Incidental Medical Services (IMS)
Y & Y Recovery provides Incidental Medical Services (IMS) that address medical issues associated with detoxification and/or the provision of treatment from substance use disorder. The goal of IMS is to enhance the safety of treatment services by allowing physicians to treat clients on site for the above-mentioned services. IMS allows us to employ quality medical staff and offer a wider breadth of medical services 24 hours a day, 7 days a week. IMS does not provide general primary medical care. IMS is a new supplemental service under our current Department of Health Care Services (DHCS) license. The following are the six core areas of IMS:
Obtaining Medical History:
A medical history will be provided on all residents prior to contacting the Physician to determine the necessity of medical treatment to be provided for residents entering detox and/or admitting with a specific need for incidental medical services accompanied by a substance use disorder.A timely and comprehensive assessment is necessary to offer quality care and a safe environment for the residents. During the admission process we will be obtaining our resident’s Health Care Questionnaire face-to-face which will be reviewed and signed off on by a physician or health care practitioner (HCP) within 24-hours of admission. A physician or HCP will also be completing, signing and dating the IMS Certification Form face-to-face. This process is imperative to provide detoxification and residential treatment.
Monitoring Health Status:
Prior to admission, an assessment will be conducted by a physician or HCP to determine
if the potential resident is appropriate for detox/residential level of care. Those who are admitted will be closely observed and physically checked, including vitals, at least every 30 minutes for the first 72 hours or the entirety of their stay in detox, whichever is longer. Residential Treatment Center level of care rounds will be conducted every hour until a resident is successfully discharged. While in detox protocol, residents will be assessed daily by following COWS or CIWA protocol as warranted. If a resident shows signs of detoxification withdrawal beyond our scope of practice/competence, then the Physician will be notified and the LVN and Clinical Program Director will arrange for a referral and/or transportation for the resident to receive medical care at the appropriate level of care. All documents will be placed in the residents file.
Testing Associated with Detoxification from Drugs and Alcohol:
All testing conducted for detoxification and residential services both initial and ongoing will follow the guidelines approved by DHCS.A variety of testing services under the discretion of the physician and/or health care practitioner will be utilized to effectively treat and monitor detoxification and residential services. Testing includes toxicology via urine drug screens, blood alcohol content via breathalyzer and laboratory analysis as deemed necessary and appropriate by the physician/health care practitioner.
Provide Alcohol and Drug Abuse Recovery or Treatment Services:
As part of an individual resident’s ongoing treatment and recovery process, lab testing will be conducted to monitor their stabilization throughout the ongoing treatment process. The Physician is the responsible person for reading and making the final determination on all tests results.Alcohol and drug misuse, recovery and treatment services will be provided. Residents shall be adequately evaluated by the physician or health care practitioner and offered pharmaceutical interventions for mental health and substance misuse conditions based on internal medicine, psychiatric medicine, and addiction medicine’s best practices.
Overseeing Patient Self-Administered Medications:
The Physician, acting within their scope of practice/competence, may advise or make recommendations to any resident regarding prescribed or over the counter medications. It is our policy that all residents who need prescribed medication from a physician have the right to take such prescriptions to the point that it does not impair their ability to function in the milieu, or conflict with our abstinence policy. It is Y & Y Recovery’s philosophy that medications with a potential for abuse including opiates, sedative/hypnotic/anxiolytic medications (including sleep medications with benzodiazepine components), stimulants, medical marijuana, and muscle relaxants are contraindicated for individuals with substance use disorders. All residents who need prescription or over the counter medication have the right to self-administer such medications to the point that it is not considered adverse.
Treating Substance Abuse Disorders Including Detoxification:
The Physician will coordinate and work with the resident’s primary care provider for any complex conditions which may impact the resident’s success in treatment If the resident does not list a Primary Care Provider they will be given the choice to continue working with the treatment facility’s physician or choose a physician from their insurance providers list. Treating substance use disorders, including detoxification, is a multidimensional process requiring interdisciplinary coordination. Y & Y Recovery’s physician aims to work with the resident’s primary care physician or any external providers to coordinate care as relevant to any complex conditions that may impact the resident’s success in treatment. Medication assisted treatment (MAT) is allowable and encouraged in residential level of care. Among the most commonly used medications in drug and alcohol treatment are Librium, Buprenorphine and Naloxone (Suboxone), Naltrexone (oral and IM), Acamprosate, and Disulfiram. Y & Y Recovery is not a maintenance program.
IMS will be provided by, or under the supervision of, one or more physicians licensed by the Medical Board of California or the Osteopathic Medical Board who are knowledgeable about addiction medicine. Additionally, services can be provided by other health care practitioners acting within the scope of their practice/competence of his or her license and under the direction of Y & Y Recovery’s physician.
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