Current through all regulations passed and filed through September 16, 2024
This rule is to supersede rule
5122-29-09 of the Administrative Code with the effective date of October 31,
2019. This rule will be effective July 1, 2023.
(A) Residential substance use disorder
services shall be provided in accordance with the American society of addiction
medicine's (ASAM) level of care three and ASAM's level of care three-withdrawal
management (WM), and associated sub levels as
appropriate to the needs of the individual being served; as published in the
ASAM criteria, third edition, 2013.
(B) A provider certified to provide this
service, may provide ASAM level of care two-withdrawal management.
(C)
For the purposes
of this rule "family" means any individual or caregiver related by blood or
affinity whose close association with the person is the equivalent of a family
relationship as identified by the person including kinship and foster
care.
(D)
Each provider shall have written
policies and procedures to ensure its referral process to other levels of care is appropriately implemented
and managed and shall include, at a minimum, the following:
(1) Referral decisions made to the
appropriate level of care as determined utilizing the American society of
addiction medicine criteria protocols for levels of care. Documentation of
referral shall appear in the client record.
(2) Discharge plan stipulating specific
recommendations and referrals for alcohol and drug addiction treatment. The
discharge plan shall be documented in the client record.
(3) Follow-up communications with client and
the service provider to which client is referred. These contacts shall be
documented in the client's record.
(4)
Provisions for
the transition of the client to other SUD treatment providers. Provisions for
use of transition communications conducted in person to include staff members
of the rendering provider organization, the SUD treatment program to which the
patient is being referred, the patient, and family, if present.
(E)
Each
provider rendering services pursuant to this rule will be capable of admitting,
initiating, and referring clients receiving medication assisted treatment and
capable of facilitating the continuity of their pharmacotherapy through care
transitions, including but not limited to other levels of care for behavioral
health treatment, hospitals, community-based providers, and criminal justice
settings.
(F) Each provider of
this service shall provide, in addition to the required ASAM level of care:
(1) Food for clients, to include at least
three nutritionally-balanced meals and at least one nutritious snack per day,
seven days per week;
(2) The
opportunity for clients to get eight hours of sleep per night; and,
(3) Services in facilities that are clean,
safe, and therapeutic.
(G) Time for meals,
unstructured activities, free time, or time spent in attendance of self-help
groups, such as alcoholics anonymous or narcotics anonymous shall not be
considered for the purposes of meeting ASAM level of care requirements for
services.
(H) Providers shall
promote interpersonal and group living skills.
(1) A service
provider may require clients to perform tasks of a housekeeping nature as
specified within service provider guidelines.
(2) Housekeeping tasks shall not be
considered for the purposes of meeting ASAM level of care requirements for
services.
(I)
Providers will offer medication assisted treatment on
site or through facilitated access off site.
(J)
Providers will
connect clients to resources for education, job training, job interviews,
employment stabilization and obtaining alternative living
arrangements.
(K)
Providers of ASAM level of care 3.1 will:
(1)
Have a prescriber
as part of the interdisciplinary team either through employment or contractual
arrangement; however, the prescriber does not provide direct services;
and,
(2)
Offer at least five hours per week of low intensity
treatment of substance use disorders.
(L)
Providers of ASAM
level of care 3.3 will:
(1)
Include, in addition to the ASAM specified
interdisciplinary team members, peer supporters certified pursuant to rule
5122-29-15.1 of the Administrative Code as appropriate and available to the
range and severity of the residents' problems.
(2)
Have an
appropriately credentialed, licensed addictions clinician manage the
program.
(3)
Have one appropriately certified or licensed addictions
clinician on site days and a certified or licensed chemical dependency
counselor or similar with telephonic availability during the remaining
hours.
(4)
Offer at least thirty hours per week of a combination
of skilled treatment services, clinically managed services and recovery support
services focused on individuals where the effects of the substance use or a
co-occurring disorder has resulted in cognitive impairment. At least ten of the
thirty hours is to include individual, group, or family
counseling.
(5)
Have staff with the knowledge and skills to work with
patients with cognitive limitations.
(6)
Have therapies,
for clients with significant cognitive deficits, delivered in a manner to
promote engagement and understanding of concepts that is slower paced, more
concrete, and more repetitive.
(7)
Have addiction
treatment professionals with sufficient cross-training to recognize the signs
and symptoms of co-occurring mental disorders and initiate treatment
interventions (treatment within the program or referral to treatment outside
the program) to address identified behavioral health needs.
(M)
Providers of ASAM level of care 3.2 -WM and 3.5 will:
(1)
Include, in
addition to the ASAM specified interdisciplinary team members, peer supporters
certified pursuant to rule 5122-29-15.1 of the Administrative Code as
appropriate and available to the range and severity of the residents'
problems.
(2)
Have an appropriately credentialed, licensed addictions
clinician manage the program.
(3)
Have one
appropriately certified or licensed addictions clinician on site days and a
certified or licensed practitioner with a declared scope of practice that
includes treating people with SUDs in the evenings, with telephonic
availability during evenings and nights. A nurse, physician assistant,
physician, or emergency services will be available twenty-four hours a day
either on site or with telephonic availability.
(4)
Offer at least
thirty hours per week of a combination of skilled treatment services,
clinically managed services and recovery and withdrawal (for 3.2 -WM programs)
support services focused on individuals who have significant social and
psychological problems. At least ten of the thirty hours is to include
individual, group, or family counseling.
(5)
Have addiction
treatment professionals with sufficient cross-training to recognize thee signs
and symptoms of co-occurring mental disorders and initiate treatment
interventions (treatment within the program or referral to treatment outside
the program) to address identified behavioral health needs.
(6)
If the provider
primarily provides this ASAM level of care to adolescents who have not
graduated from high school or who have not passed a general education
development (GED) test, offer at least twenty hours per week of a combination
of skilled treatment services, clinically managed services and recovery and
withdrawal (for 3.5 -WM adolescent programs) support services focused on
individuals who have significant social and psychological problems. At least
ten of the twenty hours is to include individual, group, or family counseling.
The provider will also provide year round schooling.
(N)
Providers of ASAM
level of care 3.7 -WM and 3.7 will:
(1)
Include, in addition to the ASAM specified
interdisciplinary team members, peer supporters certified pursuant to rule
5122-29-15.1 of the Administrative Code as appropriate and available to the
range and severity of the residents' problems.
(2)
Have one
appropriately certified or licensed addictions clinician on site days and
evenings, with telephonic availability during the remaining
hours.
(3)
Offer at least thirty hours per week of a combination
of skilled treatment services, clinically managed services and recovery and
withdrawal (For 3.7 WM programs) support services focused on individuals with
subacute biomedical and emotional, behavioral, or cognitive problems. At least
ten of the thirty hours is to include individual, group, or family
counseling.
(4)
Have addiction treatment professionals with sufficient
cross-training to recognize the signs and symptoms of co-occurring mental
disorders and initiate treatment interventions (treatment within the program or
referral to treatment outside the program) to address identified behavioral
health needs.
(O) All component
practitioner services must be provided in accordance with Chapter 5122-29 of
the Administrative Code.
(P) A health history,
including food allergies and drug reactions, shall be completed on or before
admission to a provider of this service.
(Q)
Each provider of this service
organized to serve individuals under the age of
eighteen shall provide services in a manner that is developmentally
appropriate, addresses educational needs, and
promotes family or significant other
involvement.
(R) Services provided
pursuant to this rule shall be provided and supervised by staff who are
qualified according to rule
5122-29-30
of the Administrative Code.
