908 KAR 1:372. Licensure of residential alcohol and other drug treatment entities

Section 1. General Requirements. Each type of residential AODE program as described in Section 2 through Section 6 of this administrative regulation shall implement written policies for separate housing of adult and adolescent clients, and male and female clients in accordance with the following: (1) Adult and adolescent clients shall be physically separated by floor, wing, or other physical barriers; and (2) Male and female sleeping quarters shall be physically separated by floor, wing, or other adequate physical barriers, ensuring the clients' rights to privacy and dignity in treatment. Section 2. Clinically Managed Residential Withdrawal Management. (1) In addition to the licensing requirements of 908 KAR 1:370, a program offering clinically managed residential withdrawal management shall accept and provide services only to clients meeting the: (a) Diagnostic criteria for substance-related disorder as established by the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for alcohol, tobacco, and other drug use; and (b) Dimensional criteria for clinically managed residential withdrawal management as established in the most recent version of The American Society of Addiction Medicine (ASAM) Criteria. (2) Clinically managed residential withdrawal management services shall: (a) Be delivered by staff who: 1. Are qualified to meet the needs of clients; and 2. Provide twenty-four (24) hour supervision, observation, and support for clients who are intoxicated or experiencing withdrawal; (b) Include care for clients whose intoxication and withdrawal signs and symptoms require twenty-four (24) hour structure and support without the need for medically monitored inpatient withdrawal management services; and (c) Include: 1. Use of established clinical protocols to identify clients who are in need of: a. Medical services beyond the capacity of the facility; and b. Transfer to an appropriate level of care; 2

l and other drug abuse or dependency; (e) Summary of treatment; (f) Response to treatment; (g) Referrals made to other organizations or providers; and (h) Reason for discharge. (11) Other than a personal care or housekeeping task, if a client performs work in the residential treatment program that is part of a therapeutic activity, the work shall be voluntary and consistent with the treatment plan. (12) A residential treatment program shall have written policies and procedures on the use of medication, including: (a) Documentation in the client record of any medications the client is currently prescribed and taking; (b) Documentation in the client record of any over-the-counter medication the client is taking; (c) Steps involved for self-administration of over-the-counter medication, including identification in the client record of medication that requires physician approval prior to use; (d) Documentation that any medications brought into the facility by a resident are not administered or allowed to be self-administered unless the medication has been identified and a written order to administer or allow for self-administration of the specific drug is given by the responsible prescribing practitioner; (e) Documentation of the physician's verification in the client's record; (f) Storage of all medications to ensure that all medications be kept in a locked, secure location inaccessible to clients; (g) Administration of medication, including establishment of the times for administration of medication; (h) Documentation in the client's record of self-administration of prescription or over-the-counter medication, including the: 1. Name of the medication; 2. Date and time of self-administration; 3. Dosage and amount of medication; and 4. Name of the staff person who monitored the self-administration of the medication. (13) A residential treatment program shall have a first-aid kit with supplies necessary for use in responding to minor injury or illness

s the minimum requirements of a program manager is responsible for managing a program in the absence of the program manager; and (g) Have caseworkers who: 1. Shall be responsible for: a. Coordinating clinical services in accordance with a client's treatment plan; b. Monitoring a client's progress in relation to the treatment plan; c. Conducting training on daily living and recovery supports; and d. Making referrals; and 2. Meet the training, education, and experience requirements of 908 KAR 1:370, Section 11(2) to (5). Section 6. Adolescent Residential Treatment Program. (1) An adolescent residential treatment program shall be a freestanding residential facility or a distinct part of a facility in which care is provided to two (2) or more adolescent clients who are: (a) Under eighteen (18) years of age; or (b) Eighteen (18) to twenty-one (21) years of age, if placement in an adolescent program is determined to be the appropriate level of care upon completion of the assessment described by 908 KAR 1:370, Section 18(1) and (2). (2) In addition to the requirements of 908 KAR 1:370 and Section 3 of this administrative regulation, an adolescent residential treatment program: (a) Shall admit adolescents only to areas within the facility approved by the cabinet for adolescent occupancy; (b) Shall ensure that areas for adolescents are physically separated from any part of a facility occupied by or accessible to adult clients; (c) Shall ensure that adolescent clients in the facility be separated if the age range is more than five (5) years; (d) Shall have no fewer than two (2) staff members present and on site at all times: (e) Shall have at least one (1) staff member within sight and sound and responsible for the supervision of no more than: 1. Ten (10) adolescent clients during waking hours; and 2