N.Y. Comp. Codes R. & Regs. tit. 14 § 820.5

Current through Register Vol. 46, No. 38, September 18, 2024

Section 820.5 - General program standards

(a) Policies and procedures. The program governing authority must approve written policies, procedures, and methods governing the provision of services in compliance with office regulations including a description of each service provided. These policies, procedures, and methods must address, at a minimum:

(1) admission and discharge, including transfer and referral procedures;

(2) treatment/recovery plans, including service plans where appropriate;

(3) staffing including, but not limited to, training and use of student interns, peers and volunteers, and compliance with Part 805 of this Title;

(4) screening and referral procedures for associated physical or psychiatric conditions;

(5) a schedule of fees for services rendered;

(6) infection control procedures;

(7) cooperative agreements with other substance use disorder service providers and other providers of services a resident 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 transmissible infections, including viral hepatitis, sexually transmitted infections and HIV; regarding HIV, such education, counseling, prevention and treatment shall include condom use, testing, pre-and post-exposure prophylaxis and treatment;

(ii) medication for addiction treatment;

(9) the use of alcohol and other drug screening tests, such as breath testing, urine screening;

(10) procedures for the ordering, procuring, and disposing of medication, as well as the self-administration of medication;

(11) quality improvement and utilization review;

(12) procedures for emergencies;

(13) incident reporting and review in accordance with Part 836 of this Title;

(14) record keeping;

(15) procedures whereby 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;

(16) procurement, storage, preparation of food and nutritional planning;

(17) records retention. Case records must be retained for ten years after the date of discharge or last contact, or three years after the patient reaches the age of 18, whichever time period is longer.

(b) Emergency medical kit. All programs must maintain an emergency medical kit at each certified location; such kit must include basic first aid 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 overdose prevention education and naloxone education including the prescribed use of naloxone which shall be available for use during all program hours of operation.

(1) All staff and residents should be notified of the existence of the naloxone overdose prevention kit and the authorized administering staff.

(2) Nothing in this regulation shall preclude residents from becoming authorized in the administration of the emergency overdose prevention kit, provided however, the program director must be notified of the availability of any additional authorized users.

(c) 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 for that particular program.

(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) Services. All residential programs shall make available, either directly or through referral to appropriate agencies, the following services as clinically and programmatically indicated:

(1) Supportive services: availability of a range of support services appropriate to resident needs including legal, mental health, and social services, vocational assessment and counseling.

(2) Educational and child care services: availability of required educational and childcare services in each program which provides services to school-age children.

(3) Structured activity and recreation: opportunities for residents and family members, where appropriate, to participate in activities designed to foster effective use of leisure time, to improve social skills, develop self-esteem and encourage personal responsibility.

(4) Orientation to community services: orientation for each resident including advice and instruction in identifying and obtaining needed community services such as housing and other necessary case management services.

(5) Medication for addiction treatment, consistent with this Part and guidance issued by the Office.

(6) Overdose prevention education and naloxone education and training and a naloxone kit or prescription, consistent with guidance issued by the Office.

(f) Certified capacity. The certified bed capacity of each residential program may not be exceeded at any time except:

(1) in cases of emergency and unexpected surges in demand where no alternative options are available; and

(2) failure to temporarily accept individuals into the program would jeopardize their immediate health and safety; and

(3) where the excess of capacity would be time limited.

(g) Recordkeeping and reporting.

(1) All residential services must maintain individual case records for each resident served. These records must, at a minimum, include the information required in this Part, as well as the source of referral, documentation of any case conferences or case reviews, reports of other evaluations and case consultations, medical orders, if applicable, and consent forms.

(2) Statistical information shall be reported to the office as required and on the prescribed forms therefor.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 820.5

Adopted New York State Register December 9, 2015/Volume XXXVII, Issue 49, eff. 11/20/2015

Amended New York State Register December 6, 2017/Volume XXXIX, Issue 49, eff. 12/6/2017

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