SECTION 450:18-13-81. Non-medical withdrawal management

(a)   Non-medical withdrawal management shall be provided in a non-medical setting, with trained paraprofessionals, for intoxicated consumers and consumers withdrawing from alcohol and other drugs, who present with no apparent medical or neurological symptoms as a result of their substance use disorder.

(b)   The facility shall maintain written programmatic descriptions and policy and procedures addressing the following:

(1)   Environment: The facility shall provide beds, food service, and monitor/document vital signs, and food and liquids intake. The facility shall provide a safe, welcoming, and culturally/age appropriate environment.

(2)   Support system:

(A)   A licensed physician shall be on call twenty-four (24) hours per day, seven (7) days per week;

(B)   The facility shall have a written plan for emergency procedures approved by a licensed physician; and

(C)   Supplies, as designated by the written emergency procedures, shall be available and accessible to the staff;

(3)   Staff:

(A)   The service provider assigned shall be knowledgeable about the physical signs of withdrawal, the taking of vital signs, the implication of those vital signs, and emergency procedures. Service providers shall be trained and competent to implement physician-approved protocols for consumer observation and supervision, determination of appropriate level of care, and facilitation of the consumer's transition to continuing care;

(B)   The staff shall be knowledgeable regarding facility-required education, evidenced based practices, training, and policies; and

(C)   The facility shall document in personnel records all education, training, and experience stated in (A) and (B) above prior to staff providing direct care services.

(D)   The facility shall have staff members on site twenty-four (24) hours per day, seven (7) days per week.

(4)   Treatment services: Daily (twenty-four [24] hours a day, seven [7] days a week) substance use disorder withdrawal management treatment services shall be provided, to include oral intake of fluids, three (3) meals a day, and the taking of vital signs (temperature, pulse, respiration rate, blood pressure), and fluid and food intake a minimum of one (1) time every six (6) hours or more often as indicated by the consumer's condition.

(5)   Assessment:

(A)   The consumer shall have an addiction-focused history, obtained as part of the initial assessment and reviewed with a physician during the admission process if physician-developed protocols indicate concern; and

(B)   An individualized case management plan shall be developed prior to discharge to the appropriate level of care.

(c)   Compliance with 450:18-13-81 may be determined by a review of the following:

(1)   Licenses;

(2)   Policies and procedures;

(3)   Treatment protocols;

(4)   Physician-approved withdrawal management procedures;

(5)   Personnel records, documentation of professional licensure or certification, documentation of professional work experience, and ongoing in-service trainings;

(6)   Treatment records; and

(7)   Interviews with staff.

[Source: Amended and renumbered from 450:18-3-81 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]