Oklahoma Administrative Code › Title 450 - Department of Mental Health and Substance Abuse Services › Chapter 18 - Standards and Criteria for Substance Related and Addictive Disorder Treatment Services › Subchapter 13 - Substance Use Disorder Treatment Services › Part 7 - MEDICALLY SUPERVISED WITHDRAWAL MANAGEMENT, ASAM LEVEL 3.7 › Section 450:18-13-61 - Medically-supervised withdrawal management

Current through Vol. 41, No. 20, July 1, 2024
(a)
				  Medically supervised withdrawal management shall be provided outside a medical
				  facility, but under the direction of a licensed physician and a licensed
				  registered nurse supervisor, for consumers who are withdrawing or are
				  intoxicated from alcohol or other drugs. Presenting consumers shall be assessed
				  as currently experiencing no apparent medical or neurological symptoms as a
				  result of their substance use that would require hospitalization.
(b) The facility shall maintain written
				  programmatic descriptions and operational methods addressing the following:
(1) Environment: The facility shall provide
				  for beds, food service, monitoring/documenting vital signs, food, and liquids.
				  The facility shall provide a safe, welcoming, and culturally/age appropriate
				  environment. If the facility provides services to consumers under the age of
				  eighteen (18), it shall be licensed by the Oklahoma State Department of Human
				  Services (OKDHS) as a "Residential Child Care Facility".
(2) Support system:
(A) A licensed physician providing
				  supervision of withdrawal management shall be on site or on call twenty-four
				  (24) hours per day, seven (7) days per week;
(B) The facility shall maintain a written
				  plan for emergency procedures which shall be approved by a licensed physician;
				  and
(C) The facility shall have
				  supplies, as designated in the written emergency procedures, which shall be
				  accessible to the staff.
(3) Staff:
(A) Staff members shall be knowledgeable
				  about the physical signs of withdrawal, the taking of vital signs, the
				  implication of those vital signs, and emergency procedures.
(B) Oklahoma licensed nurses shall provide
				  twenty-four (24) hour monitoring, and statutorily approved personnel shall
				  administer medications in accordance with physician's orders;
(C) Staff shall be knowledgeable regarding
				  facility-required education, evidenced based practices, training, and policies;
				  and
(D) The facility shall document
				  in personnel records all education, training, and experience stated in (A),
				  (B), and (C) above prior to staff providing direct care services.
(E) The facility shall have a minimum of two
				  (2) staff members on site twenty-four (24) hours per day, seven (7) days per
				  week. If consumers under eighteen (18) are on site, staffing ratios shall not
				  exceed those specified in OAC
				  340:110-3-153.2.
(4) Treatment services:
(A) Daily (twenty-four [24] hours a day,
				  seven [7] days a week) substance use disorder withdrawal management treatment
				  services shall be provided which shall include, but are not limited to, oral
				  intake of fluids, three (3) meals a day, taking of vital signs (temperature,
				  pulse, respiration rate, blood pressure), documentation of fluid and food
				  intake a minimum of one (1) time every six (6) hours or more often as indicated
				  by the consumer's condition.
(B)
				  Medications are to be prescribed if needed during withdrawal management. The
				  medications are to include those needed for physical health issues and mental
				  impairment if acquired during the withdrawal process.
(5) Assessment:
(A) An individualized case management plan
				  shall be developed for each consumer prior to discharge;
(B) A medical assessment for appropriateness
				  of placement shall be completed and documented by a licensed physician during
				  the admission process to the program.