contractor will provide clinical services which accommodate varying work schedules. Ordinarily, this includes morning, evening, and weekend appointments.

3.1.2 The contractor is not authorized to use videotapes, DVDs, or any type of audiovisual media during the course of treatment.

3.1.3 The contractor may not be authorized to provide all treatment services described in this SOW. Refer to the contract for a list of authorized services.

3.2 TREATMENT REFERRAL AND AUTHORIZATION. The treatment provider will receive a copy of the Treatment Referral and Authorization from the CTS Office for each referred individual. It will specify the types of services the individual should receive from the treatment provider.

3.2.1 The treatment provider shall provide all authorized services as outlined on the Treatment Referral and Authorization. The treatment provider may recommend changes in the authorized services and frequency of treatment. The Bureau must authorize any changes to the treatment regimen in advance, including discontinuing treatment. The treatment provider must accept all referrals made by the Bureau for treatment services. If the contractor determines they cannot provide treatment to a particular individual or condition, they must submit documentation, in writing, to the Bureau. An example of the justification is if placement in treatment would be a violation of local or state laws or ordinances. The Bureau reserves the right to pursue contractual remedies in the event the contractor cannot provide services to certain Federal inmates.

3.2.2 The government will not reimburse the contractor for services that were not authorized in advance of the services being provided. Additionally, the contractor will only accept Bureau referrals from CTS staff.

3.2.3 The treatment provider must ensure contact is made with the individual within three (3) days of the treatment start date identified on the Treatment Referral form.

3.3 INTAKE SCREENING. Within ten (10) calendar days of the treatment start date (shown on the Treatment Referral and Authorization), the treatment provider must meet individually with the referred individual for the following initial intakes:

• Substance use intake (CLIN 2000)

• Mental health intake (CLIN 5000)

• Sex offender intake (CLIN 6060)

3.3.1 The purpose of the intake screening is to review required state, local, and agency policies and regulations with the referred individual and to obtain their signature on all appropriate paperwork including the Transitional Drug Abuse Treatment Authorization of Release of Information and the Agreement to Participate in Community Transition Program (Informed Consent).

3.3.2 Referred individuals must be informed of the limits of confidentiality during the intake screening, and that information will be disclosed to U.S. Probation and others on a need-to-know basis.

3.3.3 Within 24 hours after completion of the intake screening, the treatment provider must securely send the following completed documents to the Bureau:

• Initial Contact Report. At the intake screening the therapist will complete this form verifying that face-to-face contact was made with the client.

• Authorization for Release of Information Form. Prior to the beginning of any interview or counseling, all clients must complete this Bureau form. Ordinarily, the authorization’s expiration should be dated a year from the client’s release date.

• Agreement to Participate in Community Transition Program (Informed Consent).

Prior to the beginning of any interview or counseling, all clients must complete the form. The therapist shall evaluate the client’s competency to give his or her informed consent prior to offering treatment or to prescribing medication.

• Competence to give informed consent means the client has a basic understanding of his or her diagnosis or condition and that the treatment being offered is for that condition. It also means the client has a basic understanding of the potential benefits, risks and side effects, and that they understand what to do in the event of any side effects.

• The client must understand he or she has the option not to participate in treatment, and they must also understand the consequences of their failure to participate if they choose not to volunteer for treatment while in the community.

3.3.4 The therapist providing services is responsible for thoroughly completing all intake documents. If the individual refuses to sign the above forms, or refuses to participate in treatment, the therapist must terminate the intake screening immediately and notify RRC and CTS staff. Upon terminating the intake, the treatment provider will also immediately alert RRC staff of the individual’s departure to the RRC to ensure accountability of the individual is maintained. The appropriate intake line item may be billed if the individual refuses to continue treatment services.

3.4 CLINICAL ASSESSMENT. When a clinical assessment is authorized by the Bureau, it shall be completed and forwarded to the CTS Office within 14 calendar days of the clinical encounter. The Bureau reserves the right to require providers complete assessments in a shorter time frame. The types of treatment services that may be authorized include the following:

• Substance use assessment and report (CLIN 2011)

• Psychological evaluation and report (CLIN 5010)

• Sex offender specific evaluation and report (CLIN 5012)

• Mental health assessment and report (CLIN 5011)

• Psychological testing and report (CLIN 5020)

• Penile plethysmograph and report (CLIN 5021)

• Polygraph exam and report (CLIN 5022)

• Polygraph maintenance or monitoring test and report (CLIN 5023)

• Abel assessment for sexual interests (CLIN 5025)

• Psychiatric evaluation and report (CLIN 5030)

• Crisis interventions (CLIN 6000)

• Medication monitoring (CLIN 6051)

3.4.1 Contractors will not complete assessments/reports (e.g. substance use assessment, mental health assessment, etc.) in conjunction with individual sessions or any other form of treatment. Crisis interventions may be completed without prior approval as deemed necessary by the treating clinician. All services provided by the contractor are expected to take place in a face-to-face, in-person setting other than pre-approved telepsychiatry.

3.5 COUNSELING SERVICES. Counseling interventions target the client’s criminogenic needs, such as criminal thinking errors, to reduce the likelihood of misconduct and recidivism. Counseling sessions shall begin as soon as possible after the intake screening has been completed. The treatment regimen must not exceed a combined total of four hours (eight 30-minute units) per week, unless prior authorization is received from CTS staff. Unless otherwise authorized by the Bureau, the contractor shall not provide breaks during the course of individual or group therapy.

3.5.1 The types of counseling services that may be authorized include the following:

• Individual substance use counseling (CLIN 2010)

• Individual mental health counseling (CLIN 6010)

• Individual sex offender counseling (CLIN 6012)

• Group substance use counseling (CLIN 2020)

• Group mental health counseling (CLIN 6020)

• Group sex offender counseling (CLIN 6022)

• Family substance use counseling (CLIN 2030)

• Family sex offender counseling (CLIN 6032)

3.6 TRANSPORTATION. Individual Transportation Expenses (CLIN 1202) may be authorized on a contract to facilitate individual transportation to and from the community treatment provider facility by public transportation including bus, train, shuttle or taxi service.

CHAPTER FOUR: SUBSTANCE USE SERVICES

4.1 SUBSTANCE USE INDIVIDUALS. The Bureau operates a structured, multi-component substance use treatment protocol to identify individuals in need of substance use treatment upon entry and throughout their incarceration. This multi-pronged treatment delivery system accommodates the entire spectrum of individuals in need of substance use programs through the Drug Abuse Education Course, Non-Residential Drug Abuse Program (NRDAP), Residential Drug Abuse Programs (RDAP), and Follow-up Treatment in general population and Community Treatment Services (CTS).

4.1.1 Successful completion of RDAP requires participation in community-based treatment.

These individuals will ordinarily be referred with clinical documentation, containing a summary of their in-prison treatment experience, including an American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis, and recommendations from the prison-based clinicians.

4.1.2 Individuals who have not completed RDAP may be referred for treatment if they meet one or more of the following criteria:

• completed the NRDAP;

• completed a Psychology Treatment Program (PTP) and have a verifiable substance use disorder;

• volunteered for treatment and have a verifiable substance use disorder;

• found guilty of, or admitted to, using drugs/alcohol while in the Residential Reentry

Center (RRC) and/or home confinement.

4.2 DESCRIPTION OF SUBSTANCE USE SERVICE LINE ITEMS:

4.2.1 Substance Use Intake (2000): Includes completion of all required forms and documentation required by state regulatory boards and the Bureau. Typically, this is the initial meeting where signatures are obtained, as well as orientation and admission paperwork completed and reviewed with the referred individual. If an individual declines treatment and has signed necessary paperwork, this remains a billable item.

4.2.2 Substance Use Assessment and Report (2011): A comprehensive diagnostic interview is conducted to identify substance use/comorbid mental health diagnoses and treatment goals. A typed report should be submitted to CTS as soon as possible. A diagnosis is required to justify continued substance use services. Assessment services will not be reimbursed prior to receipt of the report. Price is per individual.

4.2.3 Substance Use Individual Counseling (2010): One individual, no less than 60 minutes in length. Focus is on substance use and progress on treatment goals. Price is per 30 minute unit.

4.2.4 Substance Use Group Counseling (2020): From 2 to 12 individuals and 60-90 minutes in length. Session shall be process oriented in nature. Special permission must be obtained for groups that exceed 12 participants or last longer than 90 minutes. Price is per 30 minute unit.

4.2.5 Substance Use Family Counseling (2030): One or more family members with participant in attendance, no less than 60 minutes in length. Price is per 30 minute unit.

CHAPTER FIVE: MENTAL HEALTH SERVICES

5.1 MENTAL HEALTH INDIVIDUALS. The Bureau provides Psychology Treatment

Programs which are designed to effectively manage and treat seriously mentally ill and behaviorally disordered participant. Specifically, the programs reduce psychological symptoms, improve functioning, facilitate institutional adjustment, and reduce incidents of misconduct. An individual must be diagnosed with a mental illness as described in the most current version of the DSM in order to receive treatment services. Typically, the participant’s functioning is significantly reduced by the mental illness or significant cognitive impairment.

5.2 DESCRIPTION OF MENTAL HEALTH SERVICE LINE ITEMS:

5.2.1 Mental Health Intake (5000): Includes completion of all required forms and documentation required by state regulatory boards and the Bureau. This is the initial meeting where signatures are obtained, as well as orientation and admission paperwork completed and reviewed with the referred individual. If an individual declines treatment and has signed necessary paperwork, this remains a billable item.

5.2.2 Mental Health Assessment and Report (5011): A comprehensive diagnostic interview and a written report is required. Assessment services will not be reimbursed prior to receipt of the report. The report must provide a diagnosis (where applicable), mental status examination, and treatment recommendations. If a mental health diagnosis is not deemed appropriate, the provider shall indicate and explain the determination within the report. Price is per individual.

5.2.3 Mental Health Individual Counseling (6010): One individual, no less than 60 minutes in length. Focus is on mental health symptoms, medication compliance and progress toward treatment goals. Price is per 30 minute unit.

5.2.4 Mental Health Group Counseling (6020): From 2 to 12 individuals, 60-90 minutes in length. Special permission must be obtained for groups that exceed 12 individuals or last longer than 90 minutes. Price is per 30 minute unit.

5.2.5 Psychological Evaluation and Report (5010): An evaluation conducted by a licensed psychologist (Ph.D., Psy.D., or other advanced doctoral degree) which includes a diagnostic interview of the individual, a review of available criminal justice records, and a review of available mental health records. This evaluation and report serves to provide or clarify diagnostic impressions, assist in differential diagnosis, and facilitate treatment planning. Evaluation services will not be reimbursed prior to receipt of the report. Price is per individual.

5.2.5.1 Practitioners performing psychological evaluations/assessments must:

• be licensed to conduct psychological evaluations in the state where services are being rendered;

• meet the standards of practice established by their state’s professional regulatory board.

5.2.6 Psychological Testing and Report (5020): A diagnostic interview and a full range of psychological tests (e.g.: neuropsychological tests, intelligence tests, objective personality tests, symptom inventories) conducted by a licensed psychologist (Ph.D., Psy.D., or other advanced doctoral degree). The purpose of testing is to assess functioning, formulate diagnostic impressions, and develop treatment recommendations.

The resulting report must be submitted to CTS as soon as possible. Testing services will not be reimbursed prior to receipt of the report. Price is per individual.

5.2.7 Psychiatric Evaluation and Report (5030): The purpose of this evaluation is to establish a psychiatric diagnosis, assess the need for psychotropic medication, and prescribe such medication as is necessary and reasonable to ensure optimal functioning by the individual. Evaluation services will not be reimbursed prior to receipt of the report. Price is per individual.

5.2.7.1 Practitioners performing psychiatric evaluations must:

• be licensed to conduct psychiatric evaluations in the state where services are being rendered;

• meet the standards of practice established by their state’s professional regulatory board;

• services may be provided using telehealth technology if preapproved and acceptable in the state of residence.

5.2.8 Crisis Intervention Evaluation or Report (6000): A comprehensive diagnostic interview and a written report are required. The report should provide mental status examination, an assessment of risk and protective factors, a diagnosis, and follow-up treatment recommendations. Evaluation services will not be reimbursed prior to receipt of the report. The report shall be provided within one working day. Price is per individual.

5.2.9 Case Management Services (6030): Provide assistance to individuals with significant mental health needs in the following areas when applicable and not in conflict with RRC case management services. Requires specific pre-approved by CTS staff.

• facilitating service linkage in the community and coordinating integrated services from multiple providers (where applicable);

• direct service support including assistance with obtaining transportation, housing, financial support, coordinating team meetings, filing application for services (including Social Security and other local assistance programs), escort to appointments, medication compliance, and daily living skill remediation;

• general crisis intervention.

5.2.10 Administration of Medication (6050): Dispense oral medication and monitor its ingestion and/or administer intra-muscular injections. Practitioner performing any administration of medication must be licensed to do so in the state where services are being rendered and must meet Federal, state, and local regulations. Price is per administration.

5.2.11 Medication Monitoring (6051): Medication monitoring is used to evaluate the efficacy of the psychiatric medication, order and perform laboratory testing, monitor laboratory test results, and make changes to the treatment regimen when deemed clinically appropriate.

The contractor shall ensure medication is administered in compliance with all Federal, state, and local regulations. The contractor shall evaluate the efficacy of the medication, incorporating feedback from a clinical practitioner and the client. The monthly progress report (MPR) must indicate the authorized practitioner who provided the medication monitoring, the date, service code, length of contact, and comments (e.g: adjustment, responsiveness, need for change in medication, etc.). Medication monitoring services will not be reimbursed prior to receipt of the medication monitoring report. Price is per individual per visit.

CHAPTER SIX: SEX OFFENDER SERVICES

6.1 SEX OFFENDER INDIVIDUALS. Sex Offender Management Program (SOMP). The

Bureau offers treatment, management and psycho-educational opportunities for individuals with a history of sexual offense/s. This is done through a stratified treatment model where volunteers are referred to high or moderate intensity tracks based on risk factors. Programs are designed to match the delivery of treatment services to the unique characteristics of the offender (learning style, intelligence level, etc). Individuals who engage in conduct relevant to their history of sexual offending while incarcerated (e.g., offenders who collect pictures of children), may be referred to a SOMP where Correctional Management Plans (CMP) are implemented.

6.1.1 Sex offender treatment through CTS is the final component of SOMP. The Bureau recognizes the importance of, and need for, the continuation of treatment when individuals transfer to an RRC or home confinement. This allows individuals to build on the treatment received in the institution and incorporate those philosophies into daily living in the community. Sex offender treatment through CTS is a required component of the Bureau's institution based Residential Sex Offender Treatment Program (SOTP-R) and the Non-Residential Sex Offender Treatment Program (SOTP-NR).

6.1.2 SOTP-NR and SOTP-R. These individuals have participated in the institution portion SOMP. These individuals will ordinarily be referred to community treatment providers with clinical documentation related to their criminal histories. This may include a summary of their in-prison treatment experiences, including a DSM diagnosis, and recommendations from the prison-based treatment providers.

6.1.3 Non-SOTP Individuals: An individual with a documented sex offense history or diagnosis who did not participate in SOTP may also volunteer to participate in CTS while residing at an RRC. All cases must meet the following eligibility criteria in order to participate:

• documentation to verify the specific sex offense, or history;

• sex offender diagnosis or significant clinical record based on DSM criteria, and/or a moderate or higher static risk level based on an assessment of the offense history and other relevant factors.

6.2 DESCRIPTION OF SEX OFFENDER SERVICE LINE ITEMS:

6.2.1 Sex Offender Intake (6060): Includes completion of all required forms and documentation required by state regulatory boards and the Bureau. Typically, this is the initial meeting where signatures are obtained, as well as orientation and admission paperwork completed and reviewed with individual. If an individual declines treatment and has signed necessary paperwork, this remains a billable item.

6.2.2 Sex Offender Specific Evaluation and Report (5012) – A comprehensive evaluation addressing an offender's risk for reoffending and treatment needs. The evaluation must be completed by a licensed clinician, with the report ordinarily due within 30 days of treatment provider’s contact with individual. The evaluation includes a diagnostic interview, standardized static risk assessment protocol, standardized dynamic risk assessment, resulting in a comprehensive psychosexual diagnosis, risk factors (both static and dynamic), and treatment and management/supervision recommendations based upon evidenced based practices or published guides endorsed by ATSA or CSOM. If, after evaluating the individual, the treatment provider determines that a sex offender specific diagnosis is not appropriate, the treatment provider shall note this in the report. The contractor shall not require the individual to identify their victims. Price per individual.

6.2.3 Penile Plethysmograph and Report (5021) – A phallometric assessment and report of sexual arousal. This does NOT require any victim identification.

6.2.4 Polygraph Exam and Report (5022) - A diagnostic instrument and procedure focused on the individual’s sexual history which includes a report to assist in treatment and assessment strategies by detecting deception. This does NOT require any victim identification.

6.2.5 Polygraph Maintenance or Monitoring Test and Report (5023) - A periodic polygraph examination (4-6 months) to monitor compliance with treatment or supervision conditions. This does NOT require any victim identification.

6.2.6 Abel Assessment for Sexual Interests (5025) - A comprehensive evaluation and treatment tool that provides baseline data, treatment planning guidance, and evaluation of progress throughout the treatment process. This does NOT require any victim identification.

Price per individual.

6.2.7 Sex Offender Individual Counseling (6012) - Counseling of one offender by a state licensed/certified professional no less than 60 minutes in length. An intake and the completion of administrative paperwork, including psychosexual history, mental status, and treatment plan interview, are expected for each case. This does NOT require any victim identification.

6.2.8 Sex Offender Group Counseling (6022) - From 2 to 10 individuals, 60-90 minutes in length. Special permission must be obtained for groups that exceed 10 individuals or last longer than 90 minutes. This does NOT require any victim identification.

6.2.9 Sex Offender Family Counseling (6032) - Two or more family members no less than 60 minutes in length. This does NOT require any victim identification.

CHAPTER SEVEN: TREATMENT DOCUMENTATION

7.1 TREATMENT DOCUMENTATION. All treatment documents will be provided by the

Bureau. The treatment provider must thoroughly complete and submit the documents to CTS staff per required time frame of each document. Treatment providers may submit a request to the Supervisory Community Treatment Coordinator (SCTC) to use compatible internal documents, on a case-by-case basis, if they satisfy all requirements of those provided by the Bureau.

7.1.1 All treatment documentation must be signed by the therapist who provided the service.

All treatment documentation must be individualized and contain specific examples of what the individual is engaging in, discussing, and working on during the course of treatment. Progress toward treatment goals should be the focus. Generic content, templates, and general clinical themes do not constitute acceptable documentation of progress in treatment.

7.2 CLINICAL ASSESSMENT REPORTS. Clinical Assessment reports must be in typed narrative form and contain, at a minimum:

• the DSM (latest version) diagnosis (including past diagnoses), where applicable;

• the significant background issues pertaining to family, relationships, health, mental health, substance use, education, medication, social issues and employment;

• the specific test(s) administered during the assessment;

• the criminal history, to include statements documenting any disparity between self-report and supporting documentation;

• a summary of prior treatment experiences;

• specific recommendations for treatment; and

• involvement with drugs and/or alcohol, and indicate if use was 12 months before arrest on his or her current offense.

7.2.1 If treatment is not clinically indicated, the assessor is to document their analysis leading to this decision and address any identified disparities between prior and current diagnoses. When treatment is indicated, all recommended interventions are to be detailed.

7.2.2 Mental health assessments must include current mental health functioning and status, and an assessment of medication compliance, if applicable.

7.2.3 Sex offender assessment reports must also include a summary of sex offense history, and standardized dynamic and static risk assessment for violence and sexual offenses.

7.2.4 Crisis Intervention Assessments (e.g., PREA-related services, suicide risk assessment) at a minimum will include:

• reason for and source of referral;

• narrative of event (for PREA-related cases only);

• risk and protective factors assessed;

• risk assessment findings;

• diagnosis;

• follow-up recommendations.

7.2.5 The crisis intervention assessment must be completed within 24 hours of the request made by CTS staff. The contractor will take appropriate action (e.g.: ensure the individual is transported to an emergency room), and immediately (no later than the next business day) update the CTS office. The contractor will provide the assessment upon completion (no later than next business day after the assessment is completed).

7.2.6 Prison Rape Elimination Action (PREA) Intervention Guidelines. Following a PREA-related allegation, CTS will contact the community treatment provider to authorize appropriate follow-up mental health services. The individual will be seen by the community treatment provider and offered any appropriate follow-up mental health services. The community treatment provider will evaluate the current mental health adjustment, including assessing for possible suicidal thought or plan.

• the individual will be seen by a community treatment provider for the purpose of crisis intervention and the assessment of any immediate and subsequent treatment needs;

• the findings of this initial crisis evaluation session shall be summarized in a crisis intervention assessment and a copy provided to the CTS office;

• additional treatment services will be authorized as needed;

• all treatment and evaluation sessions shall be properly documented to ensure continuity of care within, between, and outside of Bureau facilities;

• the provider will ensure that the individual is informed of appropriate community mental health resources in the area should the individual release from custody prior to completion of all treatment goals.

7.3 CLINICAL TREATMENT PLAN. The individualized clinical treatment plan must be based on CBT practices and interventions. A clinical treatment plan must include goals and activities beyond abiding by RRC rules, obtaining employment, and attending treatment.