902 KAR 20:111. Medical detoxification services.


      RELATES TO: KRS 216B.010-216B.131, 216B.990(1), (2)

      STATUTORY AUTHORITY: KRS 216B.040, 216B.105

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 216B.040 and 216B.105 mandate that the Cabinet for Human Resources regulate health facilities and health services. This administrative regulation provides for the licensure requirements of medical detoxification services.


      Section 1. Definitions. (1) "Detoxification" means the systematic reduction of the amount of a toxic agent in the body or the elimination of a toxic agent from the body.

      (2) "Service" means a medical detoxification service.


      Section 2. Scope of Operation and Services. A facility with a medical detoxification service provides examination, diagnosis, treatment, and referral for intoxicated persons and persons evaluated by a physician to be alcoholics or abusers of other chemical substances in need of detoxification. Medical detoxification services are provided in a facility licensed as a hospital, psychiatric hospital or chemical dependency treatment service and are available on a twenty-four (24) hour basis.


      Section 3. Minimum Standards of Operation. (1) The medical detoxification service shall be provided on the premises of a facility licensed as a hospital, psychiatric hospital or chemical dependency treatment service under the applicable health service and health facility licensure administrative regulations. The service shall have staff, operating procedures and records appropriate to the licensure category of the facility providing the service.

      (2) A psychiatric hospital or chemical dependency treatment service providing medical detoxification shall have provisions for obtaining emergency medical treatment through a licensed hospital with an organized emergency department.

      (3) The facility shall provide extended medical care of the patient within the primary facility or through cooperative arrangement with or referral to another licensed medical care facility if services required for the patient are not available in the primary facility.

      (4) The service shall be operated by licensed staff trained in alcohol and drug treatment procedures who receive regular in-service training relating to their job activities. There shall be at least one (1) person on duty at all times who has received training in cardiopulmonary resuscitation.

      (5) The service shall have twenty-four (24) hour capability, and shall provide examination, diagnosis, treatment, and appropriate referral for all patients.

      (6) A physical examination shall be conducted prior to commencing detoxification or administering medications to determine whether the patient requires transfer to a more appropriate level of care. Admission for inpatient treatment shall be determined by an attending or examining staff physician. The medical care of the patient during detoxification shall be directed by a physician.

      (7) Prior to discharge from the detoxification service an assessment of the patient's condition shall be conducted to determine an appropriate referral for continuing care.

      (8) The facility shall designate the number of beds to be available for detoxification services and assure space is available with reasonable privacy for examination, detoxification, observation, evaluation and treatment of the medical alcohol or drug emergency patient.

      (9) The facility shall have written affiliation with other licensed alcohol and drug services available in the community such as: chemical dependency treatment services and services licensed under 902 KAR Chapter 3 including situation, identification, and disposition (SID) units, thirty (30) day residential units, halfway houses and outpatient services.

      (10) The facility shall have the following equipment immediately available:

      (a) Complete parenteral treatment equipment;

      (b) Appropriate pharmaceutical supplies to include tranquilizers, anticonvulsants, oral and parenteral vitamins;

      (c) Ventilation equipment including masks and cannulae for administration of oxygen and suction equipment; and

      (d) An emergency crash cart.

      (11) The facility shall have twenty-four (24) hour access to physician services on at least an on-call basis. (8 Ky.R. 254; eff. 11-5-81; Am. 10 Ky.R. 37; eff. 8-3-83; 18 Ky.R. 827; eff. 10-16-91.)