Current through Register Vol. 18, September 20, 2024
(1) To be licensed to provide clinically
managed residential withdrawal management defined as ASAM 3.2-WM, a provider
must be licensed as an inpatient or residential health care facility program
pursuant to
50-5-101,
MCA, and meet the following:
(a) The facility
must be equipped for clients who are impaired due to substances and may require
safety rails on beds pursuant to ARM Title 37, chapter 106, subchapter 29,
handrails on showers, and other related equipment to assure the safety of
impaired clients.
(b) The SUDF must
have physician approved protocols for the monitoring of clients in withdrawal
including when and under what circumstances clients should be transferred to
another health care facility.
(c)
The SUDF must have a written agreement with the health care facility or
physician providing for emergency services when needed.
(d) The SUDF must have written procedures
specifying how staff will respond to emergencies and for the transfer of
medically unstable clients.
(e) The
SUDF must have sufficient staff on duty 24 hours a day, seven days a week to
supervise, observe, and support clients who are intoxicated or experiencing
withdrawals.
(f) The SUDF must
train staff in physician approved protocols for monitoring clients in
withdrawal and in medication management if medication is
administered.
(g) The SUDF must
have licensed addiction counselors (LAC) or mental health professionals in
sufficient numbers to provide counseling and therapy services as described in
this chapter and in accordance with the client's individualized treatment
plan.
(h) The initial
biopsychosocial assessment indicating this level of care must be reviewed by a
licensed physician, nurse practitioner, or physician assistant during the
admission process.
(i) The SUDF
must provide daily clinical skilled treatment services to address the needs of
each client. Clinical skilled treatment services may include medical services,
individual and group therapy, and withdrawal support as required in the
client's individualized treatment plan.
(j) The SUDF must ensure regular vital signs
are taken and recorded by staff trained to recognize symptoms indicating the
client is becoming physically unstable.
(k) All progress notes must be completed in a
timely manner and before the next session of the same type, or there must be
documentation why this did not occur.
(l) Coordination of necessary services
(medical, laboratory, toxicology, psychiatric, psychological, emergency) or
other levels of care must be available through direct affiliation or referral
processes.
(2) The
facility providing clinically managed residential withdrawal management (ASAM
3.2) must not exceed the number of inpatient or residential beds licensed for
pursuant to
50-5-101
MCA.
(3) To be licensed to provide
medically managed inpatient withdrawal, as defined as ASAM Level 3.7-WM, a
provider must be licensed as an inpatient substance use disorder facility and
meet the requirements under ARM
37.106.1475
and the following:
(a) a RN must be on-site 24
hours a day, seven days a week to monitor clients receiving acute intoxication
or withdrawal management services and administer services according to
physician approved protocols;
(b)
the facility must be equipped for clients who are impaired due to substances
and who require assistive safety devices, as written in the physician approved
protocols;
(c) all bathtubs and
showers must be equipped with a safety handrail; and
(d) emergency equipment to include:
(i) oxygen;
(ii) automatic external defibrillator
(AED);
(iii) suction machine;
and
(iv) other emergency equipment
according to the physician approved protocols for responding to client health
emergencies.
AUTH:
50-5-103,
53-24-208,
MCA; IMP:
50-5-101,
50-5-103,
53-24-208,
53-24-209,
76-2-411,
MCA
