Current through Register Vol. 42, No. 11, August 30, 2024
(1)
Legal
authority for adoption of Rules under and by virtue of authority vested
in it by the Legislature of Alabama, Code of Ala.
1975, Sections
22-21-20, et seq., the State Board
of Health does hereby adopt and promulgate the following Rules.
(2)
Definitions.
(a) "AAC Rule" means Alabama Administrative
Code Rule.
(b) "Audiologist" means
a person who meets applicable legal requirements for the provisions of
audiology services and who meets education and work standards established by
the American Speech and Hearing Association for the Certificate of Clinical
Competency in Audiology.
(c) "Chief
Executive Officer" means a person who is delegated the responsibility for the
interpretation, implementation, and proper application of policies and programs
established by the governing authority, and is delegated responsibility for the
establishment of safe and effective administrative management, control and
operation of the services provided. This responsibility is accomplished by
corresponding authority. This person is also referred to as the facility
administrator.
(d) "Medical
Director" means a physician currently licensed by the Medical Licensure
Commission, State of Alabama, to practice medicine and surgery and provide
medical advice to the center.
(e)
"Occupational Therapist" means a person who is certified by the American
Occupational Therapy Association, or who is a graduate of a program of
occupational therapy accredited by the American Medical Association and who
currently meets state legal requirements.
(f) "Occupational Therapist Assistant" means
a person who is eligible for certification as a certified occupational therapy
assistant by the American Occupational Therapy Association and who meets state
legal requirements.
(g) "Patient"
means a person partaking in any of the services provided by a rehabilitation
center. The centers may identify patients as clients; however, for the purpose
of these Rules, the term patient is used.
(h) "Physician" means a person currently
licensed by the Medical Licensure Commission of the State of Alabama, to
practice medicine and surgery.
(i)
"Physical Therapist" means a person who is a graduate of a program in physical
therapy approved by the American Physical Therapy Association or the Council on
Medical Education of the American Medical Association and who is licensed by
the state.
(j) "Physical Therapist
Assistant" means a graduate of a physical therapy curriculum approved by the
American Physical Therapy Association or other associations recognized by the
Commission on Accreditation of Rehabilitation Facilities and/or its equivalent
as determined by requirements established by state regulatory agencies, and who
currently meets state legal requirements.
(k) "Psychologist" means a person who holds a
master's degree in psychology from a training program approved by the American
Psychological Association and who currently meets state legal
requirements.
(l) "Registered Nurse
(RN)" means a person currently registered in the State of Alabama in accordance
with the provisions contained in current state statutes.
(m) "Rehabilitation Center" means a business
entity offering and providing outpatient assistance in the rehabilitation of
disabled persons by providing two or more services that must be performed by or
under the supervision of a physical therapist, occupational therapist or speech
pathologist. This term does not include a business entity that is a certified
home health agency.
(n) "Social
Worker" means a person who is a graduate of a school of social work accredited
or approved by the Council on Social Work Education and who currently meets
state legal requirements.
(o)
"Speech Pathologist" means a person who meets applicable legal requirements for
the provision of speech pathology services and who meets the academic and work
experience standards established by the American Speech and Hearing Association
for the Certificate of Clinical Competence in Speech Pathology and who meets
state legal requirements.
(p)
"These Rules" means Rules
420-5-11-.01 through
420-5-11-.04, Chapter 420-5-11,
Rehabilitation Centers, Alabama Administrative Code.
(q) "Vocational Specialist" means a person
who has a bachelor's degree and:
1. Two years
experience in vocational counseling in a rehabilitation setting such as a
sheltered workshop, state employment service agency, etc., or
2. At least 18 semester hours in vocation
rehabilitation, educational or vocational guidance, psychology, social work,
special education or personnel administration, and one year's experience in
vocational counseling in a rehabilitation setting; or
3. Has a master's degree in counseling, and
who currently meets state legal requirements.
(3)
Types of License.
(a) Regular License. A regular license may be
issued by the State Board of Health after the Board has determined that the
rehabilitation center is in substantial compliance with the Rules herein
adopted.
(b) Probational License.
This license shall be granted when the Board has reason to believe that the
operation is questionable, but only when the Board is satisfied that the health
and safety of residents will not be endangered during this period. Maximum
length of time for probationary status is one year. However, an extension of
time may be granted if the governing authority is making specific plans to
construct a new rehabilitation center, establish a rehabilitation center in a
structure which meets these rules or is actually in the process of meeting
these rules. Closure of the rehabilitation center for a period of thirty days
or longer except for remodeling or alterations shall mean that it is no longer
in continuous operation and it shall meet the requirements for a regular
license prior to being reopened.
(4)
Licensing.
(a) Application for License. All
rehabilitation centers shall apply for licensure on a form designated by the
State Board of Health. The application will reflect all data required by
Code of Ala. 1975, Section
22-21-20, et seq.
(b) Fee. Each application for license shall
be accompanied by a fee as mandated by statute. No fee shall be refunded. Fees
shall be paid by cash, check or money order made payable to the Alabama
Department of Public Health.
(c)
Name of Facility. Every rehabilitation center shall be designated by a
permanent and distinctive name which shall not be changed until an application
has been completed and approved. Words in the name of the center that may
reflect a different type of facility or service shall not be used.
(d) Separate License. When more than one
facility is operated under the same operating entity, a separate license shall
be required for each facility. Separate licenses are not required for separate
buildings used by the same facility on the same grounds.
(e) Reissuance of License.
1. The following changes in the status of the
facility will require issuance of a new license, upon application and payment
of application fee (if applicable).
(i)
Change in facility ownership or operating entity (fee required).
(ii) Change in name (no fee
required).
2. The
governing authority shall file with the State Board of Health an application
for license 30 days before any proposed change requiring a new license, in
order to permit processing of the application and issuance of the license prior
to the desired effective date of the change.
(f) Plan of Services. A plan of services
shall be submitted with the initial application for licensing. The plan of
services shall specify:
1. If the center
provides nursing services.
2. Types
of physical restoration provided.
3. Professionals employed for social
adjustment.
4. Types of vocational
adjustment professionals employed.
(g) Occupancy. No part of a rehabilitation
center may be rented, leased or used for any commercial purpose not reasonably
necessary or related to the services the facility is licensed to provide. The
Department shall approve all plans for additional occupancy. Food and drink
machines may be maintained or a diet kitchen provided. Notwithstanding the
foregoing, a rehabilitation center may rent a portion of its premises to
another entity, or share a portion of its premises with another entity, if the
services the entity provides would reasonably be expected to be helpful to
patients of a rehabilitation center, such as massage therapy, chiropractic
services, acupuncture, or the provision of fitness classes, diet classes, or
exercise classes. The safety and appropriate treatment of patients on
rehabilitation center premises remain the responsibility of the rehabilitation
center, irrespective of whether those patients are receiving services from
another entity located on the premises
(5)
Right of Appeal.
(a) Any licensee dissatisfied with
administrative decisions made in application of these rules may appeal under
the procedures of the Alabama Administrative Procedures Act, Code
of Ala. 1975, Section
41-22-1 et. seq.
(6)
Waivers. The
State Health Officer may approve a waiver to these rules in the following
manner:
(a) The State Health Officer may
approve a waiver to any provision of these rules, except for any provision
which restates a statutory requirement, or which defines any term.
(b) To be eligible for a waiver, the licensee
must be affected by the provision for which the waiver is requested, and must
demonstrate by clear and convincing evidence that:
1. Local conditions are such that the
licensee cannot or need not meet the provision for which the waiver is applied;
and
2. Approval of the waiver will
not unreasonably increase the risk of harm that the affected rule provision is
intended to protect the public against.
(c) An application for a waiver shall also
contain the name and address of the licensee, a statement of purpose, the
period of time for which the waiver is requested and evidence demonstrating
that the requirements of subsection (b) above are met.
(d) An application for a waiver must be
presented in writing to the State Health Officer. All supporting evidence
referenced in the application must be attached.
(e) The State Health Officer shall deny any
application for a waiver which does not comply with the requirements of this
section. Moreover, the Department of Public Health may make periodic
evaluations of any waiver that has been granted. The State Health Officer may
revoke a waiver if the statements, representations or supporting documentation
that are part of the application are discovered to be false or inaccurate, or
if local conditions upon which it was based change, or if public health, safety
or welfare is adversely affected by a continuation of the waiver.
(f) Waivers issued by the State Health
Officer shall be valid for a finite period of time as specified in the
waiver.
(7)
Disclosure of Information. Official reports, such as statements of
deficiencies generated by the State Board of Health as a result of on-site
inspections, and plans of correction submitted in response to those statements
of deficiencies, are subject to public disclosure. Information received through
other means and reports, other than statements of deficiencies, shall be deemed
to be confidential and shall not be publicly disclosed except in response to a
valid subpoena or court order or in proceedings involving the affected
facility's license or proceedings involving the license of another facility
operated by the same governing authority. Inspection reports will never contain
the name or other identification of any patient in the inspected
facility.
Authors: L. O'Neal Green, Rick Harris, W. T.
Geary, Jr., M.D.
Statutory Authority:
Code of Ala.
1975, §§
22-2-2(6),
22-21-28, et seq.