D.C. Mun. Regs. r. 22-A6337
Current through Register Vol. 71, No. 25, June 21, 2024
Rule 22-A6337 - LEVEL OF CARE 3.7-WM: MEDICALLY MONITORED INPATIENT WITHDRAWAL MANAGEMENT (MMIWM)6337.1 MMIWM is twenty-four (24) hour, medically directed evaluation and withdrawal management service. This service is for clients with sufficiently severe signs and symptoms of withdrawal from psychoactive substances who require medical monitoring and nursing care, but for whom hospitalization is not indicated.
6337.2 MMIWM shall include the following services in accordance with ASAM criteria, as clinically appropriate:
(a) Medication Management in accordance with § 6345;(b) CCC in accordance with § 6340;(c) Medication Assisted Treatment in accordance with § 6346;(d) Drug Screening in accordance with § 6343;(e) Crisis Intervention in accordance with § 6341;(f) RSS, in accordance with § 6344, which must be billed separately;(g) SUD Counseling/Therapy, in accordance with § 6342, which must be billed separately; and(h) Comprehensive Diagnostic Assessment, in accordance with § 6339, which must be billed separately.6337.3 Discharge planning shall be conducted for all clients discharged from MMIWM. Discharge planning criteria shall include at least the following activities prior to discharge from a MMIWM program:
(a) A review of the client's behavioral health, social, and physical needs;(b) Completion of referrals to appropriate community services providers, including additional residential treatment, to address the client's identified needs;(c) If the client desires, the provider shall arrange for appointments with community providers which shall be made as soon as possible after discharge; and(d) Each client shall be given the opportunity to participate in the development of his or her discharge plan, including selecting appropriate community providers. With the consent of the client, and when clinically appropriate, reasonable attempts shall be made to contact family members for their participation in the discharge planning process. No client or family member shall be required to agree to a discharge. A provider shall make a notation in the client's record if any objection is raised to the discharge plan.6337.4 MMIWM providers shall have a physician on staff that is able to respond within one (1) hour of notification.
6337.5 MMIWM providers shall have medical staff (physician, PA, APRN, or RN) on twenty- four (24) hours per day, seven (7) days per week providing directed evaluation, care, and treatment in an inpatient setting. Medical staff shall have a client-to-staff ratio of 12-to-1 during daytime operating hours, a 17-to-1 ratio during evening hours, and a 25-to-1 ratio during the night shift.
6337.6 A withdrawal management service Level 3.7 provider shall offer twenty- four (24) hour medically supervised evaluation and withdrawal management.
6337.7 MMIWM shall have psychiatric services available on-site, through consultation or referral as medically necessary according the client 's needs for treatment and recovery.
6337.8 MMIWM shall have psychosocial and medical services delivered by appropriate staff in accordance with § 6337.4, who can administer withdrawal management services to a client by:
(1) monitoring the decreasing amount of alcohol and toxic agents in the body;(2) managing the withdrawal symptoms; and (3) motivating the client to participate in an appropriate treatment program for alcohol or other drug dependence.6337.9Qualified practitioners of Medically Monitored Inpatient Withdrawal Management (MMIWM) are:
(l) Psychology Associates; andD.C. Mun. Regs. r. 22-A6337
Final Rulemaking published at 62 DCR 12056 (9/4/2015); amended by Final Rulemaking published at 67 DCR 11585 ( 10/9/2020); amended by Final Rulemaking published at 68 DCR 012400 (11/26/2021)