Current through Register Vol. 46, No. 39, September 25, 2024
(a)
Medical
Director and medical staff.
(1) The
medical director, as defined in Part 800 of this Title, shall oversee the
development and revision of medical policies, procedures and ongoing training
for matters such as routine medical care, specialized services, and medical and
psychiatric emergency care, and supervision of medical staff.
(2) Programs providing treatment for persons
with co-existing medical or psychiatric conditions in addition to their
substance use disorder shall have an appropriately qualified physician,
physician's assistant, nurse practitioner, psychiatrist or psychologist on-site
or through telepractice, pursuant to Part 830 of this Title, providing coverage
as adequate and necessary to provide evaluation, treatment and supervision of
such other services for these patients.
(3) There shall be at least one full-time registered professional
nurse and additional licensed practical nurses, registered nurses, registered
physician's assistants, and nurse practitioners sufficient to provide the
services required. Such personnel shall be available to all patients at all
times.
(4) The medical director
may also serve as a physician of another service which is provided by the
facility.
(b)
Staff sharing. Staff may be either specifically assigned to
the inpatient service or may be part of the staff of the facility within which
the inpatient service is located. However, if these staff members are part of
the general facility staff, they must have specific training and experience in
the treatment of substance use disorder specific to the services provided. The
percentage of time that each shared staff is assigned to the inpatient service
must be documented.
(c)
Supervision and training. Each program must provide clinical
supervision and ensure and document a plan for staff training based on
individual employee needs. Subject areas appropriate for training shall be
identified by the Office.
(d)
Program director. There shall be a director of the program who
is a qualified health professional with at least three (3) years-experience in
the provision of substance use disorder services, and at least two (2)
additional years of supervisory experience prior to appointment as
director.
(e)
Other
clinical staff.
(1) At least 50
percent of all clinical staff shall be qualified health professionals as
defined in Part 800 of this Title. CASAC Trainees may be counted towards
satisfying the 50 percent requirement provided, however, that such individuals
shall not be considered qualified health professionals for any other purpose
under this Part.
(2) Clinical
staff members who are not qualified health professionals shall have
qualifications appropriate to their assigned responsibilities as set forth in
the inpatient service's written personnel policies, shall be subject to
appropriate staff supervision, and shall receive regular and continuing
education and training.
(3) There
shall be at least one clinical staff member, as defined in Part 800 of this
Title, designated to provide activities therapy;
(4) There shall be at least one counselor for every eight (8)
patients, at least 50 percent of whom shall be qualified health professionals.
Counseling staff shall be scheduled for a minimum of one and one-half shifts
five days per week, and one shift per day for the remaining two days per
week;
(5) There shall be clinical
staff available to all patients at all times. During late evening and night
shifts, there shall be at least two clinical staff members on duty. This staff
shall be awake at all times, make frequent rounds and be available to patients
who awaken during the night;
(6)
There shall be sufficient clinical staff, allocated based on clinical demands
of each shift, to achieve an overall program ratio of at least the following:
(i) if the program has 80 patients or more,
one full time equivalent staff for each four (4) patients;
(ii) if the program has between 31 and 79
patients, at least one full time equivalent staff for each three and one-half
patients; and
(iii) if the program
has 30 or fewer patients, at least one full time equivalent staff for each
three patients.
(g)
Additional required staff.
(1) Maintenance and security. There shall be
sufficient staff available to ensure that the inpatient program and all
equipment utilized therein is maintained in such a manner as to provide
patients with a clean and safe environment.
(2) Volunteers and interns. In addition to staffing requirements
of this Part, an inpatient service may utilize volunteers, students and
trainees, on a salaried or non-salaried basis. Such personnel shall be provided
close professional staff supervision and appropriate education from both
internal and external sources.
(3)
Health coordinator. Each inpatient program shall have a qualified individual
designated as the Health Coordinator who will ensure the provision of
education, risk reduction, counseling and referral services to all patients
regarding HIV, tuberculosis, hepatitis, sexually transmitted infections, and
other transmissible infections.
