Unofficial translation
In accordance with paragraph 2 of Article 178 of the Code of the Republic of Kazakhstan "On public health and health care system", I HEREBY ORDER:
Footnote. The preamble as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).1. That the following shall be approved:
1) regulations of the activities of temporary adaptation and detoxification centres pursuant to Annex 1 hereto;
2) internal regulations of temporary adaptation and detoxification centre in compliance with Annex 2 hereto.
2. That order of Acting Minister of Healthcare of the Republic of Kazakhstan № 1 dated January 5, 2011 “On Approval of the Regulations of Temporary Adaptation and Detoxification Centres' Activities” shall be deemed to have lost force (registered with the Register of State Registration of Regulatory Legal Acts under № 6757, published on March 18, 2011 in the newspaper Yegemen Kazakhstan № 94-97 (26499)).
3. That, in compliance with the legislation of the Republic of Kazakhstan, the Department of Organization of Medical Care of the Ministry of Healthcare of the Republic of Kazakhstan shall ensure:
1) state registration hereof with the Ministry of Justice of the Republic of Kazakhstan;
2) placement hereof on the web-site of the Ministry of Healthcare of the Republic of Kazakhstan after its official publication;
3) within ten working days after state registration hereof with the Ministry of Justice of the Republic of Kazakhstan, submission to the Legal Department of the Ministry of Healthcare of the Republic of Kazakhstan of the information on execution of actions stipulated by sub- paragraphs 1 and 2) of this paragraph.
4. That the supervising Vice-Minister of Healthcare of the Republic of Kazakhstan shall be charged with the control of execution hereof.
5. That this order shall be put into effect ten calendar days after the date of its first official publication.
|
Minister of Healthcare of the Republic of Kazakhstan |
A. Tsoy |
“AGREED BY”
Ministry of Internal Affairs
of the Republic of Kazakhstan
Annex 1 to order
of the Minister of Healthcare
of the Republic of Kazakhstan
№ KR DSM-233/2020
dated December 4, 2020
Regulations of the activities of temporary adaptation and detoxification centres
Chapter 1: General provisions
1. These Rules for organization of the activities of temporary adaptation and detoxification centres (hereinafter the Regulations) have been developed in accordance with paragraph 2 of Article 178 of the Code of the Republic of Kazakhstan "On public health and health care system" (hereinafter – the Code) and shall determine the procedure for organization of the activities of temporary adaptation and detoxification centres.
Footnote. Paragraph 1 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).2. The following definitions shall be used in these Regulations:
1) detoxification - a complex of medical measures aimed at elimination of toxic substances of endogenous or exogenous origin from the human body;
2) intoxication - a state resulting from the use of alcohol, characterised by a complex of mental, behavioural, vegetative and somatoneurological disorders;
3) patient - a natural person who is (was) a consumer of health services, regardless of the presence or absence of a disease or condition requiring health care;
4) temporary adaptation - the process of bringing a person out of a state of intoxication and adapting him/her to the living environment;
5) temporary adaptation and detoxification centre (hereinafter referred to as TADC/Centre) - a centre designed to provide specialised medical assistance to persons in a state of intoxication, which is a structural subdivision of an organisation providing medical assistance in the field of mental health.
3. Temporary Adaptation and Detoxification Center (hereinafter - TADC) shall be established by decision of local executive bodies of regions, cities of republican significance and the capital, is a security facility and operates around the clock to provide specialized medical assistance to persons in a state of moderate alcohol intoxication (intoxication) when taken to the hospital
Footnote. Paragraph 3 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).3-1. The bed capacity of TADC shall be determined on the basis of:
1) not less than 20 beds in cities of republican significance;
2) not less than 15 beds in regional centers;
3) not less than 5 beds in cities of regional significance, district centers, cities of district significance.
TADC bed is a conditional calculation unit reflecting the possibility to accommodate and provide specialized medical care to a person who is in a state of average alcohol intoxication (intoxication).
Footnote. The Rules as supplemented with Paragraph 3-1 in accordance with the order of the Minister of Healthcare of the Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).Chapter 2: Procedures for the operation of a temporary adaptation and detoxification centre
4. Persons suspected of being intoxicated shall be taken to the TADC by officers of the Ministry of the Interior. Upon delivery, officers of internal affairs bodies shall:
1) assist medical personnel in the examination, placement in the TADC;
2) seize firearms, cold weapons, explosives, poisonous and toxic substances and other items prohibited in circulation in the Republic of Kazakhstan.
5. The identity of a person brought in shall be established by internal affairs officers and reported to the medical personnel of the TADC.
Lack of identity documents shall not serve as a basis for refusing to admit a detainee to the Centre.
6. When a person with suspected alcohol intoxication is delivered, he/she shall be registered with the register of admissions and refusals to hospitalization according to the form in obedience to Annex 1 to these Regulations.
7. After registration of the delivered person, a doctor-psychiatrist (narcologist) or a paramedic (medical worker) who has received additional education of specialists in the field of public health on the issues of medical examination to establish the fact of psychoactive substance use and state of intoxication according to the order of the Minister of Healthcare of the Republic of Kazakhstan dated December 21, 2020 № ҚР ДСМ-303/2020 "On approval of the rules of additional and non-formal education of specialists in the field of health care, qualification requirements for organizations implementing educational programs of additional and non-formal education in the field of health care, as well as the rules of recognition of learning outcomes obtained by health care professionals through additional and non-formal education" (registered in the Register of State Registration of Regulatory Legal Acts under № 21847) a medical examination is conducted to establish the fact of PAS use and intoxication and to determine whether there are indications and contraindications for placement in TADC.
Footnote. Paragraph 7 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).8. The admission of a person with suspected alcohol intoxication shall be carried out by the medical staff of the Centre.
9. The results of the medical examination shall be formalized in a report on the medical examination conducted at TADC (hereinafter referred to as the report) in the form according to Annex 2 to these Rules.
The list of medical services provided in TADC, per one person placed in the Temporary Adaptation and Detoxification Center is determined according to Annex 3 to these Rules.
Footnote. Paragraph 9 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).10. The opinion shall describe the clinical condition with the following conclusions:
shall be subject to placement in the TADC;
person’s placement to the TADC denied.
11. The conclusion shall be drawn up in two copies, which shall be certified by the signature of a psychiatrist (narcologist) or a paramedic.
One copy of the report shall be given to the internal affairs officer who delivered the person being examined, the second copy shall be kept at TADC for 5 (five) years.
The report shall be attached to the card of the patient at TADC according to the form according to Annex 2 to these Rules.
Footnote. Paragraph 11 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).12. The personal inspection of the patient's belongings shall be carried out by the medical staff upon placement in the TADC.
13. Contraindications for admission to the TADC:
1) minor age;
2) a state of light or severe intoxication (intoxication) from alcohol;
3) state of intoxication (intoxication) from other psychoactive substances;
4) the presence of mental and/or somatic pathology requiring emergency medical care;
5) signs of an infectious disease in the period of epidemiological danger.
14. Minors brought to the Centre shall be hospitalized in the relevant departments of the relevant medical organization in compliance with Article 118, paragraph 1, sub-paragraph 2) of the Code with the consent of their legal representatives.
15. No items and substances may be taken or found among the patients' personal belongings at the TADC:
1) psychoactive substances;
2) money and valuables (jewellery, gold watches etc.)
3) mobile phones, photo-video recorders;
4) explosive, poisonous and toxic substances;
5) firearms and edged weapons;
6) literature aimed at inciting national and religious discord, containing propaganda of violence, as well as materials of pornographic nature;
7) other items prohibited by the legislation of the Republic of Kazakhstan.
Items and substances specified in sub-paragraphs 1), 4), 5), 6), and 7) of this paragraph shall be subject to seizure by officers of the internal affairs agencies.
| Annex 1 to the Regulations of the Activities of Adaptation and Detoxification Centres |
Емдеуге жатқызуға қабылдауларды және одан бас тартуларды есепке алу журналы
A register of placement and denial of hospitalisation
№ |
Күні |
Уақыты |
ТАӘ (болған жағдайда) |
ЖСН |
Тұрғылықты мекен-жайы |
Жеткізушінің ТАӘ (болған жағдайда), лауазымы |
1 | 2 | 3 | 4 | 5 | 6 | 7 |
Уақытша бейімдеу және детоксикация орталығындағы пациент картасының № |
Емдеуге жатқызу күні мен уақыты |
Келіп түскен кезде қойылған диагноз |
Шығарылған күні мен уақыты |
Қабылдаудан бас тарту себептері (ұсынымдар) |
Дәрігердің ТАӘ (болған жағдайда), қолы |
8 | 9 | 10 | 11 | 12 | 13 |
Ескертпе:
Журналдың беттері нөмірленеді, журнал жіппен тігіледі және ұйымның мөрімен расталады.
Note:
The journal's pages shall be numbered, the journal shall be laced and stamped with the organisation's seal.
| Annex 2 to the Rules for organization of the activities of temporary adaptation and detoxification centres |
Conclusion on medical examination conducted in the Temporary adaptation and detoxication center
Footnote. Annex 2 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).
1. Passport details:
1) surname, name, patronymic (if any)
______________________________________________________________________
2) Age (date, month, year of birth) ___________________________________
3) Identity document (type of document, number) ______________
______________________________________________________________________
4) Place of work, position _____________________________________________
______________________________________________________________________
______________________________________________________________________
2. Grounds and motives for delivery _______________________________________
______________________________________________________________________
______________________________________________________________________
_______________________________________________________________________
1) Circumstances of the identification of the person delivered ____________________________
_______________________________________________________________________
_______________________________________________________________________
2) Position, surname, name, patronymic (if any) of the delivering person (exact time, date)
of delivery _______________________________________________________________
3. Date and exact time of examination _______________________________________
4 Psychiatrist (narcologist) or paramedic __________________________________
5. Appearance of the delivered person (condition of clothing, skin, injuries, wounds, bruises, etc.): ________________________________________________
________________________________________________________________________
________________________________________________________________________
6. Behavior of the delivered person: tensed, withdrawn, irritated, excited, aggressive, euphoric, chatty, fidgety, sleepy, lethargic, complaints about his/her condition:
_______________________________________________________________________
________________________________________________________________________
________________________________________________________________________
7. State of consciousness, orientation in place, time, situation and one's own personality:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
8. Speech ability: connectedness of presentation, articulation problems, slurred speech, and other
speech, etc. ____________________________________________________________
________________________________________________________________________
________________________________________________________________________
9. Vegetative-vascular reactions (skin condition, mucous membranes of eyes, tongue, sweating, salivation) ______________________________________
________________________________________________________________________
________________________________________________________________________
respiration: rapid, slow __________________________________________
pulse _____________________ blood pressure _________________________
pupils: constricted, dilated, reaction to light _________________________________
nystagmus when looking to the side _____________________________________________
10. Двигательная сфера ___________________________________________________
1) facial expressions: sluggish, animated ______________________________________________
2) gait (wobbly, spreading of legs when walking), walking with turns (staggering when turning)________________________________________________________________________
________________________________________________________________________
3) standing in the Romberg pose _________________________________________________
4) precise movements (picking up a coin from the floor, finger-nose test)
________________________________________________________________________
________________________________________________________________________
5) trembling of eyelids, tongue, fingers _________________________________________
________________________________________________________________________
11. Signs of neuropsychiatric diseases, organic brain damage, physical exhaustion, trauma (according to the delivered person).
brain, physical exhaustion, traumas (according to the delivered person)________________________________________________________________________
________________________________________________________________________
12. Information about last alcohol consumption: subjective, objective
_______________________________________________________________________
_______________________________________________________________________
13. The smell of alcohol on the breath ________________________________________________
_______________________________________________________________________
14. Data of laboratory, instrumental examinations (if available)
_______________________________________________________________________
_______________________________________________________________________
15. Diagnosis, condition ___________________________________________________
_______________________________________________________________________
16. Conclusion (indicating whether to be placed in TADC or denied)
to be placed in TADC) ___________________________________________________
_______________________________________________________________________
Psychiatrist (narcologist) or paramedic ___________________________________
surname, name, patronymic (if any)
signature
Date
Time
| Annex 3 to the Rules for organization of the activities of temporary adaptation and detoxification centres |
List of medical services of a Temporary adaptation and detoxication center
Footnote. The Rules as supplemented with Annex 3 in accordance with the order of the Minister of Healthcare of the Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).
1. Appointment at a paramedic with technical and professional medical education in the specialty of "Medical care" or a nurse with technical and professional, post-secondary medical education.
2. Consultation of a specialist with higher medical education in the specialty "Psychiatry" or appointment at a paramedic with technical and professional medical education in the specialty "Medical care".
3. Medical examination for the fact of alcohol consumption and intoxication.
4. Determination of ethanol in biological material by express method (if indicated).
5. Determination of narcotic drugs and psychotropic substances in biological material by express method (if indicated*).
6. Management of acute alcohol intoxication of medium degree (if available*).
7. Medical observation of the patient in the state of medium degree of alcohol intoxication (intoxication).
* indications shall be determined by the attending physician
| Annex 2 to order of the Minister of Healthcare of the Republic of Kazakhstan № KR DSM-233/2020 dated December 4, 2020 |
Internal regulations of the temporary adaptation and detoxification centre
Chapter 1: General provisions
1. These internal rules of the temporary adaptation and detoxification center (hereinafter - Rules) are developed in accordance with paragraph 2 of Article 178 of the Code of the Republic of Kazakhstan "On public health and health care system" (hereinafter – the Code) and shall determine the internal regulations of the temporary adaptation and detoxification center (hereinafter - TADC).
Footnote. Paragraph 1 as amended by the order of the Minister of Healthcare of the Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).2. These Regulations shall apply to medical personnel, persons visiting and being placed in the TADC.
Chapter 2: Regulations for placing and discharging patients at a temporary adaptation and detoxification centre
3. Patients who are moderately intoxicated by alcohol and those without contraindications shall be placed to the TADC in compliance with the procedure for the organisation of the temporary adaptation and detoxification centre approved under paragraph 2 of Article 178 of the Code.
4. Patients with mental and (or) somatic pathology requiring emergency medical care shall be delivered to the relevant medical institution by an ambulance team upon a referral from a psychiatrist (narcologist) of the TADC.
5. Notification on the placement of patients whoa are in a state of alcoholic intoxication to the Centre shall be made in conformity with paragraph 2 of Article 180 of the Code:
close relatives (if they are present and their contacts are available) at the place of residence shall be notified within 1 (one) hour of the placement;
the public authorities referred to in paragraph 2 of Article 180 of the Code, when a foreigner is placed at the TADC, shall be informed by telephone no later than 3 (three) hours from the moment of placement;
An appropriate record of the notification with an indication of the time shall be made in the medical records.
6. Before the patient is placed at the Centre, the medical staff shall register personal belongings, documents, money and other valuables in the register of documents and personal belongings of patients in the form pursuant to Annex 1 to these Regulations.
7. The clothes of patients admitted to the TADC shall be kept in individual lockers. Documents, money and other valuables shall be kept in metal cabinets (safes) in appropriate containers. Clothing wardrobes and individual containers shall have the same serial number.
8. The person placed at the TADC shall be given sanitary and hygienic treatment. Appropriate sanitary and epidemiological measures shall be taken if infectious and parasitic diseases are detected.
9. A patient's card shall be drawn up for each person placed in TADC in the form according to Annex 2 to these Rules, which is simultaneously a statistical card, including through medical information systems.
Republic of Kazakhstan dated 04.05.2023 № 80 (shall be enforced upon expiry of ten calendar days after its first official publication).10. Men placed at the TADC shall be accommodated separately from women.
11. Patients with infectious and parasitic diseases shall be kept separately from other patients admitted to the Centre.
12. The medical staff shall constantly monitor the behaviour and health status of patients placed at the TADC.
Treatment shall be prescribed if there is a medical indication. The doctor's prescriptions shall be recorded in the patient's chart. The frequency of doctor's visits shall depend on the patient's condition.
13. The use of physical restraints in cases of psychomotor agitation and a high likelihood of danger to self and others shall be in pursuance of paragraph 2 of Article 175of the Code.
14. If a patient's somatic and (or) mental state deteriorates, he/she shall be transferred to other specialised medical organisations by an ambulance team.
15. A patient shall be discharged by a psychiatrist (narcologist) on a routine basis if his/her condition improves and does not require further observation and treatment in the Centre, within twenty-four (24) hours of admission. Upon discharge, a note shall be made in the patient's chart and in the register of placement and denial of hospitalisation.
16. Upon receipt of their documents and personal belongings, the patient shall confirm in writing that all documents and personal effects have been received as recorded in the patient's documents and personal effects register, except for items the storage of which is unlawful.
17. Upon discharge, the patient shall be provided with a medical note on placement at the TADC upon request.
18. At least one hour prior to discharge, the medical staff shall notify the personnel of the interior on the imminent discharge of the patient who have been brought to the Centre.
Chapter 3: Rules of conduct for patients at the temporary residential and detoxification centre
19. Patients placed in the TADC shall:
1) comply with its internal regulations;
2) accept the prescribed treatment.
20. Access to the TADC, except for the waiting rooms, shall be permitted only to the staff of the organisation, the staff of the security organisation, other persons, in compliance with the legislation of the Republic of Kazakhstan.
Patients admitted to the TADC shall have the rights and responsibilities set out in Article 182 of the Code.
| Annex 1 to the internal regulations of the temporary adaptation and detoxication centre |
Пациенттердің құжаттарын және жеке заттарын тіркеу журналы
Register of patients' documents and personal effects
№ |
Орналастырылған күні мен уақыты |
Пациенттің ТАӘ (болған жағдайда) |
Пациенттің құжаттары |
Пациенттің жеке заттары* |
Пациенттің ақшасы** |
Тізімдемені растайтын адамдардың Т.А.Ә. (болған жағдайда), лауазымы, қолы |
Құжаттар мен жеке заттарды алғаны туралы пациенттің қолы |
№ s/o | |||||||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
Ескертпе:
Журналдың беттері нөмірленеді, журнал жіппен тігіледі және ұйымның мөрімен бекітіледі.
* Орталыққа орналастырылған пациенттің жеке заттарының сипаттамасы айрықша сыртқы сипаттамаларды (түсі, мөлшері, тозуы, ақаулардың (зақымдардың) болуы және т.б.) қамтуы тиіс.
** Ақшаны сипаттаған кезде валютаның түрін, купюралардың құндылығын, олардың саны мен жалпы сомасын көрсету қажет.
Note:
The pages of the register shall be numbered, the register shall be laced and stamped with the organisation's seal.
* The description of the personal belongings of the patient placed in the centre shall include distinctive external characteristics (colour, size, wear and tear, presence of defects (damages), etc.).
** When describing money, state the type of currency, the value of the notes, the number of notes, and the total amount.
| Annex 2 to the internal regulations of the temporary adaptation and detoxication centre |
Уақытша бейімдеужәне детоксикация орталығындағы пациенттің №_____ картасы
Patient’s chart of a temporary adaptation and detoxification centre № _____
1. Тегі
Surname ___________________________________________________
Аты
Name_______________________________________________________
Әкесінің аты (болған жағдайда)
Patronymic (if any) ______________________________________
2. Туған күні
Date of birth /_____/______/__________/
3. Жынысы: ер - 1, әйел – 2
Gender: male - 1, female – 2
4. Ұлты
Ethnic nationality _____________________________________________
5. Тұрғын: қала – 1, ауыл – 2
resident of: city – 1, village – 2
6. ЖСН
IIN___|___|___|___|___|___|___|___|___|___|___|___|
7. Медициналық тіркеу нөмірі
Medical registration number
8. Тұрғылықты мекенжайы
Place of residence:
1) Ел, облыс, аудан
Country, region, district _________________________________________
_____________________________________________________________
2) елдімекен, көше, үй, пәтер
locality, street, house, flat ___________________________
_____________________________________________________________
9. Әлеуметтік мәртебесі:
Social status : _____________________________________________
10. Жатқызу күні мен уақыты
Date and time of placement ______/______/______ ______/______
11. Бақылау деректері:
Surveillance data :
Күні, уақыты |
Объективтік мәртебе деректері |
Тағайындаулар |
1 | 2 | 3 |
12. Шығару (қайтыс болған) күні мен уақыты
Date and time of discharge (death)) _____/____/______ ____/____
13. Төсек-күндерінің саны __________________________________
Bed-days spent __________________________________
14. Диагнозы:
Diagnosis:
Diagnosis |
АХЖ-10 бойынша код | |
Қорытынды клиникалық диагноз | ||
Асқынулар | ||
Қосалқы аурулар | ||
Патологоанатомиялық диагноз (қайтыс болу себебі) |
15. Болу нәтижесі:
The outcome of the stay :
Шығарылды (discharged) – 1, ауыстырылды (transferred) – 2, қайтыс болды (died) – 3, өз еркімен
кетіп қалды ( unauthorized leave ) – 4.
16. Дәрігер
Doctor:
ТАӘ (full name) _______________________ Code _______________
Қолы (Signature) _______________________________________
17. Орталық меңгерушісі (зав. центром):
ТАӘ (Full name) _______________________ Code _______________
Қолы (Signature) ________________________________________
