SECTION 450:18-13-61. Medically-supervised withdrawal management

(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.

(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 staff members on site twenty-four (24) hours per day, seven (7) days per week.

(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.

(c)   Compliance with 450:18-13-61 may be determined by a review of the following:

(1)   Licenses;

(2)   Policies and procedures;

(3)   Treatment protocols;

(4)   Personnel records, documentation of professional licensure, certification or licensure as an alcohol and drug counselor, documentation of professional work experience, and ongoing in-service trainings;

(5)   Treatment records;

(6)   Interviews with staff; and

(7)   Other supporting facility documentation.

[Source: Amended and renumbered from 450:18-3-61 at 23 Ok Reg 1953, eff 7-1-06; Amended at 24 Ok Reg 2580, eff 7-12-07; Amended at 27 Ok Reg 2237, eff 7-11-10; Amended at 31 Ok Reg 2004, eff 10-1-14; Amended at 34 Ok Reg 1791, eff 10-1-17]