(a) Admission and Discharge Criteria: - (i) The program shall establish written clinical criteria for determining which persons are to be admitted to the program and shall ensure that only those clients who meet the admission criteria are admitted to the program.
- (ii) The admission policy shall include, but not be limited to, provisions that prior to admission, a professional or counselor as defined in Chapter III or IV must determine that the individual:
- (A) Has a diagnosis of chemical dependency for adults in primary residential treatment or a diagnosis of chemical dependency or psychoactive substance abuse disorder for adolescents or for adults in transitional residential care according to the current Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association;
- (B) Is capable of self care;
- (C) Is not in need of detoxification, major medical care, or primary psychiatric care;
- (D) Cannot be effectively or efficiently treated on an outpatient basis; and
- (E) Has parental or guardian consent for treatment if the person to be admitted is a minor.
- (iii) The program shall have written criteria and procedures which address discharge when treatment is complete or against staff advice or at staff request.
- (iv) The program shall have written procedures for referral to appropriate continuing care services.
(b) Medical Services. - (i) The program shall establish a written plan to assist the client in obtaining appropriate medical services at the clients expense.
- (ii) An evaluation of the clients medical status shall be made as soon as possible, but not to exceed seventy-two hours following the clients admission to the program. The evaluation may be waived, if a copy of a physical exam performed within the sixty days prior to admission is contained in the client file. The evaluation shall include a medical history, a physical examination, and appropriate screening for tuberculosis, and, when indicated, other communicable diseases to include HIV and AIDS screening. All females under the age of majority as defined by Wyoming Statute shall have a pregnancy test as part of the medical evaluation. The evaluation shall be carried out, by, or under the supervision of a licensed physician. The results of the examination shall be placed in the clients clinical record.
(c) Policies/Procedures. - (i) The program shall establish house rules that shall be distributed to all clients at the time of their admission.
- (ii) All staff shall, at the time of their initial employment, be provided with copies of all program policies, procedures.
- (iii) All staff of primary and transitional treatment programs shall have basic first aid training which includes CPR training.
- (iv) The program shall maintain appropriate first aid supplies.
- (v) The program policies shall prohibit the use of isolation or restraint, except when there is an immediate danger to self or others.
(d) Food Services. - (i) A nourishing, well-balanced diet in adequate amounts shall be provided to all residents in accordance with current Recommended Daily Dietary Allowances for adults and adolescents of the American Dietary Association.
- (ii) The program shall provide for the special dietetic needs of specific clients and this information shall be maintained in the clients clinical record.
- (iii) At least three meals daily shall be provided, or arranged for, at normal mealtimes.
- (iv) Records of menus as served shall be filed and maintained in the programs records for on-site inspection.
- (v) All resident activities in food preparation areas shall be under the supervision of program staff who have received instruction in, and can instruct residents in approved food handling techniques and practices.
- (vi) Foods shall be stored at appropriate temperatures:
- (A) Refrigerators shall have a thermometer located in the warmest part of the appliance in which food is stored. Refrigeration temperatures shall be 45@F (forty-five degrees Fahrenheit) or below.
- (B) Frozen foods shall be kept frozen and stored at 0@F zero degrees Fahrenheit) or less. The freezer shall have a thermometer.
- (vii) Raw or unpasteurized milk and home-canned or preserved foods shall not be served.
- (viii) No person while infected with or suspected of being infected with communicable diseases, boils, open sores, or wounds, or acute respiratory infections shall prepare meals or come into contact with food preparation surfaces.
- (ix) Eating and serving utensils shall be washed by approved techniques and practices.
(e) Physical Plant. - (i) The facility shall be designed, constructed, equipped, and maintained in a manner that provides for the physical safety of residents, personnel, and visitors.
- (ii) Buildings shall be kept clean, in good repair, and free of infestations.
- (iii) The facility shall have fire detection and extinguishing equipment and a written fire safety plan.
- (A) Fire drills shall be conducted monthly and a record of the dates maintained.
- (B) ABC portable fire extinguishers shall be available in the kitchen and other areas as recommended by the local fire department.
- (C) Fire extinguishers shall be inspected at least annually and have a regular maintenance program.
- (D) Underwriters Laboratory approved smoke detectors shall be installed in each bedroom, and on all floors of the facility including the basement.
- (E) There shall be documentation of monthly inspection of smoke detectors and fire extinguishers conducted by the program staff.
- (F) Evacuation routes and procedures shall be posted and shall be shown to each resident at admission.
- (G) At least annually there shall be a walk-through of the facility by the local fire department and recommendations shall be implemented.
- (H) Portable space heaters shall not be used.
- (iv) Plumbing systems shall be designed, installed, operated, and maintained in a manner that is designed to provide an adequate and safe supply of water for all facility operations.
- (v) Garbage and rubbish shall be stored in leakproof, non-absorbent containers with tight fitting lids and shall be removed from the premises at least weekly.
- (vi) Poisons and other toxic materials shall be properly labeled, kept in the original container, and stored in a locked area.
- (vii) Smoking shall be permitted only in designated areas, and may for reasons of resident safety, be limited.
- (viii) Appropriate furnishings for each room shall be available, clean, and in good repair.
- (ix) Laundry facilities shall be available in the facility or on a contractual basis. When provided in the facility, the laundry room shall be kept separate from bedrooms, living areas, dining areas, and kitchen.
- (x) Separate storage areas shall be provided for food, kitchen, and eating utensils; clean linens, soiled linens, and clothing; cleaning compounds and equipment; and outdoor recreational and maintenance equipment.
- (xi) The facility shall have a kitchen area that is kept clean.
(f) Medication. - (i) All medication not administered by persons licensed by the State of Wyoming to administer medication are to be self-administered by the resident for whom the medication was prescribed.
- (ii) Medication documentation is maintained in the client record for each client taking medication. This documentation includes:
- (B) Name and dose of each medication taken;
- (C) Signature of the staff person who observed self-administration of the drug;
- (D) All medication is taken according to the written prescription.
- (E) All prescription and non-prescription medications are kept in locked storage.
- (F) All medications are stored in their original containers under appropriate storage conditions in a neat, orderly fashion.
- (G) Drugs are removed on or before their expiration date and destroyed.
- (H) Medication for a client who has left the program is destroyed.
- (I) The poison control number is posted by all telephones.
- (J) Physicians Desk Reference or other comprehensive drug reference materials published within the last year is accessible to staff.