New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XXV - Division Of Substance Abuse Services
Part 1030 - Requirements For The Operation Of Drug-free Substance Abuse Programs
Section 1030.1 - Residential drug-free treatment services
Universal Citation: 14 NY Comp Codes Rules and Regs ยง 1030.1
Current through Register Vol. 46, No. 39, September 25, 2024
(a) Definition. Residential treatment program shall mean a substance abuse program in which drug-free substance abuse treatment and living accommodations are provided to substance abusers and substance dependent persons.
(b) Program administration and staffing.
(1) Each
program shall have a full-time administrator-supervisor whose duties include:
(i) overseeing the day-to-day operations of
the program; and
(ii) supervising
the work of all staff.
(2) To insure that appropriate, quality
counseling services are available to clients, each program shall have
sufficient counseling staff. At a minimum, there shall be one full-time
counselor for every 35 active clients.
(3) Each program shall have a specific plan
for dealing with medical emergencies. There shall be as part of this plan
evidence, such as written agreements with hospitals, clinics or rescue squads,
of the availability of emergency medical services. Staff must be informed of
procedures to be followed in the case of a medical emergency.
(4) Each program shall have written
procedures for program operation and control.
(5) The personal money of any client in
residential treatment shall remain the personal property of that client and
shall not be commingled with program funds. The program shall have available,
for use at the option of each client, a means of depositing, in a separate
account, a client's personal money.
(c) Screening procedures.
(1) Each candidate for admission shall be
interviewed to determine the appropriateness of his admission to the
program.
(2) Any candidate who is
found to be inappropriate for admission shall be referred, when necessary, to
an appropriate available alternate service.
(d) Admission procedures.
(1) Each new admission shall be interviewed
by qualified program staff. The results of this interview shall be recorded in
the client's record and shall, at a minimum, include:
(i) a personal history including family,
vocational, educational and legal information;
(ii) a substance abuse history including
kind(s) of substances abused, when abuse began and prior treatment attempts;
and
(iii) notation in the client
record that the client received a copy of program rules and regulations that
such rules were discussed with the client and that the client indicated that he
understood the rules and regulations.
(2)
(i) A
medical and laboratory examination must be performed within 30 days of the
client's admission to the program. This exam must, at a minimum, include an
investigation of the possibility of infectious disease, including conduct of an
intradermal PPD appropriately given and interpreted with necessary follow-up of
all positive results, pulmonary, liver, cardiac abnormalities, dermatologic
sequelae of addiction and possible concurrent surgical problems, as well as the
conduct of a urine screening for drugs. In addition, the following laboratory
tests shall be conducted when the examining physician determines that these
tests are indicated:
(a) complete blood count
and differential;
(b) serological
test for syphilis;
(c) microscopic
urinalysis;
(d) multiphasic
chemistry profile; and
(e) a chest
X-ray, EKG or biological test for pregnancy.
The health status of each residential client must be assessed annually.
(ii)
This subdivision shall not apply to a client transferring to a new program who
received a medical and laboratory examination within three months prior to
admission to the new program. Such transferring client need not be given a
repeat medical and laboratory examination unless one is requested by the
program physician. However, the new program physician must have, as part of the
transfer summary, a medical summary and statement from the client's previous
program which indicates any significant medical problems. Copies of the
previous examination must be included in the client's file within 30
days.
(iii) A client readmitted to
the same program need not receive a repeat medical and laboratory exam if he
received a medical and laboratory exam within three months of the date of
his/her readmission and the results of the medical and laboratory exam,
provided to the program physician within 30 days, do not indicate the need for
a new medical and laboratory exam.
(iv) Programs should, however, be cognizant
of the risk of infectious disease among their clients. A detailed health
history and assessment should be made by the program physician at the time of
the client's admission to treatment to ensure that timely treatment of
infectious diseases is provided to the client and to minimize the risk of
infection of other program clients.
(3) Within 10 days of the client's admission
or readmission to the program, a preliminary treatment plan addressing the
client's individual needs must be devised for him/her. This preliminary plan
must show that consideration was given to the appropriateness of the client for
treatment in the program, short-term goals for treatment, counseling services
required and the supportive services needed by the client. Within 30 days of
the development of this preliminary plan, an amended and complete treatment
plan must be developed which includes:
(i)
long- and short-term goals for treatment generated by both staff and
client;
(ii) assignment of a
primary counselor;
(iii)
description of the type and frequency of counseling to be provided each week;
and
(iv) description of the
supportive services, particularly the educational or vocational services needed
by the client and a plan for meeting those needs.
(e) Services.
(1) Counseling. Each program shall provide to
its clients individual, group and family counseling services as appropriate.
Counseling must be provided by qualified personnel. Counseling provided shall
be documented in each client's record. Family counseling services include
services to significant others.
(2)
Support services.
(i) Each program shall take
steps to ensure that, as appropriate, a comprehensive range of rehabilitative
services, including, but not limited to vocational, educational, legal,
alcoholism, mental health and social services, are made available to each
client. The program can fulfill this responsibility by providing these services
directly or by referral to an appropriate resource. Support services
recommended and utilized shall be documented in each client record.
(ii) Each program must make arrangements with
local school districts for school age clients to receive required basic
educational services.
(3) Medical services. Each program shall be
concerned about the general health of its clients. Each client record shall
demonstrate that appropriate medical care was recommended to any client whose
health status indicated a need for such care.
(4) Urinalysis. Urine testing shall be used,
when clinically indicated, as a diagnostic tool. Results of any urine testing
performed shall be included in the client record. Treatment decisions shall not
be made solely on the basis of a single positive urine test result.
(5) Treatment review.
(i) A client's treatment plan may be amended
at any time, but any such amendment and the reason for it shall be recorded in
the client's case record.
(ii) Each
client's treatment plan must be reviewed at least quarterly, either by a
supervisory staff member who is clinically qualified or at a staff conference
at which the treatment process, including progress in meeting vocational and/or
educational goals of individual clients is reviewed.
(iii) The case of any client in residential
treatment for nine months must be reviewed in staff conference. Any decision to
retain such client in residential treatment must be based on the specific
client's needs and documentation that such needs can only be met through
continued residential care. The involvement of appropriate treatment staff and
any outside support staff, e.g., mental health or alcoholism counselors, is
encouraged.
(iv) The case of any
client who is not responding to treatment; is not meeting the goals, including
vocational and educational, defined in the treatment plan; or is disruptive to
the program must be discussed at a staff conference and specific plans to
address the client's problems in the treatment process must be devised and
documented in the client record.
(f) Client records.
(1) Each program shall maintain individual
client records for all persons admitted to the program.
(2) Each record shall include:
(i) client's name or client code, age, sex,
race, marital status, residence;
(ii) results of the admission interview,
including documentation that the client received a copy of program rules and
regulations;
(iii) results of the
physical examination;
(iv)
individual client treatment plan and any amendments;
(v) documentation which includes, at a
minimum, regular progress notes indicating the date, type, nature and length of
each counseling session, as well as a specific description of the client's
progress in the program, and any other counseling or support services
provided;
(vi) documentation of
recommendations concerning client's general health;
(vii) results of any urine testing
performed;
(viii) evidence of
quarterly treatment plan review;
(ix) when appropriate, evidence of staff
conference review; and
(x) when
appropriate, statement of reasons for discharge from the program.
(g) Facility standards.
(1) Each residential program must have safe
and adequate physical facilities to carry out its program. To insure this,
programs must adhere to the following minimum space requirements as appropriate
to the services provided:
(i) sleeping
areas--80 square feet per resident for single beds, or 40 square feet per
resident for two-deck bunks or temporary usage. Maximum dormitory capacity is
24;
(ii) kitchen--50 square
feet;
(iii) assembly--6 square feet
per person;
(iv) corridor widths--a
minimum of 3 feet;
(v) minimum
ceiling height in living areas--7 feet 6 inches;
(vi) minimum ceiling height in corridors--7
feet;
(vii) education rooms--20
square feet per person, with a maximum of 40 persons in the room at one time;
and
(viii) vocational shops--50
square feet allowed per person.
(2) Each residential substance abuse program
must be in a facility which is clean, sanitary, safe and suitable for the
comfort and care of the residents. Each facility must have, as appropriate:
(i) an interior fire alarm system, with sound
sufficient to alert all occupants. Such system must be maintained in operating
condition;
(ii) sufficient fire
extinguishers of appropriate size and type with a tag showing the latest
recharging date. Extinguishers shall be conspicuously located where they will
be readily accessible and immediately available in the event of fire;
(iii) smoke and fire barriers of one-hour
fire rating installed between floors of buildings of more than two
stories;
(iv) walls and doors of a
minimum of one-hour fire rating for all corridors of residential buildings of
more than two stories;
(v) two
means of egress with doors equipped with appropriate hardware and in compliance
with the applicable codes;
(vi)
exit signs of legible letters not less than 6 inches high and 3/4-inch wide
strokes, on contrasting backgrounds. Illuminated exit signs of same size
letters are required in places of assembly and at exits of residential building
corridors and passages;
(vii)
adequate protection from hazards in heater and boiler rooms;
(viii) a smoke detector that emits a
distinctive signal of its own, or activates the fire alarm system. A direct
connection to the local fire department is advisable where available. In its
absence, a telephone shall be provided on each floor, with the local fire
department's telephone number posted in bold print on a contrasting
background;
(ix) storage facilities
for personal articles in all approved bedrooms;
(x) adequate lighting and
ventilation;
(xi) there shall be a
minimum of one toilet and one lavatory for each 10 residents and a minimum of
one tub or shower for each 10 residents. All facilities shall provide
sufficient lavatory facilities to insure the privacy of male and female
clients;
(xii) a building heating
system capable of supplying sufficient heat to maintain a temperature of 68
degrees Fahrenheit;
(xiii)
furnishings which include comfortable beds;
(xiv) linen supplied at least
weekly;
(xv) dining space and a
comfortable living room with facilities for recreation;
(xvi) an adequate and safe water supply;
and
(xvii) proper disposal of waste
and sewage.
(3) Each
residential program shall observe at least the following safety precautions:
(i) fire drills, utilizing the interior fire
alarm system, shall be conducted every month. They shall be held at different
times of the day and night when the building is occupied. A written record
shall be maintained, indicating the time the drill is held, the number of
participants and how long it took to evacuate the building;
(ii) fire regulations and evacuation routes
shall be posted in bold print on contrasting backgrounds and in conspicuous
locations;
(iii) all buildings
shall have at least one telephone line;
(iv) there must be a first aid area equipped
with basic first aid supplies;
(v)
there shall be an employee certified in first aid, cardiopulmonary
resuscitation onsite at all times the program is in operation;
(vi) employees shall be trained in the use of
firefighting equipment and the means of rapidly evacuating the
building;
(vii) night lights of no
less than one footcandle measured at the floor shall be provided in all
hallways and stairways;
(viii)
shielding shall be provided for all unprotected high temperature piping, etc.,
which is located where people can come in contact with exposed
surfaces;
(ix) unvented open-flamed
space heaters shall not be used;
(x) only metal containers with fitted covers
shall be used for storage of refuse;
(xi) all flammable materials shall be stored
in metal cabinets;
(xii) there
shall be no obstructions to corridors or exits or accumulation of combustible
materials in unauthorized areas; and
(xiii) emergency lighting shall have
sufficient capability to provide for the safe evacuation of the
building.
(h) Food service.
(1) Three meals a day shall be
served in each residential program. All meals should be properly prepared and
nutritionally balanced.
(2) Minimum
standards.
(i) The food preparation center
shall have access to a lavatory.
(ii) Dishwashing facilities shall be provided
with a three-compartment sink or automatic dishwasher.
(iii) A three-day supply of food shall be
available in refrigerated storage. Such storage must have a temperature range
between 32 degrees and 40 degrees Fahrenheit.
(iv) A three-day supply of food shall be
available in dry storage.
(v)
Adequate waste disposal facilities shall be available.
(vi) A janitor's closet for storage of
housekeeping utensils and equipment shall be available.
(vii) There shall be no exposed wooden walls
in the food preparation area. Walls around the stove and appliances shall be
covered with galvanized or other nonflammable, nonporous materials.
(viii) There shall be a hood with an exhaust
fan over cooking equipment.
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