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Oregon Bulletin

March 1, 2013

Oregon Health Authority, Addictions and Mental Health Division: Addiction Services, Chapter 415

Rule Caption: Temporary amendments to OAR 415-050 entitled Standards For Detoxification Centers

Adm. Order No.: ADS 3-2013(Temp)

Filed with Sec. of State: 2-4-2013

Certified to be Effective: 2-4-13 thru 8-2-13

Notice Publication Date:

Rules Amended: 415-050-0000, 415-050-0005, 415-050-0015, 415-050-0025, 415-050-0035, 415-050-0040, 415-050-0045, 415-050-0050, 415-050-0055, 415-050-0060, 415-050-0065, 415-050-0070, 415-050-0075, 415-050-0090

Subject: These rules prescribe standards for the development and operation of detoxification centers and services for those with substance use disorders approved by the Addictions and Mental Health Division, of the Oregon Health Authority.

 The temporary amendments add new language regarding Level III.7-D: Medically Monitored Detoxification, and expand expectations related to medical coverage and the staffing of those, and other levels of service.

Rules Coordinator: Nola Russell—(503) 945-7652

415-050-0000

Purpose

Purpose. These rules prescribe standards for the development and operation of substance use disorder detoxification centers approved by the Addictions and Mental Health Division.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(1) & (2); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0000; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0005

Definitions

As used in these rules:

(1) “Alcoholic” means any person who has lost the ability to control the use of alcoholic beverages, or who uses alcoholic beverages to the extent that the health of the person or that of others is substantially impaired or endangered or the social or economic function of the person is substantially disrupted. An alcoholic may be physically dependent, a condition in which the body requires a continuing supply of alcohol to avoid characteristic withdrawal symptoms, or psychologically dependent, a condition characterized by an overwhelming mental desire for continued use of alcoholic beverages. An alcoholic suffers from the disease of alcoholism.

(2) “Biennial Plan” means the document prepared by the Community Mental Health Program (CMHP) or direct contractor and submitted to the Division.

(3) “Client” means a person receiving services under these rules.

(4) “Community Mental Health Program” or “CMHP” means the organization of all services for persons with mental or emotional disturbances, drug abuse problems, mental retardation or other developmental disabilities, and alcoholism and alcohol abuse problems, operated by, or contractually affiliated with, a local mental health authority, operated in a specific geographic area of the state under an omnibus contract with the Division.

(5) “Coordinated Care Organization (CCO)” means a corporation, governmental agency, public corporation or other legal entity that is certified as meeting the criteria adopted by the Oregon Health Authority under ORS 414.625 to be accountable for care management and to provide integrated and coordinated health care for each of the organization’s members.

(6) “County” means the board of county commissioners or its representatives.

(7) “Division” means the Addictions and Mental Health Division of the Oregon Health Authority.

(8) “Evaluation” means an assessment of an individual to determine the existence of a substance use disorder, and the appropriate treatment and rehabilitation likely to overcome the problem.

(9) “Level III.2-D” or “Social Detox” means clinically managed residential detoxification in a non-medical or social detoxification setting. This level emphasizes peer and social support and is intended for individuals whose intoxication is sufficient to warrant 24-hour support or whose withdrawal symptoms are sufficiently severe to require primary medical nursing care services.

(10) “Level III.7-D” or “Medically Monitored Detoxification” means an inpatient setting that provides medically managed intensive inpatient treatment services.

(11) “Local Alcoholism Planning Committee” means a committee appointed or designated by a board of county commissioners. The committee shall identify needs and establish priorities for alcoholism services in the county. Members of the committee shall be representative of the geographic area and include a number of minority members which reasonably reflect the proportion of the need for alcoholism treatment and rehabilitation services of minorities in the community.

(12) “Physical Restraint” means a device which restricts the physical movement of a client and which cannot be removed by the person and is not a normal article of clothing, a therapy device, or a simple safety device.

(13) “Problem Drinker” means a person who habitually or periodically uses alcoholic beverages to the extent that the person’s health or that of others is substantially impaired or endangered or the person’s social or economic functioning is substantially disrupted.

(14) “Rehabilitation” means those services to assist in overcoming problems associated with a substance use disorder that enable the client to function at the person’s highest potential, such as through vocational rehabilitation services.

(15) “Seclusion” means the placement of a client alone in a locked room.

(16) “Substance Use Disorders” means disorders related to the taking of a drug of abuse including alcohol; to the side effects of a medication; and to a toxin exposure. The disorders include substance use disorders such as substance dependence and substance abuse; substance-induced disorders, including substance intoxication, withdrawal, delirium, and dementia; as well as substance induced psychotic disorder, mood disorder, etc., as defined in DSM criteria.

(17) “Treatment” means the specific medical and non-medical therapeutic techniques employed to assist the client in recovering from a substance use disorder.

(18) “Treatment Staff” means paid staff directly responsible for client care and treatment.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(3); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0005; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0015

Management of Detoxification Centers

Each Center is required to meet the following standards for management:

(1) Compliance with OAR 309-013-0120 through 309-013-0220, 309-013-0075 through 309-013-0105, and applicable sections of 309-014-0000 through 309-014-0040. In addition to items listed in 309-014-0030(3)(c), the Center’s personnel policies shall include:

(a) The Center’s philosophical approach to treatment;

(b) Rules of employee conduct, including ethical standards; and

(c) Standards for employee use and abuse of alcohol and other drugs.

(2) Compliance with the Civil Rights Act of 1964, as amended in 1972, Equal Pay Act of 1963, Age Discrimination in Employment Act of 1967, and any subsequent amendments.

(3) Implementation of a policy and procedure prohibiting client abuse which is consistent with OAR 407-045.

(4) Implementation of a policy and procedure for resolving employee performance problems, which shall specify the sequence of steps to be taken when performance problems arise, and identify the resources to be used in assisting employees to deal with problems which interfere with job performance.

(5) Maintenance of personnel records for each member of the Center’s staff. The personnel record shall:

(a) Contain the employee’s resume and/or employment application, wage and salary information, and the employee’s formal performance appraisals;

(b) Contain documentation of training/development needs of the employee and identify specific methods for meeting those needs;

(c) Contain documentation of any formal corrective actions taken due to employee performance problems;

(d) Contain documentation of any actions of commendation taken for the employee; and

(e) Be maintained and utilized in such a way as to insure employee confidentiality. Records shall be retained for a period of three years following the departure of an employee.

(6) Implementation of personnel performance appraisal procedures that shall:

(a) Be based on pre-established performance criteria in terms of specific responsibilities of the position as stated in the job description;

(b) Be conducted at least annually;

(c) Require employees to review and discuss their performance appraisals with their supervisors, as evidenced by their signature on the appraisal document;

(d) Require that when the results of performance appraisal indicates there is a discrepancy between the actual performance of an employee and the criteria established for optimum job performance, the employee shall be informed of the specific deficiencies involved, in writing; and

(e) Require documentation that when deficiencies in employee performance have been found in an appraisal, a remedial plan is developed and implemented with the employee.

(7) Implementation of a development plan which addresses continuing training for staff members.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0015; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0025

Admission of Clients

Each Center shall meet the following standards pertaining to admission of clients:

(1) The Center shall have written criteria for admission and for rejecting admission requests. The criteria shall be available to clients, staff, and the community and be in compliance with ORS 430.397 through 430.401.

(2) The Center shall utilize a written intake procedure. The procedure shall include:

(a) A determination that the Center’s services are appropriate to the needs of the client;

(b) Steps for making referrals of individuals not admitted to the Center;

(c) Steps for accepting referrals from outside agencies; and

(d) A specific time limit within which the initial client assessment shall be completed on each client.

(3) The Center shall make available, for clients and others, program orientation information. The orientation information shall include:

(a) The Center’s philosophical approach to treatment;

(b) Information on clients’ rights and responsibilities while receiving services from the Center;

(c) A written description of the Center’s services; and

(d) Information on the rules governing client’s behavior and those infractions, if any, that may result in discharge or other actions.

(4) In addition to the information required by the Division’s data system, the following information shall be recorded in each client’s record at the time of admission:

(a) Name, address, and telephone number;

(b) Who to contact in case of an emergency;

(c) Name of individual completing intake; and

(d) Identification of client’s significant other, if any.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0025; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0035

Treatment Services

Each Center shall meet the following treatment standards:

(1) The Center shall provide individual or group motivational counseling sessions and client advocacy and case management services; all of which shall be documented in client files.

(2) The Center shall encourage clients to remain in treatment for an appropriate duration as determined by the treatment plan. Also, the Center shall encourage all clients to enter programs for ongoing recovery.

(3) The Center shall refer clients to Alcoholics Anonymous, Al-Anon, Alateen, or other self-help groups when clinically indicated and to the extent available in the community.

(4) Individuals fluent in the language and sensitive to the special needs of the population served shall be provided as necessary to assist in the delivery of services.

(5) The Center shall develop an individualized treatment plan for each client accepted for treatment. The treatment plan shall be appropriate to the length of stay and condition of the client. The treatment plan shall:

(a) Identify the problems from the client assessment and evaluation;

(b) Specify objectives for the treatment of each identified client problem;

(c) Specify the treatment methods and activities to be utilized to achieve the specific objectives desired and define the responsibilities of the client and treatment staff for each activity;

(d) Specify the necessary frequency of contact for the client services and activities;

(e) Specify the participation of significant others in the treatment planning process and the specified treatment where appropriate;

(f) Document the client’s participation in developing the content of the treatment plan and any modifications by, at a minimum, including the client’s signature; and

(g) Document any efforts to encourage the client to remain in the Center’s treatment, and efforts to encourage the client to accept referral for ongoing treatment.

(6) The client record shall document the client’s involvement in treatment activities and progress toward achieving objectives contained in the client’s treatment plan. The documentation shall be kept current, dated, be legible, and signed by the individual making the entry.

(7) Treatment plans shall be reviewed by the Center’s supervisor and the results of the review shall be documented in the client record.

(8) The program shall conduct and document in the client’s record discharge planning for clients who complete treatment. The discharge plan shall include:

(a) Referrals made to other services or agencies at the time of discharge;

(b) The client’s plan for follow-up, aftercare, or other post-treatment services; and

(c) Document participation by the client in the development of the discharge plan.

(9) At discharge a treatment summary and final evaluation of the client’s progress toward treatment objectives shall be entered in the client’s record.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0035; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0040

Medical Services

Each Center shall meet the following standards for medical services:

(1) The Center shall have written procedures for providing immediate transportation for clients to a general hospital in case of a medical emergency.

(2) The Center shall have a written description of its medical policies and procedures. The description shall:

(a) Specify the level of medical care provided; and

(b) Include a written policy and procedure, developed by a physician, for determining the client’s need for medical evaluation.

(3) The physician’s involvement in the development and review of medical operating procedures, quarterly reviews of physicians’ standing orders, and consultation in any medical emergencies shall be documented.

(4) Individuals shall have access to ASAM Level III.7.D medically monitored services which provide intensive inpatient treatment services, as follows:

(a) Physicians shall be available 24 hours a day by telephone;

(b) An individual shall be seen by a physician within 24 hours of admission, or sooner if medically necessary;

(c) A physician shall be available to provide onsite monitoring of care and further evaluation on a daily basis;

(d) An RN or other qualified nursing specialist shall be present to administer an initial assessment;

(e) A nurse shall be responsible for overseeing the monitoring of the individuals’ progress and medication administration on an hourly basis, if needed; and

(f) Appropriately licensed and credentialed staff shall be available to administer medications in accordance with physician orders.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0040; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0045

Management of Medications

Each Center shall have:

(1) A written order signed by a physician, a physician’s standing order, or a physician’s order received by phone and signed by the physician at the earliest opportunity before any medication is administered to, or self-administered by any client.

(2) Assurances that medications prescribed for one client shall not be administered to, or self-administered by another client or employee.

(3) A policy that no unused, outdated, or recalled drugs shall be kept in the Center. All unused, outdated, or recalled drugs shall be disposed of in a manner that assures that they cannot be retrieved, except that drugs under the control of the Food and Drug Administration shall be mailed with the appropriate forms by express, prepaid, or registered mail, every 30 days to the Oregon Board of Pharmacy. A written record of all disposals of drugs shall be maintained in the Center and shall include:

(a) A description of the drug, including the amount;

(b) The client for whom the medication was prescribed;

(c) The reason for disposal; and

(d) The method of disposal.

(4) A policy that all prescription drugs stored in the Center shall be kept in a locked stationary container. Only those medications requiring refrigeration shall be stored in a refrigerator.

(5) A policy that in the case where a client self-administers his or her own medication, self-administration shall be recommended by the Center, approved in writing by the physician, and closely monitored by the treatment staff.

(6) Individual records which shall be kept for each client for any prescription drugs administered to, or self-administered by any client. This written record shall include:

(a) Client’s name;

(b) Prescribing physician’s name;

(c) Description of medication, including prescribed dosage;

(d) Verification in writing by staff that the medication was taken and the times and dates administered, or self-administered;

(e) Method of administration;

(f) Any adverse reactions to the medication; and

(g) Continuing evaluation of the client’s ability to self-administer the medication.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0045; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0050

Staffing Pattern

(1) Each Center shall be in staffing compliance with ASAM Patient Placement Criteria 2R as follows:

(a) Each Level III.2 Center shall be staffed by:

(A) Appropriately credentialed personnel who are trained and competent to implement physician-approved protocols for patient observation and supervision, determination of appropriate level of care, and facilitation of patient’s transition to continuing care;

(B) Medical evaluation and consultation shall be available 24 hours a day, in accordance with treatment and transfer practice guidelines; and

(C) All clinicians who assess and treat patients shall be able to obtain and interpret information regarding the needs of these patients. Such knowledge includes the signs and symptoms of alcohol and other drug intoxication and withdrawal, as well as the appropriate treatment and monitoring of those conditions and how to facilitate entry into ongoing care.

(b) Each Level III.7.D Center shall be staffed by:

(A) Physicians who are available 24 hours a day by telephone, available to assess the patient within 24 hours of admission, or earlier, (if medically necessary), and available to provide on-site monitoring of care and further evaluation on a daily basis;

(B) A registered nurse or other licensed and credentialed nurse shall be available to conduct a nursing assessment upon admission and to oversee the monitoring of the patient’s progress and medication administration on an hourly basis, if needed;

(C) Appropriately licensed and credentialed staff shall be available to administer medications in accordance with physician orders; and

(D) The level of nursing care shall be appropriate to the severity of patient needs.

(2) The Center shall maintain a minimum ratio of paid full-time staff to bed capacity as follows:

(a) 1 through 8 beds — 1 staff person on duty;

(b) 9 through 18 beds — 2 staff persons on duty;

(c) 19 through 30 beds — 3 staff persons on duty;

(d) 31 beds and above — One additional staff person beyond the three staff required above for each additional 15 beds or part thereof.

(3) The Center’s written staffing plan shall address the provision of appropriate and adequate staff coverage during emergency and high demand situations.

(4) The Center shall provide a minimum of one hour per month of personal clinical supervision and consultation for each staff person and volunteer who is responsible for the delivery of treatment services. The clinical supervision shall relate to the individual’s skill level with the objective of assisting staff and volunteers to increase their treatment skills and quality of services to clients.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0050; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0055

Management Staff Qualifications

Each Center shall be directed by a person with the following qualifications at the time of hire:

(1) For an individual recovering from the disease of alcoholism and/or from other drug addiction, continuous sobriety for the immediate past three years.

(2)(a) Five years of paid full-time experience in the field of substance abuse , with at least one year in a paid administrative capacity; or

(b) A Bachelor’s degree in a relevant field and four years of paid full-time experience with at least one year in a paid administrative capacity; or

(c) A Master’s degree in a relevant field and three years of paid full-time experience with at least one year in a paid administrative capacity.

(3) Knowledge and experience demonstrating competence in planning and budgeting, fiscal management, supervision, personnel management, employee performance assessment, data collection, and reporting.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0055; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0060

Staff Qualifications

Each Center shall have:

(1) An identified clinical supervisor who has the following qualifications at the time of hire:

(a) For an individual recovering from the disease of alcoholism, and/or from other drug addiction, continuous sobriety for the immediate past three years;

(b)(A) Five years of paid full-time experience in the field of substance abuse with a minimum of two years of direct substance abuse treatment experience; or

(B) A Bachelor’s degree in a relevant field and four years of paid full-time experience, with a minimum of two years of direct substance abuse treatment experience; or

(C) A Master’s degree in a relevant field and three years of paid full-time experience with a minimum of two years of direct substance abuse treatment experience.

(c) Knowledge and experience demonstrating competence in the treatment of the disease of substance abuse, including the management of substancel withdrawal, client evaluation; motivational, individual, group, family and other counseling techniques; clinical supervision, including staff development, treatment planning and case management; and utilization of community resources including Alcoholics Anonymous, Al-Anon, and Alateen.

(2) If the Center’s director meets the qualifications of the clinical supervisor, the director may be the Center’s clinical supervisor.

(3) The Center’s treatment staff shall:

(a) For individuals recovering from the disease of alcoholism and/or from other drug addiction, have maintained continuous sobriety for the immediate past two years at the time of hire;

(b) Have training knowledge and/or experience demonstrating competence in the treatment of the disease of substance abuse, including the management of substance withdrawal; client evaluation; motivational counseling techniques; and the taking and recording of vital signs;

(c) Within six weeks of employment, be currently certified or in process of certification in first aid methods including cardiopulmonary resuscitation.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0060; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0065

Use of Volunteers

Each Center utilizing volunteers shall have the following standards for volunteers:

(1) A written policy regarding the use of volunteers that shall include:

(a) Philosophy, goals, and objectives of the volunteer program;

(b) Specific responsibilities and tasks of volunteers;

(c) Procedures and criteria used in selecting volunteers, including sobriety requirements for individuals recovering from a substance use disorder;

(d) Terms of service of volunteers;

(e) Specific accountability and reporting requirements of volunteers;

(f) Specific procedure for reviewing the performance of volunteers and providing direct feedback to them; and

(g) Specific procedure for discontinuing a volunteer’s participation in the program.

(2) There shall be documentation that volunteers complete an orientation and training program specific to their responsibilities before they participate in assignments. The orientation and training for volunteers shall:

(a) Include a thorough review of the Center’s philosophical approach to treatment;

(b) Include information on confidentiality regulations and client’s rights;

(c) Specify how volunteers are to respond to and follow procedures for unusual incidents;

(d) Explain the Center’s channels of communication and reporting requirements and the accountability requirements for volunteers;

(e) Explain the procedure for reviewing the volunteer’s performance and providing feedback to the volunteer; and

(f) Explain the procedure for discontinuing a volunteer’s participation.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15-1983, f. 7-27-83, ef. 10-25-83; ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0065; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0070

Building Requirements

Each Center shall provide facilities which shall:

(1) Comply with all applicable state and local building, electrical, plumbing, fire, safety, and zoning codes. Written evidence of compliance shall be maintained in the Center.

(2) Have floors, walls, and ceilings which meet the interior finish requirements of the Fire and Life Safety Code.

(3) Provide an adequately ventilated separate dining room or area for the exclusive use of clients, employees, and invited guests.

(4) Have a separate living room or lounge area for the exclusive use of Center clients, employees, and invited guests which shall provide a minimum of 15 square feet per client, and have adequate ventilation.

(5) Have sleeping areas that are separate from the dining, living, multi-purpose, laundry, kitchen, and storage areas; have an outside room with an openable window of at least the minimum required by the State Fire Marshal; have a ceiling height of at least seven feet six inches; provide a minimum of 60 square feet per client, with at least three feet between beds; provide permanently wired light fixtures located and maintained so as to give adequate light to all parts of the room; and provide a curtain or window shade at each window to assure privacy.

(6) Have bathrooms conveniently located in each building containing a client bedroom and that provides a minimum of one toilet for each eight clients and one bathtub or shower for each ten clients; have one handwashing sink convenient to every room containing a toilet; provide permanently wired light fixtures located and maintained so as to give adequate light to all parts of the room; have arrangements for individual privacy for clients; provide a privacy screen at each window; have a mirror; and have adequate ventilation.

(7) Have an adequate supply of hot and cold water, installed and maintained in compliance with current rules of the Health Division, which shall be distributed to taps conveniently located throughout the facility. All plumbing shall be in compliance with the State Plumbing Code.

(8) Have, if provided, laundry facilities separate from living areas including bedrooms, kitchen and dining areas, and areas used for the storage of unrefrigerated perishable foods.

(9) Have storage areas appropriate to the size of the Center. Separate storage areas shall be provided for food, kitchen supplies and utensils, clean linens and soiled linens and clothing, and cleaning compounds and equipment, poisons, chemicals, rodenticides, insecticides and other toxic materials which shall be properly labeled, stored in the original container, and kept in a locked storage area.

[Publications: Publications referenced are available from the agency.]

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0070; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0075

Client Furnishings and Linens

Each Center shall provide furniture and linen for each client which shall include:

(1) A bed, including a frame, and a clean, comfortable mattress and pillow;

(2) A private dresser or similar storage area for personal belongings which is readily accessible to the resident;

(3) Access to a closet or similar storage area for clothing;

(4) Linens, including sheets, pillowcase, blankets appropriate in number and type for the season and the client’s comfort, and towels and washcloth; and

(5) A locked area not readily accessible to clients for safe storage of such items as money and jewelry.

Stat. Auth.: ORS 413.042 & 430.256
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0075; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

415-050-0090

Food Service

Each Center shall provide food service that shall:

(1) Provide a nourishing, well-balanced diet for all clients.

(2) Provide modified or special diets as ordered by a physician.

(3) Assure at least three meals daily.

(4) Have menus that are prepared in advance which provide a sufficient variety of foods served in adequate amounts for each client at each meal, and adjusted for seasonal changes. Records of menus as served shall be filed and maintained in the facility’s record for at least 30 days.

(5) Have supplies of staple foods for a minimum of one week, and of perishable foods for a minimum of two-day periods which shall be maintained on the premises.

(6) Provide food stored and served at proper temperatures.

(7) Not serve or store raw milk and home-canned vegetables, meats, and fish.

(8) Meet the requirements of the State of Oregon Sanitary Code for Eating and Drinking Establishments relating to the preparation, storage, and serving of food.

(9) Have all utensils, including dishes, glassware, and silverware, used in the serving or preparation of drink of food for clients effectively washed, rinsed, sanitized, and stored after each individual use to prevent contamination in accordance with Health Division standards.

[Publications: Publications referenced are available from the agency.]

Stat. Auth.: ORS 409.410
Stats. Implemented: ORS 430.306 & 430.345 - 430.375
Hist.: MHD 15(Temp), f. 1-16-74, ef. 2-1-74; MHD 45, f. & ef. 7-20-77; MHD 15-1983, f. 7-27-83, ef. 10-25-83, Renumbered from 309-052-0000(6); ADAP 3-1993, f. & cert. ef. 12-6-93, Renumbered from 309-050-0090; ADS 2-2008, f. & cert. ef. 11-13-08; ADS 3-2013(Temp), f. & cert. ef. 2-4-13 thru 8-2-13

Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2012.

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