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6325 RESIDENTIAL TREATMENT AND RECOVERY PROGRAMS

6325.1 The provisions of this section apply only to residential treatment programs and environmental stability programs, as defined by this chapter.

6325.2 Each residential provider, except providers only offering environmental stability, must obtain a Certificate of Need (“CON”), from the District of Columbia State Health Planning and Development Agency (“SHPDA”).

6325.3 The CON must be submitted as part of the certification application packet.

6325.4 Each residential treatment program serving children and youth under eighteen (18) must obtain written approval from the Office of the State Superintendent of Education (“OSSE”).

6325.5 Residential treatment and environmental stability providers shall comply with all applicable construction codes and housing codes, and zoning requirements applicable to the facility, including all Certificate of Occupancy, Basic Business License (“BBL”), and Construction Permit requirements.

6325.6 Each newly established residential treatment and environmental stability provider shall provide proof of a satisfactory pre-certification inspection by DCRA for initial certification, dated not more than forty-five (45) calendar days prior to the date of submission to the Department, for District of Columbia Property Maintenance Code (12-G DCMR) and Housing Code (14 DCMR) compliance, including documentation of the inspection date and findings and proof of abatement certified by DCRA of all deficiencies identified during the inspection. This requirement can be met by submission of a Certificate of Occupancy or a BBL dated within the past six (6) months, provided that that applicant can demonstrate that DCRA performed an onsite inspection of the premises.

6325.7 For existing residential treatment and recovery programs that are applying for re- certification, the applicants shall also provide proof of current BBLs.6325.8 Residential facilities' physical design and structure shall be sufficient to accommodate staff, clients, and functions of the program and shall make available an area(s) for indoor social and recreational activities.6325.9 A program that provides overnight accommodations shall not operate more beds than the number for which it is authorized by the Department.6325.10 Other than routine household duties, no client shall be required to perform unpaid work.6325.11 Upon admission to a residential program, each client shall be provided a copy of the program's house rules.6325.12 Each residential program shall have house rules consistent with this chapter and that include, at a minimum, rules concerning:- (a) The use of tobacco;

- (b) The use of the telephone;

- (c) Utilizing, viewing or listening to cell phones, television, radio, computers, CDs, DVDs, or other media such as social media;

- (d) Movement of clients in and out of the facility, including a requirement for escorted movements by program staff or another agency-approved escort;

- (e) A policy that addresses search and drug testing upon return to the facility; and

- (f) The prohibition of sexual relations between staff/volunteers and clients.6325.13 Each residential program shall be equipped, furnished, and maintained to provide a functional, safe, and comfortable home-like setting.6325.14 The dining area shall have a sufficient number of tables and chairs to seat all individuals residing in the facility at the same time. Dining chairs shall be sturdy, non-folding, without rollers unless retractable, and designed to minimize tilting.6325.15 Each residential program shall permit each client to bring reasonable personal possessions, including clothing and personal articles, to the facility unless the provider can demonstrate that it is not practical, feasible or safe.6325.16 Each residential facility shall provide clients with access to reasonable individual

storage space for private use.

6325.17 Upon each client's discharge from a residential program, the provider shall return to the client, or the client's representative, any personal articles of the client held by the provider for safekeeping. The provider shall also ensure that the client is permitted to take all of his or her personal possessions from the facility. The provider may require the client or client's representative to sign a statement acknowledging receipt of the property. A copy of that receipt shall be placed in the client's record.

6325.18 Each residential program shall maintain a separate and accurate record of all funds that the client or the client's representative or representative payee deposits with the provider for safekeeping. This record shall include the signature of the client for each withdrawal and the signature of facility staff for each deposit and disbursement made on behalf of a client.

6325.19 Each residential facility shall be equipped with a functioning landline or mobile telephone for use by clients. The telephone numbers shall be provided to clients and to the Department.

6325.20 Staff bedrooms shall be separate from client bedrooms and all common living areas.

6325.21 Each facility housing a residential program shall have a functioning doorbell or knocker.

6325.22 Each bedroom shall comply with the space and occupancy requirements for habitable rooms in 14 DCMR § 402.

6325.23 The provider shall ensure each client has the following items:

(a) A bed, which shall not be a cot;

(b) A mattress that was new when purchased by the provider, has a manufacturer's tag or label attached to it, and is in good, intact condition with unbroken springs and clean surface fabric;

(c) A bedside table or cabinet and an individual reading lamp with at least a seventy-five (75) watt, or its LED light bulb equivalent, rate of capacity;

(d) Storage space in a stationary cabinet, chest, or closet that provides at least one (1) cubic foot of space for each client for valuables and personal items;

(e) Sufficient suitable storage space, including a dresser and closet space, for personal clothing, shoes, accessories, and other personal items; and

(f) A waste receptacle and clothes hamper with lid.

6325.24 Each bed shall be placed at least three (3) feet from any other bed and from any uncovered radiator.

6325.25 Each bedroom shall have direct access to a major corridor and at least one window to the outside, unless the DCRA, or a successor agency responsible for enforcement of the D.C. Housing Code, has determined that it otherwise meets the lighting and ventilation requirements of the D.C. Housing Code for habitable rooms.

6325.26 Each facility housing a residential program shall provide one or more bathrooms for clients that are equipped with the following fixtures, properly installed and maintained in good working condition:

1. (a) Toilet (water closet);
2. (b) Sink (lavatory);
3. (c) Shower or bathtub with shower, including a handheld shower; and
4. (d) Grab bars in showers and bathtubs.

6325.27 Each residential facility shall provide at least one (1) bathroom for each six (6) occupants in compliance with 14 DCMR § 602.

6325.28 Each bathroom shall be adequately equipped with the following:

1. (a) Toilet paper holder and toilet paper;
2. (b) Paper towel holder and paper towels or clean hand towels;
3. (c) Soap;
4. (d) Mirror;
5. (e) Adequate lighting;
6. (f) Waste receptacle;
7. (g) Floor mat;
8. (h) Non-skid tub mat or decals; and
9. (i) Shower curtain or shower door.

6325.29 Each residential provider shall ensure that properly anchored grab bars or

handrails are provided near the toilet or other areas of the bathroom, if needed by any resident in the facility.

1. 6325.30 Adequate provision shall be made to ensure each client's privacy and safety in the bathroom.
2. 6325.31 Each residential program shall promote each client's participation and skill development in menu planning, shopping, food storage, and kitchen maintenance, if appropriate.
3. 6325.32 Each residential program shall provide appropriate equipment (including a washing machine and dryer) and supplies on the premises or through a laundry service to ensure sufficient clean linen and the proper sanitary washing and handling of linen and clients' personal clothing.
4. 6325.33 Each program shall ensure that every client has at least three (3) washcloths, two (2) towels, two (2) sheet sets that include pillowcases, a bedspread, a pillow, a blanket, and a mattress cover in good and clean condition.
5. 6325.34 Each blanket, bedspread, and mattress cover shall be cleaned regularly, whenever soiled, and before being transferred from one resident to another.
6. 6325.35 Each piece of bed linen, towel, and washcloth shall be changed and cleaned as often as necessary to maintain cleanliness, provided that all towels and bed linen shall be changed at least once each week.
7. 6325.36 No person who is not a client, staff member, or child of a client (only in the case of programs for parents and children) may reside at a facility that houses a residential treatment program.
8. 6325.37 Providers shall ensure that clients can access all scheduled or emergency medical and dental appointments.
9. 6325.38 Providers serving parents and children must take precautions to ensure child safety, including but not limited to protection for windows, outlets, and stairways.
10. 6325.39 Each facility housing a program that provides services for parents with children shall have extra supplies for babies, including but not limited to diapers, wipes, baby soap, baby food and formula.
11. 6325.40 The following provisions apply only to residential treatment programs, except environmental stability programs, as defined by this chapter:
12. (a) A program that provides overnight accommodations shall ensure that evening and overnight shifts have at least two (2) staff members on duty.

1. (b) Children and youth under eighteen (18) may not reside at an adult residential treatment facility or visit overnight at a facility not certified to serve parents and children. This information must be included in the house rules.
2. (c) Each provider shall maintain a current inventory of each client's personal property and shall provide a copy of the inventory, signed by the client and staff, to the client.
3. (d) Each provider shall take appropriate measures to safeguard and account for personal property brought into the facility by a client.
4. (e) Each provider shall provide the client, or the client's representative, with a receipt for any personal articles to be held by the provider for safekeeping that includes and the date it was deposited with the provider and maintain a record of all articles held for safekeeping.
5. (f) Each residential treatment program shall have a licensed dietitian or nutritionist available, a copy of whose current license shall be maintained on file, to provide the following services:
6. (1) Review and approval of menus;
7. (2) Education for clients with nutrition deficiencies or special needs;
8. (3) Coordination with medical personnel, as appropriate; and
9. (4) A nutritional assessment for each client within three (3) calendar days of admission unless the client has a current assessment or doctor's order for dietary guidelines.
10. (g) The provider shall provide at least three (3) meals per day and between meal snacks that:
11. (1) Provide a nourishing, well-balanced diet in accordance with dietary guidelines established by the United States Department of Agriculture;
12. (2) Are suited to the special needs of each client; and
13. (3) Are adjusted for seasonal changes, particularly to allow for the use of fresh fruits and vegetables.
14. (h) The provider shall ensure that menus are written on a weekly basis, that the menus provide for a variety of foods at each meal, and that menus are varied from week to week. Menus shall be posted for the clients' review.

(i) The provider shall ensure that a copy of each weekly menu is retained for a period of six (6) months. The menus retained shall include special diets and reflect meals as planned and as actually served, including handwritten notations of any substitutions. The provider shall also retain receipts and invoices for food purchases for six (6) months. The records required to be retained by this subsection are subject to review by the Department.

(j) Each meal shall be scheduled so that the maximum interval between each meal is no more than six (6) hours, with no more than fourteen (14) hours between a substantial evening meal and breakfast the following day.

(k) If a client refuses food or misses a scheduled meal, appropriate food substitutions of comparable nutritional value shall be offered.

(l) If a client will be away from the program during mealtime for necessary medical care, work, or other scheduled appointments, the program shall provide an appropriate meal and in-between-meal snack for the client to carry with him or her and shall ensure that the meal is nutritious as required by these rules and suited to the special needs of the client.

(m) A residential treatment program providing meals shall implement a written Nutritional Standards Policy that outlines their procedures to meet the dietary needs of its clients, ensuring access to nourishing, well-balanced, and healthy meals. The policy shall identify the methods and parties responsible for food procurement, storage, inventory, and preparation.

(n) The Nutritional Standards Policy shall include procedures for clients unable to have a regular diet as follows:

(1) Providing clinical diets for medical reasons, when necessary;

(2) Recording clinical diets in the client's record;

(3) Providing special diets for clients' religious needs; and

(4) Maintaining menus of special diets or a written plan stating how special diets will be developed or obtained when needed.

(o) A residential treatment program shall make reasonable efforts to prepare meals that consider the cultural background and personal preferences of the clients.

(p) Meals shall be served in a pleasant, relaxed dining area that accommodates families and children.

(q) Under the supervision of a Qualified Practitioner, all Level 3 programs

except MMIWM programs shall:

(1) Provide training in activities of daily living;

(2) Provide therapeutic recreational activities designed to help the client learn ways to use leisure time constructively, develop new personal interests and skills, and increase social adjustment; and

(3) Ensure that staff providing activities listed in subparagraphs (1) and (2) have a high school degree or a GED and at least twenty (20) hours of in-service training per year regarding issues of substance abuse.

SOURCE: Final Rulemaking published at 62 DCR 12056 (September 4, 2015); as amended by Final Rulemaking published at 67 DCR 011585 (October 9, 2020).