North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-09.1 - Substance Abuse Treatment Programs › Chapter 75-09.1-03.1 - Clinically Managed Medium-Intensity Residential Care - Adolescent ASAM Level III.5 › Section 75-09.1-03.1-04 - Admission criteria

Current through Supplement No. 393, July, 2024
Before a clinically managed medium-intensity residential care
				  program may admit a client, the client must:
1. Meet diagnostic criteria for a
				substance-related disorder of the DSM; and
2. Meet admission criteria for clinically
				managed medium-intensity residential services also known as ASAM level III.5 in
				each of the six ASAM dimensions. Specifically, the client:
a. Is at risk of or is experiencing subacute
				intoxication or withdrawal with mild to moderate symptoms and needs containment
				and increased treatment intensity without frequent access to medical or nursing
				services to support engagement in treatment, ability to tolerate withdrawal,
				and prevention of immediate continued use;
b. Does not have a physical condition or
				complication impacting immediate safety and well-being, requiring twenty-four-
				hour medical or nursing interventions but biomedical conditions distract from
				recovery efforts and require residential supervision or continued substance use
				would place a the client at risk for serious damage to physical health because
				of a co-occurring biomedical condition and the resident is capable of
				self-administering any prescribed medications;
c. Does not have an emotional, behavioral, or
				cognitive condition or complication impacting immediate safety or well-being
				requiring twenty-four-hour medical or nursing interventions unless in a dual
				diagnosis program 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;
d. Has a low readiness to change as evidenced
				by a lack of awareness of the need for treatment characterized by active or
				passive resistance to treatment; marked difficulty understanding the
				relationship between the substance use and life problems; the client requires a
				structured therapy and a twenty-four-hour programmatic milieu to promote
				treatment progress and recovery; or the client requires repeated, structured
				motivational interventions delivered in a twenty-four-hour milieu;
e. Has a readiness to change but issues in
				other dimensions impair the ability to translate this into treatment progress
				and recovery;
f. Has a high
				relapse, continued use, or continued problem potential as evidenced by the lack
				of recognition of relapse triggers or the lack of commitment to continuing
				care; the inability to control use of alcohol or other drugs or antisocial
				behavior with the attendant probability of harm to self or others; symptoms
				such as drug craving; difficulty postponing immediate gratification and other
				drug-seeking behaviors; or imminent danger of relapse with dangerous emotional,
				behavioral, or cognitive consequences because of a crisis situation; or
g. Has a chaotic home environment
				that makes recovery goals assessed as unachievable at a less-intensive level of
				care as evidenced by a moderately high risk of physical, sexual, or emotional
				abuse; substance use so endemic that the client is assessed as unable to
				achieve or maintain recovery; a social network of regular users of alcohol or
				other drugs; living with a family or other household member who is a regular
				user, abuser, or dealer of alcohol or other drugs; neglect or lack of
				supervision; the inability to cope, even for limited periods of time, outside
				of twenty-four-hour care; a living environment characterized by criminal
				behavior, victimization, and other antisocial norms and values; or the need for
				staff monitoring before safe transfer to a less-intensive setting.