20 CAR pt. 415 | 20 CAR Part 415 — Residential Community Reintegration Program Certification

Chapter X

Subchapter A

Subpart 1

20 CAR § 415-101 Purpose {#sec-20-car-415-101 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-101}

20 CAR § 415-101. Purpose.

(a) This part sets forth the standards and criteria used in the certification of residential community reintegration program providers by the Department of Human Services.

(b) The rules regarding the certification processes including, but not necessarily limited to, applications, requirements for, levels of, and administrative sanctions are found in this part.

20 CAR § 415-102 Meaning of verbs in rules {#sec-20-car-415-102 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-102}

20 CAR § 415-102. Meaning of verbs in rules.

The attention of the facility is drawn to the distinction between the use of the words "shall", "should", and "may" in this part:

(1) "Shall" is the term used to indicate a mandatory statement, the only acceptable method under the present standards;

(2) “Should" is the term used to reflect the most preferable procedure, yet allowing for the use of effective alternatives; and

(3) "May" is the term used to reflect an acceptable method that is recognized but not necessarily preferred.

20 CAR § 415-103 Applicability {#sec-20-car-415-103 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-103}

20 CAR § 415-103. Applicability.

The standards and criteria for services as subsequently set forth in this part are applicable to residential community reintegration program providers as stated in each section.

Subpart 2

20 CAR § 415-201 Service definition {#sec-20-car-415-201 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-201}

20 CAR § 415-201. Service definition.

(a)(1)(A) The Residential Community Reintegration Program is designed to serve as an intermediate level of care between inpatient psychiatric facilities and outpatient behavioral health services.

(B) The program provides twenty-four-hour-per-day intensive therapeutic care provided in a small group home setting for children and youth with emotional and/or behavior problems that cannot be remedied by less intensive treatment.

(D) The program is also offered as a step-down or transitional level of care to prepare a youth for less intensive treatment.

(2) Services include all allowable outpatient behavioral health services (OBHS) based upon the age of the beneficiary as well as any additional interventions to address the beneficiary’s behavioral health needs.

(b) A residential community reintegration program shall be appropriately certified by the Department of Human Services to ensure quality of care and the safety of beneficiaries and staff.

(d)(1) A residential community reintegration program shall, at a minimum, have two (2) direct service staff available at all times.

(2) Direct service staff may include any allowable performing provider in the OBHS manual, teachers, or other ancillary educational staff.

(e)(1) A residential community reintegration program shall ensure the provision of educational services to all beneficiaries in the program.

(2) This may include education occurring on campus of the residential community reintegration program or the option to attend a school off campus if deemed appropriate in accordance with the Department of Education.

20 CAR § 415-202 Residential community reintegration provider certification {#sec-20-car-415-202 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-202}

20 CAR § 415-202. Residential community reintegration provider certification.

(a)(1) A residential community reintegration provider shall be certified by the Department of Human Services as a behavioral health agency.

(2) A residential community reintegration site shall be certified as a site of a behavioral health agency.

(b)(1) Residential community reintegration provider facilities shall be inspected a minimum of once per year, but are subject to visit by the department’s designee at other times to ensure continuing conformance of the operations of the facility with this part.

(2) The department may request the facility to provide information concerning programs and fiscal operations at the department’s discretion.

(c) Residential community reintegration providers will not be reimbursed for services provided without certification as a residential community reintegration provider by the department.

(d) Residential community reintegration providers shall have their programs nationally accredited.

(e) Any residential community reintegration program providing services to beneficiaries in the custody of the Division of Children and Family Services or Division of Youth Services shall adhere to appropriate certification requirements as deemed necessary by the appropriate division.

20 CAR § 415-203 Organizational structure {#sec-20-car-415-203 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-203}

20 CAR § 415-203. Organizational structure.

(a) The residential community reintegration program shall be a separate, identifiable organizational unit with its own director or supervisor and staffing pattern.

(b)(1) When the program is a portion of a larger organizational structure, the director or supervisor of the unit shall be identified and his or her responsibilities clearly defined.

(2) The organizational structure of the unit shall be described in an organizational chart.

(c) A written description of all services provided by the unit shall be on file and available to the Department of Human Services.

(d) The department shall be notified of any major change in the organizational structure or services.

20 CAR § 415-204 Treatment planning and records {#sec-20-car-415-204 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-204}

20 CAR § 415-204. Treatment planning and records.

(a)(1) An individualized treatment plan shall be formulated for patients in residential community reintegration programs by the patient’s treatment team.

(2) A treatment team shall consist of:

(A) A treatment team leader;

(B) A psychiatrist, when the treatment team leader is not a psychiatrist; and

(3) The treatment team leader shall be a mental health professional.

(4) Treatment plans shall be reviewed with parents or guardians of beneficiaries in residential community reintegration programs, if appropriate.

(b) The treatment plan shall:

(1) Be formulated, to the extent possible, with the cooperation and consent of the patient or a person acting on his or her behalf;

(2) Be based upon diagnostic evaluation that includes examination of the medical, psychological, social, cultural, behavioral, familial, educational, vocational, and developmental aspects of the patient’s situation;

(3) Set forth treatment objectives and prescribe an integrated program of therapies, activities, experiences, and appropriate education designed to meet these objectives;

(4) Be maintained and updated with signed daily notes, and be kept in the beneficiary’s medical record or on a form developed by the facility; and

(5) Be developed within the first five (5) days of service and reviewed by the treatment team a minimum of once every thirty (30) days of service to the individual beneficiary and modified as appropriate.

20 CAR § 415-205 Linkage services to higher or lower levels of care or longer term placement {#sec-20-car-415-205 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-205}

20 CAR § 415-205. Linkage services to higher or lower levels of care or longer term placement.

(a) Persons needing behavioral health services shall be treated with the least restrictive clinically appropriate methods.

(b)(1) The residential community reintegration program requires a close relationship with existing behavioral health providers.

(2) A written statement as to the availability of behavioral health services to beneficiaries is required and shall be maintained on file at the facility.

(c)(1) The residential community reintegration program shall also ensure linkages with other appropriate treatment and rehabilitative services including:

(A) Emergency services;

(B) Outpatient services; and

(2) A written statement documenting such linkages shall be maintained on file at the facility.

20 CAR § 415-206 Treatment policies and procedures {#sec-20-car-415-206 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-206}

20 CAR § 415-206. Treatment policies and procedures.

(a) Each facility shall have a written plan describing the policies and procedures of the residential community reintegration program.

(b) The plan shall provide for:

(1) The services to be provided and the scope of such services;

(2) Intake policy and procedures;

(3) Admissions and discharge policies;

(4) Policies providing for continuity of care for patients; and

(5) A planned regular, ongoing program for staff development.

Subpart 3

20 CAR § 415-301 Medical recordkeeping system {#sec-20-car-415-301 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-301}

20 CAR § 415-301. Medical recordkeeping system.

(a) Each residential community reintegration program shall maintain an organized medical recordkeeping system to collect and document information appropriate to the treatment processes.

(b) This system shall be organized; easily retrievable, contain usable medical records stored under confidential conditions, and have planned retention and disposition.

20 CAR § 415-302 Basic requirements {#sec-20-car-415-302 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-302}

20 CAR § 415-302. Basic requirements.

The residential community reintegration program’s policies and procedures shall:

(1) Define the content of the beneficiary’s medical record;

(2) Define storage, retention, and destruction requirements for beneficiary medical records;

(3) Require beneficiary medical records be confidentially maintained in locked equipment under secure measures;

(4) Require legible entries in beneficiary medical records signed with first name or initial, last name, credentials, and dated by the person making the entry;

(5) Require the beneficiary's name be typed or written on each sheet of paper or page in the beneficiary record;

(6) Require a signed consent for treatment before the beneficiary is admitted; and

(7) Require a signed consent for follow-up before any contact after discharge is made.

20 CAR § 415-303 Record access for clinical staff {#sec-20-car-415-303 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-303}

20 CAR § 415-303. Record access for clinical staff.

(a) The residential community reintegration program shall ensure beneficiary records are readily accessible to the residential community reintegration staff directly caring for the beneficiary.

(b) Such access shall be limited to the minimum necessary to carry out the staff member’s job functions or the purpose for the use of the records.

20 CAR § 415-304 Progress notes {#sec-20-car-415-304 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-304}

20 CAR § 415-304. Progress notes.

(a) The residential community reintegration program shall have a policy and procedure mandating the chronological documentation of progress notes for beneficiaries admitted to the residential community reintegration program.

(b) Progress notes shall minimally address the following:

(1) The person or persons to whom services were rendered;

(2) Activities and services provided and as they relate to the goals and objectives of the treatment plan, including ongoing reference to the treatment plan;

(3) Documentation of the progress or lack of progress as defined in the treatment plan;

(4) Documentation of the treatment plan's implementation, including beneficiary activities and services;

(5) The beneficiary's current status;

(6) Documentation of the beneficiary's response to services, changes in behavior and mood, and outcome of services;

(7) Plans for continuing therapy or for discharge, whichever is appropriate; and

(8) Progress notes shall document progress daily.

20 CAR § 415-305 Medication record {#sec-20-car-415-305 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-305}

20 CAR § 415-305. Medication record.

(a) The residential community reintegration program shall maintain a medication record on all beneficiaries who receive medications or prescriptions in order to provide a concise and accurate record of the medications the beneficiary is receiving or has been prescribed.

(b) The beneficiary medical record shall contain a medication record with information on all medications ordered or prescribed by physician staff which shall include, but not be limited to:

(1) The record of medication administered, dispensed, or prescribed shall include all of the following:

(A) Name of medication;

(B) Dosage;

(D) Route of administration; and

(E) Staff member who administered or dispensed each dose, or prescribing physician; and

(2) A record of pertinent information regarding adverse reactions to drugs, drug allergies, or sensitivities shall be:

(A) Updated when required by virtue of new information; and

(B) Kept in a highly visible location in or on the record.

20 CAR § 415-306 Aftercare and discharge planning {#sec-20-car-415-306 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-306}

20 CAR § 415-306. Aftercare and discharge planning.

(a)(1) Aftercare and discharge planning is to be initiated for the beneficiary at the earliest possible point in the residential community reintegration service delivery process.

(2) Discharge planning must be:

(A) Matched to the beneficiary’s needs; and

(B) Address the presenting problem and any identified co-occurring disorders or issues.

(b) The program will have designated staff with responsibility to initiate discharge planning.

(c) Referral and linkage procedures shall be in place so staff can adequately advocate on behalf of the person served as early as possible during the stabilization treatment process to transition to lesser restrictive or alternative treatment settings, as indicated.

20 CAR § 415-307 Other records content {#sec-20-car-415-307 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-307}

20 CAR § 415-307. Other records content.

(a) The beneficiary record shall contain copies of all consultation reports concerning the beneficiary.

(b) When psychometric or psychological testing is done, the beneficiary record shall contain a copy of a written report describing the test results and implications and recommendations for treatment.

(c) The beneficiary medical record shall contain any additional information relating to the beneficiary, which has been secured from sources outside the residential community reintegration program.

Subpart 4

20 CAR § 415-401 Department investigations {#sec-20-car-415-401 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-401}

20 CAR § 415-401. Department investigations.

The Department of Human Services in any investigation or program monitoring regarding beneficiary rights shall have access to:

(1) Beneficiaries;

(2) Residential community reintegration program records; and

(3) Residential community reintegration program staff.

Subpart 5

20 CAR § 415-501 Organizational description {#sec-20-car-415-501 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-501}

20 CAR § 415-501. Organizational description.

(a) The residential community reintegration program shall have a written organizational description which is reviewed annually by both the residential community reintegration program, behavioral health agency, and Department of Human Services, which minimally includes the:

(1) Overall target population for whom services will be provided;

(2) Overall mission statement; and

(3) Annual facility goals and objectives, including the goal of continued progress for the facility in providing person-centered, culturally competent, trauma-informed, and co-occurring capable services.

(b) The residential community reintegration program’s governing body shall:

(1) Approve the:

(A) Mission statement; and

(B) Annual goals and objectives; and

(2) Document their approval.

(c) The residential community reintegration program shall make the organizational description, mission statement, and annual goals and objectives available to staff.

(d) The residential community reintegration program shall make the organizational description, mission statement, and annual goals and objectives available to the general public upon request.

(e) Each residential community reintegration program shall have a written plan for professional services, which shall have in writing the following:

(1) Services description and philosophy;

(2) The identification of the professional staff organization to provide these services;

(3) Written admission and exclusionary criteria to identify the type of beneficiaries for whom the services are primarily intended;

(4) Written goals and objectives; and

(5) Delineation of processes to ensure accessible, integrated, and co-occurring capable services and a plan for how each program component will address the needs of individuals with co-occurring disorders.

(f)(1) There shall be a written statement of the procedures/plans for attaining the organization's goals and objectives.

(2) These procedures/plans should:

(A) Define specific tasks, including actions regarding the organization’s co-occurring capability;

(B) Set target dates; and

20 CAR § 415-502 Information analysis and planning {#sec-20-car-415-502 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-502}

20 CAR § 415-502. Information analysis and planning.

(a) The residential community reintegration program shall have a defined plan for conducting an organizational needs assessment that specifies the methods and data to be collected, which shall include but not be limited to information from:

(1) Beneficiaries;

(2) Governing authority;

(3) Staff;

(4) Stakeholders;

(5) Outcomes management processes; and

(6) Quality record review.

(b) The residential community reintegration program shall have a defined system to collect data and information on a quarterly basis to manage the organization.

(d) The residential community reintegration program shall prepare an end-of-year management report, which shall include but not be limited to:

(1) An analysis of the needs assessment process; and

(2) Performance improvement program findings.

(e) The management report shall be communicated and made available to, among others:

(1) The governing authority;

(2) Residential community reintegration staff; and

(3) The Department of Human Services if and when requested.

Subpart 6

20 CAR § 415-601 Performance improvement program {#sec-20-car-415-601 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-601}

20 CAR § 415-601. Performance improvement program.

(a) The residential community reintegration program shall have an ongoing performance improvement program designed to objectively and systematically monitor, evaluate, and improve the quality of beneficiary care.

(b) The performance improvement program shall also address the fiscal management of the organization.

(c)(1) There shall be an annual written plan for performance improvement activities.

(2) The plan shall include, but not be limited to:

(A) Outcomes management processes specific to each program component minimally measuring:

(i) Efficiency;

(ii) Effectiveness; and

(iii) Beneficiary satisfaction;

(B) A quarterly record review to minimally assess:

(i) Quality of services delivered;

(ii) Coordination with the Division of Children and Family Services and the Division of Youth Services, if appropriate;

(iii) Appropriateness of services;

(iv) Patterns of service utilization;

(v) Beneficiaries, relevant to:

(a) Their orientation to the residential community reintegration program and services being provided; and

(b) Their active involvement in making informed choices regarding the services they receive;

(vi) The beneficiary assessment information thoroughness, timeliness, and completeness;

(vii) Treatment goals and objectives are based on:

(a) Assessment findings; and

(b) Beneficiary input;

(viii) Services provided were related to the goals and objectives;

(ix) Services are documented as prescribed by policy; and

(x) The treatment plan is reviewed and updated as prescribed by policy;

(D) Fiscal management and planning, which shall include:

(i) An annual budget that is approved by the governing authority and reviewed at least annually;

(ii) The organization's capacity to generate needed revenue to produce desired beneficiary and other outcomes; and

(iii) Monitoring beneficiary records to ensure documented dates of services provided coincide with billed service encounters; and

(E) Review of critical incident reports and beneficiary grievances or complaints.

(d) The residential community reintegration program shall:

(1) Monitor the implementation of the performance improvement plan on an ongoing basis; and

(2) Make adjustments as needed.

(e) Performance improvement findings shall be communicated and made available to, among others:

(1) The governing authority;

(2) Residential community reintegration program staff; and

(3) The Department of Human Services, if and when requested.

20 CAR § 415-602 Incident reporting {#sec-20-car-415-602 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-602}

20 CAR § 415-602. Incident reporting.

(a) The residential community reintegration program shall have written policies and procedures requiring documentation and reporting of critical incidents.

(b) The documentation for critical incidents shall contain, minimally:

(1) The facility name and the name and signature of the person or persons reporting the incident;

(2) The name of the beneficiary or beneficiaries, staff person or persons, or others involved in the incident;

(3) The time, place, and date the incident occurred;

(4) The time and date the incident was reported and the name of the person within the facility to whom it was reported;

(5) A description of the incident;

(6)(A) The severity of each injury, if applicable.

(B) Severity shall be indicated as follows:

(i) No offsite medical care required or first-aid care administered onsite;

(ii) Medical care by a physician or nurse or follow-up attention required; or

(iii) Hospitalization or immediate offsite medical attention was required; and

(7) The resolution or action taken, date the action was taken, and the signature of the residential community reintegration program director.

(c) The residential community reintegration program shall report those critical incidents to the Department of Human Services that include critical incidents requiring medical care by a physician or nurse or follow-up attention and incidents requiring hospitalization or immediate offsite medical attention shall be delivered via fax or mail to DHS Provider Certification within twenty-four (24) hours of the incident being documented.

(d) The residential community reintegration program shall document and monitor internally, with a quality assurance and improvement process that will be made available for review and/or audit by an appropriate agency the following: critical incidents requiring medical care by a physician or nurse or follow-up attention and incidents requiring hospitalization or immediate offsite medical attention.

Subpart 7

20 CAR § 415-701 Personnel policies and procedures {#sec-20-car-415-701 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-701}

20 CAR § 415-701. Personnel policies and procedures.

(a) The residential community reintegration program shall have written personnel policies and procedures approved by the governing authority.

(b) All employees shall have access to personnel policies and procedures as well as other rules and regulations governing the conditions of their employment.

(1) Promote the objectives of the program; and

(2) Provide for qualified personnel during all hours of operation to support the functions of the center and provide quality care.

20 CAR § 415-702 Job descriptions {#sec-20-car-415-702 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-702}

20 CAR § 415-702. Job descriptions.

(a) The residential community reintegration program shall have written job descriptions for all positions setting forth minimum qualifications and duties of each position.

(b) All job descriptions shall include an expectation of core competencies in relation to individuals with co-occurring disorders.

Subpart 8

20 CAR § 415-801 Staff qualifications {#sec-20-car-415-801 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-801}

20 CAR § 415-801. Staff qualifications.

(a) The residential community reintegration program shall document the qualifications and training of staff providing crisis stabilization services which shall be in compliance with the residential community reintegration program’s clinical privileging process.

(b) Failure to comply with this section will result in the initiation of procedures to deny, suspend, and/or revoke certification.

20 CAR § 415-802 Staff development {#sec-20-car-415-802 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-802}

20 CAR § 415-802. Staff development.

(a) The residential community reintegration program shall have a written plan for the professional growth and development of all administrative, professional, clinical, and support staff.

(b) This plan shall include but not be limited to:

(1) Orientation procedures;

(2) In-service training and education programs;

(3) Availability of professional reference materials; and

(4) Mechanisms for ensuring outside continuing educational opportunities for staff members.

(c) The results of performance improvement activities and accrediting and audit findings and recommendations shall be addressed by and documented in the staff development and clinical privileging processes.

(d) Staff competency development shall:

(1) Be aligned with the organization’s goals related to co-occurring capability; and

(2) Incorporate a training plan, training activities, and supervision designed to improve co-occurring core competencies of all staff.

(e) Staff education and in-service training programs shall be evaluated by the residential community reintegration program at least annually.

20 CAR § 415-803 In-service {#sec-20-car-415-803 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-803}

20 CAR § 415-803. In-service.

(a) Trainings are required annually for all employees who provide clinical services within the residential community reintegration program on the following topics:

(1) Fire and safety;

(2) Infection control and universal precautions;

(3) Beneficiary's rights and the constraints of the Mental Health Beneficiary's Bill of Rights;

(4) Confidentiality;

(5) The Adult and Long-Term Care Facility Resident Maltreatment Act, Arkansas Code § 12-12-1701 et seq.;

(6) Facility policy and procedures;

(7) Cultural competence;

(8) Co-occurring disorder competency and treatment principles; and

(9) Trauma-informed and age and developmental specific trainings.

(b) All staff providing clinical services shall have a current certification in basic first aid and in cardiopulmonary resuscitation.

(c)(1) All clinical staff shall have training in nonphysical intervention techniques and philosophies addressing appropriate nonviolent interventions for potentially physical interpersonal conflicts, staff attitudes which promote dignity and enhanced self-esteem, keys to effective communication skills, verbal and nonverbal interaction, and nonviolent intervention within thirty (30) days of being hired with annual updates thereafter.

(2) This training shall occur prior to direct patient contact.

(d)(1) The residential community reintegration program executive director shall designate which positions and employees, including temporary employees, that will be required to successfully complete physical intervention training.

(2) The employee shall successfully complete this training within thirty (30) days of being hired, with annual updates thereafter.

(3) This training shall occur prior to direct patient contact.

Subpart 9

20 CAR § 415-901 Standards {#sec-20-car-415-901 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-901}

20 CAR § 415-901. Standards.

(a) Residential community reintegration programs shall apply these standards to all sites operated.

(b) The primary concern of the residential community reintegration program should always be the safety and well-being of the beneficiaries and staff.

(d) Residential community reintegration programs shall provide a safe and sanitary environment.

20 CAR § 415-902 Facility environment generally {#sec-20-car-415-902 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-902}

20 CAR § 415-902. Facility environment generally.

(a)(1) Adequate space, equipment, and supplies shall be provided in order that the residential community reintegration program services can be provided effectively and efficiently.

(2) Functional surroundings shall be readily accessible to the patient and community served.

(b) All space and equipment shall:

(1) Be well maintained; and

(2) Meet applicable federal, state, and local requirements for safety, fire, and health.

(1) Chairs;

(2) Desks;

(3) Tables; and

(4) Other necessary equipment.

(d) There shall be an adequate number of suitably equipped conference rooms to provide for staff conferences and therapy.

(e) There shall be adequate provisions for the privacy of the patient in interview rooms.

(f) The facility shall be appropriate to the age and developmental needs of the persons served.

(g) The residential community reintegration program shall obtain an annual fire and safety inspection from the State Fire Marshal or local authorities which documents approval for continued occupancy.

(h)(1) Residential community reintegration program staff shall know the exact location, contents, and use of first-aid supply kits and firefighting equipment and fire detection systems.

(2) All firefighting equipment shall be annually maintained in appropriately designated areas within the facility.

(i) The residential community reintegration program shall have a written hazardous communication program and staff shall be knowledgeable of chemicals in the workplace, location of material safety data sheets, personal protective equipment, and toxic or flammable substances shall be stored in approved locked storage cabinets.

(j) The residential community reintegration program’s telephone number or numbers and actual hours of operation shall be posted at all public entrances.

(k) Signs must be posted at all public entrances informing staff, beneficiaries, and visitors as to the following requirements:

(1) No alcohol or illicit drugs are allowed in the residential community reintegration program facility;

(2) No firearms or other dangerous weapons are allowed in the residential community reintegration program facility, with the exception of law enforcement while in the performance of their duties; and

(3) The use of tobacco is not allowed in the residential community reintegration program facility.

(l) A copy of compliance with Title VI and Title VII of the 1964 Civil Rights Act of 1964 shall be prominently displayed within the residential community reintegration program facility.

(m)(1) Plumbing in residential community reintegration facilities shall be in working condition to avoid any health threat.

(2) All toilets, sinks, and showers shall be clean and in working order.

(n) A secure, locked storage shall be provided for beneficiary valuables when requested.

(o) Separate storage areas are provided and designated for:

(1) Food, kitchen, and eating utensils;

(2) Clean linens;

(3) Soiled linens and soiled cleaning equipment; and

(4) Cleaning supplies and equipment.

(p)(1) When handling soiled linen or other potentially infectious material, universal precautions are to be followed and addressed in the residential community reintegration program policies and procedures.

(2) Hazardous and regulated waste shall be disposed of in accordance with federal requirements.

(q) Poisons, toxic materials, and other potentially dangerous items shall be stored in a secured location.

(r) A residential community reintegration program shall provide:

(1) Separate bedroom areas for males and females;

(2) Sufficient clean linens for clients; and

(3) Adequate barriers to divide clients.

(s)(1) Plumbing in residential community reintegration programs shall be in working condition to avoid any health threat.

(2) All toilets, sinks, and showers shall be clean and in working order.

(t)(1) There shall be at least one (1) toilet, one (1) sink, and one (1) shower or tub per every eight (6) residential community reintegration beds.

(2) This means that a residential community reintegration program shall have no less than:

(A) One (1) toilet;

(B) One (1) sink; and

History

Codification Notes: Title VI of the Civil Rights Act of 1964 is codified at 42 U.S.C. § 2000d et seq. Authorities: Arkansas Code § 20-76-201; Arkansas Code § 20-77-107; Arkansas Code § 25-10-129

20 CAR § 415-903 Medication clinic — Medication monitoring {#sec-20-car-415-903 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-903}

20 CAR § 415-903. Medication clinic — Medication monitoring.

(a) Medication administration, storage, and control and beneficiary reactions shall be continuously monitored.

(b) Residential community reintegration programs shall ensure proper storage and control of medications, immediate response if incorrect or overdoses occur, and have appropriate emergency supplies available if needed.

(1) Available and accessible in all medication storage areas; and

(2) Available to all staff authorized to administer medications.

(d)(1) All medications shall be kept in locked, nonbeneficiary accessible areas.

(2) Factors which shall be considered in medication storage are:

(A) Light;

(B) Moisture;

(D) Temperature;

(E) Ventilation; and

(F) The segregation and safe storage of:

(i) Poisons;

(ii) External medications; and

(iii) Internal medications.

(e) Telephone numbers of the state poison centers shall be immediately available in all locations where medications are:

(1) Prescribed;

(2) Administered; or

(3) Stored.

20 CAR § 415-904 Medication — Error rates {#sec-20-car-415-904 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-904}

20 CAR § 415-904. Medication — Error rates.

The residential community reintegration program shall have an ongoing performance improvement program that specifically, objectively, and systematically monitors medication administration or dispensing or medication orders and prescriptions to evaluate and improve the quality of beneficiary care.

20 CAR § 415-905 Food and nutrition {#sec-20-car-415-905 omnilex-key=us-ar-regs-official--title-20-part-415--20 CAR § 415-905}

20 CAR § 415-905. Food and nutrition.

(a) If the residential community reintegration program prepares meals onsite, the residential community reintegration program shall have a current food establishment health inspection as required by the Department of Health.

(b) When meals are provided by a food service, a written contract shall:

(1) Be maintained; and

(2) Require the food service to have a current food establishment health inspection as required by the department.

(c) A residential community reintegration program shall provide at least three (3) meals daily to all beneficiaries, with no more than ten (10) hours between any two (2) meals.

(d) All food shall be stored, prepared, and served in a safe, healthy manner.

(e) Perishable items shall not be used once they exceed their sell by date.

20 CAR Part 415 — Residential Community Reintegration Program Certification