2326 ADMINISTRATIVE SERVICES: HUMAN RESOURCES -- PERSONNEL POLICIES AND PROCEDURES

2326.1 Personnel policies and procedures shall apply to all staff and volunteers working in the facility or program and shall include:

1. (a) An equal opportunity plan for hiring staff;
2. (b) Requirements for consistent and fair practices in hiring staff including a statement that a person having or not having had a past problem with substance abuse is not the sole factor in denying employment;
3. (c) A current organizational flowchart reflecting each program position, and where applicable, the relationship to the larger facility of which the program is a part;
4. (d) Written job descriptions for each program position, with specific duties, responsibilities, title of supervisor(s) and, where applicable, positions supervised;
5. (e) Written descriptions of staff supervision practices;
6. (f) Written plans for developing, posting and maintaining files pertaining to work and leave schedules, time logs, and on-call schedules for each functional unit, to ensure adequate coverage during all hours of operation.
7. (g) Requirements for an annual written job performance evaluation for each employee and procedures which provide staff with the opportunity to review the evaluation;
8. (h) Disciplinary procedures and an employee grievance mechanism;
9. (i) Provisions for compliance with the federal Fair Labor Standards Act;
10. (j) A written policy requiring a designated individual be assigned responsibility for management and oversight of the volunteer program, if volunteers are utilized;
11. (k) A written policy regarding volunteer recruitment, screening, training, supervision and dismissal for cause, if volunteers are utilized;
12. (l) Provisions through which the facility shall make available to staff a copy of the personnel policies and procedures; and
13. (m) The requirement that all personnel receive training on patient confidentiality during orientation.

2326.2 A substance abuse treatment facility or program shall develop and implement procedures that prohibit the possession, use or distribution of controlled substances or alcohol, or any combination of them, by staff during their duty hours unless medically prescribed and used accordingly. These policies and procedures shall ensure that the facility:

1. (a) Provides information about the adverse effects of the non-medical use and abuse of controlled substances and alcohol to all staff;
2. (b) Initiates disciplinary action for the possession, use or distribution of controlled substances or alcohol, or any combination of them, which occurs during duty hours or which affects job performance; and

(c) Provides information and assistance to any impaired staff member to facilitate recovery.

2326.3 A substance abuse treatment facility or program shall develop and implement policies and procedures to ensure that staff

(a) Qualifications are verified and documented in the personnel files prior to employment including:

(1) Educational background and field of study, through valid licenses, transcripts or diplomas;

(2) Experience, by contacting the previous employer(s) and obtaining references; and

(3) Specialized training in relevant subjects.

(b) Have been screened through established facility mechanisms to determine that the staff is not known to have committed physical abuse, sexual abuse, child abuse/neglect, or a felony involving crimes against a person.

(c) Drug testing as applicable.

2326.4 Individual personnel records shall be maintained for each person employed by a substance abuse facility or program and shall include, at a minimum, the following:

(a) A current job description for each person that is revised as needed;

(b) Evidence of a pre-employment physical examination, which shall include the results of a tuberculin skin test, and if indicated, a chest x-ray;

(c) Evidence of the education, training and experience of the individual, and a copy of the current appropriate license, registration or certification credentials;

(d) Written personnel policies distributed to the employee;

(e) Notices of official tour of duty, notices of day, evening, night or rotating shift, payroll information, and disciplinary records; and

(f) Documentation that the employee has received all immunizations as recommended by the Center for Disease Control (CDC) for healthcare workers.

2326.5 All personnel who provide direct patient care services shall have an annual physical examination that includes but is not be limited to a tuberculosis skin test and/or a chest x-ray, and a record thereof shall be maintained in the individual's personnel file.

2326.6 All substance abuse personnel who are exposed to blood shall demonstrate evidence of full immunization against hepatitis - or documentation of refusal.

2326.7 All personnel records shall be maintained during the course of an individual's employment with the facility or program and for three (3) years following the individual's separation from the facility or program.

2326.8 The clinical director is responsible for ensuring that all personnel are free of communicable diseases.

SOURCE: Final Rulemaking published at 47 DCR 9341 (November 24, 2000), adopting Emergency and Proposed Rulemaking published at 47 DCR 7708, 7737 (September 22, 2000).