(a) Any residential program of 10 beds or more shall have a full-time program director who is a qualified health professional as defined in Part 800 of this Title. The program director shall have at least five years of full-time work experience in SUD, or related treatment field, prior to appointment as program director. A residential program with fewer than 10 beds shall have a similarly qualified program director who shall serve on at least a part-time basis.

1. (1) General and clinical staffing shall be on-site or on-call sufficient to meet the emergent needs of the resident population receiving services in a particular treatment element. Staff may be either specifically assigned to the residential service or may be part of the staff of the facility or program within which the residential service is located. However, if the staff is part of the general facility or program staff, they must have specific training and experience in the treatment of chemical use, abuse and dependence specific to the services provided.

2. (2) Applicable only to stabilization and rehabilitation services, staff sufficient to meet the emergent needs of the resident population shall include:

   1. (i) registered nurse and weekend nursing staff sufficient to resident need, on-site daily and to supervise licensed practical nurse (LPN);
   2. (ii) LPN available on-site daily for support to residents and for oversight and documentation of self-medication;
   3. (iii) physician, nurse practitioner and or physician assistants to meet the medical assessment and treatment needs of each resident. Each service shall have identified a medical director whose qualifications and responsibilities are defined in Part 800 of this Title;
   4. (iv) psychiatrist and/or psychiatric nurse practitioner to evaluate all residents who have a history of mental health disorder or who are exhibiting symptoms of a mental health disorder;
   5. (v) LMSW/LCSW/LMHC or family therapist in sufficient numbers to provide psychotherapy to all residents who are in need of such services in a frequency sufficient to meet the assessed need;
   6. (vi) clinical staff in sufficient numbers to serve as the primary counselors. Each resident shall be assigned a clinical staff member as his/her primary counselor to provide individual counseling and treatment/recovery plan preparation, monitoring and review;
   7. (vii) CASACs, CASAC-T and other clinical and milieu staff in sufficient numbers to facilitate activities of daily living, community meetings, engagement, carry out of treatment planning in milieu; at least one CASAC available at all times to intervene to help provide therapeutic interactions to foster residents’ social, cognitive and behavioral skill development. CASAC staff will provide supervision of milieu staff;
   8. (viii) milieu staff all shifts in sufficient numbers available within the community to model and provide pro-social behavioral interventions at all times. Milieu staff are included in the treatment planning process and are aware of the treatment goals of each resident; they will carry out activities that will support goal attainment through the natural interactions within the milieu;
   9. (ix) at least two staff per overnight shift, one of which must be a clinical staff member;
   10. (x) vocational counselor;
   11. (xi) case manager to develop the treatment/recovery plan and to meet regularly to identify needs and progress.

3. (3) All residential services shall have sufficient clinical staff that have been trained in, and are designated by the clinical supervisor to perform, the following tasks:

   1. (i) evaluation of resident needs, development and implementation of individualized treatment/recovery plans for each resident, including individual, group and family counseling;
   2. (ii) participation with staff and, as necessary, other services and agencies to assure the development, management and implementation of comprehensive services for each resident, reflecting both chemical dependence issues and other habilitation or rehabilitation needs; and
   3. (iii) preparation and maintenance of case records for each individual resident.

4. (4) There shall be sufficient staff available to ensure that the space and equipment of the service is clean and maintained in working order to minimize the need for treatment staff to perform non-treatment functions and to optimize operational efficiency.

   (c) Clinical supervision.

5. (1) Each residential program must provide clinical supervision and ensure and document a plan for staff training based on individual employee needs. Subject areas appropriate for training shall be identified by the office.
6. (2) All residential services shall identify a clinical supervisor who shall be responsible for the day-to-day clinical operation of each residence and provide routine supervision for the staff. The clinical supervisor shall be a qualified health professional as defined in Part 800 of this Title with at least three years of clinical experience in chemical dependence treatment.
7. (3) Clinical staff members who are not qualified health professionals shall have qualifications appropriate to their assigned responsibilities as set forth in the service's personnel policies and shall be subject to appropriate professional staff supervision and continuing education and training.

8. (4) All clinical staff should be provided with and document training, including but not limited to, crisis interventions, working with special populations, medication assisted treatment, trauma informed care, quality improvement, agency policies and procedures. Additional subject areas appropirate for training may from time to time be identified by the office.

   (d) Health coordinator.

   Each residential service shall have a qualified individual designated as the health coordinator who will ensure the provision of education, risk reduction, counseling and referral services to all residents\regarding HIV and AIDS (including pre- and post-exposure prophylaxis), tuberculosis, viral hepatitis, sexually transmitted diseases and other communicable diseases.

   (e) Volunteers, peers, students or trainees.

   A residential service may utilize volunteers, peers, students or trainees, on a salaried or non-salaried basis if such volunteers, peers, students or trainees are provided close professional staff supervision and necessary didactic education from both internal and external sources, and comply with the requirements of Part 805 where appropriate.

(b) General and clinical staffing.