Restore, Inc.’s Clinically Managed Residential Services provides adolescent and adult level of care a 24-hour living support and structure with available trained personnel, and offers at least 5 hours of clinical service a week.
ASAM LEVEL 3 TREATMENT
Level 3 encompasses residential services that are described as co-occurring capable, co-occurring enhanced, and complexity capable services, which are staffed by designated addiction treatment, mental health, and general medical personnel who provide a range of services in a 24-hour living supportive setting This level of care is for patients who need a stable place to help with their recovery, away from the distractions and triggers of daily life.
ASAM Level 3.1 on the continuum of care includes residential treatment
In level 3 treatment, patients live in a facility that also offers clinical treatment services. Staff available at all times. Not all level 3 treatment looks the same. There is a wide spectrum of care even within this level.
Treatment services in level 3 facilities range quite a bit. At the lower end of the spectrum, you will find patients who are fairly stable and nearly ready to transition to intensive outpatient care. This stage of care focuses on teaching skills for self-reliance, preventing relapse, and handling emotions and relationships better. Behavioral therapies such as Cognitive Behavioral Therapy are common in lower-end level 3 treatment situations. Still, patients at this stage are living in a full-time treatment center and being monitored for any signs of relapse or instability.
In the more intensive end of the inpatient treatment spectrum, patients are monitored and/or medically managed 24/7. This part of treatment is for people who are at risk for withdrawal or relapse. Additionally, patients who have intense medical, emotional, or mental health issues might benefit from this type of care. The length of residential services ranges from 1 to 4 months with a maximum based on each individual assessment.
Unfortunately, the only way out of withdrawal is GOING THROUGH IT. However, you don’t have to go through it on your own. We highly recommend a supervised detox at a medical facility!
ASAM Level 3.3 Clinically Managed High-Intensity Residential Services (Pop. Specific)
Clinically Managed Population-Specific High-Intensity Residential Services.
(1) These services provide a structured recovery environment in combination with high-intensity clinical service provided in a manner to meet the functional limitations of patients to support recovery from substance-related disorders. For the typical patient in a Level 3.3 program, the effects of substance use or other addictive disorder or a co-occurring disorder resulting in cognitive impairment on the individual’s life are so significant, and the resulting level of impairment so great, that outpatient motivational and/or relapse prevention strategies are not. Similarly, the patient’s cognitive limitations make it unlikely that he or she could benefit from other levels of residential care.
(2) The functional limitations seen in individuals who are appropriately placed at Level 3.3 are primarily cognitive and can be either temporary or permanent. They may result in problems in interpersonal relationships, emotional coping skills or comprehension. For example, temporary limitations may be seen in the individual who suffers from an organic brain syndrome as a result of his/her substance use and who requires treatment that is slower paced, more concrete, and more repetitive until his or her cognitive impairment subsides.
(3) When assessment indicates that such an individual no longer is cognitively impaired, he or she can be transferred to another level of care (such as a Level 3.5 program) or a less intensive level of care (such as a Level 1, 2.1, 2.5, or 3.1 program), based on a reassessment of his or her severity of illness and rehabilitative needs. (Transfer to a Level 3.7 or more intensive level of care would not be considered except in the presence of unstable or acute medical or psychiatric problems that require medical and nursing care.)
(4) By contrast, the individual who suffers from chronic brain syndrome, or the older adult who has age and substance-related cognitive limitations, or the individual who has experienced a traumatic brain injury, or the patient with developmental disabilities would continue to receive treatment in a Level 3.3 program. For such an individual, the effects of the addictive disorder or co-occurring condition are so significant, and the level of his or her impairment so great, that outpatient or other levels of residential care would not be feasible or effective.
(5) Some individuals have such severe limitations in interpersonal and coping skills that the treatment process is one of habilitation rather than rehabilitation. Treatment of such individuals is directed toward overcoming their lack of awareness of, or ambivalence about, the effects of substance-related problems or addiction on their lives, as well as enhancing their readiness to change. Treatment also is focused on preventing relapse, continued problems, and/or continued use, and promoting the eventual reintegration of the individual into the community. In every case, the individual should be involved in planning continuing care to support recovery and improve his or her functioning.
(6) Level 3.3 program generally are considered to deliver high-intensity services, which may be provided in a deliberately repetitive fashion to address the special needs of individuals for whom a Level 3.3 program is considered medically necessary. Such individuals often are elderly, cognitively impaired, or developmentally delayed, or are those for who the chronicity and intensity of the primary disease process requires a program that allows sufficient time to integrate the lessons and experiences of treatment into their daily lives. Typically, they need a slower pace of treatment because of mental health problems or reduced cognitive functioning (Dimension 3), or because of the chronicity of their illness (Dimensions 4 and 5). They also may be homeless, although homelessness is not, in itself, a sufficient indication for admission to a Level 3.3 program.
(7) Where treatment staff have been specially trained and adequate nursing supervision is available, Level 3.3 programs are able to address the needs of patients with certain medical problems as well. These include patients whose biomedical conditions otherwise would meet medical necessity criteria for placement in a nursing home or other medically staffed facility. For such persons, their general medical condition (Dimension 2 comorbidity) provides the justification for admission to a Level 3.3 program
Reintegration of patients in a Level 3.3 program into the community requires case management activities directed toward networking patients into community-based ancillary or “wraparound” services such as housing, vocational services, or transportation assistance so that they are able to attend mutual/self-help meetings or vocational activities after discharge.
Lengths of stay ranges from 30-90 days. If a patient meets criteria need for longer stay. A services authorization must be submitted after 30 days.
Unfortunately, the only way out of withdrawal is GOING THROUGH IT. However, you don’t have to go through it on your own. We highly recommend a supervised detox at a medical facility!
DETOX
Ambulatory Withdrawal Management without Extended On-site Monitoring LEVEL 1-WM
Mild withdrawal with daily or less than daily outpatient supervision; likely to complete withdrawal management and to continue treatment or recovery. There are various assessment considerations for determination of withdrawal management needs including the individual’s personal withdrawal history, course of illness, substances being used, current withdrawal symptoms, medical and mental health complication. According to SAMHSA, Ambulatory WM is defined as “outpatient treatment services providing for safe withdrawal in an ambulatory setting.”
- Ambulatory is defined as “able to walk about and not bedridden; performed on or involving an ambulatory patient” – Merriam Webster
- Thus, ambulatory WM is managing acute and post-acute withdrawal symptoms in an outpatient setting
This is services is provided in our outpatient service facility, during business hours, The facility contracts with a physician and an advance nurses practitioner along with a certified nurse assistants and outpatient staff.
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