Ala. Admin. Code r. 580-9-44-.14

Level 0.5: Early Intervention

This regulation establishes operational standards for Level 0.5 Early Intervention Programs under Alabama's substance use disorder licensing framework. Operators must develop written operational plans, admission criteria, core service offerings (screening, counseling, psychoeducation, case management), and staffing requirements. The rule includes adolescent-specific criteria, such as location restrictions to prevent shared contact with individuals in active substance use disorder treatment. Programs must document individualized service intensity, progress notes, and maintain referral agreements for higher levels of care and ancillary services.

Ala. Admin. Code r. 580-9-44-.14 - Level 0.5: Early Intervention 

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(1)
 Rule Compliance. Each Level 0.5 Early
 Intervention Program shall comply with the following rules and the rules
 specified in this chapter. 
(a)
 Operational
 Plan. The entity shall develop, maintain and document implementation of a
 written operational plan that defines its Level 0.5 Early Intervention Program.
 The program description shall comply with all of the requirements specified in
 
580-9-44-.13
 and the following
 additional specifications:
1.
 Location. The
 entity shall specifically identify and describe the setting in which Level 0.5
 Early Intervention services shall be provided. Services may be provided in any
 appropriate setting that protects the client's right to privacy,
 confidentiality, safety and meets the DMH facility certification standards as
 appropriate to the location. Service locations may include traditional clinical
 offices and behavioral health sites, residences, schools, shelters, work sites,
 community centers and other locations as pre-authorized by DMH.
 
(i)
 Adolescent Specific Criteria. 
 
(I)
 Location. Shall not provide services in
 locations that would require shared services or significant contact with
 individuals receiving treatment for substance use
 disorders.

2.

 Admission Criteria. The entity shall develop, maintain, and document
 implementation of written criteria for admission to its Level 0.5 Outpatient
 Program, as according to
 
580-9-44-.13
(9)
,
 and the following criteria: 
(i)
 The entity's
 admission criteria shall specify the target population for Level 0.5 services
 to include, at a minimum, individuals whose problems and risk factors appear to
 be related to substance use, but do not meet the diagnostic criteria for a
 substance-related disorder as defined in the current Diagnostic and Statistical
 Manual of Mental Disorders of the American Psychiatric Association.

(ii)
 The entity shall provide written
 documentation in individual case records that each client admitted to receive
 Level 0.5 Early Intervention Services meets the most current edition of the
 ASAM Patient Placement Criteria diagnostic and dimensional criteria for this
 level of care.

(iii)
 Adolescent
 Program Specific Criteria. The entity shall provide written documentation in
 individual case records that each adolescent admitted to receive Level 0.5
 Early Intervention services meets the most recent edition of the ASAM Patient
 Placement Criteria adolescent diagnostic and dimensional criteria for this
 level of care.

3.
 Core
 Services. Each Level 0.5 Early Intervention Program shall demonstrate the
 capacity to provide a basic level of skilled services appropriate to the needs
 of its clientele:
(i)
 Screening and assessment
 sufficient to screen for, and rule in or out, substance-related
 disorders.

(ii)
 Individual
 counseling.

(iii)
 Group
 counseling.

(iv)
 Family
 counseling.

(v)

 Psychoeducation.

(iv)
 Case
 Management: 
(I)
 Case planning.

(II)
 Linkage.

(III)
 Advocacy.

(IV)

 Monitoring.

4.

 Service Intensity. The entity shall document that the amount and frequency of
 services is established on the basis of the unique needs of each client
 served.

5.
 Documentation: In
 addition to meeting the requirements of
 
580-9-44-.13
(21)
,
 an individualized progress note shall be recorded for each service provided in
 Level 0.5.

6.
 Support Systems. 
 
(i)
 At a minimum, the Early Intervention
 Program shall develop, maintain and document implementation of written policies
 and procedures which govern the process used to ensure the availability of and
 provide referrals as needed for:
(I)
 Treatment
 of substance use disorders.

(II)

 Medical, psychological or psychiatric services, including assessment.

(III)
 Community social
 services.

(ii)
 The entity
 shall maintain up-to-date, written Memorandums of Understanding, Collaborative
 Agreements or Referral Agreements as applicable.

7.
 Program Personnel. Each Level 0.5 Early
 Intervention Program shall employ an adequate number of qualified individuals
 to carry out personalized care for its clientele and to meet the program's
 goals and objectives.
(i)
 Every client in a
 Level 0.5 Program shall be assigned to a specific Primary Counselor for care
 management.

8.
 Training.
 The entity shall provide written documentation that all Level 0.5 Program
 personnel satisfy the competency and training requirements as specified in
 
580-9-44-.02
(3)
.

9.
 Service Intensity: The entity shall
 document that the amount and frequency of Level 0.5 Early Intervention Services
 are established on the basis of the unique needs of each client
 served.

10.
 Length of Service: The
 entity shall provide written documentation that the duration of treatment in
 each Level 0.5 Program shall vary as determined by: 
 
(i)
 The client's ability to comprehend the
 information provided and use that information to make behavior changes;
 or

(ii)
 The appearance of new
 problems which require another modality of service.

11.
 Service Availability: The entity shall
 provide written documentation describing the process utilized to establish the
 hours of service availability for its Level 0.5 Early Intervention Program. At
 a minimum, this process shall:
(i)
 Include
 consideration of the needs of the target population, including work, school and
 parenting responsibilities.

(ii)

 Not be based solely on standard eight (8) to five (5), Monday through Friday
 office hours.

Notes

Ala. Admin. Code
 r. 
580-9-44-.14

 New Rule: Filed January
 26, 2012; effective March 1, 2012.

Amended by
 
Alabama
 Administrative Monthly Volume XLI, Issue No. 04, January 31,
 2023
, eff. 
3/17/2023
.

Author:
 Substance Abuse Services Division

Statutory Authority:

Code of Ala.
 1975
, §
 
22-50-11
.

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