CurrentOptumPolicy N/A

Behavioral health agency licensing and staffing requirements

Defines licensing, accreditation, pre-employment screening, training, staffing ratios, and clinical staffing qualifications for Therapeutic Group Homes (TGH), Psychiatric Residential Treatment Facilities (PRTF), Level 3.7 programs, FQHC/RHC behavioral health services, and Adult Crisis Providers in Louisiana; applies to provider organizations and staff involved in those settings.

Policy Summary

PayerOptum

PolicyBehavioral health agency licensing and staffing requirements

Policy CodePolicy N/A

Change TypeNo material change

Effective Date

Next Review Date

Key ActionPerform criminal background checks (including sexual offender registry) within 90 days prior to employment and check OIG LEIE and LDH State Adverse Actions prior to hiring and monthly thereafter for current employees.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

10TGH max beds

90 daysBackground check window

MonthlyOIG/LDH check frequency

1:5TGH staff ratio

24/7Crisis availability

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Operational and Program Eligibility Criteria

inv-01: Agency operational and staffing requirements

Requirements that agencies must meet to be eligible for contracting, reimbursement, and operation.

ALL of the following

Licensed by the Louisiana Department of Health (LDH) under the applicable LAC chapter for the service type (e.g., LAC 48:1 Chapter 62 for TGH; Chapter 90 for PRTF/Level 3.7).
License must cover the location being reviewed.
Accredited by CARF, COA, or The Joint Commission (TJC) for the location reviewed; new agencies must attain full accreditation within 18 months of the initial accreditation application date and pay associated accreditation fees prior to contracting/reimbursement.full accreditation within 18 months

ALL of the following

Therapeutic Group Homes (TGH) and similar providers must not exceed 10 beds at a location.

ALL of the following

Criminal background checks (including sexual offender registry) must be performed prior to employment/contracting/volunteering and documented; criminal background checks are performed no more than 90 days prior to date of employment.
Review OIG LEIE and LDH State Adverse Actions lists prior to hiring/contracting any employee or contractor who will be paid with Medicaid/Medicare funds; for current employees, perform monthly checks of OIG LEIE and LDH State Adverse Actions.

ALL of the following

Document that persons are free from communicable tuberculosis (TB) via skin test or chest exam prior to employment; TB testing is completed less than 31 days prior to date of employment.
Establish and maintain written drug-testing policies and procedures to ensure an alcohol/drug-free workplace and document compliance.

ALL of the following

Direct care staff required to complete first aid and CPR training within 90 days of hire and renew per American Heart Association timelines (physicians, APRNs/PAs, RNs, LPNs may be exempt).
Unlicensed direct-care staff must complete standardized basic clinical competency modules (examples: MH 101, crisis intervention, suicide/homicide precautions, system of care overview, co-occurring disorders, cultural & linguistic competency, treatment planning) and annual crisis curriculum before handling crisis calls where specified.
Maintain documentation verifying completion of all required trainings, licensure, and professional requirements for staff.

ALL of the following

Specify minimum education/experience per program and role (examples: house manager ≥21 and ≥3 years older than oldest client; direct care staff at least 18 and ≥3 years older than clients under 18; certain crisis roles may require older minimums and college-level education).
Agencies must provide specified supervisory structures including medical director, clinical supervisor, and LMHP availability; supervising practitioners must provide 24-hour on-call coverage where required.

ALL of the following

Program- and level-specific minimum staff-to-client ratios (examples: TGH minimum two staff per living unit per shift with ratio not less than 1:5; PRTF ratios 1:4 (6 a.m.–10 p.m.) and 1:6 (10 p.m.–6 a.m.) with staff awake at night).
Clinical caseload limits where specified (example: PRTF caseloads do not exceed eight members).

ALL of the following

Comply with applicable federal/state emergency preparedness requirements (e.g., PRTF compliance with 42 CFR §441.184), maintain an all-hazards risk assessment, approved disaster/emergency plan, and crisis mitigation plans including 24-hour on-call telephone assistance and written contracts if services are outsourced.

ALL of the following

Agencies must maintain documentation of all required screenings, background checks, trainings, licensure, accreditation, staffing verifications, and agreements (including contracts for outsourced services or nursing/daycare providers).

inv-02: Operational provider participation criteria

Provider accreditation, licensing, staffing, background checks, training, and operational policies required for participation and reimbursement.

ALL of the following

Agency must be licensed per La. R.S. references for the service type and accredited by CARF, COA, or TJC for the location reviewed.
Agencies must attain full accreditation within 18 months of initial application and pay accreditation fees prior to contracting/reimbursement.

ALL of the following

Criminal background checks including sexual offender registry checks required prior to employment; background checks performed within program-specified lookback windows (commonly within 90 days, 30 days for some programs).
Review OIG LEIE and LDH State Adverse Actions prior to hiring/contracting; perform monthly LEIE and LDH Adverse Actions checks for current employees.

inv-03: Program staffing, training, screening and operational criteria

Staff, training, background check, supervision, accreditation and operational criteria for specific program types.

ALL of the following

PSR direct-service staff must have a bachelor’s degree in specified fields or a bachelor’s with qualifying minor, or be 21+ with HS diploma and continuous PSR employment since before Jan 1, 2019.
Staff providing direct PSR services must complete approved PSR training curricula covering daily/community living skills, socialization, adaptation, leisure development, symptom management, medication compliance, mental health education, and work readiness; youth staff require documented training in psychosocial rehabilitation models.

ALL of the following

Crisis Intervention staff must be at least 20 years old, at least 3 years older than clients under 18, have an associate degree or two years equivalent education/experience, pass motor vehicle screen if duties include driving, and complete nationally recognized crisis intervention training.

ALL of the following

inv-04: Operational and staffing criteria by service level

Provider-level operational, staffing, licensure, supervision, and monitoring requirements by ASAM level and for OTPs.

ALL of the following

Many ASAM levels and OTPs require physician on-call 24/7 and physician on-site/duty as needed; specific levels may require physician assessment within 24 hours of admission (e.g., ASAM 2-WM).

ALL of the following

Minimum on-site LMHP/UP hours commonly required (often 40 hours/week) and caseload ratios vary by level: examples include 1:50 (ASAM 1), 1:25 (ASAM 2.1/2-WM adult), 1:25 or 1:16 for several residential levels, 1:12 for some levels, and 1:10 for ASAM 3.7; adolescent 3.1 ratio examples: 1:8.

ALL of the following

Licensed nurse/RN on-call 24/7 is required for many levels; some levels require RN on-site no less than 40 hours/week (e.g., 3.7-WM) and nursing staff solely assigned to those programs where specified.

inv-05: Operational criteria for behavioral health programs

Program and staff requirements by program type (OTP, ACT, MST, FFT/FFT-CW, HomeBuilders):

ALL of the following

Programs must be licensed per La. R.S. 40:2151 et seq. (or other applicable statutes) for the location reviewed and accredited by CARF, COA, or TJC where specified; ACT teams must meet SAMHSA fidelity standards and attain full accreditation within 18 months of application with fees paid prior to contracting.

ALL of the following

Agencies must arrange criminal background checks (including sexual offender registry) prior to employment and document results; lookback windows vary by program (examples: 90 days for many programs, 30 days for ACT).
Review OIG LEIE and LDH State Adverse Actions prior to hiring/contracting and perform monthly checks for current employees.

ALL of the following

Codes, Ratios, and Capacity Limits

Not specified in this sectionmixed

No codes listed

mixed

No codes listed

Licensure citationsmixed

LAC 48:I, Chapter 50	Center-Based Respite per La. R.S. 40:2120.1 et seq.
La. R.S. 40:2180.12; LAC 48:I Chapters 53 and 54	Crisis Receiving Center licensing
La. R.S. 46:1401-46:1430; LAC 67:V, Chapter 73	Child Placing Agency licensing under the Specialized Provider Licensing Act

PRTF caseload maximum

PRTF caseload maximum8 members

Maximum adult PSR group size per FTE

Maximum adult PSR group size per FTEOne FTE to 15 consumers

Maximum adult CPST group size per FTE (for comparison)One FTE to 15 youth / One FTE to 25 adults noted in claims analysis

CPST provider staff-to-member ratio (adult)

CPST provider staff-to-member ratio (adult)One FTE to 25 adult members

Required Provider Actions and Monitoring

Prior Authorization

Pre-employment screening and exclusions checks

TGH, PRTF, Adult Crisis, CPST, SUD, OTP and other behavioral health provider agencies must perform pre-employment criminal background checks (including sexual offender registry checks) and document results prior to employment, contracting, or volunteering in accordance with applicable federal and state law. Criminal background checks must be performed no more than 90 days prior to the date of employment. Agencies must also ensure and retain documentation that staff are free from communicable tuberculosis per applicable guidance (TB testing within ~30–31 days of employment where specified) and meet any role-specific training and credential requirements.

Applicable to licensed and unlicensed staff, interns, contractors, and volunteers
TB testing: completed less than 30–31 days prior to employment where required
Role-based training (e.g., first aid/CPR, crisis curriculum) per program-specific rules

Denial Risk

Ongoing exclusion/adverse action monitoring

Defined Terms and Program Labels

PRTF definition and summary

DefinitionPsychiatric Residential Treatment Facility (PRTF): Licensed by the Louisiana Department of Health per LAC 48:1, Chapter 90 to provide residential psychiatric services for the location reviewed.

Accreditation & timelineMust be accredited by CARF, COA, or TJC for the location; attain full accreditation within 18 months of initial application and pay associated fees prior to contracting/reimbursement.

Operational requirementsMust perform criminal background checks (including sexual offender registry) no more than 90 days prior to employment and review OIG LEIE and LDH State Adverse Actions prior to hiring; maintain staffing, nursing, LMHP, and on-call physician availability as specified.

TGH definition and summary

DefinitionTherapeutic Group Home (TGH): Licensed by the Louisiana Department of Health per LAC 48:1, Chapter 62 to provide community-based residential services in a home-like setting of no greater than 10 beds for children under 21 under psychiatrist or psychologist supervision.

Policy Summary

PayerOptum

PolicyBehavioral health agency licensing and staffing requirements

Policy CodePolicy N/A

Change TypeNo material change

Effective Date

Next Review Date

SourceLink

On This Page

ALL of the following

Document TB screening showing individuals are free from communicable TB prior to employment; TB testing commonly completed less than 31 days before employment.
Establish and maintain written drug-testing policies and procedures to ensure an alcohol/drug-free workplace.

ALL of the following

Direct care staff must complete first aid and CPR within 90 days of hire and renew per AHA timelines (exemptions for physicians, APRNs/PAs, RNs, LPNs).
Unlicensed staff must complete standardized competency modules (MH101, crisis intervention, suicide/homicide precautions, system of care, co-occurring disorders, cultural competency, treatment planning) prior to providing services; quarterly or annual training documentation/submission required where specified.

ALL of the following

Medical director or designated prescriber must be available 24/7 for mobile, behavioral health crisis, and community brief crisis support; Behavioral Health Crisis Care requires at least two staff present and a minimum 1:4 staff-to-member ratio.

ALL of the following

One Recognized Peer Support Specialist (RPSS) per 25 active members; RPSS must meet LDH/OBH training, age, education, recovery-duration, NPI, and annual CEU/attestation requirements.

ALL of the following

CPST/PSR agencies must employ at least one full-time physician or LMHP as mental health supervisor (full-time = 35 hours/week); LMHPs in this role limited to specified license types.
Provider must be credentialed and participating in Medicaid managed care network to receive Medicaid reimbursement unless licensed and accredited and holding an executed single case agreement.

ALL of the following

Certain staff age minimums apply (examples vary by program); motor vehicle screen required if duties include driving/transporting members.

Agencies must have medical director, administrator, clinical supervisor, nursing staff, crisis mitigation plan; perform TB testing prior to employment; perform criminal background checks within 90 days; check OIG LEIE and LDH Adverse Actions prior to hiring and monthly thereafter; ensure unlicensed staff complete standardized competency modules and annual crisis curriculum.

ALL of the following

Residential substance use treatment facilities must be accredited by CARF/COA/TJC for location reviewed and attain full accreditation within 18 months of application; agencies must arrange criminal background checks within 90 days and perform OIG/LDH exclusion checks prior to hiring and monthly for current employees.
SUD providers must ensure appropriate medical director and clinical supervision arrangements, meet specified staff age/training requirements, and document required training and background checks.

ALL of the following

ASAM Level 1 (Outpatient) offers <9 clinical hours/week for adults (<6 for adolescents); each LMHP/UP caseload must not exceed 1:50; physician and nursing services must be available as needed; LMHP must be available at all times for crisis; clinical supervisor available on-site and on call.

ALL of the following

ASAM Level 2.1 intensive outpatient: adults minimum 9 clinical hours/week (3+ days) up to 19 hours; adolescents minimum 6 hours/week; physician on-site as needed and on-call 24/7; clinical supervisor on-site 10 hours/week and on-call 24/7; LMHP/UP caseload max 1:25; nursing services available as needed; LMHP available for crisis and supervision.

ALL of the following

ASAM Level 2-WM (Ambulatory Detox) must provide services with ASAM 2.1, have a physician on-site at least 10 hours/week and on-call 24/7, physician available to assess individuals within 24 hours of admission, LMHP/UP on-site 40 hours/week, licensed nurse on-site ≥40 hours/week and on-call 24/7, and LMHP supervision/consultation availability.

ALL of the following

Direct care aide requirements specify number of FTEs per shift and outing ratios that vary by level (examples: Level 3.1 adolescent: two FTEs per shift and 1:8 overall / 1:5 on outings; Level 3.5 requires two direct care aides with ratios up to 1:8).

ALL of the following

Care coordinator and clerical support typically required (examples: one FTE care coordinator per day shift; one to two FTE clerical support per day shift in PRTF).

ALL of the following

ASAM 3.7 requires an interdisciplinary team (physicians, nurses, counselors, social workers, psychologists) appropriate to client needs; staffing must ensure the team is available to assess and treat individuals.

ALL of the following

OTPs must maintain an approved disaster/emergency plan, coordinate access to the Methadone Central Registry for direct-care employees, maintain accreditation, perform pre-employment criminal background checks within 90 days, review OIG LEIE and LDH State Adverse Actions prior to hiring, and perform monthly LEIE/LDH checks for current employees.

ALL of the following

Agencies must maintain documentation verifying background checks, accreditation, staffing, and any agreements for outside nursing or other contracted services as applicable.

Document TB testing completed less than 31 days prior to employment across many program types; establish and maintain written drug-testing policies and procedures to ensure an alcohol/drug-free workplace.

ALL of the following

Direct care and unlicensed staff must complete specified training modules (MH101, crisis intervention, suicide/homicide precautions, system of care, co-occurring disorders, cultural & linguistic competency, treatment planning) and first aid/CPR within 90 days where required; some programs require quarterly training documentation and submission to SOTA and attestations to the MCO for unlicensed staff (e.g., FFT, HB).

ALL of the following

Caseload per LMHP/UP shall not exceed 75 active members (OTP context); ACT teams have maximum 1:10 staff-to-member ratio and must include specified roles (full-time LMHP team leader, prescriber, two nurses including one RN, other LMHPs, substance use specialist, employment and housing specialists, peer specialist).
MST, FFT, and HomeBuilders programs have defined degree, experience, certification, and contracting requirements for therapists, supervisors, and consultants (e.g., MST orientation and booster trainings, FFT certification by Institute for FFT, MST licensing by MST Services, Inc., HomeBuilders contract with Institute for Family Development).

ALL of the following

Providers must maintain crisis mitigation plans that include 24-hour on-call telephone assistance, steps for handling medical/psychiatric/medication/relapse crises, contact names/numbers, and written contracts if mitigation services are contracted out.

ALL of the following

Providers must maintain and submit documentation of background checks, training completion, accreditation, staffing qualifications, and quarterly training submissions to SOTA where required; unlicensed staff must submit attestations to MCO when specified.

ALL of the following

Licensed and unlicensed professional staff must be at least 18 years old (some programs require higher minimum ages); staff must generally be at least three years older than members under 18; program-specific degree/experience minima apply for therapists, supervisors, and consultants (e.g., FFT therapists master's-level; MST therapists master's-level; HB therapists master's-level or bachelor plus experience).

Mental health supervisor requirementAgency must employ at least one full-time physician or full-time LMHP as mental health supervisor (full-time = 35 hrs/week)

CPST provider staff-to-member ratio (youth)

CPST/PSR provider staff-to-member ratio (youth)One FTE to 15 youth members (PSR youth max group size is 8 in some contexts)

Staff age/education noteStaff must be at least three years older than clients under 18; PSR staff education requirements apply

ASAM contact hours

ASAM Level 1 contact hours (adults)Fewer than 9 clinical service hours per week

ASAM Level 2.1 contact hours (adults)Minimum 9 hours/week (at least 3 days) with a maximum of 19 hours/week

ASAM Level 2.1 contact hours (adolescents)Minimum 6 hours/week (at least 3 days) with a maximum of 19 hours/week

Before hiring or contracting any individual who will provide services paid with Medicaid or Medicare funds, agencies must check both the HHS OIG List of Excluded Individuals and Entities (LEIE) and the LDH State Adverse Actions list. For current employees and contractors, agencies must run monthly checks of the OIG LEIE and the LDH State Adverse Actions site to identify exclusions or adverse findings (including abuse, neglect, or extortion) and take appropriate action if a match is found. Maintain documentation of all exclusion checks and follow applicable remediation or reporting requirements.

Run LEIE and LDH Adverse Actions checks prior to hiring/contracting for any position compensated with Medicaid/Medicare funds
Perform monthly rechecks of LEIE and LDH Adverse Actions for current employees and contractors
Document results and actions taken for matches

Documentation Required

Crisis mitigation plan and on-call requirement

Providers delivering crisis services (including Adolescent/Child Crisis Stabilization and other MHR crisis programs) must maintain a written crisis mitigation plan that provides 24-hour on-call telephone assistance to prevent relapse or harm, provide referrals, and support during crises. If on-call services are outsourced, the contract or service arrangement must be documented and retained. Crisis plans should include procedures for triage, referral, recordkeeping, and timely escalation to clinical supervisors or emergency services as appropriate.

Maintain a 24-hour on-call telephone crisis mitigation plan
Document contracts or agreements when outsourcing on-call services
Include triage, referral, escalation, and documentation procedures in the plan

Note

OTP operational and credentialing actions

Opioid Treatment Programs (OTPs) must meet OTP-specific operational and credentialing obligations in addition to general provider requirements: maintain an up-to-date disaster and emergency plan approved by the SOTA, coordinate employee access to the Methadone Central Registry for direct care staff, and comply with applicable LDH licensing and accreditation rules. OTPs must perform the same pre-employment background and exclusions checks (including LEIE and LDH Adverse Actions) and monthly monitoring for current employees.

Maintain a disaster and emergency plan approved by the SOTA
Coordinate Methadone Central Registry access for direct care staff
Meet LDH licensing and accreditation requirements and perform background/exclusion checks and monthly rechecks

Billing Rule

Network participation and exclusion screening for reimbursement

Across programs, agencies must be credentialed and participating (contracted) in the Medicaid managed care provider network to be eligible for Medicaid reimbursement unless an executed single-case agreement applies. Credentialing and contracting processes must confirm compliance with licensure, accreditation, staff qualifications, and exclusion-screening requirements prior to reimbursement.

Credentialing and active participation in Medicaid managed care network required for reimbursement eligibility (unless single case agreement)
Credentialing must verify licensure, accreditation, required staff credentials, and exclusion screening

Capacity limitMust not exceed 10 beds at a location; staffing includes minimum two staff per living unit per shift and a ratio not less than 1:5.

Screening & accreditationMust be accredited by CARF, COA, or TJC for the location; perform criminal background checks within 90 days and review OIG LEIE and LDH State Adverse Actions prior to hiring.

Full-time definition for mental health supervisor

Full-time definitionFull-time (for mental health supervisor) means employment by the provider agency for at least 35 hours per week.

ApplicabilityApplies to CPST and PSR agencies requiring a full-time physician or full-time LMHP to serve as mental health supervisor.

Recognized Peer Support Specialist (RPSS)

DefinitionRecognized Peer Support Specialist (RPSS): Peer support staff with lived experience who must have an NPI, be at least 21 years old, have a high school diploma or GED, and complete LDH/OBH approved RPSS training.

Role & oversightProvided under administrative oversight of licensed and accredited local governing entities; RPSS must submit annual CEU documentation and an attestation of compliance with the Code of Ethics to OBH by December 31 each year.

Training and recoveryRequires documented clinical supervision hours (unless employed before Feb 1, 2021) and at least 12 months of continuous recovery; CEU distribution includes ethics and peer-support competencies.

PSR staffing qualifications

Eligibility pathwaysPSR direct-service staff must have a bachelor's degree in specified human services fields or a bachelor's with a minor in counseling/social work/psychology, or qualify via continuous employment pathway (21+ years old as of Jan 1, 2022 with HS diploma and continuous employment since before Jan 1, 2019).

Training requirementStaff providing direct services must complete approved PSR training curricula covering daily/community living skills, socialization, adaptation, leisure development, symptom management, medication compliance, mental health education, and work readiness prior to providing services.

SupervisionPSR agencies must employ at least one full-time physician or full-time LMHP as mental health supervisor (full-time = 35 hrs/week).

Exclusion screening definition

DefinitionExclusion screening: Review of the HHS OIG List of Excluded Individuals and Entities (LEIE) and the LDH State Adverse Actions list prior to hiring or contracting and monthly thereafter for current employees.

ScopeApplies to any employee or contractor whose services are compensated with Medicaid/Medicare funds, including licensed/unlicensed staff, interns, and contractors.

FrequencyMonthly checks required for current employees to determine exclusion or adverse action findings.

ASAM Level 2-WM definition

DefinitionASAM Level 2-WM (Ambulatory Detoxification with extended on-site monitoring): Licensed program providing ambulatory detox with evidence of service in conjunction with ASAM 2.1; requires physician on-site at least 10 hours/week and physician on-call 24/7.

Clinical monitoringPhysician must be available to assess individuals within 24 hours of admission, provide on-site daily monitoring and further evaluation; LMHP/UP on-site 40 hours/week and licensed nurse on-site no less than 40 hours/week with nurse on call 24/7.

Caseload and staffingEach LMHP/UP caseload must not exceed 1:25 active members; appropriately licensed staff must be available to administer medications per physician orders.

ASAM Level 3.1 definition

DefinitionASAM Level 3.1 (Clinically Managed Low-Intensity Residential Treatment): Residential program providing minimum of 5 hours/week of low-intensity clinical and recovery-focused services for adolescents and adults.

Adolescent-specific staffingAdolescents: LMHP/UP caseload not to exceed 1:8; at least two direct care aides (two FTE) per shift; direct care aide ratios 1:8 on shifts and 1:5 on therapy outings; LMHP/UP on duty 40 hours/week.

Adult-specific staffingAdults: LMHP/UP caseload not to exceed 1:25; at least one LMHP/UP on duty 40 hours/week and one direct care aide (one FTE) on all shifts; care coordinator required.

ASAM Level 3.2-WM definition

DefinitionASAM Level 3.2-WM (Clinically Managed Residential Detoxification): Residential detoxification requiring physician on-call 24/7 and physician on duty as needed; minimum LMHP/UP on-site 40 hours/week.

Caseloads & aidesAdolescents: LMHP/UP caseload max 1:16; two direct care aides per shift with ratio not to exceed 1:10; Adults: LMHP/UP caseload max 1:25; one direct care aide per shift with additional as needed.

Support staffAt least one clerical support staff per day shift and a care coordinator (one FTE per day shift); LMHP supervision and telephone consultation required.

ASAM Level 3.5 definition

DefinitionASAM Level 3.5 (Clinically Managed High-Intensity Residential Treatment): Licensed residential program providing high-intensity clinical services for adolescents and adults.

Adolescent staffing specificsAdolescents: LMHP/UP caseload not to exceed 1:8; at least two direct care aides (two FTE) on all shifts; RN on call 24/7; LMHP/UP on duty 40 hours/week.

Adult staffing specificsAdults: LMHP/UP caseload not to exceed 1:12; at least one direct care aide on all shifts; RN on call 24/7; on-site nursing coverage during day/evening shifts; care coordinator and clerical support required.

ASAM Level 3.7 / 3.7-WM definition

DefinitionASAM Level 3.7 (Medically Monitored Intensive Residential Treatment) and 3.7-WM (Medically Managed Residential Detoxification): Licensed residential programs requiring interdisciplinary teams and 24/7 physician on-call availability.

Nursing & LMHP staffingRequire at least one licensed RN on call 24/7, at least one licensed nurse on duty each shift, RN on-site minimum 40 hours/week for 3.7-WM; LMHP/UP on-site at least 40 hours/week with caseloads not to exceed 1:10.

Program exclusivityOn-site nursing staff must be solely responsible for the 3.7/3.7-WM program and not provide services for other levels of care concurrently; care coordinator and clerical support one FTE per day shift required.

OTP definition

DefinitionOpioid Treatment Program (OTP): Licensed by the Louisiana Department of Health per La. R.S. 40:2151 et seq. as an Opioid Treatment Program for the reviewed location.

Operational requirementsOTPs must maintain an approved disaster/emergency plan, coordinate Methadone Central Registry access for employees providing direct care, and meet accreditation and background screening requirements.

Screening & monitoringCriminal background checks performed no more than 90 days prior to employment; review OIG LEIE and LDH State Adverse Actions prior to hiring and perform monthly checks for current employees.

LMHP definition

DefinitionLicensed Mental Health Professional (LMHP): A licensed clinician required to be on-site when clinical services are provided and to serve in clinical supervisory roles per program requirements.

Full-time supervisorLMHP serving as a full-time mental health supervisor for CPST/PSR must be employed at least 35 hours per week; LMHPs must meet license-specific qualification requirements (e.g., LCSW, LPC, LMFT, medical psychologist, licensed psychologist, APRN with psychiatric specialization).

Clinical dutiesLMHPs provide clinical supervision, be available for crisis intervention (on-site or by phone) and meet caseload limits specified by ASAM level or program type.

OTP licensing reference

Licensing referenceOTP licensing: Opioid Treatment Programs are licensed by the Louisiana Department of Health per La. R.S. 40:2151 et seq.

Accreditation expectationOTPs must be accredited by CARF, COA, or TJC for the location reviewed as specified.

ACT definition

DefinitionAssertive Community Treatment (ACT): Multi-disciplinary team-based service meeting SAMHSA ACT fidelity standards and licensed by LDH per La. R.S. 40:2151 et seq. for the location reviewed.

Team composition & ratioACT teams must include required roles (team leader, prescriber, nurses, LMHPs, substance use specialist, employment/housing specialists, peer specialist) and adhere to a maximum staff-to-member ratio of 1:10.

Accreditation & timelineACT agencies must attain full accreditation within 18 months of the initial accreditation application date and pay associated fees prior to contracting/reimbursement.