On approval of the regulations of the activities of temporary adaptation and detoxification centres and the internal regulations of the temporary adaptation and detoxification centre

New Unofficial translation

Order of the Minister of Healthcare of the Republic of Kazakhstan No. KP DSM-233/2020 of 4 December 2020. Registered with the Ministry of Justice of the Republic of Kazakhstan on 4 December 2020 under No. 21726

      Unofficial translation

      In obedience to paragraph 2 of Article 178 of the Code of the Republic of Kazakhstan of 7 July 2020 “On Public Health and the Health Care System”, I HEREBY ORDER:

      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 No. 6757, published on March 18, 2011 in the newspaper Yegemen Kazakhstan No. 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
No. KR DSM-233/2020
dated December 4, 2020

Regulations of the activities of temporary adaptation and detoxification centres
Chapter 1: General provisions

      1. These regulations of the activities of temporary adaptation and detoxification centres (hereinafter the Regulations) have been developed in compliance with paragraph 2 of article 178 of the Code of the Republic of Kazakhstan 7 July 2020 “On Public Health and the Health Care System" (hereinafter the Code) and determine the procedure for the activities of temporary adaptation and detoxification centres.

      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. The Centre shall operate 24 hours a day, seven days a week, to provide medical assistance to moderately intoxicated patients on admission.

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 a person is registered, a psychiatrist (narcologist) shall conduct a medical examination to determine whether there are indications and contraindications for admission to the TADC.

      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 documented in the conclusion on the medical examination conducted at the TADC (hereinafter - the conclusion) in the form pursuant to Annex 2 to these Regulations.

      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 report shall be drawn up in two copies, which shall be certified by the signature of the psychiatrist (narcologist). One copy of the report shall be given to the internal affairs officer who carried out the delivery, while the second one shall be kept at the TADC.

      The report shall be attached to the file of the patient in the temporary adaptation and detoxification centre.

      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
Date

Уақыты
Time

ТАӘ (болған жағдайда)
Full name

ЖСН
IIN

Тұрғылықты мекен-жайы
Residential address

Жеткізушінің ТАӘ (болған жағдайда), лауазымы
Full name, position of the person who delivered the patient

1

2

3

4

5

6

7









Уақытша бейімдеу және детоксикация орталығындағы пациент картасының №
Card number of a patient in a temporary adaptation and detoxification centre

Емдеуге жатқызу күні мен уақыты
Date and time of hospitalisation

Келіп түскен кезде қойылған диагноз
Diagnosis when hospitalisied

Шығарылған күні мен уақыты
Date and time of discharge

Қабылдаудан бас тарту себептері (ұсынымдар)
Reasons for refusal of hospitalisation (recommendations)

Дәрігердің ТАӘ (болған жағдайда), қолы
full name (if any), physician's signature

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 Regulations
of the Activities of Adaptation
and Detoxification Centres

Уақытша бейімдеу және детоксикация орталығындағы жүргізілген
медициналық куәландыру туралы қорытынды

Medical examination report from a temporary adaptation and detoxification centre

      1. Паспорттық деректер:

      Passport details:

      1) Тегі, аты, әкесінің аты (болған жағдайда)

      Surname, first name, patronymic (if any) _______________________________________

      _________________________________________________________________________

      2) Жасы (туған күні, айы, жылы)

      Age (date, month, year of birth) ________________________________________

      3) Жеке басын куәландыратын құжат (құжат түрі, нөмір)

      Identity document (type of document, number) ___________________

      _________________________________________________________________________

      4) Жұмыс орны, лауазымы

      Place of employment, position __________________________________________________

      _________________________________________________________________________

      _________________________________________________________________________

      2. Жеткізу негіздері және уәждемелері

      Grounds and motives for delivery ____________________________________________

      __________________________________________________________________________

      __________________________________________________________________________

      __________________________________________________________________________

      1) Жеткізілген адамды анықтау жағдайлары

      Circumstances of the identification of the person delivered _________________________________

      __________________________________________________________________________

      __________________________________________________________________________

      2) Жеткізген адамның лауазымы, Т. А. Ә, (болған жағдайда) (нақты уақыты, күні)

      Position, surname, name patronymic (if any) of the delivering person (exact time, date) of delivery

      __________________________________________________________________________

      3. Зерттеп-қарау күні мен нақты уақыты

      Date and exact time of the medical survey ________________________________________

      4. Кім зерттеп-қарады (дәрігер)

      Examined by: (physician)_____________________________________________________

      5. Жеткізілген адамның сыртқы түрі (киімінің, терісінің жай-күйі, жарақаттардың,

      зақымдардың, соққылардың және тағы басқаларының болуы):

      Appearance of the person delivered (condition of clothing, skin, injuries, wounds, bruises, etc.):

      _______________________________________________________

      _________________________________________________________________________

      _________________________________________________________________________

      6. Жеткізілген адамның мінез-құлқы: ашулы, тұйық, қызба, қозу күйінде, агрессивті,

      эйфориялық, көп сөйлейді, абыржығыш, ұйқышыл, тежелген, өзінің жай-күйіне шағымдар білдіреді

      Behaviour of the person delivered: tense, withdrawn, irritable, agitated, aggressive, euphoric,

      chatty, fidgety, sleepy, lethargic, complaints about his/her

      condition:___________________________________________________________________

      _________________________________________________________________________

      _________________________________________________________________________

      7. Сана күйі, орынды, уақытты, жағдайды және өз тұлғасын бағдарлауы

      State of consciousness, orientation to place, time, situation and self:

      _________________________________________________________________________

      _________________________________________________________________________

      _________________________________________________________________________

      8. Сөйлеу қабілеті: баяндаудың байланыстылығы, артикуляцияның бұзылуы, сөйлеу

      тілінің шұбарлануы және тағы басқалары.

      Speech ability: coherence of expression, articulation disorders, slurred speech and others

      ________________________________________________________________________

      ________________________________________________________________________

      ________________________________________________________________________

      9. Вегетативтік-тамырлық реакциялар (тері тіндерінің күйі, көздің шырышты қабығы,

      тіл, тершілдік, сілекей ағу)

      Autonomic vascular reactions (skin, mucous membranes, eyes, tongue, sweating, salivation)

      ____________________________________________

      _________________________________________________________________________

      _________________________________________________________________________

      1) тыныс алу: жиіленген, баяу

      breathing: rapid, slowed ___________________________________________

      тамыр соғуы _______________ артериялық қан қысымы ________________________

      pulse _____________________ blood pressure __________________________

      көздің қарашықтары: тарылған, кеңейген, жарыққа реакция

      pupils: constricted, dilated, reaction to light __________________________________

      жан-жағына қарағандағы нистагм

      nystagmus at sideward glance______________________________________________

      10. Қозғалыс аясы

      motor skills _______________________________________________________

      1) ым: солғын, қызу

      facial expressions: sluggish, animated ________________________________________________

      2) жүріс-тұрысы (теңселіп жүру, жүргенде аяқтарын оңды-солды сілтеп жүру),

      бұрылыстармен жүру (бұрылғанда теңселу)

      gait (staggering, spreading legs when walking), walking with turns (staggering when turning)

      _________________________________________________________________________

      _________________________________________________________________________

      3) Ромберг күйінде тұру

      standing in Romberg's pose ____________________________________________________

      4) нақты қимылдар (еденнен тиынды алу, саусақтан-мұрыннан сынама)

      precise movements (picking up a coin from the floor, finger-nose test) _________________

      _________________________________________________________________________

      5) қабақтардың, тілдің, қол саусақтарының дірілдеуі

      trembling eyelids, tongue, fingers ____________________________________________

      _________________________________________________________________________

      11. Нервтік-психикалық аурулардың, мидың органикалық зақымдануының,

      физикалық қалжыраудың белгілері, бастан өткерген жарақаттар (жеткізілген адамның өз сөздерінен)

      Signs of neuropsychiatric illness, organic brain damage, physical exhaustion, trauma (according to the person

      delivered)_________________________________________________________________________

      _________________________________________________________________________

      12. Алкогольді соңғы рет тұтынғаны туралы мәліметтер: субъективті, объективті

      Information on last alcohol use: subjective, objective

      _________________________________________________________________________

      _________________________________________________________________________

      13. Ауыздан алкоголь иісінің шығуы

      Alcohol breath _____________________________________________________

      _________________________________________________________________________

      14. Зертханалық, жабдықтық зерттеп-қарау деректері (жүргізген жағдайда)

      Data from laboratory, instrumental examinations (if any)

      _________________________________________________________________________

      _________________________________________________________________________

      15. Диагноз, жай-күйі

      Diagnosis, state _______________________________________________________

      _________________________________________________________________________

      16. Қорытындылар (көрсете отырып: УБДО-ға орналастырылуға жатады немесе

      УБДО-ға орналастырудан бас тартылды):

      Opinion (indicating whether to be placed in a TADC or to be refused placement in a TADC):

      __________________________________________________________________________

      __________________________________________________________________________

      Психиатр (нарколог) дәрігер Т.А.Ә. (болған жағдайда)

      Psychiatrist (narcologist) ________________________________

      Surname, name, patronymic (if any)

                                    қолы signature

      Күні date

      Уақыты, time

  Annex 2 to order
of the Minister of Healthcare
of the Republic of Kazakhstan
No. KR DSM-233/2020
dated December 4, 2020

Internal regulations of the temporary adaptation and detoxification centre
Chapter 1: General provisions

      1. These internal Regulations for the temporary adaptation and detoxification centre (hereinafter the Regulations) have been developed in obedience to paragraph 2 of Article 178 of the Code of the Republic of Kazakhstan dated 7 July 2020 “On Public Health and the Health Care System” (hereinafter the Code) and sets out the internal regulations of the temporary adaptation and detoxification centre (hereinafter the TADC).

      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. For each person placed at the TADC, a chart of a patient staying in the temporary adaptation and detoxification centre shall be opened (hereinafter referred to as a patient chart), in accordance with Annex 2 to these Regulations, which at the same time is a statistical chart.

      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
Date and time of placement

Пациенттің ТАӘ (болған жағдайда)
Surname, name and patronymic (if any) of the patient

Пациенттің құжаттары
Patient documents

Пациенттің жеке заттары*
Patient's personal effects*

Пациенттің ақшасы**
Patient's money**

Тізімдемені растайтын адамдардың Т.А.Ә. (болған жағдайда), лауазымы, қолы
Name, surname, patronymic (if any), position, signatures of persons certifying the inventory

Құжаттар мен жеке заттарды алғаны туралы пациенттің қолы
Patient's signature on receipt of documents and personal belongings

No. 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 No. _____

      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
Date, time

Объективтік мәртебе деректері
Objective status data

Тағайындаулар
Prescriptions

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
ICD-10 code

Қорытынды клиникалық диагноз
Final clinical diagnosis



Асқынулар
Health complications



Қосалқы аурулар
Associated illnesses



Патологоанатомиялық диагноз (қайтыс болу себебі)
Pathological diagnosis (cause of death)



      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) ________________________________________

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