(a) Detoxification services must meet all applicable standards, Chapters 1 and 2, and Sections 1 through 9, and Section 14 of Chapter 4, of these standards, including the following service level requirements.
(b) Clinically Managed Residential Social Detoxification. - (i) Description of Services. A social detoxification service, per ASAM description, is an organized service that may be delivered by appropriately trained staff that provides 24-hour supervision, observation and support for clients who are intoxicated or experiencing withdrawal. Services must integrate serial inebriate elements to services. Social Detoxification services are characterized by their emphasis on peer and social support. This service must meet all therapeutic and physical plant requirements of Chapter 4, Section 14.
- (ii) Required Personnel. A social detoxification service shall ensure that a client receives appropriate information and consultation from a licensed clinical staff person when possible regarding treatment options before the scheduled discharge of the client from the service. Program staff will be cross trained and will implement motivational enhancement techniques to engage clients into treatment.
- (A) Access to a physician shall be available via on call protocol on a twenty-four (24) hours a day, seven (7) days a week basis.
- (B) Services shall have sufficient clinical staff and support staff to meet the needs of the client.
- (C) All staff persons who assess and treat clients must be able to obtain and interpret information regarding the needs of clients, and must be knowledgeable about the bio-psychosocial dimensions of alcohol and other drug dependence.
- (iii) Service Operations.
- (A) The program shall maintain a standard detoxification protocol that includes emergency procedures, which are reviewed and approved by a physician at least annually.
- (B) The program shall have immediate access to first aid supplies.
- (C) Service shall have separate locked cabinets exclusively for pharmaceutical supplies.
- (D) The program shall have written policies and procedures for the management of belligerent and disturbed clients, which shall include transfer of a client to another facility, if necessary.
- (E) If possible, the program shall develop a discharge plan for each client that addresses the client's follow-up service needs and the provision for referral, escort, and transportation to other treatment services, as necessary, to ensure the continuity of care.
(c) Medically-Monitored Residential Detoxification Services. - (i) Description of Services. A medically-monitored detoxification service, per ASAM description, is an organized service delivered by medical and nursing professionals, which provides twenty-four (24) hours a day, seven (7) days a week medically supervised evaluation and withdrawal management in a permanent facility with inpatient beds. Services are delivered under a set of physician-approved policies and physician-monitored procedures or clinical protocols. This service must meet all therapeutic and physical plant requirements of Chapter 4, Section 14.
- (ii) Required Personnel.
- (A) The program shall ensure that a client receives consultation from a substance use clinical staff person before the client is discharged from the service.
- (B) The program shall ensure there is sufficient clinical staff to meet the needs of clients served.
- (C) The program shall have a medical director who is appropriately licensed or registered in the State of Wyoming and is responsible for overseeing the monitoring of the client's progress and medication administration, and who is trained and competent to implement physician approved protocols for client observation and supervision.
- (D) A Registered Nurse or Licensed Practical Nurse shall be available on site on a twenty-four (24) hours a day, seven (7) days a week basis, and will conduct a nursing assessment on the client at the time of admission.
- (E) A physician shall be available on-call twenty four (24) hours a day, seven (7) days a week.
- (F) All staff that assess and treat clients must be able to obtain and interpret information regarding the needs of clients, and must be knowledgeable about the bio-psychosocial spiritual dimensions of alcohol and other drug dependence.
- (iii) Service Operations.
- (A) The staff physician shall review and document the medical status of a client within twenty-four (24) hours after admission.
- (B) The program shall have written policies and procedures for the management of belligerent and disturbed clients, which shall include transfer of a client to another appropriate facility.
- (C) The program shall have written agreement with a certified substance abuse service program, if not provided on-site at the service, to provide ongoing care following the client discharge from the facility.
- (D) The program shall have a written agreement with a hospital or local medical clinic to provide emergency medical services for clients, if determined to be clinically necessary.
- (E) The program shall develop with each client a detoxification plan and a discharge plan that addresses the client's follow-up service needs, determined from the application of approved client placement criteria administered by qualified clinical staff, and shall include provision for referral, escort, and transportation to other treatment services, as necessary, to ensure that continuity of care is provided.
(d) Medically-Managed Intensive Inpatient Detoxification Services. - (i) Description of Services. A medically-monitored detoxification service, per ASAM description, is an organized service delivered by medical and nursing professionals that provides for 24-hour, medically directed evaluation and withdrawal management in an acute care inpatient setting. Services are delivered under a defined set of physician-approved policies and physician managed procedures or medical protocols. This service must meet all therapeutic and physical plant requirements of Chapter 4, Section 14.
- (ii) Required Personnel.
- (A) The program shall ensure that a client receives consultation from a substance use clinical staff person before the client is discharged from the service.
- (B) The program shall ensure there is sufficient clinical staff to meet the needs of clients served.
- (C) The program shall have a medical director who is appropriately licensed or registered in the State of Wyoming and is responsible for overseeing the monitoring of the client's progress and medication administration, and who is trained and competent to implement physician approved protocols for client observation and supervision.
- (D) A Registered Nurse or Licensed Practical Nurse shall be available on site on a twenty-four (24) hours a day, seven (7) days a week basis, and will conduct a nursing assessment on client at the time of admission.
- (E) Physicians shall be available twenty-four (24) hours a day, seven (7) days a week, as an active member of an interdisciplinary team who medically manage the care of the client.
- (F) All staff that assesses and treats clients must be able to obtain and interpret information regarding the needs of clients, and must be knowledgeable about the bio-psychosocial spiritual dimensions of alcohol and other drug dependence.
- (iii) Service Operations.
- (A) The staff physician shall review and document the medical status of a client within twenty-four (24) hours after admission.
- (B) The program shall have written policies and procedures for the management of belligerent and disturbed clients, which shall include transfer of a client to another appropriate facility.
- (C) The program shall have written agreement with a certified substance abuse service program, if not provided on-site at the service, to provide ongoing care following the client discharge from the facility.
- (D) The program shall have a written agreement with a hospital or local medical clinic to provide emergency medical services for clients, if determined to be clinically necessary.
- (E) The program shall develop with each client a detoxification plan and a discharge plan that addresses the client's follow-up service needs, determined from the application of approved client placement criteria administered by qualified clinical staff, and shall include provisions for referral, escort, and transportation to other treatment services, as necessary, to ensure that continuity of care is provided.
048-4 Wyo. Code R. § 4-15