N.Y. Comp. Codes R. & Regs. tit. 14 § 819.3

Current through Register Vol. 46, No. 45, November 2, 2024

Section 819.3 - Standards applicable to all residential service providers

(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.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 819.3

Amended New York State Register September 14, 2022/Volume XLIV, Issue 37, eff. 10/1/2022