This North Dakota regulation establishes licensing and operating standards for Medically Monitored High-Intensity Inpatient Substance Abuse Treatment programs at ASAM Level III.7 specifically for adolescents. Providers must offer 24-hour skilled nursing care, daily onsite counseling, and around-the-clock physician availability. Program requirements include individual and group therapy, medical/nursing services for detoxification and psychiatric needs, family treatment, and onsite or contracted educational services appropriate for school-age clients. Admission requires a DSM substance-related disorder diagnosis and meeting at least two ASAM dimensions, with at least one in dimensions one, two, or three.
View official sourceCHAPTER 75-09.1-04.1 MEDICALLY MONITORED HIGH-INTENSITY INPATIENT TREATMENT - ADOLESCENT ASAM LEVEL III.7 Section 75-09.1-04.1-01 Definition 75-09.1-04.1-02 Provider Criteria 75-09.1-04.1-03 Program Criteria 75-09.1-04.1-04 Admission Criteria 75-09.1-04.1-01. Definition. As used in this chapter, "medically monitored intensive inpatient treatment program" 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 clients whose subacute detoxification, withdrawal, biomedical, and emotional, behavioral, or cognitive problems are so severe that they require inpatient treatment but who do 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 75-09.1-04.1-02. Provider criteria. A medically monitored intensive inpatient treatment program shall: 1. Offer twenty-four-hour skilled nursing care, daily onsite counseling services, and the services of a physician twenty-four hours per day seven days per week; 2. Make specialized professional consultation available; 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 75-09.1-04.1-03. 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 such services are not available in the program; 4. Family treatment services as deemed appropriate by an assessment and treatment plan; 5. Educational and informational programming adaptive to individual client needs; and 1 6. Onsite staff provided or contracted accredited educational services if a client is still in school; general educational development preparation if the client does not possess a high school diploma and is no longer in school; or short -term educational services linked to home school designed to maintain current learning. History: Effective October 26, 2004. General Authority: NDCC 50-06-16, 50-31 Law Implemented: NDCC 50-31 75-09.1-04.1-04. Admission criteria. Before a medically monitored intensive inpatient program may admit a client, the client must: 1. Meet diagnostic criteria for a substance-related 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 or at risk of acute or subacute intoxication or withdrawal with moderate to severe signs and symptoms 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. A biomedical complication of addiction or co -occurring medical condition requires active nursing and medical monitoring which does not require the resources of an acute care hospital or continued substance use would place the client at risk for serious damage to physical health because of a co-occurring biomedical condition; c. The client has problems in one of the following areas requiring twenty-four-hour supervision and a high -intensity therapeutic milieu with access to nursing and medical monitoring and treatment; dangerousness or lethality; interference with addiction recovery efforts; social functioning; ability for self-care; or course of illness; d. The client exhibits severe impairment in significant life areas such as legal, family, school, 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 2