Current through Register Vol. 46, No. 39, September 25, 2024
(a)
Policies and procedures. The program governing authority must
approve written policies, procedures and methods governing the provision of
services that are strength-based, person centered and trauma informed to
patients in compliance with Office regulations including a description of each
service provided and the overall approach to service delivery and a description
of evidence-based practices employed in group, individual and family treatment.
Such policies and procedures shall address, at a minimum, the following:
(1) procedures and specific criteria for
admission, retention, transfer, referrals and discharge;
(2) level of care determinations utilizing
the OASAS level of care determination protocol, treatment/recovery plans, and
placement services;
(3) staffing,
including but not limited to, training, supervision, and use of student
interns, peers, and volunteers;
(4)
the provision of medical and psychiatric services, including screening and
referral for associated physical or mental health conditions;
(5) a schedule of fees for services
rendered;
(6) infection control
procedures;
(7) cooperative
agreements with other substance use disorder services providers and other
providers of services that the patient may need;
(8) compliance with other requirements of
applicable local, state and federal laws and regulations, OASAS guidance
documents and standards of care regarding, but not limited to:
(i) education, counseling, prevention and
treatment of communicable diseases, including viral hepatitis, sexually
transmitted infections and HIV/AIDS; regarding HIV, such education, counseling,
prevention and treatment shall include condom use, testing, pre- and
post-exposure prophylaxis and treatment;
(ii) the use of toxicology tests as
clinically appropriate; and
(iii)
medication and the use of medication for addiction treatment;
(iv) if acupuncture is provided it must be
provided in accordance with Part 830 of this Title;
(v) the use of a problem gambling screen
approved by OASAS.
(9)
record keeping procedures which ensure that documentation is accurate, timely,
prepared by appropriate staff, and in conformance with the federal
confidentiality regulations contained in 42 Code of Federal Regulations Part 2;
and
(10) Utilization review and
quality improvement. All programs must have a utilization review process, a
quality improvement committee, and a written plan that identifies key
performance measures.
(b)
Program goals. The program shall have as its goals:
(1) the improvement of functioning and
development of coping skills necessary to enable the patient to be safely,
adequately and responsibly treated in the least intensive environment;
and
(2) the development of
individualized plans to support the maintenance of recovery, attain
selfsufficiency, and improve the patient's quality of life.
(c)
Minimum services. An
array of services shall be provided including, but not limited to, those listed
below. The services must be clinically indicated and specified in the
individualized treatment/recovery plan.
(1)
Clinical services including:
(i) Counseling
services: trauma-informed, person centered individual, group and family
counseling as appropriate; Group counseling sessions must be structured in size
and duration to maximize therapeutic benefit for each participant. Program
policies must include a process for determining group size, group purpose,
monitoring patient experience, and assessing group efficacy; activities
therapy;
(ii) Assessment and
referral services for patients and significant others;
(iii) Medical and psychiatric
consultation;
(iv) HIV and AIDS,
hepatitis C, tuberculosis, and other communicable diseases education, risk
assessment, supportive counseling and referral;
(2) Recovery support services including:
(i) substance use education, awareness and
recurrence prevention;
(ii)
education about, orientation to, and the opportunity for participation in,
available and relevant selfhelp and peer support groups including Alternative
Peer Groups;
(iii) holistic health
practices; socialization skills;
(3) Educational assessment and educational
services, as appropriate and as required by law, either directly or by
arrangement with local school districts including:
(i) Vocational assessment and vocational
services;
(ii) life skills
training.
(d)
Medication for Addiction Treatment.
(1) All programs shall maintain a patient
with substance use disorder on approved medication, including those federal
Food and Drug Administration (FDA) approved medications to treat substance use
disorder, if deemed clinically appropriate and in collaboration with the
patient's existing provider, and with patient consent, in accordance with
federal and state rules and guidance issued by the Office. The program shall
document such contact with the existing program or practitioner prescribing
such medications.
(2) To facilitate
access to full opioid agonist medication for patients who are maintained on
such medication at the time of admission or who choose to start such medication
during admission, the program shall develop a formal agreement with at least
one Opioid Treatment Program (OTP) certified by the Office to facilitate
patient access to full opioid agonist medication, if clinically appropriate.
Such agreements shall address the program and the OTPs responsibilities to
facilitate patient access to such medication in accordance with guidance issued
by the Office.
(3) The program
shall provide FDA approved medications to treat substance use disorder to an
existing patient or prospective patient seeking admission to an Office
certified program in accordance with all federal and state rules and guidance
issued by the Office.
(4) The
program shall provide education to an existing patient or prospective patient
with substance use disorder about approved medications for the treatment of
substance use disorder if the patient is not already taking such medications,
including the benefits and risks. The program shall document such discussion
and the outcome of such discussion, including a patient's preference for or
refusal of medication, in the patients record.
(5) The program shall ensure that the
patient's discharge plan includes an appointment with a treatment provider or
program that can continue the medication post-discharge.
(e)
Emergency medical kit.
Pursuant to Part 800 of this Title, all programs must maintain an emergency
medical kit at each certified or funded location; such kit must include basic
first aid and naloxone emergency overdose prevention kit in a quantity
sufficient to meet the needs of the program. Programs must develop and
implement a plan to have staff trained in the prescribed use of a naloxone
overdose prevention kit such that it is available for use during all program
hours of operation.
(1) All staff and
patients should be notified of the existence of the naloxone overdose
prevention kit and the authorized administering staff.
(2) Nothing in this regulation shall preclude
patients from becoming authorized in the administration of the naloxone
emergency overdose prevention kit, provided however, the program director must
be notified of the availability of any additional authorized
users.
(f)
Food
and nutrition.
(1) Each facility
shall provide to each patient three (3) nutritious meals each day which furnish
sufficient nutrients and calories to meet normal needs as well as the special
needs of persons in recovery.
(2)
The facility shall have available snacks and beverages between meals.
(3) A dietician or dietetic technician acting
within their scope of practice shall provide menu planning services. Other
suitable staff shall be responsible for the procurement of food supplies and
the training and directing of food preparation and serving
personnel.
(g)
Certified capacity. The certified bed capacity of each RRSY
program shall not be exceeded at any time except with the written approval of
the Office.
(h)
Medicaid. Providers seeking Medicaid reimbursement must comply
with the requirements of this Part and Part 841 of this Title.
(i) Segregation. All
patients must at all times be kept physically separated from patients of
non-Part 817 services. In accordance with a provider-specific plan approved by
the Office prior to implementation, certain groups of patients shall be kept
physically separated within the facility based upon clinically appropriate age,
gender and developmental grouping.
(k)
Telehealth. Services may
be delivered using telehealth consistent with Part 830 of this Title.
