reglab/statecodes huggingface dataset:
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 6 - Community Gero-Psychiatric Residential Services › Section 12VAC35-105-1290 - Service requirements for providers of gero-psychiatric residential services

Current through Register Vol. 40, No. 24, July 15, 2024
A.
					 Providers shall provide mental health, nursing and rehabilitative services;
					 medical and psychiatric services; and pharmaceutical services for each
					 individual as specified in the ISP.
B. Providers shall provide crisis
					 stabilization services.
C.
					 Providers shall implement written policies and procedures that support an
					 active program of mental health and behavioral management services directed
					 toward assisting each individual to achieve outcomes consistent with the
					 highest level of self-care, independence, and quality of life. Programming may
					 be on-site or at another location in the community.
D. Providers shall implement written policies
					 and procedures that respond to the nursing needs of each individual to achieve
					 outcomes consistent with the highest level of self-care, independence, and
					 quality of life. Providers shall be responsible for:
1. Providing each individual services to
					 prevent clinically avoidable complications, including: skin care, dexterity and
					 mobility, continence, hydration, and nutrition;
2. Giving each individual proper daily
					 personal attention and care, including skin, nail, hair, and oral hygiene, in
					 addition to any specific care ordered by the attending physician;
3. Dressing each individual in clean clothing
					 and encouraging each individual to wear day clothing when out of bed;
4. Providing each individual tub or shower
					 baths as often as needed, but not less than twice weekly or a sponge bath daily
					 if the medical condition prohibits tub or shower baths;
5. Providing each individual appropriate pain
					 management; and
6. Ensuring that
					 each individual has his own personal utensils, grooming items, adaptive
					 devices, and other personal belongings including those with sentimental
					 value.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 6 - Community Gero-Psychiatric Residential Services › Section 12VAC35-105-1300 - Staffing requirements for community gero-psychiatric residential services

Current through Register Vol. 40, No. 24, July 15, 2024
A.
					 Community gero-psychiatric residential services shall be under the direction of
					 a:
1. Program director with experience in
					 gero-psychiatric services;
2.
					 Medical director; and
3. Director
					 of clinical services who is a registered nurse with experience in
					 gero-psychiatric services.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 6 - Community Gero-Psychiatric Residential Services › Section 12VAC35-105-1310 - Interdisciplinary services planning team

Current through Register Vol. 40, No. 24, July 15, 2024
A. At a minimum, a registered nurse, a
					 licensed psychologist, a licensed social worker, a therapist (recreational,
					 occupational or physical therapist), a pharmacist, and a psychiatrist shall
					 participate in the development and review of the ISP. Other employees or
					 contractors as appropriate shall be included.
B. The interdisciplinary services planning
					 team shall meet to develop the ISP and review it quarterly. Members of the team
					 shall be available for consultation on an as needed basis.
C. The interdisciplinary services planning
					 team shall review the medications prescribed at least quarterly and consult
					 with the primary care physician as needed.
D. The interdisciplinary services planning
					 team shall integrate medical care plans prescribed by the primary care
					 physician into the ISP and consult with the primary care physician as
					 needed.
Statutory Authority
§ 37.2-203 of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 6 - Community Gero-Psychiatric Residential Services › Section 12VAC35-105-1320 - Employee or contractor qualifications and training

Current through Register Vol. 40, No. 24, July 15, 2024
A. A nurse aide may be employed only if he is
					 certified by the Board of Nursing. During the initial 120 days of employment, a
					 nurse aide may be employed if he is enrolled full-time in a nurse aide
					 education program approved by the Virginia Board of Nursing or has completed a
					 nurse aide education program or competency testing.
B. All nursing employees or contractors,
					 including certified nursing assistants, must have additional competency-based
					 training in providing mental health services to geriatric individuals,
					 including behavior management.
Statutory Authority
§ 37.2-203 of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 6 - Community Gero-Psychiatric Residential Services › Section 12VAC35-105-1330 - Medical director

Current through Register Vol. 40, No. 24, July 15, 2024
Providers of community gero-psychiatric residential
						services shall employ or have a written agreement with one or more
						psychiatrists with training and experience in gero-psychiatric services to
						serve as medical director. The duties of the medical director shall include
						:
1. Responsibility for overall
					 medical and psychiatric care;
2.
					 Advising the program director and the director of clinical services on medical
					 and psychiatric issues, including the criteria for residents to be admitted,
					 transferred , or discharged;
3.
					 Advising on the development, execution, and coordination of policies and
					 procedures that have a direct effect upon the quality of medical, nursing, and
					 psychiatric care delivered to individuals; and
4. Acting as liaison and consulting with the
					 administrator and the primary care physician on matters regarding medical,
					 nursing, and psychiatric care policies and procedures.
Statutory Authority
§ 37.2-203 of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 6 - Community Gero-Psychiatric Residential Services › Section 12VAC35-105-1340 - Physician services and medical care

Current through Register Vol. 40, No. 24, July 15, 2024
A. Each individual in a community
					 gero-psychiatric residential service shall be under the care of a primary care
					 physician. Nurse practitioners and physician assistants licensed to practice in
					 Virginia may provide care in accordance with their practice agreements. Prior
					 to, or at the time of admission, each individual, his authorized
					 representative, or the entity responsible for his care shall designate a
					 primary care physician.
B. The
					 primary care physician shall conduct a physical examination at the time of
					 admission or within 72 hours of admission into a community gero-psychiatric
					 residential service. The primary care physician shall develop, in coordination
					 with the interdisciplinary services planning team, a medical care plan of
					 treatment for an individual.
C. All
					 physicians or other prescribers shall review all medication orders at least
					 every 60 days or whenever there is a change in medication.
D. The provider shall have a signed agreement
					 with a local general hospital describing back-up and emergency medical care
					 plans.
Statutory Authority
§ 37.2-203 of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 6 - Community Gero-Psychiatric Residential Services › Section 12VAC35-105-1350 - Pharmacy services for providers of community gero-psychiatric residential services

Current through Register Vol. 40, No. 24, July 15, 2024
A. The
					 provider shall make provision for 24-hour emergency pharmacy
					 services.
B. The provider shall
					 have a written agreement with a qualified pharmacist to provide consultation on
					 all aspects of the provision of pharmacy services and for regular visits, at
					 least monthly.
C. A pharmacist
					 licensed by the Virginia Board of Pharmacy shall review each individual's
					 medication regimen. Any irregularities identified by the pharmacist shall be
					 reported to the physician and the director of clinical services, and their
					 response documented.
Statutory Authority
§ 37.2-203 of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 7 - Assertive Community Treatment Services › Section 12VAC35-105-1360 - Admission and discharge criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A. Individuals must meet the following
					 admission criteria:
1. Diagnosis of a severe
					 and persistent mental illness, predominantly schizophrenia, other psychotic
					 disorder, or bipolar disorder that seriously impairs functioning in the
					 community. Individuals with a sole diagnosis of a substance use disorder or
					 developmental disability, personality disorder, traumatic brain injury, or an
					 autism spectrum disorder are not the intended service recipients and should not
					 be referred to ACT if they do not have a co-occurring psychiatric
					 disorder.
2. Significant challenges
					 to community integration without intensive community support including
					 persistent or recurrent difficulty with one or more of the following:
a. Performing practical daily living
					 tasks;
b. Maintaining employment at
					 a self-sustaining level or consistently carrying out homemaker roles;
					 or
c. Maintaining a safe living
					 situation.
3. High
					 service needs indicated due to one or more of the following:
a. Residence in a state hospital or other
					 psychiatric hospital but clinically assessed to be able to live in a more
					 independent situation if intensive services were provided or anticipated to
					 require extended hospitalization, if more intensive services are not
					 available;
b. Multiple admissions
					 to or at least one recent long-term stay (30 days or more) in a state hospital
					 or other acute psychiatric hospital inpatient setting within the past two
					 years; or a recent history of more than four interventions by psychiatric
					 emergency services per year;
c.
					 Persistent or very recurrent severe major symptoms (e.g., affective, psychotic,
					 suicidal);
d. Co-occurring
					 substance addiction or abuse of significant duration (e.g., greater than six
					 months);
e. High risk or a recent
					 history (within the past six months) of criminal justice involvement (e.g.,
					 arrest or incarceration);
f.
					 Ongoing difficulty meeting basic survival needs or residing in substandard
					 housing, homeless, or at imminent risk of becoming homeless; or
g. Inability to consistently participate in
					 traditional office-based services.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 7 - Assertive Community Treatment Services › Section 12VAC35-105-1380 - Contacts

Current through Register Vol. 40, No. 24, July 15, 2024
A. The ACT team
					 shall provide multiple contacts per week to individuals experiencing severe
					 symptoms or significant problems in daily living.
B. Each individual receiving ACT services
					 shall be seen face-to-face by an employee or contractor as specified in the
					 individual's ISP. Providers shall document all attempts to make contact, and if
					 contact is not made, the reasons why contact was not made.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 7 - Assertive Community Treatment Services › Section 12VAC35-105-1390 - ACT service daily operation and progress notes

Current through Register Vol. 40, No. 24, July 15, 2024
A. ACT teams shall conduct organizational
					 meetings Monday through Friday at least four days per week at a regularly
					 scheduled time to review the status of all individuals and the outcome of the
					 most recent employee or contractor contact, assign daily and weekly tasks to
					 employees and contractors, revise treatment plans as needed, plan for emergency
					 and crisis situations, and to add service contacts that are identified as
					 needed.
B. A daily log that
					 provides a roster of individuals served in the ACT services program and
					 documentation of services provided and contacts made with them shall be
					 maintained and utilized in the team meeting. Daily logs shall not be considered
					 progress notes.
C. There shall also
					 be individual progress notes documenting services provided in accordance with
					 the ISP each time the individual receives services, which shall be included
					 within the individual's record. ACT teams shall also document within the
					 individual's record attempts at outreach and engagement.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 7 - Assertive Community Treatment Services › Section 12VAC35-105-1400 - ICT and PACT assessment

Current through Register Vol. 40, No. 24, July 15, 2024
The provider shall solicit the individual's own
						assessment of his needs, strengths, goals, preferences, and abilities to
						identify the need for recovery oriented treatment, rehabilitation, and support
						services and the status of his environmental supports within the individual's
						cultural context. With the participation of the individual, the provider shall
						assess:
1. Psychiatric history, mental
					 status and diagnosis, including the content of an advance directive;
2. Medical, dental, and other health
					 needs;
3. Extent and effect of drug
					 or alcohol use;
4. Education and
					 employment, including current daily structured use of time, school or work
					 status, interests and preferences, and supports and barriers to educational and
					 employment performance;
5. Social
					 development and functioning, including childhood and family history, religious
					 beliefs, leisure interests, and social skills;
6. Housing and daily living skills, including
					 the support needed to obtain and maintain decent, affordable housing integrated
					 into the broader community; the current ability to meet basic needs such as
					 personal hygiene, food preparation, housekeeping, shopping, money management,
					 and the use of public transportation and other community based
					 resources;
7. Family and social
					 network, including the current scope and strength of an individual's network of
					 family, peers, friends, and co-workers, and their understanding and
					 expectations of the team's services;
8. Finances and benefits, including the
					 management of income, the need for and eligibility for benefits, and the
					 limitations and restrictions of those benefits; and
9. Legal and criminal justice involvement,
					 including guardianship, commitment, representative payee status, and experience
					 as either a victim or an accused person.
Statutory Authority
§ 37.2-203 of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 7 - Assertive Community Treatment Services › Section 12VAC35-105-1420 - Reserved

Current through Register Vol. 40, No. 24, July 15, 2024
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 7 - Assertive Community Treatment Services › Form - FORMS (12VAC35-105)

Current through Register Vol. 40, No. 24, July 15, 2024
Initial Provider Application For Licensing
						(rev.1/10).
Renewal Provider Application For Licensing (rev.
						2/09).
Service Modification - Provider Request, DMH 966E 1140
						(rev. 1/09).
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VI - Additional Requirements for Selected Services › Article 7 - Assertive Community Treatment Services › Section - DOCUMENTS INCORPORATED BY REFERENCE (12VAC35-105)

Current through Register Vol. 40, No. 24, July 15, 2024
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 1 - Medically Managed Intensive Inpatient › Section 12VAC35-105-1430 - Medically managed intensive inpatient Level of care 4.0 staff criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A medically managed intensive inpatient program shall
						meet the following staff requirements:
1. Have a team of appropriately trained and
					 credentialed professionals who provide medical management by physicians 24
					 hours a day, primary nursing care and observation 24 hours a day, and
					 professional counseling services 16 hours a day;
2. Have an interdisciplinary team of
					 appropriately credentialed clinical staff, which may include
					 addiction-credentialed physicians, nurse practitioners, physician assistants,
					 nurses, counselors, psychologists, and social workers, who assess and treat
					 individuals with severe substance use disorders or addicted individuals with
					 concomitant acute biomedical, emotional, or behavioral disorders;
3. Have staff who are knowledgeable about the
					 biopsychosocial dimensions of addiction as well as biomedical, emotional,
					 behavioral, and cognitive disorders;
4. Have facility-approved addiction
					 counselors or licensed, certified, or registered addiction clinicians who
					 administer planned interventions according to the assessed needs of the
					 individual; and
5. All clinical
					 staff shall be qualified by training and experience and appropriately licensed,
					 certified, or registered by the appropriate health regulatory board to serve
					 individuals admitted to the service.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 1 - Medically Managed Intensive Inpatient › Section 12VAC35-105-1440 - Medically managed intensive inpatient Level of care 4.0 program criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A medically managed intensive inpatient program shall
						meet the following programmatic requirements. The program shall:
1. Deliver services in a 24-hour medically
					 managed, acute care setting and shall be available to all individuals within
					 that setting;
2. Provide cognitive,
					 behavioral, motivational, pharmacologic, and other therapies provided on an
					 individual or group basis, depending on the individual's needs;
3. Provide, for the individual who has a
					 severe biomedical disorder, physical health interventions to supplement
					 addiction treatment;
4. Provide,
					 for the individual who has stable psychiatric symptoms, individualized
					 treatment activities designed to monitor the individual's mental
					 health;
5. Provide planned clinical
					 interventions that are designed to enhance the individual's understanding and
					 acceptance of his addiction illness;
6. Provide family and caregiver treatment
					 services as deemed appropriate by a licensed professional and included in an
					 assessment and treatment plan;
7.
					 Provide health education services;
8. Make medication assisted treatment (MAT)
					 available for all individuals admitted to the service. MAT may be provided by
					 facility staff or coordinated through alternative resources; and
9. Comply with
					 12VAC35-105-1055 through
					 12VAC35-105-1130.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 1 - Medically Managed Intensive Inpatient › Section 12VAC35-105-1450 - Medically managed intensive inpatient Level of care 4.0 admission criteria

Current through Register Vol. 40, No. 24, July 15, 2024
Before a medically managed intensive inpatient program
						may admit an individual, the individual shall meet the criteria for admission
						as defined by the provider's policies. The provider's policy regarding
						admission shall at a minimum require the individual to:
1. Meet diagnostic criteria for a substance
					 use disorder or substance induced disorder as defined by the DSM; and
2. Meet the admission criteria of Level 4.0
					 of ASAM, including the specific criteria for adult and adolescent
					 populations.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 1 - Medically Managed Intensive Inpatient › Section 12VAC35-105-1460 - Medically managed intensive inpatient Level of care 4.0 discharge criteria

Current through Register Vol. 40, No. 24, July 15, 2024
Before a medically managed intensive inpatient program
						may discharge or transfer an individual, the individual shall meet the criteria
						for discharge or transfer as defined by the provider's policies, which shall
						include provisions for the discharge or transfer of individuals who
						have:
1. Achieved the goals of the
					 treatment services and no longer require ASAM 4.0 level of care;
2. Been unable to achieve the goals of the
					 individual's treatment but could achieve the individual's goals with a
					 different type of treatment; or
3.
					 Achieved the individual's original treatment goals but have developed new
					 treatment challenges that can only be adequately addressed in a different type
					 of treatment.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 1 - Medically Managed Intensive Inpatient › Section 12VAC35-105-1470 - Medically managed intensive inpatient Level of care 4.0 co-occurring enhanced programs

Current through Register Vol. 40, No. 24, July 15, 2024
A. Medically
					 managed intensive inpatient co-occurring enhanced programs shall be staffed by
					 appropriately credentialed mental health professionals who assess and treat the
					 individual's co-occurring mental disorders. All clinical staff shall be
					 qualified by training and experience and appropriately licensed, certified, or
					 registered by the appropriate health regulatory board to serve individuals
					 admitted to the service.
B.
					 Medically managed intensive inpatient co-occurring enhanced programs shall
					 offer individualized treatment activities designed to stabilize the
					 individual's active psychiatric symptoms, including medication evaluation and
					 management.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 2 - Medically Monitored Intensive Inpatient Services › Section 12VAC35-105-1480 - Medically monitored intensive inpatient services Level of care 3.7 staff criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A medically monitored intensive inpatient treatment
						program shall meet the following staff requirements. The program shall:
1. Have a licensed physician to oversee the
					 treatment process and ensure quality of care. A physician, a licensed nurse
					 practitioner, or a licensed physician assistant shall be available 24 hours a
					 day in person or by telephone. A physician, a licensed nurse practitioner, or a
					 licensed physician assistant shall assess the individual in person within 24
					 hours of admission;
2. Offer
					 24-hour nursing care and conduct a nursing assessment on admission. The level
					 of nursing care must be appropriate to the severity of needs of individuals
					 admitted to the service;
3. Have
					 interdisciplinary staff, which may include physicians, nurses, addiction
					 counselors, and behavioral health specialists who are able to assess and treat
					 the individual and obtain and interpret information regarding the individual's
					 psychiatric and substance use or addictive disorders;
4. Offer daily onsite counseling and clinical
					 services. Clinical staff shall be knowledgeable about the biological and
					 psychosocial dimensions of addiction and other behavioral health disorders with
					 specialized training in behavior management techniques and evidence-based
					 practices;
5. Have staff able to
					 provide a planned regimen of 24-hour professionally directed evaluation, care,
					 and treatment services;
6. Make MAT
					 available for all individuals with opioid use disorder or alcohol use disorder
					 . MAT may be provided by facility staff or coordinated through alternative
					 resources; and
7. Ensure all
					 clinical staff are qualified by training and experience and appropriately
					 licensed, certified, or registered by the appropriate health regulatory board
					 to serve individuals admitted to the service.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 2 - Medically Monitored Intensive Inpatient Services › Section 12VAC35-105-1490 - Medically monitored intensive inpatient services Level of care 3.7 program criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A medically monitored intensive inpatient treatment
						program shall meet the following programmatic requirements. The program
						shall:
1. Be made available to all
					 individuals within the inpatient setting;
2. Provide a combination of individual and
					 group therapy as deemed appropriate by a credentialed addiction treatment
					 professional and included in an assessment and treatment plan. Such therapy
					 shall be adapted to the individual's level of comprehension;
3. Make available medical and nursing
					 services onsite to provide ongoing assessment and care of addiction
					 needs;
4. Provide direct
					 affiliations with other easily accessible levels of care or close coordination
					 through referral to more or less intensive levels of care and other
					 services;
5. Provide family and
					 caregiver treatment services as deemed appropriate by a credentialed addiction
					 treatment professional and included in an assessment and treatment
					 plan;
6. Provide educational and
					 informational programming adapted to individual needs. The educational and
					 informational programming shall include materials designed to enhance the
					 individual's understanding of addiction and may include peer recovery support
					 services as appropriate;
7. Utilize
					 random drug screening to monitor drug use and reinforce treatment
					 gains;
8. Regularly monitor the
					 individual's adherence in taking any prescribed medications; and
9. Comply with
					 12VAC35-105-1055 through
					 12VAC35-105-1130.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 2 - Medically Monitored Intensive Inpatient Services › Section 12VAC35-105-1500 - Medically monitored intensive inpatient Level of care 3.7 admission criteria

Current through Register Vol. 40, No. 24, July 15, 2024
Before a medically monitored intensive inpatient program
						may admit an individual, the individual shall meet the criteria for admission
						as defined by the provider's policies. The provider's policy regarding
						admission shall at a minimum require the individual to:
1. Meet diagnostic criteria for a moderate or
					 severe substance use or addictive disorder ; and
2. Meet the admission criteria of Level 3.7
					 of ASAM, including the specific criteria for adult and adolescent
					 populations.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 2 - Medically Monitored Intensive Inpatient Services › Section 12VAC35-105-1510 - Medically monitored intensive inpatient Level of care 3.7 discharge criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A. Before a
					 medically monitored intensive inpatient program may discharge or transfer an
					 individual, the individual shall meet the criteria for discharge or transfer as
					 defined by the provider's policies, which shall include provisions for the
					 discharge or transfer of individuals who have:
1. Achieved the goals of the treatment
					 services and no longer require ASAM 3.7 level of care;
2. Been unable to achieve the goals of the
					 individual's treatment but could achieve the individual's goals with a
					 different type of treatment; or
3.
					 Achieved the individual's original treatment goals but have developed new
					 treatment challenges that can only be adequately addressed in a different type
					 of treatment.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 2 - Medically Monitored Intensive Inpatient Services › Section 12VAC35-105-1520 - Medically monitored intensive inpatient Level of care 3.7 co-occurring enhanced programs

Current through Register Vol. 40, No. 24, July 15, 2024
A. Medically
					 monitored intensive inpatient co-occurring enhanced programs shall offer
					 psychiatric services, medication evaluation, and laboratory services as
					 indicated by the needs of individuals admitted to the service. A psychiatrist
					 shall assess the individual by telephone within four hours of admission and in
					 person with 24 hours following admission. A credentialed addiction treatment
					 professional shall conduct a behavioral health-focused assessment at the time
					 of admission. A registered nurse shall monitor the individual's progress and
					 administer or monitor the individual's self-administration of psychotropic
					 medications.
B. Medically monitored
					 intensive inpatient co-occurring enhanced programs shall be staffed by
					 addiction psychiatrists and appropriately credentialed behavioral health
					 professionals who are able to assess and treat co-occurring psychiatric
					 disorders and who have specialized training in behavior management techniques
					 and evidence based practices. All clinical staff shall be qualified by training
					 and experience and appropriately licensed, certified, or registered by the
					 appropriate health regulatory board to serve individuals admitted to the
					 service.
C. Medically monitored
					 intensive inpatient co-occurring enhanced programs shall offer planned clinical
					 activities designed to promote stabilization of the individual's behavioral
					 health needs and psychiatric symptoms and to promote such stabilization,
					 including medication education and management and motivational and engagement
					 strategies.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 3 - Clinically Managed High-Intensity Residential Services Level of care 3.5 › Section 12VAC35-105-1530 - Clinically managed high-intensity residential services Level of care 3.5 staff criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A clinically managed high-intensity residential care
						program shall meet the following staff requirements. The program shall:
1. Offer telephone or in-person consultation
					 with a physician, a licensed nurse practitioner, or a licensed physician
					 assistant in case of emergency related to an individual's substance use
					 disorder 24 hours a day seven days a week;
2. Offer onsite 24-hour-a-day clinical
					 staffing by credentialed addiction treatment professionals in addition to other
					 allied health professionals, such as peer recovery specialists, who work in an
					 interdisciplinary team;
3. Have
					 clinical staff knowledgeable about the biological and psychosocial dimensions
					 of substance use and mental health disorders and their treatment. Staff shall
					 be able to identify the signs and symptoms of acute psychiatric conditions.
					 Staff shall have specialized training in behavior management techniques;
					 and
4. Ensure that all clinical
					 staff are qualified by training and experience and appropriately licensed,
					 certified, or registered by the appropriate health regulatory board to serve
					 individuals admitted to the service.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 3 - Clinically Managed High-Intensity Residential Services Level of care 3.5 › Section 12VAC35-105-1540 - Clinically managed high-intensity residential services Level of care 3.5 program criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A clinically managed high-intensity residential care
						program shall meet the following programmatic requirements. The program
						shall:
1. Provide daily clinical
					 services, including a range of cognitive, behavioral, and other therapies in
					 individual or group therapy; programming; and psychoeducation as deemed
					 appropriate by a credentialed addiction treatment professional and included in
					 an assessment and treatment plan;
2. Provide counseling and clinical
					 interventions to teach an individual the skills needed for daily productive
					 activity, prosocial behavior, and reintegration into family and
					 community;
3. Provide motivational
					 enhancement and engagement strategies appropriate to an individual's stage of
					 readiness to change and level of comprehension;
4. Have direct affiliations with other easily
					 accessible levels of care or provide coordination through referral to more or
					 less intensive levels of care and other services;
5. Provide family and caregiver treatment
					 services as deemed appropriate by a credentialed addiction treatment
					 professional and included in an assessment and treatment plan;
6. Provide educational, vocational, and
					 informational programming adaptive to individual needs;
7. Utilize random drug screening to monitor
					 progress and reinforce treatment gains as appropriate to an individual
					 treatment plan;
8. Ensure and
					 document that the length of an individual's stay shall be determined by the
					 individual's condition and functioning;
9. Make a substance use treatment program
					 available for all individuals; and
10. Make MAT available for all individuals
					 with opioid use disorder or alcohol use disorder. Medication assisted treatment
					 may be provided by facility staff, or coordinated through alternative
					 resources.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 3 - Clinically Managed High-Intensity Residential Services Level of care 3.5 › Section 12VAC35-105-1550 - Clinically managed high-intensity residential services Level of care 3.5 admission criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A. The
					 individuals served by a clinically managed high-intensity residential care
					 program are individuals who are not sufficiently stable to benefit from
					 outpatient treatment regardless of intensity of service.
B. Before a clinically managed high-intensity
					 residential service program may admit an individual, the individual shall meet
					 the criteria for admission as defined by the provider's policies. The
					 provider's policy regarding admission shall at a minimum require the individual
					 to:
1. Meet diagnostic criteria for a
					 substance use disorder or addictive disorder of moderate to high severity as
					 defined by the DSM; and
2. Meet the
					 admission criteria of Level 3.5 of ASAM.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 3 - Clinically Managed High-Intensity Residential Services Level of care 3.5 › Section 12VAC35-105-1560 - Clinically managed high-intensity residential services Level of care 3.5 discharge criteria

Current through Register Vol. 40, No. 24, July 15, 2024
Before a clinically managed high-intensity residential
						service program may discharge or transfer an individual, the individual shall
						meet the criteria for discharge or transfer as defined by the provider's
						policies, which shall include provisions for the discharge or transfer of
						individuals who have:
1. Achieved the
					 goals of the treatment services and no longer require ASAM 3.5 level of
					 care;
2. Been unable to achieve the
					 goals of the individual's treatment but could achieve the individual's goals
					 with a different type of treatment; or
3. Achieved the individual's original
					 treatment goals but have developed new treatment challenges that can only be
					 adequately addressed in a different type of treatment.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 3 - Clinically Managed High-Intensity Residential Services Level of care 3.5 › Section 12VAC35-105-1570 - Clinically managed high-intensity residential services Level of care 3.5 co-occurring enhanced programs

Current through Register Vol. 40, No. 24, July 15, 2024
A. Clinically
					 managed high-intensity residential services co-occurring enhanced programs
					 shall offer psychiatric services, medication evaluation, and laboratory
					 services. Such services shall be available by telephone within eight hours and
					 onsite or closely coordinated offsite within 24 hours.
B. Clinically managed high-intensity
					 residential services co-occurring enhanced programs shall be staffed by
					 appropriately credentialed mental health professionals, including addiction
					 psychiatrists who are able to assess and treat co-occurring mental disorders
					 and who have specialized training in behavior management techniques. All
					 clinical staff shall be qualified by training and experience and appropriately
					 licensed, certified, or registered by the appropriate health regulatory board
					 to serve individuals admitted to the service.
C. Clinically managed high-intensity
					 residential services co-occurring enhanced programs shall offer planned
					 clinical activities designed to stabilize the individual's mental health
					 problems and psychiatric symptoms and to maintain such stabilization, including
					 medication education and management and motivational and engagement strategies.
					 Goals of therapy shall apply to both the individual's substance use disorder
					 and any co-occurring mental disorder.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 35 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Chapter 105 - RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES › Part VII - Addition Medicine Service Requirements › Article 4 - Clinically Managed Population-Specific High Intensity Residential Services › Section 12VAC35-105-1580 - Clinically managed population-specific high-intensity residential services Level of care 3.3 staff criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A clinically managed, population-specific, high-intensity
						residential services program shall meet the following staff requirements. The
						program shall:
1. Offer telephone or
					 in-person consultation with a physician, a licensed nurse practitioner, or a
					 physician assistant in case of emergency related to an individual's substance
					 use disorder 24 hours a day, seven days a week;
2. Have allied health professional staff
					 onsite 24 hours a day. At least one clinician with competence in the treatment
					 of substance use disorder shall be available onsite or by telephone 24 hours a
					 day;
3. Have clinical staff
					 knowledgeable about the biological and psychosocial dimensions of substance use
					 and mental health disorders and their treatment and able to identify the signs
					 and symptoms of acute psychiatric conditions. Staff shall have specialized
					 training in behavior management techniques; and
4. Ensure all clinical staff are qualified by
					 training and experience and appropriately licensed, certified, or registered by
					 the appropriate health regulatory board to serve individuals admitted to the
					 service.
Statutory Authority: §§ 37.2-302 and 37.2-400
						  of the Code of Virginia.