Facility Based Crisis/Non-Hospital Medical Detoxification

​​​See Clinical Coverage Policy for full service definition information.

Facility Based Crisis (FBC)/Non-Hospital Medical Detoxification (NHD) units are open 24/7/365 with 16 or fewer beds under the direction of a physician and with nursing, licensed therapist and qualified professional supports. These units offer an alternative to inpatient hospitalization for those experiencing a behavioral health crisis. They offer assessment, evaluation and treatment/intervention with the goal of crisis de-escalation and stabilization so that a member can safely return to a lower level of care. Treatment includes group and individual therapy and skills training to assist members in preventing or managing future crises, as well as medication management and case management. They also offer medical substance detoxification for those who need it. Some facilities are licensed to accept involuntarily committed members.

Intended Population

  • Those with behavioral health diagnoses whose symptoms are causing a disruption in safety, placement and/or functioning such that 24/7 supervision is required in the context of a behavioral health crisis to ensure safety, but for whom an inpatient level of care is not required.

  • Those with addictions to alcohol, sedative-hypnotics, and/or opiates who require medical detoxification but who are at low risk for medical complications of detoxification. ASAM withdrawal management level 3.7.

Recommended Best Practices

Expected Outcomes

  • Core Expected Outcomes

  • Low rates of repeat crisis system use

  • Low rates of future psychiatric hospitalization or FBC/detox admissions

  • Low rates of legal system use 90 days post-discharge

  • High rates of kept follow-up appointments within 48 hours of discharge​

Management Approach

  • Core Management Strategies

  •  Authorization Guidelines​

  • Programs will be monitored for average length of stay (expected five days or less), readmission rates and for excellence in the above expected outcomes; programs that fall below community standards will receive focused utilization and quality reviews.

  • Conduct focused Utilization Review (UR) of Outpatient providers based upon over/under-utilization, negative outcomes (e.g., lack of progress due to lack of using evidence based practices, decline in functioning in spite of high use of services), concerning incidents and/or grievances, and other data suggesting a clinician's practices are an outlier compared to the community standard of care.

  • Link to special populations management