{"id":376,"date":"2025-02-25T17:30:13","date_gmt":"2025-02-25T17:30:13","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dsamh\/eeuprociv\/"},"modified":"2025-02-25T17:30:13","modified_gmt":"2025-02-25T17:30:13","slug":"eeuprociv","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dsamh\/eeuprociv\/","title":{"rendered":"eeuprociv ~  IV. Utilization Review  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n  <br>\n\n  \n\n  <div class=\"container\" id=\"main_header\">\n\n     <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dsamh\/eeuprociv.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1><!--[type=EDIT name=\"Page Title\"]-->IV. Utilization Review<!--[END]--><\/h1>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Substance Abuse and Mental Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dsamh\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n    <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n    <li>\n      <a href=\"\/dsamh\/about.html\">About DSAMH<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/sections.html\">Sections &#038; Programs<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/faq.html\">FAQs<\/a>\n    <\/li>\n    \n    <li>\n      <a href=\"\/dsamh\/contact.html\">Contact Information<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/ofclocations.html\">Office Locations<\/a>\n    <\/li>\n  <\/ul><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n    <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">  \n   <!-- <li>\n      <a href=\"\/dsamh\/cccp_red.html\">CCCP & Residential Programs<\/a>\n    <\/li>-->\n        <li>\n      <a href=\"\/988.html\">988<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/crisis_intervention.html\">Crisis Intervention<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/court_programs.html\">Court Programs<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/mental_health_cmhc.html\">PROMISE Assessment Center&#8217;s<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/dpc.html\">Delaware Psychiatric Center<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/eeu_home.html\">Eligibility &#038; Enrollment Unit<\/a>\n    <\/li>\n   \n   \n      <li>\n      <a href=\"\/dsamh\/peerservices.html\">Peer Services<\/a>\n    <\/li>\n\n  \n    <li>\n      <a href=\"\/dsamh\/promise.html\">PROMISE<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/gambling.html\">Problem Gambling<\/a>\n    <\/li>\n    \n    <li>\n      <a href=\"\/dsamh\/substance_abuse.html\">Substance Abuse<\/a>\n    <\/li>\n \n    <li>\n      <a href=\"\/dsamh\/tasc.html\">Treatment Access Centers<\/a>\n    <\/li>\n  <\/ul><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n    <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n    <li>\n      <a href=\"\/dsamh\/train.html\">Training<\/a>\n    <\/li>\n   \n    <li>\n      <a href=\"\/dsamh\/screenerscorner.html\">Mental Health Screener&#8217;s Corner<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/recovery_resources.html\">Recovery Resources<\/a>\n    <\/li>\n    <li>\n      <a href=\"\/dsamh\/regs.html\">Regulations<\/a>\n    <\/li>\n \n    <li>\n      <a href=\"\/dsamh\/residency\/index.html\">Residency<\/a>\n    <\/li>\n   \n  \n         <li>\n      <a href=\"\/dsamh\/policies\/index.html\">Provider Policies  &#038; Resources<\/a>\n    <\/li>\n         \n        \n        \n        \n  <\/ul><\/li>\n<!--    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n  <ul id=\"SocialMenu\">\n    <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" title=\"Division of Public Health Facebook Page\" target=\"_blank\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n    <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" title=\"Delaware Health and Social Services Twitter Account\" target=\"_blank\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n  <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n    <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n    <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n    <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n    <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n    <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li>\n  <\/ul>\n<\/li> -->\n<\/ul>\n\n\n\n              <\/div>\n\n            <\/div>\n\n          <\/div>\n\n        <\/div><br>\n\n      <\/div>\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n  <!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n<p>\n\n\n  An enrollee\u2019s continued eligibility for the DSAMH LTC system will be monitored by the EEU. The EEU will analyze utilization\n\n\n  patterns on an individual and aggregate basis for all enrollees and will identify enrollees whose utilization appear low given the\n\n\n  individual&#8217;s identified clinical needs at enrollment. When the EEU has identified under-utilizing consumers, it will ask the provider\n\n\n  to submit a Consumer Status Review so that the EEU can work with the provider to analyze reasons for low service utilization; evaluate\n\n\n  the provider\u2019s response to the consumer\u2019s use of service; and determine additional outreach activities which may be required.\n\n\n<\/p>\n\n\n<p>\n\n\n  The EEU will conduct sample chart reviews to review enrollees&#8217; clinical status, treatment, rehabilitation and support service needs\n\n\n  and receipt of such services. All service utilization and provision will be assessed in terms of progressing toward recovery goals. The\n\n\n  EEU will also review the \u201cDays Lapse Report\u201d to monitor consumers\u2019 active service connection.\n\n\n<\/p>\n\n\n<p>\n\n\n  The EEU will notify the Primary Service Provider when it identifies consumers who have either not engaged in treatment or who appear to\n\n\n  be withdrawing from treatment. When the EEU identifies an enrollee as potentially able to be disenrolled from the LTC system, it will\n\n\n  conduct a clinical review with the Primary Service Provider to assess the individual&#8217;s self-care potential and recovery status.\n\n\n<\/p>  <!--[END]-->\n\n  \n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Listen IV. Utilization Review Substance Abuse and Mental Health Menu Home About About DSAMH Sections &#038; Programs FAQs Contact Information Office Locations Services 988 Crisis Intervention Court Programs PROMISE Assessment Center&#8217;s Delaware Psychiatric Center Eligibility &#038; Enrollment Unit Peer Services PROMISE Problem Gambling Substance Abuse Treatment Access Centers Information Training Mental Health Screener&#8217;s Corner Recovery [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-376","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dsamh\/wp-json\/wp\/v2\/pages\/376","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dsamh\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dsamh\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dsamh\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dsamh\/wp-json\/wp\/v2\/comments?post=376"}],"version-history":[{"count":0,"href":"https:\/\/dhss.delaware.gov\/dsamh\/wp-json\/wp\/v2\/pages\/376\/revisions"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dsamh\/wp-json\/wp\/v2\/media?parent=376"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}