This North Dakota regulation establishes standards for adolescent substance use partial hospitalization (day treatment) programs at ASAM Level II.5. Providers must offer at least 20 hours of structured programming per week across a minimum of four days, ensure 24/7 emergency service access when not in session, and provide a combination of individual/group therapy, medical/nursing services, family treatment, and educational services. Clients must meet DSM diagnostic criteria for a substance-related disorder and satisfy specific admission criteria related to withdrawal risk, stability, and treatment history before enrollment.
View official sourceCHAPTER 75-09.1-05.1 PARTIAL HOSPITALIZATION - DAY TREATMENT - ADOLESCENT ASAM LEVEL II.5 Section 75-09.1-05.1-01 Definition 75-09.1-05.1-02 Provider Criteria 75-09.1-05.1-03 Program Criteria 75-09.1-05.1-04 Admission Criteria 75-09.1-05.1-01. Definition. As used in this chapter, "partial hospitalization program" means a substance abuse treatment program that uses multidisciplinary staff and is provided for clients who require a more intensive treatment experience than intensive outpatient treatment but who do not require inpatient care or residential treatment with the exception of clients at ASAM level III.1. This level of care is designed to offer highly structured intensive treatment to a client whose condition is sufficiently stable so as not to require twenty -four hour per day monitoring and care, but whose illness has progressed so as to require consistent near -daily treatment intervention. Partial hospitalization may also be referred to as day treatment. History: Effective October 26, 2004. General Authority: NDCC 50-06-16, 50-31 Law Implemented: NDCC 50-31 75-09.1-05.1-02. Provider criteria. 1. A partial hospitalization program shall offer no less than twenty hours of programming per week in a structured program. 2. A partial hospitalization program shall offer the program no less than four days per week with the length of stay to be determined by a client's condition and functioning. 3. A partial hospitalization program shall make clients aware of emergency services that are available twenty-four hours a day seven days a week when the program is not in session. History: Effective October 26, 2004. General Authority: NDCC 50-06-16, 50-31 Law Implemented: NDCC 50-31 75-09.1-05.1-03. Program criteria. A partial hospitalization program shall offer a client: 1. A combination of individual and group therapy as deemed appropriate by an assessment and treatment plan; 2. Medical and nursing services as deemed appropriate by an assessment and treatment plan; 3. A system for referral for needs identified but not available in the program; 4. Family treatment services as deemed appropriate by an assessment and treatment plan; 5. Educational and informational programming adaptable to individual client needs; and 6. Onsite staff provided or contracted accredited educational services for clients still in school or short-term educational services linked to home school designed to maintain current learning. History: Effective October 26, 2004. 1 General Authority: NDCC 50-06-16, 50-31 Law Implemented: NDCC 50-31 75-09.1-05.1-04. Admission criteria. Before a partial hospitalization program may admit a client, the client must: 1. Meet diagnostic criteria for a substance-related disorder of the DSM; 2. Be at low risk for withdrawal symptoms or have minimal remaining withdrawal symptoms; 3. Be physically stable but may have a medical condition that is severe enough to distract from recovery efforts or would be aggravated by continued use of alcohol or drugs or the client is psychologically stable enough not to require a twenty-four-hour observation and care but does have problems in the areas of dangerousness or lethality; interference with addiction recovery efforts; social functioning; ability for self-care or course of illness; and 4. The client meets at least two of the following: a. The client requires repeated, structured, clinically directed motivational enhancement strategies not available at a less-intensive level of care; b. The client made previous attempts at a treatment program of lower intensity with an inability to remain sober or has been an active participant at a less -intensive level of care but is experiencing an intensification of symptoms of the substance-related disorders and the client's functioning is deteriorating despite modifications of the treatment plan or there is a high likelihood that the client will continue to use or relapse without close outpatient monitoring and structured therapeutic services; c. The client minimal support for sustaining beginning recovery in the client's home or customary environment; d. The client has experienced significant impairment in life areas that require a high level of intensity best accomplished as close to the client's home community as is feasible; or e. The client has experienced significant life traumas or stresses that require therapeutic interventions as an adjunct to addiction treatment to assure continuing recovery. History: Effective October 26, 2004. General Authority: NDCC 50-05-16, 50-31 Law Implemented: NDCC 50-31 2