Level 3.5 Clinically Managed High-Intensity Residential Services

Level 3.5 Clinically Managed High-Intensity Residential Services A. Level 3.5 Clinically Managed High-Intensity Residential Service is the highest community-based level of care for the treatment of substance use disorders. This level of treatment provides a safe and stable group living environment where the person can develop, practice, and demonstrate necessary recovery skills. People admitted to this level of care must be in imminent danger to justify admission and continued stay. The person’s length of stay is determined by the goals the person has achieved on their Individual Service Plan. There is no fixed length of stay in this level of care. People placed in a high-intensity residential setting (Level 3.5 or higher) must be re-assessed at minimum every 14 calendar days to ensure level of care appropriateness. The multi-disciplinary team and treatment professionals have a responsibility to make admission, continued service, and discharge decisions based on clinical evaluation of a person’s assessed needs and treatment progress for all people seeking services, including people under a court order with a specified length of stay. If a person has improved significantly enough to warrant discharge or transfer to another LOC, the treatment professional has a responsibility to contact the appropriate court and seek to have the court order amended. The provider should refer to the current version of the ASAM Criteria. B. People admitted into this level of care must receive a medical assessment within 48 hours of admission to screen for health risks. C. Services must ensure access to each of the following professionals, either through agency provider employees or affiliation agreement/contract: 1. A licensed psychiatrist or psychologist with experience in the treatment of substance use disorders; or 2. A licensed physician with experience in the treatment of substance use disorders. D. The service components include at a minimum: 1. At least one (1) hour of individual therapy per week with each person. 2. A minimum attendance of at least five (5) hours of group therapy per week with each person. 3. Family therapy must be offered and available at least twice during the course of treatment. Documentation of attendance or refusal by the person or family is required. 4. At least 20 hours of psychoeducational groups individualized to the people. Topics to be addressed may include, but are not limited to, substance use disorders, self- help/personal growth, increasing self-esteem, wellness education, social skills, anger management, the recovery process, and a philosophy of living which will support recovery. 5. At least three (3) hours of family-oriented education activities during the course of treatment. 6. Therapeutic and leisure/recreational/physical exercise activities (with physician's approval). 7. Vocational counseling and planning/referral for follow-up vocational services. 8. For children/youth, an academic schedule indicating school hours. E. A written master schedule that documents the provision of the following services: 1. Group therapy; 2. Psychoeducational groups; 3. Family-oriented education; 4. Therapeutic and leisure/recreational/physical exercise activities; 5. Vocational counseling and planning/referral; and 6. For children/youth, an academic schedule indicating school hours.