Residential substance use disorder treatment services provide substance use disorder treatment for an individual in a facility with twenty-four hours a day supervision.
(1) Residential treatment services include:
(a) Intensive inpatient services;
(b) Low intensity (recovery house) residential treatment services; and
(c) Long-term residential treatment services.
(2) An agency certified to provide residential treatment services must:
(a) Provide education to each individual admitted to the treatment facility on:
(i) Substance use disorders;
(ii) Relapse prevention;
(iii) Bloodborne pathogens;
(iv) Tuberculosis (TB);
(v) Emotional, physical, and sexual abuse; and
(vi) Nicotine use disorder.
(b) Maintain a list or source of resources, including self-help groups, and referral options that can be used by staff to refer an individual to appropriate services; and
(c) Develop and implement written procedures for:
(i) Urinalysis and drug testing, including laboratory testing; and
(ii) How agency staff members respond to medical and psychiatric emergencies.
(3) An agency that provides services to a pregnant woman must:
(a) Develop and implement a written procedure to address specific issues regarding the woman's pregnancy and prenatal care needs;
(b) Provide referral information to applicable resources; and
(c) Provide education on the impact of substance use during pregnancy, risks to the developing fetus, and the importance of informing medical practitioners of chemical use during pregnancy.
(4) An agency that provides an assessment to an individual under RCW
46.61.5056 must also meet the requirements for driving under the influence (DUI) assessment providers in WAC
246-341-0820.
(5) An agency that provides substance use disorder residential services to youth must:
(a) Ensure staff members are trained in safe and therapeutic techniques for dealing with a youth's behavior and emotional crisis, including:
(i) Verbal deescalation;
(ii) Crisis intervention;
(iii) Anger management;
(vi) Suicide assessment and intervention;
(v) Conflict management and problem solving skills;
(vii) Management of assaultive behavior;
(viii) Proper use of therapeutic physical intervention techniques; and
(ix) Emergency procedures.
(b) Provide group meetings to promote personal growth.
(c) Provide leisure, and other therapy or related activities.
(d) Provide seven or more hours of structured recreation each week, that is led or supervised by staff members.
(e) Provide each youth one or more hours per day, five days each week, of supervised academic tutoring or instruction by a certified teacher when the youth is unable to attend school for an estimated period of four weeks or more. The agency must:
(i) Document the individual's most recent academic placement and achievement level; and
(ii) Obtain school work from the individual's school, or when applicable, provide school work and assignments consistent with the individual's academic level and functioning.
(f) Conduct random and regular room checks when an individual is in their room, and more often when clinically indicated.
(g) Ensure each individual's clinical record:
(i) Contains any consent or release forms signed by the youth and their parent or legal guardian;
(ii) Contains the parent's or other referring person's agreement to participate in the treatment process, as appropriate and if possible; and
(iii) Documents any problems identified in specific youth assessment, including any referrals to school and community support services, on the individual service plan.
Residential substance use disorder treatment services provide substance use disorder treatment for an individual in a facility with 24 hours a day supervision.
(1) An agency providing residential and inpatient substance use disorder treatment services must:
(a) Provide education to each individual admitted to the treatment facility on:
(i) Substance use disorders;
(ii) Relapse prevention;
(iii) Bloodborne pathogens;
(iv) Tuberculosis (TB);
(v) Emotional, physical, and sexual abuse; and
(vi) Nicotine use disorder;
(b) Maintain a list or source of resources, including self-help groups, and referral options that can be used by staff to refer an individual to appropriate services; and
(c) Develop and implement written procedures for:
(i) Urinalysis and drug testing, including laboratory testing; and
(ii) How agency staff members respond to medical and psychiatric emergencies.
(2) An agency that provides services to a pregnant woman must:
(a) Develop and implement a written procedure to address specific issues regarding the woman's pregnancy and prenatal care needs;
(b) Provide referral information to applicable resources; and
(c) Provide education on the impact of substance use during pregnancy, risks to the developing fetus, and the importance of informing medical practitioners of substance use during pregnancy.
(3) An agency that provides an assessment to an individual under RCW
46.61.5056 must also meet the requirements for driving under the influence (DUI) assessment providers in WAC 246-341-0820.
(4) Inform individuals of their treatment options so they can make individualized choices for their treatment. This includes, as applicable, the initiation, continuation, or discontinuation of medications for substance use disorders.
(5) For individuals choosing to initiate or continue medications for their substance use disorder, make available on-site or facilitate off-site access to continue or initiate Federal Drug Administration (FDA)-approved medication for any substance use disorder, when clinically appropriate, as determined by a medical practitioner.
(6) Provide continuity of care that allows individuals to receive timely and appropriate follow up services upon discharge and, if applicable, allows the individual to continue medications with no missed doses.
(7) In addition to the requirements in WAC 246-341-0640, document in the individual service record:
(a) The individual being informed of their treatment options, including the use of medications for substance use disorder;
(b) The continuation or initiation of FDA-approved medication for substance use disorder treatment that has been provided on-site or facilitated off-site, if applicable;
(c) Referrals made to behavioral health providers, including documentation that a discharge summary was provided to the receiving behavioral health provider as allowed under 42 C.F.R. Part 2; and
(d) Contact or attempts to follow up with the individual post-discharge, including the date of correspondence.
(8) An agency may not deny admission based solely on an individual taking FDA-approved medications, under the supervision of a medical provider, for their substance use disorder or require titration of dosages in order to be admitted or remain in the program.