Attachment B

MILFORD COUNSELING

RECOVERY HOUSING LEVEL II MONITORED SERVICES

FY 17/18

Recovery Housing provides a location where individuals in early recovery from a behavioral
health disorder are given the time needed to rebuild their lives, while developing the necessary
skills to embark on a life of recovery. This temporary arrangement will provide the individual
with a safe and secure environment to begin process of reintegration into society, and to build the
necessary recovery capital to provide varying degrees of support and structure. Participation is
based on individual need and the ability to follow the requirements of the program.

I. Staff Qualifications

A. High School Diploma or equivalent

B. Must possess interpersonal skills
 Empathy
 Verbal and written communication skills
 Listening skills
C. Must have a good working knowledge of recovery resources and activities.

Training Requirements
o Personal Safety
o Ethics
o Confidentiality
o Cultural Competence
o Recipient Rights
o Communicable Disease/HIV Level 1
o CPR/First Aid/Universal Precautions (recommended)

II. Program Services

A. Staff will maintain an alcohol-and illicit-drug-free environment.
B. Maintain a safe, structured, and supportive environment.
C. Set clear rules, policies, and procedures for the house and participating residents
D. Establish a screening process for residents.
E. The Provider will adhere to and demonstrate compliance regarding
services/structure/guidelines outlined by the National Alliance of Recovery Residences
(NARR).
F. Program Criteria must be consistent with NARR Level II Monitored Services.

III. Eligibility Requirements

A. Individual meet the criteria for OCHN funding (income, residency, and substance use
disorder diagnosis).

Attachment B/Milford_ Recovery Housing 1

 Attachment B

B. Individual is in need of a highly structured and monitored living environment where

recovery support is available.
C. Individual has a history of unsuccessful recovery attempts
D. Individual has significant negative factors in the areas of family, social, work, or
environment that places him/her at-risk for relapse.

IV. Admission Requirements

I. Individual has completed or does not need medical or sub-acute detoxification.
II. Individual does not present with a severe medical or psychiatric condition that would
interfere in his/her ability to function in a supervised supportive living environment.
III. Individual will engage in treatment services and/or recovery groups/activities.
IV. Individual demonstrates active motivation for recovery and a desire to work towards self-
sufficiency.

V. Recovery Housing Placement

A. ACCESS Management System Staff will refer and coordinate admission to the home.
B. In cases where the Treatment Provider request placement. The provider will contact the
AMS Staff. The Provider will enter a note in EHR with the following information:
 Summary of progress and level of engagement
 Rationale for placement
 Plan for community integration and self-sufficiency, such as employment,
independent housing and so forth.
C. AMS staff will review the information and make a recommendation for placement based
on the admission requirements/availability.
D. AMS staff will assist in arranging admission.
E. The Provider will complete an Initial Authorization Form for approval from the AMS.
F. Recovery Home placement is based on first come first serve availability. Waiting list will
not be established for this service level. DIOP or DOP maybe an option. The AMS staff
will make the determination.
G. Recovery Home staff will keep the AMS staff apprised of openings.

VI. Recovery House Admission Procedure

A. Recovery Home Provider will complete the standard information required for
admission. In addition to the OCHN required documents.
B. Recovery Home Provider will assist the client in developing an individualized
recovery plan including Peer and Case Management Services if applicable.

VII. Authorizations/Re-Authorization Request

A. Clients will be authorized for 60 (sixty) days. Thirty (30) day extensions will be
considered on an individual basis. Extensions will be based on the following criteria:

Attachment B/Milford_ Recovery Housing 2

 Attachment B

 No behavioral challenges with staff or other residents

 Seeking employment or employed
 Compliance with house rules and regulations
 Engagement in treatment services and /or recovery groups/activities
 Progress toward recovery goals as evidenced by measurable improvement in
meeting recovery plan goals/recovery process
 Other pertinent information
B. If services are needed after sixty days an extension maybe requested. The Recovery
Home Provider may request a reauthorization for continued stay through AMS ten (10)
days prior to the expiration date of the initial authorization. Information noted above for
extension request must be included in the reauthorization request.

VIII. Records
The Recovery Home Provider will maintain adequate program, and fiscal records and
files, including source documentation, to support program activities and all expenditures
made under the terms of this agreement, as required.
A. A daily log for each billable date of service will be kept for each client served.
B. OCHN EHR Forms (such as Admission/Discharge, Etc.) will be completed within
timeframes noted in Attachment E. Timelines are consistent with outpatient
guidelines.
C. OCHN required documents including the Provider Consent for services.
D. All client specific information will be kept in a secure location and the Recovery
Home Provider will adhere to confidentiality requirements.
E. Release of Information Forms must be obtained before sharing client information
with outside entities.

IX: Critical Incident/Sentinel Event Reporting

Refer to Attachment E Section XV for reporting guidelines.
Attachment -31

X: Code/Rate
Code H2036
Rate $22.00 per day

Attachment B/Milford_ Recovery Housing 3

 Recovery Residence Levels of Support

Level I Level II Level III Level IV

Peer-Run Monitored Supervised Service Provider

 Democratically run  House manager or  Organized hierarchy  Overseen

 Manual or policy and senior resident  Administrative organizational
procedures  Policy and procedures oversight for service hierarchy
providers  Clinical and
Administration  Policy and procedures administrative
 Licensing varies from supervision
state to state  Policy and procedures
 Licensing varies from
state to state
 Drug screening  House rules provide  Life skill development  Clinical services and
 House meetings structure emphasis programming are
 Self-help meetings  Peer-run groups  Clinical services provided in-house
Standards encouraged  Drug screening utilized in outside  Life skill development
Criteria Services community
 House meetings
 Involvement in self-  Service hours provided
help and/or treatment in-house
services
 Generally single family  Primarily single family  Varies – all types of  All types – often a step-
residences residences residential settings down phase within care
 Possibly apartments or continuum of a
Residence other dwelling types treatment center
 May be a more
institutional in
environment
 No paid positions  At least 1 compensated  Facility manager  Credentialed staff
Staff
within the residence position  Certified staff or case
 Perhaps an overseeing managers
officer

Contract 16-17 / Attachment B/Milford Recovery Housing 4

 Attachment B
OCHN Recovery Home Standards

Adapted From the National Association of Recovery Providers

Member Standards

Currently In Not
Organizational/Administrative Standards
Met Process Applicable
Provider is a legal business entity as evidenced by
business licenses or incorporation documents.
Provider has a written mission and vision
statement.
Provider has a written code of ethics.
Provider complies with state and federal
requirements. If required, documents such as
license and certificate of occupancy are visible for
public view.
Provider clearly identifies the responsible
person(s) in a written job description and/or
contract.
Provider provides drug and alcohol free
environment.
Provider collects and reports accurate process and
outcome data for continuous quality improvement.
Provider has written permission from the owner of
record to operate a Recovery provider on their
property.
Provider maintains an accounting system that fully
documents all residents’ financial transactions
such as fees, payments and deposits.
Provider posts emergency procedures and staff
phone number in conspicuous locations.
Provider posts emergency numbers, protocols and
evacuation maps.
Provider uses an applicant screening process that
helps maintain a safe and supportive environment
for a specific group of persons in recovery.
Provider adheres to applicable confidentiality laws.
Provider keeps resident records secure with access
limited to authorized staff only.

Contract 16-17 / Attachment B/Milford Recovery Housing 5

 Attachment B
Currently In Not
Organizational/Administrative Standards
Met Process Applicable
Provider has a grievance policy and procedure for
residents.
Provider creates a safe, structured, and recovery
supportive environment through written and
enforced residents’ rights and requirements.
Provider has an orientation process that clearly
communicates residents’ rights and requirements
prior to them signing any agreement; collects
demographic and emergency contact information
and provides new residents with written
instructions on emergency procedures and staff
contact information.
Provider fosters recovery-supportive alcohol and
drug-free environment through written and
enforced policies and procedures that address
residents who return to alcohol and/or drug use;
hazardous item searches; drug-screening and/or
toxicology protocols; and prescription and non-
prescription medications usage and storage.
Provider encourages each resident to develop and
participate in their own personalized recovery
plan.
Provider informs residents on the wide range of
local treatment and recovery support services
available to them including: 12 step or other
mutual support groups, recovery community
centers, recovery ministries, recovery-focused
leisure activities and recovery advocacy
opportunities.
Provider provides nonclinical, recovery support
and related services.
Provider encourages residents to attend mutually
supportive, self-help groups and/or outside
professional services.
Provider provides access to scheduled and
structured peer-based services such as didactic
presentations.
Provider offers life skills development services
Provider abides by all local building and fire safety
codes.

Contract 16-17 / Attachment B/Milford Recovery Housing 6

 Attachment B
Currently In Not
Organizational/Administrative Standards
Met Process Applicable
Provider provides each resident with food and
personal item storage.
Provider places functioning fire extinguishers in
plain sight and/or in clearly marked locations.
Provider has functioning smoke detectors installed.
If the provider has gas appliances, functioning
carbon monoxide detectors are installed.
Provider provides a non-smoking internal living
environment.
Provider has a community room large enough to
accommodate house meetings and sleeping rooms
that adhere to local and state square footage
requirements.
Provider has one sink, toilet and shower per six
residents or adheres to local and state
requirements.
Provider has laundry services that are accessible to
all residents.
Provider maintains the interior and exterior of the
property in a functional, safe and clean manor that
is compatible with the neighborhood
Provider has a meeting space that accommodates
all residents.
Provider has appliances that are in working order
and furniture that is in good condition.
Provider addresses routine and emergency repairs
in a timely fashion.
Provider provides neighbors with the responsible
person(s) contact information upon request. The
responsible person(s) respond to neighbor’s
complaints, even if it is not possible to resolve the
issue.
Provider has rules regarding noise, smoking,
loitering and parking that are responsive to
neighbor’s reasonable complaints.
Provider has and enforces parking courtesy rules
where street parking is scarce.

Contract 16-17 / Attachment B/Milford Recovery Housing 7