An individual is considered eligible for admission to a residential
rehabilitation/treatment service when the individual meets the required
conditions of paragraphs (1) and (2) of this section.
(1) Diagnosis. The diagnosis must meet the criteria
for the definition of chemical dependence, as detailed in the most
current revision of the international classification of diseases,
or the most current revision of the diagnostic and statistical manual
for professional practitioners, accompanied by evidence that some
of the symptoms have persisted for at least one month or have occurred
repeatedly over a longer period of time.
(2) Other factors for admission to residential rehabilitation/treatment
services. Once the diagnostic criteria for chemical dependency have
been met, the patient must meet the conditions of each of the subparagraphs
(A)-(D) of this paragraph, in order to be eligible for treatment provided
in an adult residential rehabilitation/treatment service program.
Once the diagnostic criteria for chemical dependency have been met,
the patient must meet the conditions of each of the subparagraphs
(A)-(F) of this paragraph in order to be eligible for treatment provided
in an adolescent residential rehabilitation/treatment service program.
(A) Category 1: medical functioning. The patient must
meet the criteria in clauses (i) and (ii) of this subparagraph.
(i) A documented medical assessment following admission
(except in instances in which the patient is being referred from an
inpatient service) indicates that the patient is medically stable
and not in acute withdrawal.
(ii) The patient is not bed-confined or has no medical
complications that would hamper participation in the residential service.
(B) Category 2: family, social, or academic dysfunction
and logistic impairments. The patient must meet the criteria in at
least one clause out of clauses (i)-(v) in this subparagraph.
(i) The patient manifests severe social isolation or
withdrawal from social contacts.
(ii) The patient lives in an environment (social and
interpersonal network) in which treatment is unlikely to succeed (e.g.,
a chaotic family dominated by interpersonal conflict which undermines
patient's efforts to change).
(iii) Patient's family and/or significant others are
opposed to the patient's treatment efforts and are not willing to
participate in the treatment process.
(iv) Family members and/or significant other(s) living
with the patient manifest current chemical dependence disorders, and
are likely to undermine treatment.
(v) Logistic impairments (e.g., distance from treatment
facility, mobility limitations, etc.) preclude participation in a
partial hospitalization or outpatient treatment service.
(C) Category 3: emotional/behavioral status. The patient
must meet the criteria in all three of the clauses (i)-(iii) of this
subparagraph.
(i) Patient is coherent, rational, and oriented for
treatment.
(ii) Mental state of the patient does not preclude
the patient's ability to:
(I) comprehend and understand the materials presented;
and
(II) participate in rehabilitation/treatment process.
(iii) There is documentation that:
(I) with continued treatment the patient will be able
to improve and/or internalize the patient's motivation toward recovery
within the recommended length of stay time frames (e.g., becoming
less defensive, verbalizing, and working on alcohol and/or drug related
issues, etc.);
(II) interventions, treatment goals, and/or contracts
are in place to help the patient deal with or confront the blocks
to treatment (e.g., family intervention, employee counseling confrontation,
etc.).
(D) Category 4: recent chemical substance use. The
patient must meet the criteria in at least one clause out of clauses
(i) and (ii) of this subparagraph.
(i) The patient's chemical substance use is excessive,
and the patient has attempted to reduce or control it, but has been
unable to do so (as long as chemical substances are available).
(ii) Virtually all of the patient's daily activities
revolve around obtaining, using, and/or recuperating from the effects
of chemical substances and the patient requires a secured environment
to control the patient's access to chemical substances.
(E) Category 5: maturation level. The patient must
meet the criteria in both clauses (i) and (ii) of this subparagraph.
(i) The adolescent is assessed as manifesting physical
maturation at least in middle adolescent range (i.e., post pubescent;
not growth retarded).
(ii) The history of the adolescent reflects cognitive
development of at least 11 years of age.
(F) Category 6: developmental status. The adolescent
patient must display:
(i) documented history of inability to function within
the expected age norms despite normal cognitive and physical maturation
(e.g., refusal to interact with family members, overt prostitution,
felony, other criminal charges, etc.); and/or
(ii) a recent history of moderate to severe conduct
disorder, as defined in the Diagnostic and Statistical Manual, or
impulsive disregard for social norms and rights of others; and/or
(iii) documented difficulty in meeting developmental
expectations in a major area of functioning (e.g., social, academic,
or psychosexual) to an extent which interferes with the capacity to
remain behaviorally stable.
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