Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0054 - Substance Abuse
Chapter 4 - DESCRIPTION OF SERVICES AND REQUIREMENTS FOR SUBSTANCE ABUSE SERVICES
Section 4-15 - Detoxification Services
Universal Citation: WY Code of Rules 4-15
Current through September 21, 2024
(a) Detoxification services must meet all applicable standards, Chapters 1 and 2, and Sections 1 through 9, and Section 14 of Chapter 4, of these standards, including the following service level requirements.
(b) Clinically Managed Residential Social Detoxification.
(i) Description of Services.
A social detoxification service, per ASAM description, is an organized service
that may be delivered by appropriately trained staff that provides 24-hour
supervision, observation and support for clients who are intoxicated or
experiencing withdrawal. Services must integrate serial inebriate elements to
services. Social Detoxification services are characterized by their emphasis on
peer and social support. This service must meet all therapeutic and physical
plant requirements of Chapter 4, Section 14.
(ii) Required Personnel. A social
detoxification service shall ensure that a client receives appropriate
information and consultation from a licensed clinical staff person when
possible regarding treatment options before the scheduled discharge of the
client from the service. Program staff will be cross trained and will implement
motivational enhancement techniques to engage clients into treatment.
(A) Access to a physician shall be available
via on call protocol on a twenty-four (24) hours a day, seven (7) days a week
basis.
(B) Services shall have
sufficient clinical staff and support staff to meet the needs of the
client.
(C) All staff persons who
assess and treat clients must be able to obtain and interpret information
regarding the needs of clients, and must be knowledgeable about the
bio-psychosocial dimensions of alcohol and other drug dependence.
(iii) Service Operations.
(A) The program shall maintain a standard
detoxification protocol that includes emergency procedures, which are reviewed
and approved by a physician at least annually.
(B) The program shall have immediate access
to first aid supplies.
(C) Service
shall have separate locked cabinets exclusively for pharmaceutical
supplies.
(D) The program shall
have written policies and procedures for the management of belligerent and
disturbed clients, which shall include transfer of a client to another
facility, if necessary.
(E) If
possible, the program shall develop a discharge plan for each client that
addresses the client's follow-up service needs and the provision for referral,
escort, and transportation to other treatment services, as necessary, to ensure
the continuity of care.
(c) Medically-Monitored Residential Detoxification Services.
(i) Description of
Services. A medically-monitored detoxification service, per ASAM description,
is an organized service delivered by medical and nursing professionals, which
provides twenty-four (24) hours a day, seven (7) days a week medically
supervised evaluation and withdrawal management in a permanent facility with
inpatient beds. Services are delivered under a set of physician-approved
policies and physician-monitored procedures or clinical protocols. This service
must meet all therapeutic and physical plant requirements of Chapter 4, Section
14.
(ii) Required Personnel.
(A) The program shall ensure that a client
receives consultation from a substance use clinical staff person before the
client is discharged from the service.
(B) The program shall ensure there is
sufficient clinical staff to meet the needs of clients served.
(C) The program shall have a medical director
who is appropriately licensed or registered in the State of Wyoming and is
responsible for overseeing the monitoring of the client's progress and
medication administration, and who is trained and competent to implement
physician approved protocols for client observation and supervision.
(D) A Registered Nurse or Licensed Practical
Nurse shall be available on site on a twenty-four (24) hours a day, seven (7)
days a week basis, and will conduct a nursing assessment on the client at the
time of admission.
(E) A physician
shall be available on-call twenty four (24) hours a day, seven (7) days a
week.
(F) All staff that assess and
treat clients must be able to obtain and interpret information regarding the
needs of clients, and must be knowledgeable about the bio-psychosocial
spiritual dimensions of alcohol and other drug dependence.
(iii) Service Operations.
(A) The staff physician shall review and
document the medical status of a client within twenty-four (24) hours after
admission.
(B) The program shall
have written policies and procedures for the management of belligerent and
disturbed clients, which shall include transfer of a client to another
appropriate facility.
(C) The
program shall have written agreement with a certified substance abuse service
program, if not provided on-site at the service, to provide ongoing care
following the client discharge from the facility.
(D) The program shall have a written
agreement with a hospital or local medical clinic to provide emergency medical
services for clients, if determined to be clinically necessary.
(E) The program shall develop with each
client a detoxification plan and a discharge plan that addresses the client's
follow-up service needs, determined from the application of approved client
placement criteria administered by qualified clinical staff, and shall include
provision for referral, escort, and transportation to other treatment services,
as necessary, to ensure that continuity of care is provided.
(d) Medically-Managed Intensive Inpatient Detoxification Services.
(i) Description of Services. A
medically-monitored detoxification service, per ASAM description, is an
organized service delivered by medical and nursing professionals that provides
for 24-hour, medically directed evaluation and withdrawal management in an
acute care inpatient setting. Services are delivered under a defined set of
physician-approved policies and physician managed procedures or medical
protocols. This service must meet all therapeutic and physical plant
requirements of Chapter 4, Section 14.
(ii) Required Personnel.
(A) The program shall ensure that a client
receives consultation from a substance use clinical staff person before the
client is discharged from the service.
(B) The program shall ensure there is
sufficient clinical staff to meet the needs of clients served.
(C) The program shall have a medical director
who is appropriately licensed or registered in the State of Wyoming and is
responsible for overseeing the monitoring of the client's progress and
medication administration, and who is trained and competent to implement
physician approved protocols for client observation and supervision.
(D) A Registered Nurse or Licensed Practical
Nurse shall be available on site on a twenty-four (24) hours a day, seven (7)
days a week basis, and will conduct a nursing assessment on client at the time
of admission.
(E) Physicians shall
be available twenty-four (24) hours a day, seven (7) days a week, as an active
member of an interdisciplinary team who medically manage the care of the
client.
(F) All staff that assesses
and treats clients must be able to obtain and interpret information regarding
the needs of clients, and must be knowledgeable about the bio-psychosocial
spiritual dimensions of alcohol and other drug dependence.
(iii) Service Operations.
(A) The staff physician shall review and
document the medical status of a client within twenty-four (24) hours after
admission.
(B) The program shall
have written policies and procedures for the management of belligerent and
disturbed clients, which shall include transfer of a client to another
appropriate facility.
(C) The
program shall have written agreement with a certified substance abuse service
program, if not provided on-site at the service, to provide ongoing care
following the client discharge from the facility.
(D) The program shall have a written
agreement with a hospital or local medical clinic to provide emergency medical
services for clients, if determined to be clinically necessary.
(E) The program shall develop with each
client a detoxification plan and a discharge plan that addresses the client's
follow-up service needs, determined from the application of approved client
placement criteria administered by qualified clinical staff, and shall include
provisions for referral, escort, and transportation to other treatment
services, as necessary, to ensure that continuity of care is
provided.
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