Level 2.5 ASAM Criteria Service Definition and Required Components Substance Abuse Comprehensive Outpatient Treatment (SACOT) program means:  a periodic service that is a time-limited, multi-faceted approach treatment service for adults who require structure and support to achieve and sustain recovery.

SACOT Program is a service emphasizing:

• reduction in use of substances or continued abstinence;
• the negative consequences of substance use;
• development of social support network and necessary lifestyle changes;
• educational skills;
• vocational skills leading to work activity by reducing substance use as a barrier to employment;
• social and interpersonal skills;
• improved family functioning;
• the understanding of addictive disease; and
• the continued commitment to a recovery and maintenance program.

These services are provided during day and evening hours to enable individuals to maintain residence:

• in their community,
• continue to work or go to school,
• and to be a part of their family life.

The following types of services are included in the SACOT Program:

•  individual counseling and support;
• group counseling and support;
• family counseling, training or support;
• biochemical assays to identify recent drug use (e.g., urine drug screens);
• strategies for relapse prevention to include community and social support systems in treatment;
• life skills;
• crisis contingency planning;
• disease management; and
• treatment support activities that have been adapted or specifically designed for individuals with physical disabilities; or individuals with co-occurring disorders of mental illness and substance use; or an intellectual and developmental disability and substance use disorder.

SACOT programs can be designed for homogenous groups of individuals, including:

• individuals being detoxed on an outpatient basis;
• individuals with chronic relapse issues;
• pregnant women, and women and their children;
• individuals with co-occurring mental health and substance use disorders;
• individuals with HIV; or
• individuals with similar cognitive levels of functioning.

NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services Enhanced Mental Health and Substance Abuse Services Date Amended: August 1, 2022 State 76 -Funded Enhanced MH/SA Services – August 1, 2022 SACOT includes case management to arrange, link or integrate multiple services as well as assessment and reassessment of the individual’s need for services.

SACOT services also:

• inform the individual about benefits, community resources, and services;
• assist the individual in accessing benefits and services;
• arrange for the individual to receive benefits and services; and
• monitor the provision of services. Individuals receiving SACOT may be residents of their own home, a substitute home, or a group care setting; however, the SACOT Program must be provided in a setting separate from the individual’s residence.
• This service must operate at least 20 hours per week and offer a minimum of 4 hours of scheduled services per day, with availability at least 5 days per week with no more than 2 consecutive days without services available.
• The individual must be in attendance for a minimum of 4 hours a day.
• Group counseling services must be offered each day the program operates. Services must be available during both day and evening hours.

• be familiar with the SACOT Program treatment plan for each individual seen in consultation,
• shall have access to SACOT Program treatment records for the individual, and
• shall be able to consult by phone or in person with the CCS, LCAS, CSAC or CADC providing SACOT Program services.

• The program must be under the clinical supervision of a CCS or LCAS who is on site a minimum of 90% of the hours the service is in operation.
• Clinical services may also be provided by staff who meet the requirements specified for QP or AP status for Substance Abuse according to 10A NCAC 27G .0104, under the supervision of a CCS or LCAS.

• These services shall be delivered by a psychiatrists who meet requirements as specified in NCAC 27G .0104.
• The providers shall be familiar with the SACOT Program treatment plan for each individual seen in consultation, shall have access to SACOT Program treatment records for the individual, and shall be able to consult by phone or in person with the CCS, LCAS, CSAC or CADC providing SACOT Program services.