| (a) An intensive outpatient rehabilitation/treatment
service is defined as one consisting of at least 10 hours per week
for four to 12 weeks, but less than 24 hours per day.
(b) An individual is considered eligible for treatment
in an outpatient service when the individual meets the conditions
of paragraph (3) of this subsection, as well as the conditions of
paragraph (1) or (2) of this subsection.
(1) 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) Concerning diagnosis of alcohol/drug abuse, the
individual must meet the criteria for the definition of chemical substance
abuse, as detailed in either the most current revision of the international
classification of diseases, or the most current revision of the diagnostic
and statistical manual for professional practitioners.
(3) Concerning factors for admission to an intensive
outpatient rehabilitation/treatment service, the patient must have
met the diagnostic criteria for chemical dependency under paragraph
(1) of this subsection or for abuse under paragraph (2) of this subsection,
and must meet the conditions of all four of the subparagraphs (A)-(D)
of this paragraph.
(A) Category 1: medical functioning. The patient must
meet the following criterion: the patient is not bed-confined or has
no medical complications that would hamper the patient's participation
in the outpatient service.
(B) Category 2: family, social, academic dysfunction.
The patient must meet the criteria of at least one clause out of clauses
(i) and (ii) of this subparagraph.
(i) Patient's social system and significant others
are supportive of recovery to the extent that the patient can adhere
to a treatment plan and treatment service schedules without substantial
risk of reactivating the patient's addiction.
(ii) Patient has no primary or social support system
to assist with immediate recovery, but has the social skills to
obtain such a support system or to become involved in a self-help
fellowship.
(C) Category 3: emotional/behavioral status. The patient
must meet the criteria under all three 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 the patient expresses
an interest to work toward rehabilitation/treatment goals.
(D) Category 4: recent chemical substance use. The
patient must meet the following criterion: the patient's chemical
substance use is excessive and maladaptive.
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