(a) Clients who have completed a DWI
substance abuse assessment shall be placed in the appropriate service
level.
(b) Placement of clients in a specific category shall
be based on the assessment outcome, diagnosis, and level of care determined
to be necessary for treatment.
(c) In addition to the terms defined in Rule .3805(10)
of this Section for each of the following progressive categories, determination
for placement shall be based on the criteria specified in this Paragraph.
(1) Alcohol and Drug Education Traffic School (ADETS):
(A) the assessment did not identify a substance
abuse handicap;
(B) the person has no previous DWI offense conviction;
(C) the person had an alcohol concentration of
0.14% or less at the time of arrest;
(D) the person did not refuse to submit to a chemical
test;
(E) the person meets the admission criteria for
Level 0.5 (Early Intervention) of ASAM PPC-2; and
(F) ADETS shall be conducted in accordance with
the rules established in this Section.
(2) Short-term Outpatient Treatment:
(A) the assessment outcome suggests diagnosis of
psychoactive substance abuse only;
(B) the client does not fit all aspects of the
diagnosis, but, under certain circumstances, the clinical impression
provides reason to conclude that a treatment setting would be more
appropriate than ADETS. Some of these circumstances include, but
are not limited to:
(i) alcohol concentration is .15 or higher
(ii) refusal of chemical test at time of arrest;
(iii) problems relating to family history of
substance abuse;
(iv) other problems which seem to be a contributing
factor to DWI behavior, such as grief, loss; and
(v) the client meets the criteria for Level I
of the ASAM Placement Criteria;
(C) this category of service requires a minimum
of 20 contact hours over a minimum of 30 days. Each client must
have services scheduled weekly.
(3) Longer –term Outpatient Treatment:
(A) when a client meets minimal conditions for
the diagnosis of "substance dependence";
(B) the criteria for Level I of the ASAM placement
criteria are met; and
(C) this category of service requires a minimum
of 40 contact hours over a minimum of 60 days. Each client must
have services scheduled weekly.
(4) Day Treatment/Intensive Outpatient Treatment:
(A) the assessment confirms a diagnosis of substance
dependence, with or without physiological dependence;
(B) the ASAM placement criteria for Level II Outpatient
Treatment is met;
(C) the program:
(i) offers additional continuing care, urging
voluntary participation of the client and significant others;
and
(ii) requires a minimum of 90 contact hours and
participation of the client over a period of at least 90 days,
for any client referred under G.S. 20-179(g k), or G.S. 20-17.6;
and
(D) the program may be preceded by a brief inpatient
admission for detoxification or stabilization of a medical or psychiatric
condition.
(5) Inpatient and Residential Treatment Services:
(A) the level of care requires that the client
meets the same diagnostic criteria as Day Treatment, as defined
in this Rule;
(B) outpatient treatment of other associated
problems has not been successful;
(C) the client meets the placement criteria for
Levels III.5 or IV.7 (inpatient) of the ASAM Placement Criteria
with regard to the "Criteria Dimensions" as set forth
in ASAM Patient Placement Criteria, Adult Crosswalk:
(i) withdrawal risk;
(ii) need for medical monitoring;
(iii) emotional and behavioral problems requiring
a structured setting;
(iv) high resistance to treatment;
(v) inability to abstain; and
(vi) lives in a negative and destructive environment;
(D) in order for the client to meet the required
minimum 90-day time frame for treatment, the client, upon discharge,
shall enroll in an approved continuing care or other outpatient
program:
(i) these services shall be provided according
to a written continuing care plan which shall address the needs
of the client;
(ii) these services shall utilize individual,
family and group counseling as required to meet the needs of the
client; and
(iii) the plan shall include client participation.
(6) Special Service Plan:
(A) Documentation of the need for a special program
to correspond with the recommendations of the DWI assessment;
(B) Conditions under which a Special Service Plan
is implemented may include, but need not be limited to, the following:
(i) severe hearing impairment;
(ii) other physical disabilities;
(iii) concurrent psychiatric illness and; or
(iv) language differences and communication problems.