# Title 75 — Department of Human Services

## Article 75-09.1 — Substance Abuse Treatment Programs

## Chapter 75-09.1-04.1 — Medically Monitored High-Intensity Inpatient Treatment - Adolescent ASAM Level III.7

### § 75-09.1-04.1-01. Definition.

As used in this chapter, "medically monitored intensive inpatient treatment program" means a
substance abuse treatment program that provides a planned regimen of twenty-four-hour professionally
directed evaluation, observation, medical monitoring, and addiction treatment in an inpatient setting.
This program is appropriate for clients whose subacute detoxification, withdrawal, biomedical, and
emotional, behavioral, or cognitive problems are so severe that they require inpatient treatment but who
do not need the full resources of an acute care general hospital or a medically managed inpatient
treatment program.
History: Effective October 26, 2004.
General Authority: NDCC 50-06-16, 50-31
Law Implemented: NDCC 50-31
### § 75-09.1-04.1-02. Provider criteria.

A medically monitored intensive inpatient treatment program shall:
1. Offer twenty-four-hour skilled nursing care, daily onsite counseling services, and the services
of a physician twenty-four hours per day seven days per week;
2. Make specialized professional consultation available;
3. Offer the inpatient treatment program for seven days per week with the length of stay to be
determined by a client's condition and functioning.
History: Effective October 26, 2004.
General Authority: NDCC 50-06-16, 50-31
Law Implemented: NDCC 50-31
### § 75-09.1-04.1-03. Program criteria.

A medically monitored intensive inpatient treatment program shall provide:
1. A combination of individual and group therapy as deemed appropriate by an assessment and
treatment plan;
2. Medical and nursing services available onsite to provide ongoing assessment and care of
acute detoxification needs, medical, and psychiatric problems;
3. A system for referral of clients for identified treatment needs if such services are not available
in the program;
4. Family treatment services as deemed appropriate by an assessment and treatment plan;
5. Educational and informational programming adaptive to individual client needs; and

6. Onsite staff provided or contracted accredited educational services if a client is still in school;
general educational development preparation if the client does not possess a high school
diploma and is no longer in school; or short-term educational services linked to home school
designed to maintain current learning.
History: Effective October 26, 2004.
General Authority: NDCC 50-06-16, 50-31
Law Implemented: NDCC 50-31
### § 75-09.1-04.1-04. Admission criteria.

Before a medically monitored intensive inpatient program may admit a client, the client must:
1. Meet diagnostic criteria for a substance-related disorder of the DSM; and
2. Meet specifications in at least two of the six ASAM dimensions, at least one of which is in
dimension one, two, or three as in the following criteria:
a. The client is experiencing or at risk of acute or subacute intoxication or withdrawal with
moderate to severe signs and symptoms or there is a strong likelihood that the client who
requires medication will not complete detoxification at another level of care and enter
continued treatment or self-help recovery;
b. A biomedical complication of addiction or co-occurring medical condition requires active
nursing and medical monitoring which does not require the resources of an acute care
hospital or continued substance use would place the client at risk for serious damage to
physical health because of a co-occurring biomedical condition;
c. The client has problems in one of the following areas requiring twenty-four-hour
supervision and a high-intensity therapeutic milieu with access to nursing and medical
monitoring and treatment; dangerousness or lethality; interference with addiction
recovery efforts; social functioning; ability for self-care; or course of illness;
d. The client exhibits severe impairment in significant life areas such as legal, family,
school, or work;
e. The client exhibits significant loss of control and relapse symptoms; or
f. The client has had multiple attempts at treatment programs of lower intensity with an
inability to stay sober.
History: Effective October 26, 2004.
General Authority: NDCC 50-06-16, 50-31
Law Implemented: NDCC 50-31
