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Department of Human Services (DHS) Division of Addiction Services (DAS) Information Systems ... - page 11 / 21

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LEVEL III.7 – Dual Diagnosis Enhanced

Meets criteria for Level III.7 plus any of the following:

a.

A history of moderate psychiatric decompensation on discontinuation of drugs of abuse, and such decompensation is present; OR

b.

Moderate to high risk endangering self, others, or property and imminent danger of relapse with dangerous emotional, behavioral or cognitive consequences without the 24-hour setting and does not require one-on –one suicide watch; OR

c.

Severe depression, with suicidal impulses and a plan, but is able to reach out for help as needed in an intensive 24-hour setting and does not require one-on-one suicide watch;

d.

A co-occurring psychiatric disorder requires stabilization with psychotropic medications; OR

e.

A severe co-occurring psychiatric disorder is marginally and tenuously stable and requires close management and care available only in a program with integrated mental health and addiction treatment services to prevent decompensation.

LEVEL IV – MEDICALLY MANAGED INPATIENT SERVICES

Status characterized by  any of the following:

a.

Emotional/behavioral complications of the patient’s addictive disorder require psychiatric management and skilled nursing care; OR

b.

A concurrent emotional, behavioral or cognitive disorder requires stabilization, daily medical management and primary nursing interventions; OR

c.

Uncontrolled behavior seriously endangers self or others; OR

d.

The patient’s mental confusion and fluctuating orientation poses an imminent danger to self or others; OR

e.

A serious emotional, behavioral, or cognitive disorder complicates the treatment of addiction and requires differential diagnosis and medical management; OR

f.

Extreme depression poses an imminent risk to his or her safety; OR

g.

Impairments in cognitive functioning preclude the ability to manage activities of daily living and pose an imminent risk to personal safety; OR

h.

Continued alcohol and/or drug use has caused grave complications or exacerbation of a previously diagnosed psychiatric, emotional, behavioral condition; OR

i.

Altered mental status., with or without delirium as manifested by

1.

Disorientation to self; OR

2.

Alcoholic hallucinosis; OR

3.

Toxic psychosis.

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