This section applies to facilities who are serving parents or guardians who have a minor child residing with them at the same facility. For the purposes of the Department’s regulations, a minor residing with their parent or guardian at the facility does not meet the definition of a service recipient. These specialized programs provide behavioral health treatment; therapy; parenting skills training; medication management, in settings where allowed; psychosocial services; life skills; and job readiness education. These settings are supported by professional staff who ensure the safety of children in the environment while their parent or guardian and families work towards sobriety and recovery.

1. (1) Facilities must notify the Office of Licensure and receive approval in writing before allowing children to reside with their parent or guardian at the facility. The licensure chapters where this model may be in place, post-approval, are limited to the following:

   1. (a) Mental Health Adult Residential Treatment Services;
   2. (b) Mental Health Supportive Living Facilities;
   3. (c) Alcohol and Drug Halfway House Treatment Facilities;
   4. (d) Alcohol and Drug Residential Detoxification Treatment Facilities;
   5. (e) Alcohol and Drug Residential Rehabilitation Facilities; and
   6. (f) Adult Supportive Residential Facilities. AND FACILITIES

2. (2) The following policy and procedure requirements shall apply when minors are present:

   1. (a) Policies and procedures regarding minor(s) residing with their parent or guardian at the facility which shall include a description of responsibility the facility will undertake related to the care and responsibility for the minor(s), if any.

      1. 1. If the facility will undertake any level of care and responsibility for minor(s) present, it shall ensure it obtains a Child Care license, should such license be required by the appropriate licensing authority.
   2. (b) Policies and procedures addressing needs of school age children, including but not limited to, education and other basic needs.

   3. (c) Policies and procedures that dictate how direct care staff will have been trained in the following areas:

      1. 1. Pregnancy, perinatal, and postpartum care;
      2. 2. Recognize the importance of family, social networks, and community systems in the therapeutic continuum of care;
      3. 3. Know and address incidents of intimate partner violence (IPV);
      4. 4. Working with interdisciplinary treatment teams to provide integrated care;
      5. 5. Ensure knowledge of maternity care providers within your surrounding communities;
      6. 6. Infant and child first aid, including but not limited to CPR and sleep safety; and
      7. 7. Employees assisting minor(s) residing with their parent not capable of self- preservation during an emergency.
   4. (d) Policies and procedures addressing parenting education for service recipients.
   5. (e) Policies and procedures addressing the parent or guardian’s responsibility for meeting the minor’s basic needs regarding: food, clothing, hygiene, safety, discipline, supervision, and obtaining services in response to a referral made on behalf of the child.
   6. (f) Policies and procedures to address making arrangements for the care of the child at any time when the parent or guardian is not present at the facility or while they are receiving treatment.
   7. (g) Policies and procedures addressing parent-child interaction between staff, parent, and children services in order to provide a safe and healthy environment for service recipients and their children.

   8. (h) Policies and procedures for when a child is present at the facility, including but not limited to the following:

      1. 1. Requirements for whether children must be immunized prior to the admission of the parent or guardian service recipient; AND FACILITIES
      2. 2. Requirements for whether children must show no signs of illness prior to parent or guardian service recipient admission; and
      3. 3. How the facility will ensure children are to continue receiving primary medical care during their stay and their parents/guardian’s admission in the facility;

   9. (i) Facilities shall develop and implement written policies and procedures related to:

      1. 1. The maximum number of children permitted to reside in the facility at one (1) time; and
      2. 2. Allowed ranges of age of children permitted to reside in the facility.

Authority: T.C.A. §§ 4-4-103, 33-1-302, 33-1-305, 33-1-309, and 33-2-404. Administrative History: Original rule filed May 28, 2010; to have been effective August 26, 2010. Stay of amendment filed by the Tennessee Department of Mental Health and Substance Abuse Services on July 21, 2010; new effective date November 9, 2010. Withdrawal of amendment filed August 2, 2010. Amendment filed August 30, 2010; to have been effective January 29, 2011. Stay of amendment filed by the Tennessee Department of Mental Health and Substance Abuse Services on January 29, 2011; new effective date March 7, 2011. Withdrawal of amendment filed by the Tennessee Department of Mental Health and Substance Abuse Services on February 25, 2011. Repeal and new rules filed November 30, 2016; effective February 28, 2017. Administrative corrections made to agency names in December 2022 pursuant to Public Chapter 575 of 2012. Amendments filed February 24, 2026; effective May 25, 2026.