An individual is considered eligible for treatment in an outpatient
detoxification treatment service when the individual meets the conditions
of paragraphs (1) and (2) of this subsection.
  (1) The diagnosis must meet the criteria for the definition
of substance (chemical) dependence, as detailed in the most current revision
of the international classification of diseases, or the most current revision
of the diagnostic and statistical manual for professional practitioners, accompanied
by evidence that some of the symptoms have persisted for at least one month
or have occurred repeatedly over a longer period of time.
  (2) Once the diagnostic criteria for substance (chemical) dependency
as described in subsection (1) have been met, the conditions of all subparagraphs
(A)-(D) of this paragraph must also be met.
    (A) Category 1: chemical substance withdrawal. The individual
is expected to have a stable withdrawal from alcohol/drugs.
    (B) Category 2: medical functioning. The patient must meet
all the criteria in clauses (i)-(viii) of this subparagraph.
      (i) No history of recent seizures or past history of seizures
on withdrawal,
      (ii) Lack clinical evidence of altered mental state as manifested
by:
        (I) disorientation to self,
        (II) alcoholic hallucinations,
        (III) toxic psychosis,
        (IV) altered level of consciousness, as manifested by clinical
significant obtundation, stupor, or coma.
      (iii) The symptoms are not due to a general medical condition.

      (iv) Absence of any presumed new asymmetric and/or focal findings
(i.e., limb weakness, clonus, spasticity, unequal pupils, facial asymmetry,
eye ocular movement paresis, papilledema, or localized cerebellar dysfunction,
as reflected in asymmetrical limb coordination).
      (v) The patient must have vital signs interpreted by a physician
to be stable, without a previous history of complications from acute chemical
substance withdrawal, and judged to be free of a physician-determined health
risk.
      (vi) The patient has no evidence of a coexisting serious injury
or systemic illness, newly discovered or progressive in nature.
      (vii) Absence of serious disulfiram-alcohol (Antabuse) reaction
with hypothermia, chest pains, arrhythmia or hypotension.
      (viii) The patient's clinical condition allows for a comprehensive
and satisfactory assessment of items cited in clauses (i)-(vii) of this subparagraph
and paragraphs (A)-(D).
    (C) Category 3: family, social, academic dysfunction. The patient
must meet the criteria of at least one clause out of clauses (i)-(iv) of this
subparagraph.
      (i) The patient's social system and significant others are
supportive of recovery to the extent that the patient can adhere to a treatment
plan and treatment service schedules without substantial risk of reactivating
the patient's addiction.
      (ii) The patient's family and/or significant others are willing
to participate in the outpatient detoxification treatment program.
      (iii) The patient may or may not have a primary or social support
system to assist with immediate recovery, but has the social skills to obtain
such a support system and/or to become involved in a self-help fellowship.

      (iv) The patient's living environment should be considered
as a factor. An individual living in an environment where licit or illicit
mood altering substances are being used may not be a candidate for this level
of care.
    (D) Category 4: emotional/behavioral status. The patient must
meet all the criteria under clauses (i)-(vii) of this subparagraph.
      (i) Patient is coherent, rational and oriented for treatment.

      (ii) Mental state of the patient does not preclude the patient's
ability to :
        (I) comprehend and understand the materials presented; and

        (II) participate in outpatient detoxification treatment
process.
      (iii) There is documentation that the patient expresses an
interest to work toward outpatient detoxification treatment goals.
      (iv) Patient has no neuropsychiatric condition that places
the client at imminent risk of harming self or others (e.g. pathological intoxication,
alcohol idiosyncratic intoxication, etc.),
      (v) Patient has no neurological, psychological, or uncontrolled
behavior that places the individual at imminent risk of harming self or others
(depression, anguish, mood fluctuations, overreactions to stress, lower stress
tolerance, impaired ability to concentrate, limited attention span, high level
of distractibility, negative emotions, anxiety, etc.).
      (vi) Patient has no documented DSM-IV axis I condition or disorder
which, in combination with alcohol and/or drug use, compounds a pre-existing
or concurrent emotional or behavioral disorder and presents a major risk to
the patient.
      (vii) The patient has no mental confusion and/or fluctuating
orientation.
    (E) Category 5: recent chemical substance use. The patient
must meet the criteria in at least one clause out of clauses (i) and (ii)
of this subparagraph.
      (i) The patient's chemical substance use is excessive, and
the patient has attempted to reduce or control it, but has been unable to
do so (as long as chemical substances are available).
      (ii) The patient is motivated to stop using alcohol/drugs,
and is in need of a supportive structured treatment program to facilitate
withdrawal from chemical substances.


Source Note: The provisions of this §3.8027 adopted to be effective February 14, 1999, 24 TexReg 713