37.106.1475    ASAM 3.7 MEDICALLY MONITORED INTENSIVE INPATIENT REQUIREMENTS

(1) To be licensed to provide ASAM 3.7 services, as outlined in the ASAM criteria, a substance use disorder facility (SUDF) must meet the following staffing requirements:

(a) a medical director that oversees the treatment process, medication management, and all medical services;

(b) a physician, nurse practitioner, or physician assistant licensed under Title 37, chapters 3 or 20, MCA, available on-call 24 hours a day, seven days a week to provide medical consultation, evaluate clients, and prescribe medications;

(c) a registered nurse (RN) licensed under Title 37, MCA, on-site or on call 24 hours a day, seven days a week to supervise nursing services;

(d) a RN or licensed practical nurse (LPN) on-site 24 hours a day, seven days a week;

(e) additional RNs, LPNs or certified nurse aides (CNA) in sufficient numbers to assist in the administration of medical protocols and assure the client's safety. LPNs and CNAs must be under the supervision of the RN;

(f) licensed addiction counselors or mental health professionals in sufficient numbers to provide therapeutic services to clients with substance use and mental disorders, as described by this chapter and in accordance with the clients' individualized treatment plans;

(g) a licensed addiction counselor or mental health professional must be on-site or on-call 16 hours a day, seven days a week;

(h) care managers in sufficient numbers to provide adequate services to clients; and

(i) rehabilitation aides in sufficient number to provide on-site 24 hours a day, seven days a week staffing patterns to ensure the safety of clients and to provide direct care services and appropriate supervision of clients.

(2) Medical service must be provided, according to written physician approved protocols, 24 hours a day, seven days a week and must include: 

(a) a physical examination and screening conducted by a physician, nurse practitioner, or a physician assistant of clients on-site within 24 hours of admission, to identify medical needs for health problems and screen for communicable diseases; 

(b) a comprehensive nursing assessment that includes a mental health screening and evaluates the need for acute intoxication and withdrawal management services completed by a registered nurse at the time of admission; and 

(c) medication management. 

(3) Daily clinical skilled treatment services and medical services must be provided on-site by an interdisciplinary team seven days a week. 

(4) The SUDF must provide recreational activities seven days a week. 

(5) All progress notes must be completed in a timely manner and before the next session of the same type or there must be documentation why this did not occur. 

(6) The SUDF must ensure a coordinated transfer to an acute care hospital or other licensed health care facilities. 

(7) Coordination of necessary services (medical, laboratory, toxicology, psychiatric, psychological, emergency) or other levels of care must be available through direct affiliation or referral processes.

History: 50-5-103, 53-24-208, MCA; IMP, 50-5-101, 50-5-103, 53-24-208, 53-24-209, 76-2-411, MCA; NEW, 2010 MAR p. 2975, Eff. 12/24/10; AMD, 2022 MAR p. 1889, Eff. 9/24/22.