DAR File No. 39732

Human Services, Administration, Administrative Services, Licensing

Rule R501-18

Recovery Residence Services

Notice of Proposed Rule

(Amendment)

DAR File No.: 39732
Filed: 09/14/2015 11:03:08 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rule is being amended to clarify what living circumstances are not a recovery residence as noted in definition. The amendment also includes an update to health and safety language for clients receiving services in a licensed recovery residence program.

Summary of the rule or change:

This is a proposed amendment to the rule that initially went into effect in 12/22/2014. It is based on stakeholder feedback. The proposed amendment clarifies what a recovery residence is not. In addition the amendment will update requirements for program staffing, recovery residence oversight, client contacts, and physical facility safety requirements.

State statutory or constitutional authorization for this rule:

• Section 62A-2-106
• Section 62A-2-101

Anticipated cost or savings to:

the state budget:

It is not anticipated that this amendment to rule will have any change on state government budget. It does not change state duties or workload, but simply provides clarification.

local governments:

It is not anticipated that this amendment to rule will have any change on local government budget.

small businesses:

It is not anticipated that this amendment to rule will have any significant change for small businesses. Organizations that hold a recovery residence license with the Office of Licensing will have to come into compliance with this rule, however, that will require only minimal effort and cost.

persons other than small businesses, businesses, or local governmental entities:

This rule establishes requirements only for recovery residence programs, it will have no impact on other persons or entities.

Compliance costs for affected persons:

Any compliance costs will be limited to recovery residence programs. Other costs incurred are related to doing business as a recovery residence program. The requirements related to these updates are comparable to other similar licenses.

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule will have no impact to small business.

Ann Williamson, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Human Services
Administration, Administrative Services, Licensing
195 N 1950 W 1ST FLR
SALT LAKE CITY, UT 84116

Direct questions regarding this rule to:

• Julene Robbins at the above address, by phone at 801-538-4521, by FAX at 801-538-3942, or by Internet E-mail at jhjonesrobbins@utah.gov
• John Ortiz at the above address, by phone at 801-374-7672, by FAX at 801-538-4553, or by Internet E-mail at jortiz@utah.gov
• Diane Moore at the above address, by phone at 801-538-4235, by FAX at 801-538-4553, or by Internet E-mail at dmoore@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

11/02/2015

This rule may become effective on:

11/09/2015

Authorized by:

Diane Moore, Director

R501. Human Services, Administration, Administrative Services, Licensing.

R501-18. Recovery Residence Services.

R501-18-1. Authority.

This Rule is authorized by Section 62A-2-101 et seq.

 

R501-18-2. Purpose.

This rule establishes:

(1) basic health and safety standards for recovery residences; and

(2) minimum administration and financial requirements.

 

R501-18-3. Definitions.

(1) (a) "Recovery residence" is as defined in Subsection 62A-2-101(22).

(b) "Recovery residence" does not include a home which is occupied only by peers who:

(i) govern themselves democratically in an unsupervised environment;

(ii) are not accountable to compensated staff, managers, or program owners; and

(iii) whose rent and utility expenses are equitably shared.

(2) "SUD" means Substance Use Disorder.

 

R501-18-4. Legal Requirements.

(1) A recovery residence shall comply with this R501-18 and:

(a) R501-1, General Provisions;

(b) R501-2, Core Rules;

(c) all applicable local, state, and federal laws.

(2) Prior to offering any residential treatment services, a recovery residence shall comply with R501-19 and obtain a residential treatment license.

(3) A recovery residence shall comply with the Americans with Disabilities Act.

(4) A recovery residence shall only serve adults.

 

R501-18-5. Administration.

(1) The recovery residence shall ensure that clients receive supportive services from a person associated with the licensee or from a licensed professional. Supportive services include but are not limited to:

(a) vocational services;

(b) peer support;

(c) skills training;

(d) community resource referral.

(2) A list of current clients shall be maintained on-site at all times and available to the Department of Human Services Office of Licensing upon request.

 

R501-18-6. Staffing.

(1) The recovery residence shall have an identified recovery residence director(s)who shall have at least one of the following:

(a) a minimum of two years of documented administrative experience in recovery residence;

(b) a minimum of two years documented substance use disorder treatment;

(c) a minimum of two year documented recovery support services; or

(d) minimum Utah licensure as a substance use disorder counselor, licensed clinical social worker or equivalent.

(2) The director's responsibilities that shall not be delegated include:

(a) policy and procedure implementation and oversight;

(b) quality assurance plan implementation and oversight;

(c) training curriculum;

(d) supervision of staff;

(e) oversight of client activities;

(f) ensure continual compliance with local, state and federal laws;

(g) notify the Office of Licensing 30 days prior to changes in program administration or purpose;

(h) ensure that the program is fiscally sound;

(i) ensure program maintains the staffing ratios outlined in program policy and procedure;

(j) ensure that the program has general liability insurance, professional liability insurance, vehicle insurance, and fire insurance; and

(k) monitoring all aspects of the program as outlined in the quality assurance plan.

[(2)](3) The recovery residence director may employ a manager[, who may be a client,] to work under the supervision of the director.

(a) The manager may be responsible for the day-to-day staff, volunteer, and client supervision and operation of the facility.

(b) The responsibilities of the manager shall be clearly defined in the recovery residence policies and procedures.

(c) Whenever the manager is on leave (vacation, sick, etc.), the director shall designate a substitute to assume managerial responsibility.

(d) The recovery residence director, whether physically present or not, shares responsibility for the acts and omissions of the manager.

[(3)](4) The recovery residence shall provide each director, recovery residence manager, substitute, and staff, [including clients ]serving in those capacities, with a minimum of:

(a) 40 hours of training completed prior to working with clients. Training topics shall include: SUD curriculum, peer support, emergency overdose response, recognition of and response to drug-related activities, and certified first aid and CPR;

(b) training prior to working with clients that includes, but is not limited to: how to comply with Core and Recovery Residence Rules, program policies and procedures, ethics, conflicts of interest, and case management;

(c) ongoing training to maintain proficiency in the above topics.

[(4) A recovery residence with 6 or fewer licensed client capacity:

(a) shall have a recovery residence manager(s), who may be a client, and substitute(s), who may be a client, approved in writing by the recovery residence director;

(b) shall have a residence director, manager or substitute on-site a minimum of 5 days per week in order to assess safety and support clients. These visits shall be scheduled and documented;

(c) shall have a residence director, manager or substitute have daily client contact with each admitted client. These contacts shall be documented;

(d) the recovery residence director shall ensure that the recovery residence director or a manager, substitute, or staff maintains on-call availability at all times and remains able to respond to the recovery residence and the Office of Licensing immediately by phone, and remains able to respond in person at the recovery residence within one hour.

] (5) A recovery [residence with 7 or more licensed client capacity:

(a) ]residence shall have a recovery residence manager(s), who may not be a currently enrolled client, and substitute(s), who may not be a currently enrolled client, approved in writing by the recovery residence director;

([b]a) shall have a residence director, manager or substitute on-site a minimum of 7 days per week in order to assess safety and support clients. These visits shall be [scheduled and ]documented , and shall be per site not per client[;]. Documented visits shall assess general safety, including but not limited to: general cleanliness checks; verification that only admitted residence are residing at the site; no presence of alcohol or substances of abuse that are not lawfully prescribed; and medications are properly secured in locked storage.

([c]b) shall have a residence director, manager or substitute have daily client contact with each admitted client. Daily contacts are not required to be face to face. These contacts shall be documented;

([d]c) the recovery residence director shall ensure that the recovery residence director or a manager, substitute, or staff maintains on-call availability at all times, and remains able to respond to the recovery residence and the Office of Licensing immediately by phone, and remains able to respond in person at the recovery residence within one hour.

(6) The recovery residence shall determine and comply with a written policy which clearly defines the minimum staff-to-client ratios and levels of supervision of clients by the person(s) associated with the licensee.

(7) The recovery residence shall have a written:

(a) emergency plan posted and available to clients;

(b) grievance procedure posted and available to clients.

(8) A recovery residence which utilizes non-client volunteers shall provide training and evaluation of non-client volunteers. Non-client volunteers providing care without paid staff present shall have direct communication access to the recovery residence manager or recovery residence director at all times. Non-client volunteers shall be trained in recovery residence policies and procedures, objectives, and scope of service. All volunteers will be supervised by the recovery residence director who is responsible for their conduct.

(9) Professional Staff shall include the following individuals who are either employed, under contract or are otherwise available for referral to the clients of the recovery residence:

(a) a licensed physician; and/or

(b) a licensed psychiatrist; and/or

(c) a licensed mental health therapist; and/or

(d) a licensed substance use disorder counselor (SUDC).

 

R501-18-7. Direct Service.

(1) This subsection supersedes the Record Keeping section of Core Rules, [Section ]R501-2[-5]. The recovery residence client records shall contain the following:

(a) name, address, telephone number, email;

(b) admission date;

(c) emergency contact information with names, address, email, and telephone numbers;

(d) an intake application and assessment indicating that the client meets the admission criteria;

(e) individual recovery plan, including the signature and title of the persons preparing the recovery plan and the signature of the client;

(f) documentation of services provided, including the signature and title of the persons providing recovery residence services;

(g) documentation of supportive services not directly associated with the recovery residence;

(h) the signed written lease agreement for the recovery residence;

(i) signed crisis intervention reports;

(j) the recovery residence's client recovery plan shall offer and document individualized and supportive services;

(k) treatment is not a required component of a recovery residence. However, off-site treatment referrals shall be made available upon request. On-site treatment and other services must first be licensed in accordance with applicable Office of Licensing categorical rules;

(l) clients will be notified prior to admission regarding their responsibilities related to the transportation and location of off-site services.

 

R501-18-8. Physical Environment.

(1) The recovery residence shall provide written documentation of compliance with the following:

(a) local zoning ordinances;

(b) local business license requirements;

(c) local building codes;

(d) local fire safety regulations;

(e) local health codes; and

(f) local approval from the appropriate government agency for new program services or increased client capacity.

(2) Building and Grounds:

(a) the recovery residence shall ensure that the appearance, safety and cleanliness of the building and grounds are maintained.

 

R501-18-9. Physical Facility.

(1) Live-in staff[, who may be a client,] shall have a separate sleeping area with a private bathroom.

(2) The recovery residence shall have a designated secure location that serves as an administrative office for records, secretarial work, and bookkeeping if such work is done onsite.

(3) Bathrooms:

(a) the recovery residence shall have locking bathrooms. Clients shall have access to a toilet, lavatory sink, and a tub or shower. These shall be maintained in good operating order and in a clean and safe condition;

(b) client to bathroom ratios shall comply with the residential international building code, as administered by the local government authority;

(c) each bathroom shall be maintained in good operating order;

(d) there shall be mirrors secured to the walls at convenient heights;

(e) each bathroom shall be ventilated by mechanical means or equipped with a screened window that opens;

(f) clients will be notified prior to admission regarding their responsibilities related to the provision of toiletries.

(4) Sleeping Accommodations:

(a) a minimum of 60 square feet per client shall be provided in a multiple occupant bedroom and 80 square feet in a single occupant bedroom. Storage space shall not be counted;

(b) sleeping areas shall have a source of natural light, and shall be ventilated by mechanical means or equipped with a screened window that opens;

(c) each bed, none of which shall be portable, shall be solidly constructed;

(d) sleeping quarters serving male and female clients shall be structurally separated and have locking bedroom doors;

(e) clients shall be allowed to decorate and personalize bedrooms with respect for other clients and property;

(f) If a fire clearance is not required from the local fire authority, a bedroom on the ground floor shall have a minimum of one window that may be used to evacuate the room in case of fire;

(g) If a fire clearance is not required from the local fire authority, a bedroom that is not on the ground floor (this includes basements) shall have a minimum of two exits, at least one of which shall exit directly to outside the building that may be used to evacuate the room in case of fire;

(h) furniture and residence equipment shall be of sufficient quantity and quality to meet recovery residence and client needs;

(i) all furniture and residence equipment shall be maintained in a clean and safe condition;

(j) clients will be notified prior to admission regarding their responsibilities related to the provision of bedding and linens.

(5) Weapons Safety:

(a) all facilities shall have and comply with a written weapons policy.

(6) Laundry Service:

(a) recovery residences shall provide either equipment or reasonable access to equipment for washing and drying of linens and clothing;

(b) laundry appliances shall be maintained in good operating order and in a clean and safe condition.

 

R501-18-10. Food Service.

(1) Meals may be prepared by staff or clients at the recovery residence or meals may be catered.

(2) If the recovery residence provides food for clients, it shall comply with food service requirements as follows:

(a) current weekly menu shall be posted in the kitchen and the office;

(b) the staff or clients responsible for food service shall maintain a current list of clients with special nutritional needs, shall provide food that meets those needs, and record in the client's service record information relating to special nutritional needs.

(3) The recovery residence shall have one or more kitchens, which shall have clean and safe operational equipment in sufficient quantity for the preparation, storage, serving, and clean-up of all meals.

(4) The recovery residence shall have dining space/s large enough to provide seating for all clients. The dining space shall be maintained in a clean and safe condition.

(5) When meals consumed by clients are prepared by staff or other clients, the recovery residence shall have and comply with a written policy that complies with all minimum requirements of the local Health Department.

(6) Clients will be notified prior to admission regarding their responsibilities related to the provision or preparation of food.

 

R501-18-11. Medical Standards.

(1) The recovery residence shall not admit anyone who is currently experiencing convulsions, in shock, delirium tremens, in a coma or unconscious.

(2) Before admission, clients shall be screened for Tuberculosis by a questionnaire approved by the local health department.

(3) All clients and staff shall provide current proof of negative test results for Tuberculosis and shall be tested annually or more frequently when directed by the local health department.

(4) A recovery residence that manages clients' medications shall keep all prescription and non-prescription medications in locked storage that is not accessible by clients when not in active use.

(5) Each recovery residence shall have and comply with a written policy and procedure regarding the safe storage and disposal of medications.

(6) A recovery residence shall ensure that clients who manage their own medications keep all prescription and non-prescription medications in locked storage when not in active use, using individual locked storage that is not accessible by any client other than the client who owns the medication. Clients will be notified prior to admission regarding their responsibilities related to the provision of locked storage for personal medications.

(7) Non-prescription medications shall be stored in their original manufacturer's packaging together with manufacturer's directions and warnings.

(8) Prescription medications shall be stored in their original pharmacy packaging together with the pharmacy label, directions and warnings.

 

R501-18-12. Hazardous Chemicals and Materials.

(1) The recovery residence shall provide safe storage for hazardous chemicals, materials, and aerosols, including but not limited to poisonous substances, explosive or flammable substances, bleach, and cleaning supplies. The recovery residence shall maintain hazardous chemicals, materials, and aerosols in their original packaging and follow the manufacturer's instructions printed on the label.

 

R501-18-13. Compliance.

Any licensee that is in operation on the effective date of this rule shall be given 30 days after the effective date to achieve compliance with this rule.

 

KEY: licensing, human services, recovery residence

Date of Enactment or Last Substantive Amendment: [December 22, 2014]2015

Authorizing, and Implemented or Interpreted Law: 62A-2-101; 62A-2-106