Michigan Administrative Code › Department - Licensing and Regulatory Affairs › Bureau of Community and Health Systems › Substance Use Disorder Programs › Substance Use Disorder Programs › Part 4 - SPECIAL REQUIREMENTS BY SERVICE CATEGORIES › Section R. 325.1388 - Residential withdrawal management program requirements

Current through Vol. 24-12, July 15, 2024
Rule 1388.
(1)
					 Residential withdrawal management programs must be based on a documented
					 assessment of the recipient's needs and a subsequent agreement between the
					 recipient and the provider about the services to be offered.
(2) A program offering clinically managed
					 withdrawal management services shall offer peer and social support services
					 only and not offer or administer schedule II-V controlled substances, as
					 classified under 21 USC
					 812, for the management of withdrawal,
					 including methadone and buprenorphine.
(3) A program offering medically monitored
					 withdrawal management services shall offer medical and nursing care and may
					 administer medications for the management of withdrawal.
(4) A residential withdrawal management
					 program shall meet all of the following requirements:
(a) An applicant or licensee shall employ a
					 medical director.
(b) Before
					 treatment, a licensee shall provide a recipient, or a person acting on the
					 individual's behalf, information about all relevant, available medical
					 treatment options related to the recipient's assessment, including relevant
					 forms of medication-assisted treatment, as well as the risks and benefits of
					 each treatment option. The service plan must contain a written document that
					 the recipient has been informed of the risks and benefits of all relevant
					 treatment options, and identify the option selected by the recipient.
(c) A physician, physician's assistant, or
					 advanced practice registered nurse shall review and assess each recipient upon
					 admission and every 72 hours after the initial review and assessment to
					 determine if the recipient is suitable for the services being offered. If a
					 recipient is referred from a licensed acute care hospital, psychiatric unit, or
					 hospital directly to a licensed residential withdrawal management program, the
					 transfer documentation, including the health assessment from the transferring
					 hospital, may be used as the initial assessment for admission if all of the
					 following are met:
(i) The transfer record
					 must be reviewed and signed by the program's physician, physician assistant, or
					 advanced practice nurse and documented in the recipient's record within 24
					 hours of admission.
(ii) The
					 transfer record must be accessible in the recipient's record at the time of
					 admission.
(iii) The transfer
					 record must include that the recipient was referred directly to a licensed
					 residential withdrawal management program.
(d) A licensee shall perform an initial test
					 for opioids, benzodiazepine, methadone and methadone metabolites, buprenorphine
					 and buprenorphine metabolites, barbiturates, amphetamines, cocaine, and other
					 drugs based on a recipient assessment and local drug use pattern and trends
					 upon admission with results documented in the recipient service plan within 48
					 hours after collection of that information.
(e) An applicant or licensee shall employ the
					 equivalent of a full-time licensed counselor, LMSW, licensed psychologist,
					 LMFT, or certified counselor.
(f) A
					 licensed counselor, limited licensed counselor under the supervision of a
					 licensed counselor, LMSW, limited LMSW under the supervision of a LMSW,
					 licensed psychologist, limited licensed psychologist under the supervision of a
					 licensed psychologist, temporary limited licensed psychologist under the
					 supervision of a licensed psychologist, post-doctoral education limited
					 licensed psychologist under the supervision of a licensed psychologist, LMFT,
					 limited LMFT under the supervision of an LMFT, certified counselor, or limited
					 certified counselor under the supervision of a licensed or certified individual
					 listed in these rules shall be available to provide counseling services as
					 required in the recipient service plan.
(g) A licensee shall ensure that any licensed
					 counselor, limited licensed counselor, LMSW, limited LMSW, licensed
					 psychologist, limited licensed psychologist, temporary limited licensed
					 psychologist, post-doctoral education limited licensed psychologist, LMFT,
					 limited LMFT, or certified counselor is not responsible for more than 20
					 recipients.
(h) A licensee shall
					 ensure that a limited certified counselor is not responsible for more than 10
					 recipients.