Behavioral Health Services, Inc.
Subject: Residential SUD Treatment Policy#: 4.11.6
Title: Incidental Medical Services
Effective Date: January 21, 2018
PURPOSE:
The purpose of this document is to outline BHS policy and protocol for the implementation of Incidental Medical Services (IMS) in BHS residential SUD treatment facilities licensed by the Department of Health Care Services (DHCS).
POLICY:
BHS residential treatment facilities that are licensed by DHCS shall provide IMS with approval of DHCS. IMS shall include the following six categories of services:
1) Obtaining medical histories
2) Monitoring the health status to determine necessity for urgent or emergency care transfer
3) Testing associated with detoxification from alcohol or drugs
4) Providing alcoholism or drug abuse recovery or treatment services
5) Overseeing patient self-administered medications
6) Treating substance abuse disorders, including detoxification
BHS shall submit application(s) to DHCS for the provision of IMS for its DHCS-licensed residential treatment facilities. DHCS-licensed BHS residential treatment facilities shall have
and follow written protocol and procedures in accordance with relevant Health and Safety codes and other regulatory requirements for the implementation of approved IMS in their facilities.
PROCEDURES:
Staffing - BHS will have appropriate staff to provide IMS.
Physician - BHS programs will have on staff, either through employment or contractual
agreement, one or more physicians licensed by the Medical Board of California or the Osteopathic Medical Board who are knowledgeable about addiction medicine. A copy of the relevant, current professional license of the physician will be maintained in the provider’s personnel file.
Alternate physician or other health care practitioner – In the absence of the facility
physician, BHS programs will have on staff an alternate physician licensed by the
Medical Board of California or the Osteopathic Medical Board who will be available to perform physician duties, or other health care practitioner, (such as a nurse practitioner), acting within the scope of practice of his or her license to perform duties under the
direction of the physician. A copy of the relevant, current professional license will be
maintained in the provider’s personnel file.
Other staff members – Each residential facility licensed for IMS will have staff who are
qualified and trained to provide IMS at the facility. These other staff may include:
o Medical Assistant (MA),
o Licensed Vocational Nurse (LVN)
o Registered nurse (RN)
o Registered or certified Substance Use Disorder (SUD) counselors
The physician and any other health care practitioner who will participate in or supervise the provision of IMS at the facility will sign an acknowledgement form provided by DHCS. The Health Care Practitioner Incidental Medical Services Acknowledgement form (DHCS 5256) indicates that the physician or other health care practitioner has been advised of and understands the statutory and regulatory limitations of the services that may legally be provided at the facility related to providing IMS. A copy of the signed DHCS 5256 form will be maintained in the provider’s personnel file.
Conditions for Providing IMS
Prior to providing IMS to a program participant, the following conditions must be met:
1) The physician or alternate physician shall assess the resident in a face to face session in
the physical examination room in the facility to determine whether it is medically appropriate for that resident to receive IMS at the premises. The provider shall complete and sign the Health Care Practitioner Client Assessment form (DHCS 4026) for the participant within 24 hours of the participant’s admission to the facility/program. Completion of the Health Care Practitioner Client Assessment form (DHCS 4026) is included as part of the admission process to the residential program, which also includes the resident’s completion of the Client Health Questionnaire and Initial Screening Questions (DHCS 5103) that is reviewed by the physician or other health care practitioner as part of this assessment. Completed, signed and dated forms are maintained in the resident’s file.
Those individuals who are determined at this point to not be appropriate to receive IMS at
the facility shall be referred to an appropriate provider. Emergency services will be contacted for conditions requiring immediate medical treatment and transport to nearest
medical facility. Documentation of referrals shall be included in the resident’s file.
2) The resident of the facility must sign the facility’s Admission Agreement which describes the IMS that the facility may permit to be provided. The Admission Agreement states that the permitted IMS will be provided by, or under the supervision of, a physician and surgeon. A copy of the signed Admission Agreement is maintained in the resident’s file.
Categories of IMS
BHS residential treatment programs will offer and/or provide the six categories of IMS as
defined in Section 11834.026(a) of the CA Health and Safety Code as follows:
1) Obtaining medical histories
2) Monitoring health status to determine whether the health status warrants transfer of
resident in order to receive urgent or emergent care
3) Testing associated with detoxification from alcohol or drugs
4) Providing alcoholism or drug abuse recovery or treatment services
5) Overseeing patient self-administered medications
6) Treating substance abuse disorders, including detoxification.
Residential SUD
Treatment
Incidental Medical Services Policy # 4.11.6
Reviewed by: Board of Directors Review Date: 1/21/18
Approved by: Board of Directors Approval Date: 1/21/18
Effective Date 1/21/18
Supersedes Policy/Date: Not applicable
