(a) An outpatient treatment service is defined as one
consisting of at least one to two hours per week.
(b) An individual is considered eligible for treatment
in an outpatient treatment service when the individual meets the conditions
of paragraphs (1) through (3) 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 the 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 the factors for admission to an outpatient
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 three subparagraphs (A)-(C) of this paragraph.
(A) Category 1: medical functioning. The patient has
no medical complications that would hamper the patient's participation
in the outpatient treatment service.
(B) Category 2: family, social, academic dysfunction.
The patient must meet the criteria of at least one clause out of clauses
(i) or (ii) of this subparagraph. The patient's living environment
should be considered as a factor. An individual living in an environment
where licit or illicit mood altering substances are being used may
not be a candidate for this level of care early in episode of care
(early considered the first 30 days).
(i) The 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) The 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:
(l) comprehend and understand the materials presented;
and
(ll) participate in rehabilitation/treatment process
(iii) There is documentation that the patient expresses
an interest to work toward rehabilitation/treatment goals.
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