New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XXI - OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
Part 819 - Chemical Dependence Residential Services
Section 819.3 - Standards applicable to all residential service providers
Universal Citation: 14 NY Comp Codes Rules and Regs ยง 819.3
Current through Register Vol. 46, No. 12, March 20, 2024
(a) The program governing authority must approve written policies, procedures and methods governing the provision of services to residents in compliance with Office regulations and guidance which shall include a description of each service provided, including procedures for making appropriate referrals to and from other services, when necessary. These policies, procedures, and methods, shall address, at a minimum, the following:
(1)
procedures and specific criteria for admission, retention, transfers,
referrals, and discharge;
(2) level
of care determinations utilizing the OASAS level of care determination
protocol, comprehensive evaluations, treatment/recovery plans, and placement
services;
(3) staffing including,
but not limited to, training and the use of students, peers, and volunteers,
and appropriate criminal history reviews as otherwise required by this
Title;
(4) the provision of medical
services, including screening and referral procedures for associated physical
conditions;
(5) the provision of
psychiatric services, including the use of OASAS approved, validated screening
instruments for co-occurring mental health conditions, and referral procedures
for associated mental health conditions;
(6) a schedule of fees for services
rendered;
(7) infection control
procedures;
(8) cooperative
agreements with other substance use disorder treatment providers and other
providers of services that the resident may need;
(9) compliance with other requirements of
applicable local, state, and federal laws and regulations, OASAS guidance
documents and standards of care regarding:
(i)
education, counseling, prevention, and treatment of transmissible infections,
including tuberculosis, viral hepatitis, sexually transmitted infections, HIV,
and other infectious diseases, in accordance with guidance from the Office.
Regarding HIV, such education, counseling, prevention and treatment shall
include condom use, testing, and pre- and postexposure prophylaxis and
treatment;
(ii) the use of
toxicology tests, in accordance with guidance issued by the Office;
(iii) medication and the use of medication
for addiction treatment;
(iv) if
acupuncture is provided as an adjunct to the services provided by the program,
it must be provided in accordance with Part 830 of this
Title.
(10) procedures
for the ordering, procuring, and disposing of medication, as well as the
selfadministration of medication;
(11) quality improvement and utilization
review;
(12) clinical supervision
and related procedures;
(13)
procedures for emergencies;
(14)
incident reporting and review in accordance with Part 836 of this
Title;
(15) 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;
(16) procedures by which required educational
services are provided for school age children who are in residence as either an
individual who is receiving treatment or as part of a family unit;
(17) procurement, storage, and preparation of
food;
(18) record retention;
and
(19) safety plan
development.
(b) 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 items and naloxone emergency overdose prevention kits sufficient to meet the needs of the program. Programs must develop and implement a plan to have staff and residents, where appropriate, trained in the prescribed use of a naloxone overdose prevention kit such that it is available for use during all program hours of operation, in accordance with guidance from the Office.
(1) All staff and residents
should be notified of the existence of the naloxone prevention kit and the
authorized administering staff.
(2)
Nothing in this Part shall preclude residents 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.
(c) Medication for Addiction Treatment (MAT) for Substance Use Disorder (SUD)
(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.
(d) A substance use disorder residential service shall have as its goals
(1) the
improvement of functioning and development of coping skills necessary to enable
the resident to be treated safely, adequately and responsibly in the least
intensive environment; and
(2) the
utilization of individualized treatment/recovery plans to support the
maintenance of recovery and the attainment of self-sufficiency, including,
where appropriate, the ability to be employed functionally, and the improvement
of the resident's quality of life.
(e) All residential services shall provide, either directly or through referral to appropriate agencies, habilitative and rehabilitative services consistent with identified needs and treatment/recovery plans for services for individual residents. The following services shall be provided to residents as clinically indicated:
(1) Psychosocial Treatment. Each residential
service shall make available to its residents individual, group and family
services as appropriate that are evidence-based, person-centered, and
trauma-informed.
(i) 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 resident experience, and
assessing group efficacy. These sessions shall contain no more than fifteen
residents.
(ii) These treatments
must be evidence-based, person-centered, and trauma-informed, and
individualized to the needs of the resident per the clinical assessment, in
accordance with guidance and standards from the Office.
(iii) Evidence-based, person-centered, trauma
informed individual, group and family counseling must be provided by a staff
member operating within their scope of practice.
(iv) Family counseling services that include
significant others are provided by program staff with appropriate training or
by referral to community providers with this expertise.
(v) Peer support may occur in a peer group
setting where the group is facilitated by residents who have greater experience
or seniority within the service. Such counseling must be supervised directly by
a clinical staff member in attendance.
(2) Supportive services. Each service shall
ensure that a comprehensive and appropriate range of support services are
available to each resident. Such services shall include, as needed and as
appropriate, legal, medical, mental health, recovery, wellness, and social
services, as well as vocational assessment and activities.
(3) Educational and childcare services. Each
residential service that provides services to school-age children must make
arrangements to ensure the availability of required educational and childcare
services.
(4) Structured activity
and recreation. Residents shall be afforded the opportunity to participate in
recovery and wellness activities designed to develop skills to enable them to
make effective use of leisure time as well as improve social skills, self
esteem and responsibility.
(5)
Orientation to community services. Each substance use disorder residential
service shall provide orientation to, and instruction in identifying and
obtaining needed community recovery and wellness services, including housing
and other necessary case management services, to each
resident.
(f) The certified bed capacity of each residential service may not be exceeded at any time except in cases of emergency and unexpected surges in demand where no alternative options are available, when the failure to accept individuals temporarily into the service would jeopardize their immediate health and safety, and where the excess of capacity would be time limited. Standards and procedures for such exceptions that are based upon the availability of adequate space, supplies and staff must be established with the prior approval of the Office.
(g) Food and nutrition.
(1) Intensive residential rehabilitation
services shall ensure the availability of three meals each day to each resident
and community residences shall ensure the availability of two meals each day to
each resident. Such meals shall furnish sufficient nutrients and calories to
meet normal needs as well as the special needs of persons in recovery.
Supportive living services shall ensure the availability of adequate food to
all participants.
(2) Intensive
residential rehabilitation services and community residences shall have
available snacks and beverages between meals. A qualified dietician, dietetic
technician, nutritionist, or other appropriately qualified personnel working
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. Copies of
menus shall be kept on file for a period of one year.
(f) Safety plan development in accordance with guidance issued by the Office.
Disclaimer: These regulations may not be the most recent version. New York may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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