(a) For purposes of this Part, chemical dependence residential service or residential service means a chemical dependence residential service providing an array of services for persons suffering from chemical dependence. Such services may be provided directly or through cooperative relationships with other community service providers. This Part applies to any entity certified by the office to provide a chemical dependence residential service and governs all residential programs formerly certified by the Division of Alcoholism and Alcohol Abuse and/or the office pursuant to Part 375 of this Title and all residential programs formerly licensed by the Division of Substance Abuse Services and/or the office pursuant to Part 1030 of this Title. There are three levels of service that can be offered in a residential setting: intensive residential rehabilitation services, community residential services, and supportive living services. Each is distinguished by the complement of services available on site as well as the degree of dysfunction of the individual served in each setting. The three levels of residential services are defined as follows:

1. (1) Intensive residential rehabilitation services means residential services requiring 24 hours a day, seven days per week treatment in a structured environment for individuals whose potential for independent living in recovery is contingent upon substantial social habilitation or rehabilitation. An integral part of this service is the case management of additional services from other providers that are needed by the resident. This level of residential service requires established written agreements with other appropriately certified providers to furnish psychiatric and health care services, in addition to educational, social and vocational services. These services are appropriate for individuals who require chemical dependence services in a residential setting due to previous noncompliance, or relapse, in outpatient service settings, or their life skills deficits require sustained intensive rehabilitation.
2. (2) Community residential services means chemical dependence residential services providing supervised services to persons making the transition to abstinent living. Persons appropriate for this service require the support of a drug and alcohol-free environment while receiving either outpatient services or educational and/or vocational services. These transitional residential services are for individuals who are completing or have completed a course of treatment, but who are not yet ready for independent living due to outstanding clinical issues or unmet needs for personal, social or vocational skills development. These services are appropriate for individuals who require ongoing clinical support.
3. (3) Supportive living services means chemical dependence treatment services which are designed to promote independent living in a supervised setting for individuals who have completed another course of treatment, are making the transition to independent living, and whose need for services does not require staffing on site on a 24-hour-a-day basis. These treatment services are for individuals who either require a long-term supportive environment following care in another type of residential service for an undetermined length of stay, or who are in need of a transitional living environment prior to establishing independent community living.

(b) The governing authority shall determine and establish written policies, procedures and methods governing the provision of services to residents which shall include a description of each service provided, including procedures for making appropriate referrals to and from other services, when necessary. These policies, procedures, and methods, which require review and approval by the governing authority, shall address, at a minimum, the following:

1. (1) admission, retention and discharge, including specific criteria relating thereto, as well as transfer procedures;
2. (2) level of care determinations, comprehensive evaluations, treatment plans, and placement services;
3. (3) staffing plans, including the use of volunteers;
4. (4) screening and referral procedures for associated physical or psychiatric conditions;
5. (5) the determination of fees for services rendered;
6. (6) infection control;
7. (7) public health education and screening with regard to tuberculosis, sexually transmitted diseases, hepatitis, AIDS and HIV prevention and harm reduction;
8. (8) cooperative agreements with other chemical dependence service providers and other providers of services that the resident may need;
9. (9) a requirement that if acupuncture is provided as an adjunct to the services provided by the service, it must be provided in accordance with Part 830 of this Title;
10. (10) a requirement that when HIV and AIDS education, testing and counseling are provided, such services must be provided in accordance with article 27-F of the Public Health Law and this Title;
11. (11) the use of alcohol and other drug screening tests, such as breath testing, urine screening and/or blood tests;
12. (12) procedures for the ordering, procuring, and disposing of medication, as well as the self-administration of medication;
13. (13) quality improvement and utilization review;
14. (14) clinical supervision and related procedures;
15. (15) procedures for emergencies;
16. (16) incident reporting and review in accordance with Part 836 of this Title;
17. (17) recordkeeping procedures which ensure that documentation is accurate, timely, prepared by appropriate staff, and in conformance with the Federal confidentiality regulations contained in 42 Code of Federal Regulations part 2;
18. (18) personnel;
19. (19) procedures by which required educational services are provided for school age children who are in residence as either an individual who is receiving treatment or as part of a family unit; and
20. (20) procurement, storage, and preparation of food.

(d) A chemical dependence residential service shall have as its goals:

1. (1) the promotion and maintenance of abstinence from alcohol and other mood-altering drugs and substances except those lawfully prescribed by a physician, physician's assistant, or nurse practitioner; however, if a residential service objects to a resident's continued use of such prescribed drugs or substances, the residential service shall document each of the following:

   1. (i) obtain a signed consent form in accordance with the requirements of 42 Code of Federal Regulations part 2 which authorizes the release of patient identifying information to the physician, physician's assistant, or nurse practitioner who prescribed the drug or substance to the resident (the prescribing professional);
   2. (ii) consult with the prescribing professional to ascertain their knowledge and awareness of the resident's history of chemical dependence, and if the prescribing professional is unaware of the resident's history of chemical dependence, inform the prescribing professional accordingly; and
   3. (iii) after the required consultation in subparagraph (ii) of this paragraph, if the prescribing professional believes that the resident should be permitted to continue to use the drug or substance, the resident must be permitted to continue to use the drug or substance;
2. (2) the improvement of functioning and development of coping skills necessary to enable the resident to be safely, adequately and responsibly treated in the least intensive environment; and
3. (3) the utilization of individualized treatment/service plans to support the maintenance of recovery and the attainment of self-sufficiency, including, where appropriate, the ability to be functionally employed, and the improvement of the resident's quality of life.

(e) All residential services shall provide, either directly or through referral to appropriate agencies, habilitative and rehabilitative services consistent with identified needs and plans for services for individual residents. The following services shall be provided to residents as clinically indicated:

1. (1) Counseling. Each residential service shall make available to its residents individual, group and family counseling services as appropriate.

   1. (i) A group therapy session shall contain no more than 15 persons.
   2. (ii) Chemical dependence individual, group and family counseling must be provided by a clinical staff member.
   3. (iii) Family counseling services include services to significant others.
   4. (iv) Peer support may occur in a peer group setting where the group is facilitated by residents who have greater experience or seniority within the service. Such counseling must be directly supervised by a clinical staff member in attendance.
2. (2) Supportive services. Each service shall ensure that a comprehensive and appropriate range of support services are available to each resident. Such services shall include, as needed and as appropriate, legal, mental health, and social services, as well as vocational assessment and counseling.
3. (3) Educational and child care services. Each residential service which provides services to school-age children must make arrangements to ensure the availability of required educational and child care services.
4. (4) Structured activity and recreation. Residents shall be afforded the opportunity to participate in activities designed to develop skills to enable them to make effective use of leisure time as well as improve social skills, self esteem and responsibility.
5. (5) Orientation to community services. Each chemical dependence residential service shall provide orientation, advice and instruction in identifying and obtaining needed community services, including housing and other necessary case management services, to each resident.

(f) The certified bed capacity of each residential service may not be exceeded at any time except in cases of emergency and unexpected surges in demand where no alternative options are available, when the failure to temporarily accept individuals into the service would jeopardize their immediate health and safety, and where the excess of capacity would be time limited. Standards and procedures for such exceptions that are based upon the availability of adequate space, supplies and staff must be established with the prior approval of the office.

1. (1) Intensive residential rehabilitation services shall ensure the availability of three meals each day to each resident and community residences shall ensure the availability of two meals each day to each resident. Such meals shall furnish sufficient nutrients and calories to meet normal needs as well as the special needs of persons in recovery. Supportive living services shall ensure the availability of adequate food to all participants.
2. (2) For intensive residential rehabilitation services and community residences, the facility shall have available snacks and beverages between meals. A qualified dietician, dietetic technician, nutritionist, or other appropriately qualified personnel shall provide menu planning services. Other suitable staff shall be responsible for the procurement of food supplies and the training and directing of food preparation and serving personnel. Copies of menus shall be kept on file for a period of one year.

(g) Food and nutrition.