NDAC 75-09.1-04

NDAC 75-09.1-04 Medically Monitored Intensive Inpatient Treatment - Adult ASAM Level III.7

This chapter establishes licensing and operating standards for Medically Monitored Intensive Inpatient Treatment programs at ASAM Level III.7 in North Dakota, specifically for adults. Providers must offer 24-hour skilled nursing care, daily onsite counseling, and around-the-clock physician availability. Admission requires a DSM substance dependence diagnosis and meeting at least two ASAM dimensions, with at least one in dimensions one, two, or three (withdrawal, biomedical, or psychiatric). Program criteria include individual and group therapy, medical and nursing services for acute detoxification, family treatment, and educational programming.

CHAPTER 75-09.1-04
MEDICALLY MONITORED INTENSIVE INPATIENT TREATMENT - 
ADULT ASAM LEVEL III.7
Section
75-09.1-04-01 Definition
75-09.1-04-02 Provider Criteria
75-09.1-04-03 Program Criteria
75-09.1-04-04 Admission Criteria
75-09.1-04-01. Definition.
As used in this chapter, "medically monitored intensive inpatient treatment" means a substance 
abuse treatment program that provides a planned regimen of twenty -four-hour professionally directed 
evaluation, observation, medical monitoring, and addiction treatment in an inpatient setting. This 
program is appropriate for a client whose subacute detoxification, withdrawal, biomedical, and 
emotional, behavioral, or cognitive problems are so severe that they require inpatient treatment but who 
does not need the full resources of an acute care general hospital or a medically managed inpatient 
treatment program.
History: Effective October 26, 2004.
General Authority: NDCC 50-06-16, 50-31
Law Implemented: NDCC 50-31
75-09.1-04-02. Provider criteria.
A medically monitored intensive inpatient treatment program shall:
1. Offer twenty-four-hour skilled nursing care, daily onsite counseling services, and a physician's 
services twenty-four hours per day seven days per week;
2. Make available specialized professional consultation; and
3. Offer the inpatient treatment program for seven days per week with the length of stay to be 
determined by a client's condition and functioning. 
History: Effective October 26, 2004.
General Authority: NDCC 50-06-16, 50-31
Law Implemented: NDCC 50-31
75-09.1-04-03. Program criteria.
A medically monitored intensive inpatient treatment program shall provide:
1. A combination of individual and group therapy as deemed appropriate by an assessment and 
treatment plan;
2. Medical and nursing services available onsite to provide ongoing assessment and care of 
acute detoxification needs, medical, and psychiatric problems;
3. A system for referral of clients for identified treatment needs if the service is not available in 
the program;
4. Family treatment services as deemed appropriate by an assessment and treatment plan; and 
5. Educational and informational programming adapted to individual client needs. 
History: Effective October 26, 2004.
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General Authority: NDCC 50-06-16, 50-31
Law Implemented: NDCC 50-31
75-09.1-04-04. Admission criteria.
Before a medically monitored intensive inpatient program may admit a client, the client shall:
1. Meet diagnostic criteria for a substance dependence disorder of the DSM; and
2. Meet specifications in at least two of the six ASAM dimensions, at least one of which is in 
dimension one, two, or three as in the following criteria:
a. The client is experiencing signs and symptoms of acute withdrawal or there is evidence 
that a severe withdrawal syndrome is imminent or there is a strong likelihood that the 
client who requires medication will not complete detoxification at another level of care 
and enter continued treatment or self-help recovery;
b. The client has a physical condition or complication impacting immediate safety or 
well-being; 
c. The client has a psychiatric condition or complication impacting immediate safety or 
well-being;
d. The client exhibits severe impairment in significant life areas such as legal, family, or 
work;
e. The client exhibits significant loss of control and relapse symptoms; or
f. The client has had multiple attempts at treatment programs of lower intensity with an 
inability to stay sober. 
History: Effective October 26, 2004.
General Authority: NDCC 50-06-16, 50-31
Law Implemented: NDCC 50-31
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