No. 30179 (Repeal and Reenact): R501-19. Residential Treatment Programs

DAR File No.: 30179
Filed: 07/11/2007, 09:12
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

Changes to this rule are necessary to address requirements set forth in Subsection 62A-2-108.2(1)(a), which requires that the Office of Licensing make rules that establish categories of Residential Treatment licenses based on the differences in the types of Residential Treatment programs. It also provides more clarity to those rules that are generally the same as ones currently in effect.

Summary of the rule or change:

This rule facilitates substantive changes by establishing the following sections, which did not previously exist in the repealed rule: Definitions; Legal Requirements; Staff Requirements; and, Documentation Requirements. It also creates definitions and new categories for Residential Treatment Group, Residential Treatment Facility, Residential Treatment Center, Residential Treatment Campus, and a category for programs serving clients that offend sexually or violently. Although there are few other minor changes within this rule, most of the facility requirements, health and safety regulations, record keeping, and client services requirements are basically the same as those found in the previous rule.

State statutory or constitutional authorization for this rule:

Sections 62A-2-106 and 62A-2-108.2

Anticipated cost or savings to:

the state budget:

It is anticipated that there will be some initial implementation costs associated to this rule in the way of development and printing of new check lists, and training of staff to the new rule, but all of these costs can be absorbed in current budgets.

local governments:

There should be no direct costs to local governments because they do not operate programs that are regulated by this rule.

other persons:

There should be no costs to other persons except for those listed below in "compliance costs for affected persons" and "comments by the department head".

Compliance costs for affected persons:

Human service programs that are required to be licensed for Residential Treatment will experience some minimal administrative costs to modify or update policies and procedures manuals and record keeping procedures. There are both costs and savings anticipated in regard to the staffing requirements. Depending on the program it is possible to have some moderate cost increase as a result of staffing and training requirements.

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

The businesses that may experience some mild to moderate fiscal impact as a result of these rules are the human services programs that will be licensed to provide residential treatment services. Some of these business receive public funds through contracts with the department, and will be evaluated for fiscal impact through the rate setting process. Private noncontracted Residential Treatment programs may need to set higher fees to offset any additional costs due to these regulations.

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
120 N 200 W
SALT LAKE CITY UT 84103-1500

Direct questions regarding this rule to:

Ken Stettler at the above address, by phone at 801-538-4235, by FAX at 801-538-4553, or by Internet E-mail at [e-mail]

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:

08/31/2007

This rule may become effective on:

09/07/2007

Authorized by:

Ken Stettler, Director

RULE TEXT

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

R501-19. Residential Treatment Programs.

[R501-19-1. Authority.

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

 

R501-19-2. Purpose.

Residential treatment programs offer room and board and provides for or arranges for the provision of specialized treatment, rehabilitation or habilitation services for persons with emotional, psychological, developmental, or behavioral dysfunctions, impairments, or chemical dependencies. In residential treatment programs, consumers are assisted in acquiring the social and behavioral skills necessary for living independently in the community in accordance with Subsection 62A-2-101(15).

 

R501-19-3. Definition.

Residential treatment program means a 24-hour group living environment for four or more individuals unrelated to the owner or provider in accordance with Subsection 62A-2-101(15).

 

R501-19-4. Administration.

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

B. A current list of enrollment of all registered consumers shall be on-site at all times.

 

R501-19-5. Staffing.

A. The program shall have an employed manager who is 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 available.

B. The program shall have a staff person trained, by a certified instructor, in standard first aid and CPR on duty with the consumers at all times.

C. Programs which utilize students and volunteers, shall provide screening, training, and evaluation of volunteers. Volunteers shall be informed verbally and in writing of program objectives and scope of service.

D. Professional staff shall include the following individuals who have received training in the specific area listed below:

1. Mental Health

a. a licensed physician or consulting licensed physician,

b. a licensed psychologist, or consulting licensed psychologist,

c. a licensed mental health therapist,

d. a licensed advanced practice registered nurse-psychiatric mental health nurse specialist, or a consulting advanced practice registered nurse-psychiatric mental health nurse specialist, and

e. if unlicensed staff are used, they shall be supervised by a licensed clinical professional.

2. Substance Abuse

a. a licensed physician, or a consulting licensed physician,

b. a licensed psychologist or consulting licensed psychologist,

c. a licensed mental health therapist or consulting licensed, mental health therapist, and

d. a licensed substance abuse counselor or unlicensed staff who work with substance abusers shall be supervised by a licensed clinical professional.

3. Children and Youth

a. a licensed physician, or consulting licensed physician,

b. a licensed psychologist, or consulting licensed psychologist, and

c. a licensed mental health therapist or consulting licensed mental health therapist, to provide a minimum of one hour of service to the program per week per consumer enrolled.

d. A licensed medical practitioner, by written agreement, shall be available to provide, as needed, a minimum of one hour of service per week for every two consumers enrolled.

e. Other staff trained to work with emotionally and behaviorally disturbed, or conduct-disordered children and youth shall be under the supervision of a licensed clinical professional.

f. A minimum of two staff on duty and, a staff ratio of no less than one staff to every four consumers shall exist at all times, except nighttime sleeping hours when staff may be reduced.

g. A mixed gender population shall have at least one male and one female staff on duty at all times.

4. Services for People With Disabilities shall have a staff person responsible for program supervision and operation of the facility. Staff person shall be adequately trained to provide the services and treatment stated in the consumer plan.

 

R501-19-6. Direct Service.

Treatment plans shall be reviewed and signed by the clinical supervisor. Treatment plans shall be reviewed and signed by the clinical supervisor, or other qualified individuals for Division of Services for People With Disabilities services. Plans shall be reviewed and signed as noted in the treatment plan.

 

R501-19-7. Physical Facilities.

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

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 consumers and staff.

 

R501-19-8. Physical Environment.

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. Indoor space for free and informal activities of consumers shall be available.

D. Provision shall be made for consumer privacy.

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

F. Sleeping Space

1. No more than four persons, or two for Division of Services for People With Disabilities programs, shall be housed in a single bedroom.

2. A minimum of sixty square feet per consumer shall be provided in a multiple occupant bedroom. Storage space will not be counted.

3. A minimum eighty square feet per individual shall be provided in a single occupant bedroom. Storage space will not be counted.

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

5. 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.

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

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

G. Bathrooms

1. The program shall have separate bathrooms for males and females. These shall be maintained in good operating order and in a clean and safe condition.

2. Bathrooms shall accommodate consumers with physical disabilities as required.

3. Each bathroom shall be properly equipped with toilet paper, towels, soap, and other items required for personal hygiene.

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

5. Bathrooms shall meet a minimum ratio of one toilet, one lavatory, and one tub or shower for each six residents.

6. There shall be toilets and baths or showers which allow for individual privacy.

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

8. Bathrooms shall be located as to allow access without disturbing other residents during sleeping hours.

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

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

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

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

L. Laundry appliances shall be maintained in a clean and safe operating condition.

 

R501-19-9. 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 consumers service record information relating to special nutritional needs and provide for nutrition 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, and 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.

 

R501-19-10. Medication.

A. The program shall have locked storage for medications.

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

C. Prescriptive medication shall be provided as prescribed by a qualified physician, according to the Medical Practices Act.

D. The program shall have designated qualified staff, who shall be responsible to:

1. administer medication,

2. supervise self-medication,

3. record medication, including time and dosage, according to prescription, and

4. record effects of medication.

 

R501-19-11. 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. At a minimum, the program shall document that direct service staff complete standard first aid and CPR training within six months of being hired. Training shall be updated as required by the certifying agency.

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

 

R501-19-12. Specialized Services for Programs Serving Children and Youth.

A. Provisions shall be available for adolescents to continue their education with a curriculum approved by the State Office of Education.

B. Programs which provide their own school shall be recognized by an educational accreditation organization, i.e., State Board of Education or the National School Accreditation Board.

C. Individual, group, couple, and family counseling sessions or other appropriate treatment, including skills development, shall be conducted at least weekly, or more often if defined by the treatment plan. The consumer's record shall document the time and date of the service provided and include the signature of the counselor.

D. An accurate record shall be kept of all funds deposited and withdrawn with the residential facility for use by a consumer. Consumer purchases of over $20.00 per item, shall be substantiated by receipts signed by the consumer and appropriate staff.

 

R501-19-13. Specialized Services for Division of Services for People With Disabilities.

A. Rules governing the daily operation and activities of the facility shall be available to all consumers and visitors, and shall apply to family members, consumers, and staff that come into the facility.

B. The program shall have policy specifying the amount of time family or friends may stay as overnight guests.

C. All consumers in residential programs shall have an individual plan that addresses appropriate day treatment.

D. A monthly schedule of activities shall be shared with the consumer and available on request. Schedules shall be filed and maintained for review.

E. A record of income, earned, unearned, and consumer service fees, shall be maintained by the provider.

F. Residential facilities shall be located where school, church, recreation, and other community facilities are available.

G. An accurate record shall be kept of all funds deposited with the residential facility for use by a consumer. This record shall contain a list of deposits and withdrawals. Consumer purchases of over $20.00, per item, shall be substantiated by receipts signed by the consumer and professional staff. A record shall be kept of consumer petty cash funds.

H. The program, in conjunction with the parent or guardian and the Division of Services for People With Disabilities support coordinator, shall apply for unearned income benefits for which a consumer is entitled.]

R501-19-1. Authority and Purpose.

(1) This Ris authorized under Sections 62A-2-106 and 62A-2-108.2.

(2) This Restablishes:

(a) basic health and safety standards for residential treatment programs;

(b) procedures and standards for permitting a residential treatment program to provide services to an adult in the same facility and under the same conditions as a child;

(c) minimum administration and financial requirements; and

(d) categories of residential treatment licenses.

 

R501-19-2. Definitions.

(1) "Abuse" may also include "severe emotional abuse", "severe physical abuse", and "emotional or psychological abuse", as these terms are defined in Sections 62A-4a-101 and Section 62A-3-301.

(2) "Adult" means a person 18 years old or older.

(3) "Background screening clearance" means written verification that the Office of Licensing has approved an applicant's criminal, abuse, neglect, and exploitation background screenings.

(4) "Certified local inspector" is defined in Section 62A-2-101.

(5) "Child" is defined in Section 62A-2-101.

(6) "Client" is defined in Section 62A-2-101, and shall include the child of a client when the child resides with the client at the program.

(7) "Dangerous weapon" includes "firearms", "antique firearms", "explosive, chemical, or incendiary devices", ammunition, and other items as defined in Sections 76-10-306 and 76-10-501.

(8) "Dietician" means an individual certified in accordance with Utah Code Ann. Title 58 Chapter 49.

(9) "Direct access" is defined in Section 62A-2-101.

(10) "Direct care staff" means an individual who provides educational, vocational, therapeutic, or treatment services, supervision of a client or care directly to a client, and does not include support staff.

(11) "Directly supervised" is defined in Section 62A-2-120.

(12) "Exploitation" is as described in Subsection 76-5-111(4).

(13) "Facility" means the physical area where program activities take place, and include the buildings and grounds that are owned or leased by the program or its governing body.

(14) "Guardian" means a client's legal guardian or custodian, who is legally authorized to make placement, medical, or treatment decisions on behalf of the client.

(15) "Incident report" means a written description of any notable event, including but not limited to any crime, discipline, injury or illness, or unauthorized absence, and how that event was addressed.

(16) "Medical emergency" means any medical condition that may:

(a) be life threatening, including but not limited to shock, delirium tremens, coma, unconsciousness, convulsions, severe bleeding, or severe pain; or

(b) require additional medical assistance after treatment with basic first-aid.

(17) "Medical practitioner" means an individual currently licensed by the State of Utah under Utah Code Ann. Title 58 as a physician, physician's assistant, advanced practice registered nurse, practical nurse, or registered nurse.

(18) "Mental health therapist" means an individual currently licensed under Title 58, Chapter 60, as a physician engaged in the practice of mental health therapy, an advanced practice registered nurse specializing in psychiatric mental health nursing, a psychologist qualified to engage in the practice of mental health therapy, a clinical social worker, a certified social worker, a marriage and family therapist, or a professional counselor.

(19) "Mental illness" is defined in Section 62A-15-602.

(20) "Neglect" may also include "severe neglect", as these terms are defined in Section 62A-4a-101.

(21) "On call" means immediately available to staff by telephone, and able to be present on site within one hour after a staff telephone call for assistance.

(22) "On duty" means awake, within visual or auditory proximity of clients, and immediately available to clients.

(23) "Recreational therapist" means an individual licensed to practice recreational therapy in accordance with Title 58, Chapter 40.

(24) "Regular business hours" is defined in Section 62A-2-101.

(25) "Residential treatment" is defined in Section 62A-2-101.

(26) "Sick" means to have a fever, an illness that may be contagious, or to be experiencing diarrhea or vomiting.

(27) "Significant criminal activity" means any act or omission resulting in:

(a) the abuse, neglect, or exploitation of a child or vulnerable adult;

(b) the death, kidnapping, or rape of any person;

(c) an assault resulting in an injury that requires additional medical assistance after treatment with basic first-aid;

(d) an assault using a dangerous weapon; or

(e) the damage, destruction, or misappropriation of any property or service valued at $1000 or more.

(28) "Staff" means program directors, supervisors, faculty, employees, contract employees, agents, interns or volunteers who provide any program services.

(29) "Staff-in-charge" means a staff who currently meets the criteria established by Section R501-2-11 and who is designated by the program as the on duty staff who is currently responsible for client supervision, program services, and compliance during a period of time designated by the program director. The staff-in-charge is not required to be designated as a supervisor by the program.

(30) "Staffing ratio that is more restrictive" means a greater number of staff for a given number of clients than would otherwise required by this rule.

(31) "Support staff" means staff who do not supervise clients and who only provide support services.

(32) "Treatment plan" means a written description of the therapeutic and other services an individual client requires, as determined and updated after periodic assessments by a mental health therapist.

(33) "Vulnerable Adult" is defined in Section 62A-2-101.

 

R501-19-3. Legal Requirements.

(1) At the time of the program's initial application to operate a residential treatment program, the program shall provide written verification to the Office of Licensing of compliance with Section 62A-2-108.2(4), which requires the program to provide information to the local government.

(2) A residential treatment program shall comply with this rule and:

(a) Rule R501-1, General Provisions;

(b) Rule R501-2, Core Standards;

(c) Rule R501-14, Background screening;

(d) state fire prevention laws and rules, including but not limited to Rule R710-4, Buildings Under the Jurisdiction of the State Fire Prevention Board, and Rule R710-9, Rules Pursuant to the Utah Fire Prevention Law; and

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

(3) At the time of a program's initial application, and annually thereafter, the program shall provide written verification of compliance with:

(a) local zoning ordinances;

(b) local business license requirements;

(c) local building codes, as required by the local governmental entity's licensed building inspector;

(d) state fire prevention laws and rules, as determined through a fire safety inspection by a certified fire safety inspector or fire marshal; and

(e) state and local health codes.

(4) A program shall comply with Rule R501-16 and obtain an intermediate secure treatment license prior to offering any intermediate secure treatment services.

(5) A program shall not exceed the maximum client capacity indicated on the current license issued by the Office of Licensing.

(6) Each time a program changes the type of client population, or applies for a license with an increased consumer capacity or for a new service category, the program shall provide written verification of local government approval to the Office of Licensing.

 

R501-19-4. Staff Requirements.

(1) Each owner or member of the governing body of a program who makes decisions regarding the program's daily operations shall successfully complete a minimum of 8 hours of annual training relating to residential treatment services.

(2) Directors, clinical directors, and acting directors who have responsibility for the on-site daily administration or operation of the program shall meet the requirements specified in Subsection R501-2-11(7) and shall have a minimum of two years of residential treatment program supervisory experience.

(a) A director or acting director shall be on duty or on call at all times.

(3) A program shall have a minimum of one staff-in-charge on duty at all times.

(4) A program providing services to children shall maintain a minimum direct care staff ratio of one direct care staff on duty for every six clients, and never fewer than two direct care staff on duty, between 7:00 a.m. and 9:00 p.m., or during any off site activity.

(a) When more than two direct care staff are required to be on duty before 9:00 p.m., the additional direct care staff shall not leave until after all children are asleep.

(b) If clients are awake before 7:00 a.m., the program shall maintain a minimum direct care staff ratio of one direct care staff on duty for every six clients, and never fewer than two direct care staff on duty while clients are awake.

(5) A program providing services to children shall maintain a minimum direct care staff ratio of one direct care staff on duty for every twelve clients, and never fewer than two direct care staff on duty in each building where clients sleep, between 9:00 p.m. and 7:00 a.m.

(6) A program is not required to include a child who is directly supervised by the child's parent in the staff ratios described in this section, R501-19-4.

(7) A program providing services to adults only shall maintain a minimum direct care staff ratio of one direct care staff on duty for every ten clients, and never fewer than one direct care staff on duty and one direct care staff on call, between 7:00 a.m. and 11:00 p.m., or during any off site activity.

(8) A program providing services to adults only shall maintain a minimum direct care staff ratio of one direct care staff on duty for every twenty clients, and never fewer than one direct care staff on duty in each building where clients sleep and one direct care staff on call, between 11:00 p.m. and 7:00 a.m.

(9) A substance abuse program providing services to adults only may reduce the minimum direct care staff ratio in this section if it has and complies with a written policy and procedures regarding staff ratios that considers factors particular to its client population, including but not limited to its clients presenting problems and the risks they may present to other clients, staff and the community.

(10) A program shall comply with a staffing ratio that is more restrictive when required by a client's treatment plan or a contract with the Department of Human Services or its Divisions.

 

R501-19-5. Documentation.

(1) A program shall maintain a written record for each individual client, as specified in Section R501-2-6.

(a) Each client written record shall include progress notes specific to the client's treatment plan, which shall be completed within one week following each counseling session, describing the client's behavior, staff interventions, and client responses.

(2) A program shall maintain, and direct care staff shall read, a daily shift log, which shall include:

(a) a description of the activities and incidents occurring during each shift;

(b) the date, time, and signature of the staff-in-charge at the end of each work shift; and

(c) the date, time, and signature of each direct care staff at the beginning of the staff's work shift.

 

R501-19-6. Client Services.

(1) A program shall describe how medical services will be promptly provided.

(a) Upon admission, each client shall be informed of the right to consult with a medical practitioner and a mental health therapist.

(b) A program that must travel more than 30 miles to an emergency room or 24-hour urgent care facility shall retain the on-call services of a medical practitioner and a mental health therapist.

(2) A monthly schedule of activities shall be posted in the common area and the office. Monthly schedules of activities shall be filed and retained for a minimum of one year.

 

R501-19-7. Physical Environment.

(1) The program buildings and grounds shall be maintained in a safe and clean manner.

(2) Live-in staff shall have a separate living space with a private bedroom and bathroom.

(3) The program shall have an on-site office or designated space for records.

(4) A program shall provide indoor common areas, such as gymnasiums, recreation areas, cafeterias, classrooms, libraries, and lounges, for group activities.

(a) The total common area space in a program shall be a minimum of thirty square feet per client, and shall not include hallways, bedrooms, kitchens, storage space, or utility rooms.

(5) A program shall have rooms available for private individual and group counseling sessions.

(6) Client Sleeping Space

(a) Except as authorized by Subsection R501-19-10(2) or subsection (i) below, no more than four persons shall be housed in a single bedroom.

(i) A program that has a fully functional automatic fire suppression system may house up to six persons in a single bedroom.

(ii) In the event that a contract with the Department of Human Services or one of the Divisions of the Department of Human Services further restricts the number of clients that may be housed in a single bedroom, the more restrictive number shall apply.

(b) A minimum of sixty square feet per client shall be provided in a multiple occupant bedroom.

(i) Storage space shall not be counted when calculating square footage requirements.

(c) A minimum eighty square feet per client shall be provided in a single occupant bedroom.

(i) Storage space shall not be counted when calculating square footage requirements.

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

(e) Each bed, none of which shall be portable, shall be solidly constructed.

(f) Bed mattresses shall be in a clean and safe condition.

(g) A program shall ensure that each client has clean linens upon arrival, when soiled, and a minimum of once per week.

(h) Sleeping quarters serving male and female clients shall be structurally separated.

(i) Sleeping quarters are structurally separated if permanent structures, such as doors and walls, prevent occupants in a room from seeing and communicating with occupants in other bedrooms.

(ii)(A) Sleeping quarters serving male and female clients shall not exit into a common hallway, except as provided by subsection B below.

(B) A program may have sleeping quarters serving male and female clients that exit into a common hallway only after it submits, and the Office of Licensing approves, a written policy describing how the program will reliably separate male and female clients during sleeping hours, and an accurate to-scale floor plan of each building where client-sleeping quarters are located.

(i) A program shall have and comply with a written policy and procedures regarding the times when clients shall be prohibited from entering each other's bedrooms and how it shall preserve client safety and privacy.

(j) Bedrooms housing children shall be inaccessible to adult clients at all times.

(k)(i) 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.

(ii) A bedroom that is not on the ground floor shall have a minimum of two exits from that floor, at least one of which shall exit directly to outside the building, that may be used to evacuate the room in case of fire.

(7) Client Bathrooms

(a) Each multiple occupant bathroom shall be designated for males only or for females only.

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

(c) Each bathroom shall be equipped with personal hygiene supplies, including but not limited to toilet paper, clean towels or air hand-dryers, soap, and trash receptacle.

(d) Bathrooms shall be well lighted and ventilated by mechanical means or equipped with a screened window that opens.

(e) A program shall provide a minimum of one toilet, one sink, and one tub or shower, for each six clients.

(f) Toilets, showers, and bathtubs shall be designed to preserve each client's privacy.

(8) Notwithstanding Subsections R501-19-7(6)(h), (i), and (j), and R501-19-7(7)(a), a program may permit a client's child to share sleeping quarters and bathrooms with the client after the Office of Licensing approves the program's written policies and procedures describing how the program will prevent the client's child from having any direct access with other clients when the child is not directly supervised by the child's parent or direct care staff.

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

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

(11) Each client shall have a minimum of thirty cubic feet of private storage space, such as dressers, trunks, closets, or lockers.

 

R501-19-8. Laundry Service.

(1) A program shall contract with a laundry service or shall provide laundry appliances and supplies for washing and drying.

(a) Each client shall have a dirty laundry hamper or a cloth or mesh bag for personal linens and clothing;

(b) all used personal linens and clothing shall be laundered at least weekly or more often as needed;

(c) subject to Subsection R501-2-15(4), clients who launder their own linens or clothing shall have weekly access to laundry appliances and supplies for washing and drying;

(d) a program that provides common laundry of linens or clothing shall provide hampers for soiled laundry separate from storage for clean laundry; and

(e) laundry appliances shall be maintained in a clean and safe operating condition.

 

R501-19-9. Food Service.

(1)(a) A program shall contract with or employ a dietitian to plan nutritious, appetizing, snacks and meals.

(b) A current weekly menu shall be posted in the kitchen.

(c) A program shall provide snacks and three daily meals in accordance with the dietitian's menu.

(2) A program shall maintain a current log of each client's food allergies and other individual dietary needs, and comply with the instructions of the client's physician or dietician.

(3) A program shall establish, post, and comply with kitchen safety and sanitation rules.

(4) A program kitchen shall have clean, safe, and operational equipment and supplies for the preparation, storage, serving, and clean up of food.

(5) A safe and clean dining area shall be provided, with tables and chairs suitable for the age and size of each client.

(6) A program's food service establishment shall be managed by a food safety manager certified in accordance with Title 26, Chapter 15a.

(7) Except for a familial status home as defined by the Federal Fair Housing Act 42 U.S.C. 3602(k), no staff or client shall prepare food for anyone other than themselves without first obtaining a food handler certification.

 

R501-19-10. Additional Rules for Substance Abuse Treatment Programs.

(1)(a) In addition to Sections R501-19-1 through R501-19-9 and other applicable subsections, substance abuse treatment programs shall comply with this section, R501-19-10.

(b) In the event of any conflict between Rules, the more restrictive provision shall apply.

(2) A substance abuse program providing services to adults only may utilize male-only and female-only dormitory-style sleeping arrangements if it submits, and the Office of Licensing approves, a written policy describing a treatment-related necessity for a dormitory arrangement.

(a) A dormitory shall provide a minimum of 50 square feet per person.

(b) A minimum of 3 feet shall be maintained between beds and 2 feet at the end of each bed.

(c) Storage space shall not be counted when calculating square footage requirements.

(d) Each client shall have a minimum of thirty cubic feet of private storage space.

(3) A dormitory shall have a fully functional automatic fire suppression system.

(4) A minimum of one licensed substance abuse counselor or mental health therapist shall be:

(a) on duty during any group or individual therapy session; and

(b) shall be on duty or on call at all other times.

(5) A substance abuse treatment program shall also hire or contract with mental health therapists to perform Section R501-19-4 Staff Requirements and Section R501-19-6 Client Services.

 

R501-19-11. Additional Rules for Programs Serving Children.

(1)(a) In addition to Sections R501-19-1 through R501-19-9 and other applicable subsections, a residential treatment program providing services to children shall comply with this section, R501-19-11.

(b) In the event of any conflict between Rules, the more restrictive provision shall apply.

(2) A program's educational services shall be accredited by an accrediting entity recognized by the Utah State Board of Education, or the program shall present an educational service plan and educational funding plan in accordance with Section 62A-2-108.1.

(a) The program course descriptions shall be provided to the client's guardian prior to accepting any payment or executing a contract to provide services.

(b) The program course descriptions shall be reviewed and updated annually.

(c) Modifications to the course descriptions shall be provided to the client's guardian annually and upon request.

(d) The program shall monitor and document each client's academic records including academic progress, reports, standardized testing, grades, credits earned, and diploma's awarded, and shall communicate this information to the client's guardian quarterly and upon request.

(3)(a) A client enrolled or attempting to enroll in a school may not attend public, private, or parochial school unless there is presented a certificate of immunization from a licensed physician or authorized representative of the state or local health department stating that the student has received immunization against communicable diseases as required by Rule R396-100, unless exempted as provided in Section 53A-11-302.

(b) A program that admits a child without a certificate of immunization shall obtain the certificate and any required immunizations within 7 calendar days of the date of admission.

(4) In addition to the requirements of Subsection R501-2-7(6), the client manual shall include detailed descriptions of:

(a) the program's academic accreditation, or disclosure that the school is not accredited;

(b) the program's course descriptions, criteria for awarding course credit, and whether credits are transferable;

(c) the program's grading, progress assessment, and testing policies and procedures;

(d) the program's academic and career counseling, activities and methods;

(e) the program's treatment and academic graduation requirements;

(f) the program's post-graduation planning services;

(g) the program's policies and procedures regarding the provision of services to adults in the same facility as children; and

(h) an emergency transportation plan, describing how the program shall safely transport clients to the client's guardian, or a person designated by the client's guardian in writing, within 48 hours.

(5) A program may provide services to an adult in the same facility as a child, in accordance with Subsection 62A-2-106(1)(a)(iii), only after the Office of Licensing approves the program's assessment of risk factors and methods of reducing assessed risks. In order for a client who was a child when admitted to the program to qualify to remain in the program after the client's 18th birthday, the client shall have:

(a) resided at the program at least 3 months immediately preceding the client's 18th birthday;

(b) not completed the program's course of treatment or academic graduation requirements;

(c) signed a voluntary consent form, that has previously been approved by the Office of Licensing and that describes the client's right to leave the program at any time, on a date following the client's 18th birthday;

(i) an individual who is 18 years old or older and under the jurisdiction of the Utah juvenile courts is not required to sign the consent form described in Subsection R501-19-11(5)(c).

(6) Except as permitted by Subsection R501-19-7(8), a child shall not share a bedroom with a person who is more than 3 years older or younger than the child.

(7)(a) Each client shall receive a minimum of one counseling session each week by a mental health therapist, or an intern in a supervised clinical training internship who is certified under Title 58, Chapter 60.

(b) A mental health therapist may increase or decrease the number of counseling sessions required by clearly explaining the treatment reasons for the change in writing in the client's treatment plan.

(c) The client's record shall document the time and date of each service provided and include the signature of the mental health therapist or the intern in a supervised clinical training internship who is certified under Title 58, Chapter 60.

(8) A minimum of two direct care staff shall be on duty at all times.

(9) A minimum of one male direct care staff shall be on duty when a male client is present, and a minimum of one female direct care staff shall be on duty when a female client is present.

(10) On duty staff shall ensure that no adult has unsupervised direct access to a child, who is not the adult's child and who is residing at or visiting the program, unless the adult has first received a background screening clearance in accordance with Section 62A-2-120 and Rule R501-14.

(11)(a) A program may delegate the responsibility for direct supervision of a child to the child's parent in its written policies and procedures, which shall describe how the program shall monitor the parent's supervision of the child.

(b) A program that permits a client's child to reside with the client shall:

(i) provide the client with parenting skills training;

(ii) provide oversight to ensure that the child is receiving appropriate care and treatment, including but not limited to clothing, food, medication, and education, in accordance with the child's needs while the child resides at the program; and

(iii) provide the child with appropriate care and treatment, including but not limited to clothing, food, medication, and education, in accordance with the child's needs if the child's parent fails to do so, while the child resides at the program.

 

R501-19-12. Additional Rules for Programs Serving Vulnerable Adults or People With Disabilities.

(1)(a) In addition to Subsection R501-19-1 through R501-19-9 and other applicable subsections, a residential treatment program providing services to persons with disabilities shall comply with this section, R501-19-12 and Rule R710-3, Assisted Living Facilities.

(b) In the event of any conflict between Rules, the more restrictive provision shall apply.

(2) A minimum direct care staff ratio of one direct care staff on duty for every six clients, and never fewer than two direct care staff on duty, shall be maintained between 7:00 a.m. and 11:00 p.m.

(3) A minimum direct care staff ratio of one direct care staff on duty for every ten clients, and never fewer than two direct care staff on duty in each building where clients sleep, shall be maintained between 11:00 p.m. and 7:00 a.m.

(4) A minimum direct care staff ratio of one direct care staff on duty for every six clients, and never fewer than two direct care staff on duty, shall be maintained during any off-site activity.

(5) A program shall comply with a staffing ratio that is more restrictive when required by a client's treatment plan or a contract with the Department of Human Services or its Divisions.

(6) A minimum of 2 direct care staff shall be on duty at all times.

(7) A minimum of one male direct care staff shall be on duty when a male client is present, and a minimum of one female direct care staff shall be on duty when a female client is present.

 

R501-19-13. Additional Rules for a Residential Treatment Group (Capacity 4-16).

(1)(a) In addition to Sections R501-19-1 through R501-19-9 and other applicable subsections, a residential treatment program licensed to provide services to 4-16 clients shall comply with this section, R501-19-13.

(b) In the event of any conflict between Rules, the more restrictive provision shall apply.

(2) A residential treatment group whose staff resides with clients in a familial status home, as defined by the Federal Fair Housing Act, 42 U.S.C. 3602(k), is excused from compliance with any laws, such as zoning laws, which discriminate against or make a dwelling unavailable because of its occupants' familial status.

(3)(a) A residential treatment group shall maintain a minimum of one mental health therapist on call at all times.

(b) A residential treatment group shall hire or contract with mental health therapists to perform Sections R501-19-4, Staff Requirements and R501-19-6, Client Services.

 

R501-19-14. Additional Rules for a Residential Treatment Facility (Capacity 17-49).

(1)(a) In addition to Sections R501-19-1 through R501-19-9 and other applicable subsections, a residential treatment program licensed to provide services to 17-49 clients shall comply with this section, R501-19-14.

(b) In the event of any conflict between Rules, the more restrictive provision shall apply.

(2) A residential treatment facility shall:

(a) maintain a minimum of one mental health therapist on call at all times; and

(b) maintain a minimum of one medical practitioner available on staff or by contract to provide any necessary medical services.

 

R501-19-15. Additional Rules for a Residential Treatment Center (Capacity 50-99).

(1)(a) In addition to Sections R501-19-1 through R501-19-9 and other applicable subsections, a residential treatment program licensed to provide services to 50-99 clients shall comply with this section, R501-19-15.

(b) In the event of any conflict between Rules, the more restrictive provision shall apply.

(2) A residential treatment center shall:

(a) maintain a mental health therapist on duty for a minimum of 8 hours daily, Monday through Friday, between the hours of 7:00 a.m. and 11:00 p.m.;

(b) maintain a medical practitioner on duty for a minimum of 40 hours weekly, between the hours of 7:00 a.m. and 11:00 p.m.;

(i) a substance abuse program providing services to adults only may contract with an off-site provider for the medical services described in Subsection R501-19-15(2)(b);

(c) maintain a minimum of one mental health therapist and one medical practitioner on-call at all times; and

(d) maintain a cook, kitchen staff, and maintenance staff.

 

R501-19-16. Additional Rules for a Residential Treatment Campus (Capacity 100 plus).

(1)(a) In addition to Sections R501-19-1 through R501-19-9 and other applicable subsections, a residential treatment program licensed to provide services to 100 or more clients shall comply with this section, R501-19-16.

(b) In the event of any conflict between Rules, the more restrictive provision shall apply.

2. A residential treatment campus shall:

(a) maintain a mental health therapist on duty for a minimum of 8 hours daily, between the hours of 7:00 a.m. and 11:00 p.m.;

(b) maintain a minimum of one mental health therapist on call at all times;

(c) maintain a medical practitioner on duty for a minimum of 40 hours weekly, between the hours of 7:00 a.m. and 11:00 p.m., and on call at all other times;

(d) maintain a full time cook and kitchen staff; and

(e) maintain a full time facility maintenance staff.

 

R501-19-17. Additional Rules for Programs Serving Clients That Offend Violently or Sexually.

(1)(a) In addition to Sections R501-19-1 through R501-19-9 and any other applicable subsections, a residential treatment program providing services to a person that has offended violently or sexually shall comply with this section, R501-19-17.

(b) In the event of any conflict between Rules, the more restrictive provision shall apply.

(2) A program may provide services to a person that has offended violently or sexually only after the program provides documentation of review and approval by a mental health therapist with documented expertise in clients who offend violently or sexually, of the program's:

(a) treatment services;

(b) detailed assessment of individual and community risk factors particular to the program site;

(c) specific methods for reducing assessed risks; and

(d) detailed description of the security measures it shall employ to protect each client, staff, and the community.

(3) A program shall comply with its approved risk reduction policies and procedures.

(4) A program providing services to persons that offend violently or sexually shall maintain a minimum direct care staff ratio of one direct care staff on duty for every four clients, and never fewer than two direct care staff on duty.

(a) A program shall comply with a staffing ratio that is more restrictive when required by a client's treatment plan or a contract with the Department of Human Services or its Divisions.

(5) A minimum of one male direct care staff shall be on duty when a male client is present, and a minimum of one female direct care staff shall be on duty when a female client is present.

 

R501-19-18. Compliance.

Any licensee that is in operation on the effective date of this Rshall be given 90 days after the effective date to achieve compliance with this rule.

 

KEY: human services, licensing, residential treatment

Date of Enactment or Last Substantive Amendment: [May 2, 2000]2007

Notice of Continuation: April 25, 2005

Authorizing, and Implemented or Interpreted Law: 62A-2-101 et seq.; 62A-2-106; 62A-2-108.2