DAR File No. 44034

This rule was published in the October 1, 2019, issue (Vol. 2019, No. 19) of the Utah State Bulletin.


Human Services, Administration, Administrative Services, Licensing

Rule R501-22

Residential Support Programs

Notice of Proposed Rule

(Repeal and Reenact)

DAR File No.: 44034
Filed: 09/04/2019 01:15:42 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

Residential Support is defined in Subsection 62A-2-101(35) as: (a) "Residential Support" means arranging for or providing the necessities of life to individual or families who have a disability to who are experiencing a dislocation or emergency that prevents them from providing these services for themselves or their families. (b) "Residential Support" includes providing a supervised living environment for persons with dysfunctions or impairments that are: (i) emotional, (ii) psychological; (iii) developmental; (iv) behavioral. (c) treatment is not a necessary component of Residential Support. The Department of Human Services (Department) has a Housing Committee compiled of representatives from all divisions in the Department and participated heavily with the Rio Grande project to address homeless population issues in Salt Lake City. It was determined that the Homeless Shelters do fit into the Office of Licensing's (OL) statutory definition requiring licensure and the Department as a whole moved toward this process. Over the course of a year, OL engaged all stakeholders in shelters, resource centers, domestic violence representatives, Department of Workforce Services (DWS), and Division of Substance Abuse and Mental Health (DSAMH) to develop this rule that addresses the key health and safety needs for individuals in these settings while deferring to other regulatory oversight that might already be in place for these entities. Most of these facilities are already in compliance with safety requirements and ones that cannot meet rule requirements may be granted variances as long as the variances won't interfere with client health and safety.

Summary of the rule or change:

This is a repeal and reenactment to incorporate homeless shelters into the Residential Support rule category and streamline the rules that govern the licensure of these programs. Once the Housing Committee determined that the Homeless Shelters do fit into the OL's statutory definition requiring licensure and the Department as a whole moved toward this process, it was determined that OL would need to amend this rule. Over the course of a year, OL engaged all stakeholders in shelters, resource centers, domestic violence representatives, DWS, and DSAMH to develop this rule change that addresses the key health and safety needs for individuals in these settings while deferring to other regulatory oversight that might already be in place for these entities. During this process, it was determined that to meet those needs a repeal and reenactment would be best as the rule had grown quite extensively with these additions.

Statutory or constitutional authorization for this rule:

  • Subsection 62A-2-101(35)

Anticipated cost or savings to:

the state budget:

The OL's caseload is being distributed statewide across multiple licensors and the increase to caseloads will be nominal and offset by the licensing fees charged. There are no other anticipated costs or benefits to any entities outside the Department and homeless providers. The gain OL foresees is protected communities, protected clients, and safe providers.

local governments:

The shelters are already in operation in all of their respective jurisdictions, adding licensure to them will not have any fiscal impact on local governments.

small businesses:

Fiscal impact was calculated based on the fact that there will be a $900 initial licensing fee for each of the 30 shelter locations across the state. They will incur $300 annual renewal fees. Calculation of and a one-time $38.25 per employee background screening fee is difficult to predict due to the fact that there are non-licensed entities (Community Action/Kane Security) who provide staff to multiple shelter facilities. Community action reports having 6 employees (at a cost of $229.50) and Kane reports having 50 employees (at a cost of $1,912.50) so a total of $2,142 was estimated for screenings for their staff. OL has enlisted a way for them to submit clearances as a non-licensed entity and pay the one time clearance fee and transfer the clearance to all sites they will be affiliated with. Community action incurs the screening cost for these employees, which spares the facilities the cost. It is impossible to estimate how many employees will be hired, renewed, or shared between multiple facilities, as shifts are assigned where the need is and employees are not necessarily linked to just one facility, making any further calculations inestimable.

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

No person, entity, or public or private organization will be impacted by the implementation of this rule.

Compliance costs for affected persons:

There will be no compliance costs for anyone affected by the implementation of this rule.

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

After conducting a thorough analysis, it was determined that this repeal and reenactment will result in a fiscal impact to small businesses.

Ann Williamson, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office 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:

  • Janice Weinman at the above address, by phone at 385-321-5586, by FAX at 801-538-4553, or by Internet E-mail at jweinman@utah.gov
  • Jonah Shaw at the above address, by phone at 801-538-4219, by FAX at 801-538-3942, or by Internet E-mail at jshaw@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:

10/31/2019

This rule may become effective on:

11/07/2019

Authorized by:

Ann Williamson, Executive Director

RULE TEXT

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs

FY 2020

FY 2021

FY 2022

State Government

$0

$0

$0

Local Government

$0

$0

$0

Small Businesses

$27,000

$9,000

$9,000

Non-Small Businesses

$0

$0

$0

Other Person

$0

$0

$0

Total Fiscal Costs:

$27,000

$9,000

$9,000,





Fiscal Benefits




State Government

$0

$0

$0

Local Government

$0

$0

$0

Small Businesses

$0

$0

$0

Non-Small Businesses

$0

$0

$0

Other Persons

$0

$0

$0

Total Fiscal Benefits:

$0

$0

$0





Net Fiscal Benefits:

$0

$0

$0

 

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described in the narrative. Inestimable impacts for Non - Small Businesses are described in Appendix 2.

 

Appendix 2: Regulatory Impact to Non - Small Businesses

The changes in this rule submission will not have an impact on non-small businesses in Utah, as homeless shelters are small independent businesses distributed throughout the state.

 

The head of the department of Human Services, Ann Williamson, has reviewed and approved this fiscal analysis.

 

 

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

R501-22. Residential Support Programs.

[R501-22-1. Authority.

Pursuant to Section 62A-2-101 et seq., the Office of Licensing, shall license residential support programs according to the following rules.

 

R501-22-2. Purpose.

This rule establishes basic health and safety standards for residential support programs.

 

R501-22-3. Definition.

Residential Support is as defined in section 62A-2-101. Temporary Homeless Youth Shelter is as defined in Section 62A-4a-501.

 

R501-22-4. Administration.

A. In addition to the following rules, all Residential Support Programs shall comply with R501-2, Core Standards.

B. The program shall ensure that consumers receive direct service from an assigned worker or other appropriate professional.

C. A list of current consumers shall be available and on-site at all times.

 

R501-22-5. Staffing.

A. The program shall have an employed manager responsible for the day to day resident supervision and operation of the facility. The responsibilities of the manager shall be clearly defined. Whenever the manager is absent there shall be a substitute to assume managerial responsibility. With the exception of Domestic Violence Shelters, adult programs are not required to provide twenty four hour supervision.

B. The program shall make arrangement for medical backup with a medical clinic or physician licensed to practice medicine in the State of Utah.

C. The program shall have at least one person on duty who has completed and remains current in a certified first aid and CPR program.

D. Programs which utilize students and volunteers, shall provide screening, training, and evaluation of volunteers. Volunteers providing care in Domestic Violence Shelters, without paid staff present, shall have direct communication access to designated staff at all times. Volunteers shall be informed verbally and in writing of program objectives and scope of service.

 

R501-22-6. Direct Service.

This section supersedes core standards, Section R501-2-8.

A. The program consumer records shall contain the following:

1. name, address, telephone number, admission date, and personal information required by the program,

2. emergency information with names, address, and telephone numbers,

3. a statement indicating that the resident meets the admission criteria,

4. description of presenting problems,

5. service plan and services provided, and referral arrangements as required by the program,

6. discharge date,

7. signature of person or persons, or designee providing services, and

8. crisis intervention and incident reports.

B. The program's consumer service plan shall offer and document as many life enhancement opportunities as are appropriate and reasonable.

C. Domestic Violence Shelter action plans shall include the following:

1. a review of danger and lethality with victim and discussion of the level of the victim's risk of safety.

2. a review of safety plan with the victim,

3. a review of the procedure for a protective order and referral to appropriate agency or clerk of the court authorized to issue the protective order, and

4. a review of supportive services to include, but not limited to medical, self-sufficiency, day care, legal, financial, and housing assistance. The program shall facilitate connecting services to those resources as requested. Appropriate referrals shall be made, when indicated, and documented in the consumer record for victim treatment, psychiatric consultation, drug and alcohol treatment, or other allied services.

5. Domestic Violence Shelter staff completing action plans shall have at least a Bachelor's Degree in Behavioral Sciences.

 

R501-22-7. Physical Environment.

A. The program shall provide written documentation of compliance with the following:

1. local zoning ordinances,

2. local business license requirements,

3. local building codes,

4. local fire safety regulations,

5. local health codes, and

6. local approval from the appropriate government agency for new program services or increased consumer capacity.

B. Building and Grounds

1. The program shall ensure that the appearance and cleanliness of the building and grounds are maintained.

2. The program shall take reasonable measures to ensure a safe physical environment for its consumers and staff.

 

R501-22-8. Physical Facility.

A. Live-in staff shall have separate living space with a private bathroom.

B. The program shall have space to serve as an administrative office for records, secretarial work and bookkeeping.

C. Space shall be provided for private and group counseling sessions.

D. Bathrooms -- The following bathroom standards shall apply.

1. There shall be separate bathrooms, including a toilet, lavatory, tub or shower, for males and females. These shall be maintained in good operating order and in a clean and safe condition.

2. Consumer to bathroom ratios shall be 10 to one.

3. Bathrooms shall accommodate consumers with physical disabilities, as required.

4. Each bathroom shall be maintained in good operating order and be equipped with toilet paper, towels, and soap.

5. There shall be mirrors secured to the walls at convenient heights.

6. Bathrooms shall be placed as to allow access without disturbing other residents during sleeping hours.

7. Bathrooms shall be ventilated by mechanical means or equipped with a screened window that opens.

8. Domestic Violence Shelters Bathrooms

a. family members may share bathrooms, and

b. where bathrooms are shared by more than one family or by children over the age of eight, parents or program staff shall ensure that privacy is protected.

9. Temporary Homeless Youth Shelters Bathrooms

a. Single occupancy unisex bathrooms are permissible.

E. Sleeping Accommodations

1. A minimum of 60 square feet per consumer shall be provided in a multiple occupant bedroom and 80 square feet in a single occupant bedroom. Storage space shall not be counted.

2. Sleeping areas shall have a source of natural light, and shall be ventilated by mechanical means or equipped with a screened window that opens.

3. Each bed, none of which shall be portable, shall be solidly constructed and be provided with clean linens after each consumer stay and at least weekly.

4. Sleeping quarters serving male and female residents shall be structurally separated.

5. Consumers shall be allowed to decorate and personalize bedrooms with respect for other residents and property.

6. For Domestic Violence Shelters, Family Support Centers, Temporary Homeless Youth Shelters and children's shelters, the following shall apply:

a. A minimum of 40 square feet per consumer shall be provided in a multiple occupant bedroom. Storage space shall not be counted. The use of one crib for children under two years of age shall not be counted in the square foot requirement as long as it does not inhibit access to and from the room.

b. Roll away and hide-a-beds may be used as long as the consumer square foot requirement is maintained.

c. Family members are allowed to share bedrooms. Where bedrooms are shared by more than one family, parents or program staff shall make appropriate arrangements to ensure privacy is protected.

7. For Temporary Homeless Youth Shelters, the following shall apply:

a. A minimum of 40 square feet per consumer shall be provided in a multiple occupant dormitory style bedroom. Storage space shall not be counted.

b. For youth with their own children, a minimum of 40 square feet per person shall be provided in an separately enclosed bedroom that houses only youth that have their own children. Storage space shall not be counted.

F. Equipment

1. Furniture and equipment shall be of sufficient quantity, variety, and quality to meet program and consumer needs.

2. All furniture and equipment shall be maintained in a clean and safe condition.

G. Storage

1. The program shall have locked storage for medications.

2. The program shall have locked storage for hazardous chemicals and materials, according to the direction of the local fire authorities.

3. Any weapons brought into the facility shall be secured in a locked storage area or removed from the premises.

H. Laundry Service

1. Programs which permit consumers to do their own laundry shall provide equipment and supplies for washing, drying, and ironing.

2. Programs which provide for common laundry of linens and clothing, shall provide containers for soiled laundry separate from storage for clean linens and clothing.

3. Laundry appliances shall be maintained in good operating order and in a clean and safe condition.

 

R501-22-9. Food Service.

A. One staff shall be responsible for food service. If this person is not a professionally qualified dietitian, regularly scheduled consultation with a professionally qualified dietitian shall be obtained. Meals served shall be from dietitian approved menus.

B. The staff responsible for food service shall maintain a current list of consumers with special nutritional needs and record in the consumer's service record information relating to special nutritional needs and provide for nutritional counseling where indicated.

C. The program shall establish and post kitchen rules and privileges according to consumer needs.

D. Consumers present in the facility for four or more consecutive hours shall be provided nutritious food.

E. Meals may be prepared at the facility or catered.

F. Kitchens shall have clean, safe operational equipment for the preparation, storage, serving, and clean-up of all meals.

G. Adequate dining space shall be provided for consumers. The dining space shall be maintained in a clean and safe condition.

H. When meals are prepared by consumers, there shall be a written policy to include the following:

1. rules of kitchen privileges,

2. menu planning and procedures,

3. nutritional and sanitation requirements, and

4. schedule of responsibilities.

 

R501-22-10. Specialized Services for Substance Abuse.

A. The program shall not admit anyone who is currently experiencing convulsions, in shock, delirium tremens, in a coma or unconscious.

B. Before admission, consumers shall be tested for Tuberculosis. Both consumers and staff shall be tested annually or as directed by the local health requirements.

 

R501-22-11. Specialized Services for Programs Serving Children.

A. The program shall provide clean and safe age appropriate toys for children.

B. The program shall provide an outdoor play area enclosed with a five foot safety fence.

C. Only custodial parents, legal guardian, or persons designated in writing, are allowed to remove any child from the program.

D. The program shall provide adequate staff to supervise children at all times.

 

R501-22-12. Specialized Services for Domestic Violence Shelters.

A. The program shall provide clean and safe age appropriate toys for children.

B. The program shall provide an outdoor play area enclosed with a five foot safety fence.

C. The program shall provide and document the following information both verbally and in writing to the consumer: Shelter rules, reason for termination, and confidentiality issues.

D. Parents are responsible for supervising their children while at the shelter. If parents are required to be away from the shelter or involved in shelter activities without their children, they shall arrange for appropriate child care services.

 

R501-22-13. Specialized Services for Temporary Homeless Youth Shelters.

A. Temporary Homeless Youth Shelters shall provide a staff ratio of no less than one direct care staff to ten youth.

B. The age of the youth to be admitted shall be between 12 years of age and 17 years of age. Youth may be admitted with their own biological children of any age.

C. Youth shall be assessed by facility staff who meet the qualifications of a mental health therapist as defined in Section 58-60-102, to determine whether they are an imminent risk of harming themselves or others. Youth who are assessed as an imminent risk shall be referred to programs qualified to serve them.

D. Temporary Homeless Youth Shelters shall comply with Section 62A-4a-501 regarding mandatory notifications.

E. Temporary Homeless Youth Shelters shall comply with Section 62A-2-108.1 to coordinate educational requirements for all youth admitted.]

R501-22-1. Authority.

Pursuant to Section 62A-2-101 et seq., the Office of Licensing, shall license residential support programs according to the following rules.

 

R501-22-2. Purpose.

This rule establishes basic health and safety standards for residential support programs.

 

R501-22-3. Definition.

A. Residential Support is defined in 62A-2-101.

B. Temporary Homeless Youth Shelter is defined in 62A-4a-50.

C. Emergency Homeless Shelter means any facility, the primary purpose of which is to provide a temporary shelter for those experiencing homelessness in general or for specific populations of those experiencing homelessness and does not require occupants to sign leases or occupancy agreements.

1. Emergency Shelters must operate with priority of the safety of those needing their services and with an emphasis on transitioning into a more permanent housing setting.

 

R501-22-4. Administration.

A. In addition to the following rules, all Residential Support Programs shall comply with R501-1-11 Provider Code of Conduct and Client rights, 501-1-2-9/501-1-9-2 regarding critical incidents and R-501-14 regarding staff/volunteer background screenings, applicable DHS contract requirements and all State and Federal Laws.

B. Programs offering treatment shall also obtain the appropriate categorical DHS license for that treatment.

C. Programs shall have current program information readily available to the Office and the public, including a description of:

1. Program services;

2. The client population served;

3. Program requirements and expectations;

4. Information regarding any clinical and non-clinical services offered;

5. Costs, fees, and expenses that may be assessed, including any non-refundable costs, fees or expenses; and

6. Complaint reporting and resolution processes.

7. A list of current staff and clients shall be available to the Office and onsite at all times.

8. Emergency shelters providing primarily domestic violence services may replace identifying victim client information wherever required by this rule with non-identifying victim client numbers in accordance with VAWA and Federal Confidentiality Mandates.

D. Programs serving those experiencing homelessness in settings with one or more contracted service provider shall identify all key decision makers and service providers associated with the site license application.

1. All identified contractors shall be subject to all Licensing rules and requirements while operating in the licensed setting.

 

R501-22-5. Staffing.

A. The program shall identify a director or qualified designee who shall be immediately available at all times that the program is in operation; the responsibilities of the manager shall be clearly defined.

1. Whenever the manager is absent there shall be an employed and fully trained substitute to

assume managerial responsibility.

2. With the exception of Emergency Homeless and Domestic Violence Shelters, adult programs are not required to provide twenty-four hour supervision.

B. The program shall establish a policy and procedure that identifies situations requiring medical attention and who the program utilizes to meet the medical needs of the program's clients.

C. Programs shall ensure at least one CPR/First Aid trained or certified staff member is available onsite at all times with clients;

D. Programs which utilize students and volunteers shall provide screening, training, and evaluation of the students/volunteers.

1. Volunteers providing care in all Emergency Homeless and Domestic Violence Shelters, without paid staff present, shall have direct communication access to designated staff at all times and shall have cleared background screenings prior to unsupervised client access. Volunteers shall be informed verbally and in writing of program objectives and scope of service.

E. Programs shall consider the dynamics of the population in making staffing decisions to maintain compliance with ratio and staffing requirements of this rule.

 

R501-22-6. Direct Service.

A. The program shall:

1. Identify and provide to the Office the organizational structure of the program including:

2. Names and titles of owners, directors and individuals responsible for implementing all aspects of the program, and

3. A job description, duties and qualifications for each job title;

4. Disclose any potential conflicts of interest to the Office;

5. Ensure that staff are licensed or certified in good standing as required and that unlicensed individuals providing direct client services shall do so only in accordance with the Mental Health Professional Practices Act;

B. The program manager shall:

1. Train and monitor staff compliance regarding:

(a) Program policy and procedures;

(b) The needs of the program's clients;

(c) Office of Licensing rule 501-22 and annual training on the Licensing Code of Conduct and client rights as outlined in R501-1-11;

(d) emergency response plan

2. Create and maintain personnel files for each staff member to include:

(a) applicable qualifications, experience, certifications and licenses;

(b) approved and current Office of Licensing background screening except as excluded in 501-14-17; and

C. Training records with date completed, topic and employee signature(s) verifying completion.

D. Programs shall comply with Office rules and;

1. Maintain proof of financial viability of the program;

2. Maintain general liability insurance, professional liability insurance that covers all program staff, vehicle insurance for transport of clients, fire insurance and any additional insurance required to cover all program activities; and

3. Maintain proof of completion of the National Mental Health Services Survey (NMHSS) annually if providing mental health services; and

4. The program shall develop, implement and comply with policies and procedures sufficient to ensure the health and safety and meet the needs of the client population served. Policies and procedures shall address at a minimum:

(a) Client eligibility;

(b) Intake and discharge process;

(c) Client rights as outlined in R501-1-11;

(d) Staff and client grievance procedures;

(e) Behavior management;

(f) Medication management;

(g) Critical incident reporting as outlined in R501-1-2-9 and R501-1-9-2;

(h) Emergency procedures;

(i) Transportation of clients to include requirement of Insurance, valid driver license, driver and client safety and vehicle maintenance;

(j) Firearms policy see 501-22-7-22(c);

(k) Client safety including any unique circumstances regarding physical facility, supervision, community safety and mixing populations; and

(l) Levels of client engagement offered by the program and what types of services are available to participants.

(m) Any supplemental services that may be provided outside the scope of licensure and the process followed for obtaining informed consent to voluntarily participate in these services.

5. Programs, excluding emergency homeless shelters whose requirements are outlined in 501-22-6-E, shall maintain client files to include the following:

(a) Client name, address, email address, phone numbers, date of birth and gender;

(b) Emergency contact names, including legal guardian where applicable, and a minimum of: an actual address, actual email address or actual phone numbers to reach identified contacts;

(c) All information that could affect health safety or well-being of the client to include all medications, allergies, chronic

(d) A statement indicating how the client meets the admission criteria;

(e) Description of presenting situation

(f) Intake assessment

(g) Grievance and complaint procedure; and

(h) Discharge documentation

(i) Service plan and services provided and any referral arrangements made by the program

(j) Any clinical services are recommended by treatment or service plans signed by a clinical professional and provided by appropriately credentialed and trained staff

(k) A signed fee disclosure statement including Medicaid number, insurance information and identification of any other entities that are billed for the client's services

(l) Client or guardian signed consent or court order of commitment to services in lieu of signed consent for all treatment and non-clinical services.

(m) All crisis interventions or critical incident reports

(n) Detailed documentation of all clinical and non-clinical services provided with date and signature of staff completing each entry and

(o) Client treatment/service plans shall offer and document as many life enhancing opportunities as are appropriate and reasonable.

E. Emergency Homeless Shelters shall, at a minimum, be able to provide the following information (or have documented reasons why unobtainable) regarding each client:

(a) Name

(b) Date of birth

(c) Race

(d) Ethnicity

(e) Gender

(f) Veteran status

(g) Disabling condition

(h) Start date

(i) Exit date

(j) Destination

(k) Relationship to head of household

(l) Client services location

(m) Prior living situation

(n) Case management logs and service plans as applicable

(o) All information that could affect health safety or well-being of the client to include all medication

(p) All documentation shall be updated to include all services and contacts and shall be summarily updated at 90 day intervals

(q) All documentation shall remain in effect for re-opening for 30 days past the last shelter stay with the exception of single night stays

(r) Service plans shall emphasize self-sufficiency and identify and refer to applicable resources.

F. Programs shall have policies and procedures for training all staff to identify and address at a minimum:

(a) Clients who pose a risk of violence

(b) Clients in possession of contraband

(c) Clients who are at risk for suicide

(d) Managing clients with mental health concerns

(e) Identifying the signs and symptoms of clients presenting under the influence of substances or alcohol, and

(f) Prescribed staff responses to any of the above situations including ongoing monitoring and assessment for remaining in the program

G. Programs shall document a plan detailing how all program staff and client files shall be maintained and remain available to the Office and other legally authorized access for 7 years regardless of whether or not the program remains licensed.

H. The program shall ensure that assessment, treatment and service planning practices are clinically appropriate, updated as needed, timely, individualized, and involve the participation of the client or guardian.

I. All programs shall maintain documentation of all critical incidents as defined in 501-1-2-9 and as outlined in the DHS Critical Incident Reporting Guide.

1. All critical incident reports shall be made to licensingconcerns@utah.gov or via the Office of Licensing Website within 24 hours.

2. Incident reports will contain at a minimum:

(a) Name of provider and all involved staff, clients and witnesses

(b) Date, time and location of the incident and date and time of incident discovery if different from the time of the incident.

(c) Description of the incident

(d) Actions taken by program

(e) Actions planned to be taken by program

(f) Program DHS contract status (if any)

 

R501-22-7. Physical Facility.

A. The program shall provide written documentation of compliance with the following:

1. Local zoning ordinances,

2. Local business license requirements,

3. Local building codes,

4. Local fire safety regulations,

5. Local health codes and clearance or exclusion from health clearance per R392-110,

6. Local approval from the appropriate government agency for new program services or increased client capacity.

B. Space shall meet service needs as follows:

1. All furniture and equipment shall be maintained in a clean and safe condition.

2. The program shall post the following documents where they are clearly visible by clients, staff, and visitors:

(a) Civil Rights and anti-discrimination laws;

(b) Program license;

(c) Current or pending Notices of Agency Action;

(d) Abuse and neglect reporting laws; and

(e) Client rights and grievance process.

3. The program shall ensure that the physical environment is safe for clients and staff and that the appearance and cleanliness of the building and grounds are maintained.

4. The program shall strictly adhere to and enforce all laws and rules, particularly those pertaining to the use and possession of illegal substances.

5. Live-in staff shall each have separate living space with a private bathroom.

6. The program shall have space to serve as an administrative office for records, secretarial work and bookkeeping.

7. Space shall be provided for private and group counseling sessions if offered on-site.

8. Bathrooms: The following bathroom standards shall apply.

(a) There shall be separate bathrooms, including a toilet, lavatory, tub or shower, for males and females. These shall be maintained in good operating order and in a clean and safe condition.

(b) Client to bathroom ratios shall be 10:1, except as outlined in 501-22-7-F(11).

(c) Bathrooms shall accommodate clients with physical disabilities, as required by federal, state and local law.

(d) Each bathroom shall be maintained in good operating order and be provided with toilet paper, towels or hand dryers, and soap.

(e) There shall be mirrors secured to the walls at convenient heights.

(f) Bathrooms shall be placed as to allow access without disturbing other clients during sleeping hours.

(g) Bathrooms shall be ventilated by mechanical means or equipped with a screened window that opens.

9. Domestic Violence Shelters and Emergency Homeless Shelter family bathrooms

(a) Family members may share bathrooms, and

(b) Where bathrooms are shared by more than one family or by children over the age of eight, parents or program staff shall ensure that privacy is protected.

10. In Temporary Homeless Youth Shelters Bathrooms single occupancy unisex bathrooms are permissible.

11. In Emergency Homeless Shelter group bathrooms that exceed minimum bathroom ratios listed above are permissible if they are:

(a) Approved by the local authority that determines capacity or by the Department of Health;

(b) Specifically designated for males and females in adult-only nightly shelter settings;

(c) Inspected, cleaned and re-stocked as needed and at least daily;

(d) Allow for individual privacy in bathing and toileting;

(e) At least one locking bathroom or stall is accessible for handicapped individuals;

(f) Accommodate parents' needs for changing, toileting and bathing their children (if applicable).

12. Sleeping Accommodations, the following bedroom standards apply:

(a) Except as otherwise outlined in this rule: 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) Emergency homeless settings shall have a policy to identify how to manage emergency overflow when capacity has been reached during extreme weather conditions.

13. Sleeping areas shall have a source of natural light and shall be ventilated by mechanical means or equipped with a screened window that opens.

(a) Pre-existing homeless sits may be excluded from natural light and screened window requirements as long as there is mechanical ventilation and an exit plan approved by the local fire authority.

14. Each bed, none of which shall be portable, shall be solidly constructed and be provided with clean linens after each client's stay.

15. Programs shall have policies and procedures in place that allow for and encourage clients to have clean linens on at least a weekly basis

(a) Programs serving short-term emergency populations of those experiencing homelessness may have portable beds, cots or mats as a means to accommodate the fluctuating client volume

(b) Clean bedding shall be provided as needed and shall be laundered at least weekly

16. Sleeping quarters serving male and female clients shall be structurally separated except in family shelters serving populations experiencing homelessness, in which case families may be permitted to share bedroom space with rules outlined by the program per R501-22-7-A-20(d)and in dormitory settings allowed by this rule.

17. Clients shall be allowed to decorate and personalize bedrooms with respect for other clients and property unless agency policy and procedures transparently outline otherwise.

18. For Domestic Violence Shelters, Family Support Centers, Temporary Homeless Youth Shelters, Emergency Homeless Family Shelters and children's shelters, the following shall apply to bedroom spaces:

(a) A minimum of 40 square feet per client shall be provided in a multiple occupant bedroom. Storage space shall not be counted. The use of one crib for children under two years of age shall not be counted in the square foot requirement as long as it does not inhibit access to and from the room.

(b) Roll away and hide-a-beds may be used as long as the client square foot requirement is maintained.

(c) Family members are allowed to share bedrooms. Where bedrooms are shared by more than one family, parents or program staff shall make appropriate arrangements to ensure privacy is protected.

19. For Temporary Homeless Youth Shelters, the following shall apply:

(a) A minimum of 40 square feet per client shall be provided in a multiple occupant dormitory style bedroom. Storage space shall not be counted.

(b) For youth with their own children, a minimum of 40 square feet per person shall be provided in a separately enclosed bedroom that houses only youth that have their own children. Storage space shall not be counted.

20. For Emergency Homeless and temporary homeless youth Shelters the following shall apply:

(a) Dormitory style bedrooms are permitted with square footage and capacity determinations made by the local authority to include any staff present in the facility.

(b) If the local authority does not identify capacity Licensing square footage requirements

apply to capacity determinations.

(c) The program shall have a policy to identify how to manage overflow when capacity has been reached.

(d) The program shall outline policies and procedures regarding:

(i) rules and guidelines for families or mixed genders sharing the same dormitory space or bedrooms, including boundaries and separation of unrelated residents;

(ii) securing personal belongings;

(iii) supervision responsibility for own children;

(iv) conflict resolution/nuisance and disruptive behaviors;

(v) housekeeping responsibilities;

(vi) daily schedules;

(vii) prohibited items and search policy;

(viii) medication policies to include: lawful storage, staff and client responsibilities and administration policy

21. Equipment

(a) Furniture and equipment shall be of sufficient quantity, variety, and quality to meet program and client needs.

(b) All furniture and equipment shall be maintained in a clean and safe condition.

22. Storage

(a) The program shall have locked storage for medications and shall adhere to medication policies regarding locked storage, staff and client responsibilities and administration of medications.

(b) The program shall maintain potentially hazardous items on-site lawfully, responsibly and with consideration of the safety and risk level of the population(s) served.

(c) The program shall have a weapons policy that identifies that when weapons are brought into the facility, those weapons shall be secured by the program in a locked storage area or removed from the premises.

23. Laundry Service

(a) Programs which permit clients to do their own laundry shall provide equipment and supplies for washing and drying,

(b) Programs which provide for common laundry of linens and clothing, shall provide containers for soiled laundry separate from storage for clean linens and clothing unless otherwise outlined in the program policy and procedure manual. Programs that require clients to provide their own laundry supplies and locate a laundromat for laundering, will have a policy to assist clients on a limited basis when they are unable to provide these services for themselves.

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

 

R501-22-8. Food Service.

A. One staff shall be responsible for food service when the program provides meals for clients.

1. Meals shall be served from dietician approved menus or in accordance with USDA standard for Homeless settings.

2. In self-serve programs, one staff member shall be trained by Serv-Safe, USDA, Dept. of Health Food Handler's permit or a comparable program to oversee kitchen use and redirect and train kitchen users as needed.

(a) The staff responsible for food service shall maintain a current list of clients with special nutritional needs and record in client record all information relating to special nutritional needs and provide for nutritional counseling to staff and clients where indicated.

(b) In self-serve programs, the staff responsible for food service shall ensure that all clients with special nutritional needs have food storage and preparation areas that are not exposed to any identified allergens or contaminants.

3. Programs are permitted to establish policies and procedures requiring adult clients to maintain full responsibility for their (and their childrens') special dietary needs as long as clients sign off on this responsibility prior to entering the program.

4. The program shall establish and post kitchen rules and privileges in communal kitchen and dining space according to client needs and safe food handling practices.

5. Homeless settings may create policies regarding meals and snacks according to established practices, USDA guidelines incoming food donations and volunteer scheduling.

(a) Adequate dining space shall be provided for all clients and shall be maintained in a clean and safe condition.

(b) When meals are prepared by clients, there shall be a written policy to include the following:

(i) sanitation requirements

(ii) shopping and storage responsibilities

 

R 501-22-9. Specialized Services for Substance Use Disorders.

The program shall not admit anyone who is currently experiencing convulsions, in shock, delirium tremens, in a coma or unconscious.

A. All homeless shelters and other programs potentially serving substance use disorder clients shall provide evidence of ongoing coordination with the local health authorities regarding managing communicable diseases within the licensed setting to include that staff are informed regarding:

1. Types of communicable diseases

2. Recognizing signs and symptoms

3. Steps to take when a potential disease is identified or outbreak occurs.

4. Screening staff and clients for risk of tuberculosis

B. All Homeless shelters and other programs potentially interacting with opioid users shall have at least one opioid overdose reversal kit onsite with on duty staff trained to utilize it as needed.

C. A licensed substance abuse treatment program shall complete the National Survey of Substance Abuse Treatment annually.

 

R501-22-10. Specialized Services for Programs Serving Children.

A. The program shall provide clean and safe age appropriate toys for children.

B. The program shall provide an outdoor play area enclosed with a five foot safety fence or enclosure as otherwise required by local ordinances.

C. Only custodial parents, legal guardian, or persons designated in writing are allowed to remove any child from the program.

D. The program shall provide adequate staff to supervise children at all times or be available to monitor parents supervising their own children.

E. The program shall comply as required with the Interstate Compact on the Placement of Children (ICPC), including ensuring the disruption plan is followed when a minor presents at a shelter as a result of a failed ICPC placement in a Utah residential setting.

F. The Program shall comply with 62A-2-108.1 when sending education entitled children to the school within the District where the program is located to include:

1. Required contents of educational service plans

2. Ongoing compliance with educational service plans

 

R501-22-11. Specialized Services for Domestic Violence Shelters.

A. The program shall provide and document the following information both verbally and in writing to the client: Shelter rules, reason for termination, and confidentiality issues.

B. Parents are responsible for supervising their children while at the shelter. If parents are required to be away from the shelter or involved in shelter activities without their children, they shall arrange for appropriate child care services.

C. Domestic Violence Shelter action plans shall include the following:

1. A review of danger and lethality with victim and discussion of the level of the victim's risk of safety.

2. A review of safety plan with the victim,

3. A review of the procedure for a protective order and referral to appropriate agency or clerk of the court authorized to issue the protective order, and

4. A review of supportive services to include, but not limited to medical, self-sufficiency, day care, legal, financial, and housing assistance. The program shall facilitate connecting services to those resources as requested. Appropriate referrals shall be made, when indicated, and documented in the client record for victim treatment, psychiatric consultation, drug and alcohol treatment, or other allied services.

5. Domestic Violence Shelter staff completing action plans shall at a minimum be supervised by an experienced and trained Domestic Violence provider.

 

R501-22-12. Specialized Services for Temporary Homeless Youth Shelters.

A. Temporary Homeless Youth Shelters shall provide a staff ratio of no less than one direct care staff to ten youth.

B. The age of the youth to be admitted shall be between 12 years of age and 17 years of age. Youth may be admitted with their own biological children of any age.

C. Youth shall be assessed by facility staff who meet the qualifications of a mental health therapist as defined in Section 58-60-102, to determine whether they are an imminent risk of harming themselves or others. Youth who are assessed as an imminent risk shall be referred to programs qualified to serve them.

D. Temporary Homeless Youth Shelters shall comply with Section 62A-4a-501 regarding mandatory notifications.

E. Temporary Homeless Youth Shelters shall comply with Section 62A-2-108.1 to coordinate educational requirements for all youth admitted.

 

R501-22-13. Specialized Services for Emergency Homeless Shelters.

A. Emergency Homeless Shelters shall adhere to a ratio of no less than 2 direct care staff present or available to clients at all times. A ratio of 1:40 shall be maintained during weekday daytime hours with ratios increased but not decreased as the dynamics of the population dictate.

B. This staffing and capacity ratio can be exceeded during extreme weather, on weekends and during sleeping hours in emergency homeless settings if:

1. There is an identified and utilized chain of command for on-call availability, and;

2. The program has a surveillance camera system, or;

3. The program has an emergency radio onsite and all staff on-duty are trained regarding how and when it is to be used, or;

4. The program identifies and can rely upon other means of back up support in the event of an emergency;

 

R501-22-14. Specialized Services for Programs serving clients of the Division of Services for People with Disabilities.

A. In accordance with the Federal Home and Community Based Services (HCBS)Settings Final Rule, programs serving HCBS Waiver clients shall complete and adhere to the characteristics of a compliant setting outlined in the Residential Attestation Agreement form for each licensed program.

1. Residential Attestation Agreement form can be found here http://health.utah.gov/ltc/hcbstransition/Files/Residential_Attestion.pdf

2. Copies of this form shall be located in program documentation and updated as needed.

3. In the event of a conflict between Licensing rule and Settings rule, the Settings rule shall prevail.

4. Any violations of the Settings rule noted by the Office of Licensing shall be reported to the Office of Quality Design for contract consideration. After 2022, violations of Settings rule will constitute a violation of federal law.

 

R501-22-15. Compliance.

Programs operating within the scope of this rule at the time it is made effective shall have 60 days to come into compliance with this rule.

 

KEY: human services, licensing

Date of Enactment or Last Substantive Amendment: [October 23, 2014]2019

Notice of Continuation: April 1, 2015

Authorizing, and Implemented or Interpreted Law: 62A-2-101 et seq.


Additional Information

More information about a Notice of Proposed Rule is available online.

The Portable Document Format (PDF) version of the Bulletin is the official version. The PDF version of this issue is available at https://rules.utah.gov/publicat/bull_pdf/2019/b20191001.pdf. The HTML edition of the Bulletin is a convenience copy. Any discrepancy between the PDF version and HTML version is resolved in favor of the PDF version.

Text to be deleted is struck through and surrounded by brackets ([example]). Text to be added is underlined (example).  Older browsers may not depict some or any of these attributes on the screen or when the document is printed.

For questions regarding the content or application of this rule, please contact Janice Weinman at the above address, by phone at 385-321-5586, by FAX at 801-538-4553, or by Internet E-mail at jweinman@utah.gov; Jonah Shaw at the above address, by phone at 801-538-4219, by FAX at 801-538-3942, or by Internet E-mail at jshaw@utah.gov.  For questions about the rulemaking process, please contact the Office of Administrative Rules.