CHAPTER 67:61:17

CLINICALLY-MANAGED RESIDENTIAL DETOXIFICATION PROGRAM

Section

67:61:17:01       Eligibility criteria.

67:61:17:02       Information required to be obtained at time of admission.

67:61:17:03       Agreement with hospital for emergency care.

67:61:17:04       Availability of medical director.

67:61:17:05       Monitoring and documentation of client's condition.

67:61:17:06       Emergency first aid training.

67:61:17:07       Services provided.

67:61:17:08       Intensity of services.

67:61:17:09       Reimbursable services.

67:61:17:10       Nonreimbursable services.

    67:61:17:01.  Eligibility criteria. To be eligible for clinically-managed, residential detoxification program services:

    (1)  The client must be experiencing signs and symptoms of a withdrawal that is manageable at this level of care; or

    (2)  There must be evidence that withdrawal is imminent, based on the client's:

        (a)  History of substance intake;

        (b)  Previous withdrawal history;

        (c)  Present symptoms;

        (d)  Physical condition; or

        (e)  Emotional, behavioral, or cognitive condition.

    Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.

    General Authority: SDCL 1-36-25, 34-20A-27.

    Law Implemented: SDCL 34-20A-27.

    67:61:17:02.  Information required to be obtained at time of admission. An agency admitting a client to a clinically-managed, residential detoxification program must obtain the information required by subdivision 67:61:17:07(1), and record the following observations and information in the client's case record:

    (1)  Blood pressure, pulse, and respiration;

    (2)  The presence of bruises, lacerations, cuts, and wounds;

    (3)  Medications the client is currently taking;

    (4)  Medications carried by the client or found on the client's person;

    (5)  Any history of:

        (a)  Diabetes;

        (b)  Seizure disorders, including epilepsy;

        (c)  Delirium tremens; and

        (d)  Convulsive therapies;

    (6)  Any history of exposure to tuberculosis and any current signs or symptoms of the disease;

    (7)  Any history of medical, psychological, or psychiatric treatment; and

    (8)  Any symptoms of mental illness.

    Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.

    General Authority: SDCL 1-36-25, 34-20A-27.

    Law Implemented: SDCL 34-20A-27.

    67:61:17:03.  Agreement with hospital for emergency care. An agency shall have a written affiliation agreement, with a licensed hospital serving the area in which the clinically-managed, residential detoxification program is located, for the provision of emergency, inpatient, and ambulatory medical services. The agreement must specify that the hospital consents to accept all transfers for prompt medical evaluation. Documentation of the reason for the transfer must accompany all transferred clients, as well as the documented history of each client's vital signs. Disclosure of information about clients to the hospital must be in compliance with the requirements of 42 U.S.C. § 290dd-2, in effect on March 27, 2020; 42 C.F.R. Part 2, in effect on January 18, 2017; and 45 C.F.R. Parts 160 and 164, in effect on September 26, 2016.

    Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.

    General Authority: SDCL 1-36-25, 34-20A-27.

    Law Implemented: SDCL 34-20A-27.

    67:61:17:04.  Availability of medical director. An agency's clinically-managed, residential detoxification program must have a written agreement with a licensed physician, physician assistant, or certified nurse practitioner to serve as the medical director, or employ a licensed physician who is primarily responsible for providing medical care to clients to serve as medical director. The medical director's responsibilities to the clinically-managed, residential detoxification program are:

    (1)  Providing advice on health-related policies and issues;

    (2)  Providing emergency medical care to admitted clients; and

    (3)  Supervising the medical treatment provided to the clients.

    Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.

    General Authority: SDCL 1-36-25, 34-20A-27.

    Law Implemented: SDCL 34-20A-27.

    67:61:17:05.  Monitoring and documentation of client's condition. The clinically-managed, residential detoxification program shall establish a policy and procedure concerning the steps staff shall take when assessing and monitoring a client's physical condition and responding to medical complications throughout the detoxification process.

    Staff shall closely monitor the condition of each client during detoxification and document the following information in the client's case record:

    (1)  Blood pressure, pulse, and respiration:

        (a)  At admission;

        (b)  At least two times in the first eight hours after admission and at a greater frequency depending on the degree of the client's hypertension or hypotension; and

        (c)  At least once every eight hours thereafter;

    (2)  Physical, mental, and emotional state, including presence of confusion, anxiety, depression, hallucinations, restlessness, sleep disturbances, tremors, ataxia, or excessive perspiration; and

    (3)  Type and amount of fluid intake.

    Any staff member who assesses, monitors, or responds to a client's condition, must be trained to perform those functions.

    Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.

    General Authority: SDCL 1-36-25, 34-20A-27.

    Law Implemented: SDCL 34-20A-27.

    67:61:17:06.  Emergency first aid training. Counseling and client supervisory staff of a clinically-managed, residential detoxification program must be certified in emergency first aid and cardiopulmonary resuscitation, and trained to respond to fires and other natural disasters. The certifications and verification of the training must be kept in the staff member's personnel file.

    Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.

    General Authority: SDCL 1-36-25, 34-20A-27.

    Law Implemented: SDCL 34-20A-27.

    67:61:17:07.  Services provided. The clinically-managed, residential detoxification program must provide:

    (1)  Initial assessment and planning within forty-eight hours of admission. The initial assessment must be recorded in the client's case record and describe:

        (a)  The client's current problems and needs;

        (b)  The client's emotional and physical state, including screening for the presence of cognitive disability, mental illness, medical disorders, collateral information, and prescribed medications;

        (c)  The client's drug and alcohol use, including the types of substances used, both prescribed and over the counter medications, the age of first use, the amount used, the frequency of use, the date of last use, the duration of use, and the criteria met for a diagnosis of use disorder for each substance; and

        (d)  A statement of the intended course of action;

    (2)  Individual, group, and family counseling providing:

        (a)  Information about alcohol and drug abuse programs whose capabilities most nearly match the client's needs, based on completion of the initial assessment;

        (b)  Encouragement to the client to use alcohol and drug abuse programs for long-term rehabilitation;

        (c)  Education regarding alcohol and drug abuse and dependence, including the biomedical effects of drug and alcohol use and abuse and the importance of medical care and treatment in recovery; and

        (d)  Education regarding tuberculosis and the human immunodeficiency virus, how each is transmitted, and how to safeguard against transmission;

    (3)  Housing and dietary services;

    (4)  Medical care, including tuberculosis and human immunodeficiency virus services, pursuant to 42 U.S.C. § 300x-24, in effect on December 13, 2016; and

    (5)  Discharge planning providing:

        (a)  Continued care planning and counseling;

        (b)  Referral to and coordination of care with other resources that will assist a client's recovery, including education, vocational, medical, legal, social, mental health, employment, and other related alcohol and drug services; and

        (c)  Referral to and coordination of medical services, including information detailing the availability of tuberculosis and human immunodeficiency virus services, pursuant to 42 U.S.C. § 300x-24, in effect on December 13, 2016.

    Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.

    General Authority: SDCL1-36-25, 34-20A-27.

    Law Implemented: SDCL 34-20A-27.

    67:61:17:08.  Intensity of services. A clinically-managed, residential detoxification program shall provide a minimum of thirty minutes of any combination of the services listed in subsections 67:61:17:07(2)(a)(b)(c) and (d), within forty-eight hours of admission, with an additional thirty minute minimum for each subsequent twenty-four hour period.

    Source: 43 SDR 80, effective December 5, 2016; 46 SDR 50, effective October 10, 2019; 50 SDR 63, effective November 27, 2023.

    General Authority: SDCL 1-36-25, 34-20A-27.

    Law Implemented: SDCL 34-20A-27.

    67:61:17:10.  Nonreimbursable services. The following are nonreimbursable under this chapter:

    (1)  Driving under the influence and driving while intoxicated education courses;

    (2)  Services that are solely recreational in nature;

    (3)  Time spent preparing paperwork from client assessments or clinical documentation;

    (4)  Time spent traveling; and

    (5)  Community twelve-step programs.

    Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.

    General Authority: SDCL 1-36-25, 34-20A-27.

    Law Implemented: SDCL 34-20A-27.