What Levels of Care Can Substance Use Facilities Offer?

We all know substance use is a growing concern and problem not just on the Oneida Reservation, but across the United States. While there are many treatment options and offerings available, there is not a nearby detox facility.

Oneida Behavioral Health is in the process of studying the need for a substance use detox, residential or transitional living facility in our community. Before we can have an informed community discussion about the need, it’s important to understand what each type of facility can and cannot offer if one becomes a reality. The following are descriptions of the three types of facilities begin studied.

Detox Center (Residential Withdrawal Management Service)

• What it is: A residential substance use treatment service that provides alcohol withdrawal management and intoxication monitoring. This includes medically managed 24-hour on-site nursing care, under the supervision of a physician. This is necessary because alcohol withdrawal can cause seizures and even death.
• Who it’s for: Participants must meet medical criteria for admission related to alcohol detox only. Those 18 and older are eligible for admission under IHS funding.
• Length of stay: Up to three days.
• What it doesn’t do/cannot provide: This facility can’t be used for withdrawal from methamphetamines, cocaine or opiate use.
• Admission cannot be limited to enrolled Oneida only and the length of stay is based on medical necessity, not homelessness or other psychosocial factors. This is NOT an inpatient psychiatric unit. Patients must be 18 years of age or older.

Medically Monitored Residential Treatment Service

• What it is: A residential substance use treatment service provides 20 or more hours of treatment services per patient per week. This treatment can be for alcohol, methamphetamines, cocaine, opiate or other substances. Substance use and mental health treatment personnel provide assessment and treatment for substance use disorders and co-occurring mental health disorders, under the oversight of a medical director. Medically monitored residential treatment services are delivered in a 24-hour clinical residential setting. This level of care is appropriate for patients who require a 24-hour supportive treatment environment to develop sufficient recovery skills and address functional limitations to prevent imminent relapse or dangerous substance use.
• Who it’s for: Those with substance use disorders as well as those with co-occurring mental health disorders.
• Length of stay: Up to 30 to 45 days.
• What it doesn’t do/cannot provide: Admission cannot be limited to enrolled Oneida only and the length of stay is based on medical necessity, not homelessness or other psychosocial reasons. This is NOT an inpatient psychiatric unit. A medication prescriber does not remain on site (Methadone is not provided). Medicaid does not cover room and board expenses. Participants must be 18 years of age or older.

Transitional Residential Treatment Service

• What it is/does: A residential substance use treatment service providing six or more hours of treatment services per patient per week. This treatment can be for alcohol, methamphetamines, cocaine, opiate or other substances. Substance use treatment personnel provide assessment and treatment for substance use disorders in a structured and recovery-supportive 24-hour residential setting, under the oversight of a physician or a prescriber knowledgeable in addiction, providing medical supervision and clinical consultation.
• Who it’s for: Those 18 years of age or older.
• Length of stay: Varies depending upon need.
• What it doesn’t do/cannot provide: Does not provide temporary residence for homelessness, domestic violence or abuse. Admission cannot be limited to enrolled Oneida only.

Oneida Behavioral Health deeply appreciates the importance of having the right types of services available for our community. As we move forward with our feasibility study, please know that Oneida Behavioral Health offers extensive outpatient substance use services for members of our community. We are here to help those who choose to enter recovery and can connect them with critical resources to support their journey. Learn more about our services at https://oneida-nsn.gov/resources/health/behavioral-health/.

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