N.Y. Comp. Codes R. & Regs. tit. 14 § 584.10

Current through Register Vol. 46, No. 45, November 2, 2024

Section 584.10 - Staffing

(a) A residential treatment facility shall continuously employ an adequate number of staff and an appropriate mix of staff to carry out its goals and objectives as well as to ensure the continuous provision of sufficient regular and emergency supervision of all residents 24 hours a day. As a component of the written plan for services and staff composition, the residential treatment facility shall submit a staffing plan which includes the qualifications and duties of each staff position, by title. The residential treatment facility shall submit a written staffing rationale which justifies the staff to be utilized, the mix of staff and the plan for appropriate supervision of staff. The staffing plan shall include procedures for periodic supervisory conferences with staff and procedures for written performance evaluation consistent with any collective bargaining requirements. This staffing plan shall be based on the population to be served and the services to be provided. The staffing plan and its rationale shall be submitted for approval by the Office of Mental Health.

(b) All clinical staff shall have at least a high school diploma or its equivalent.

(c) At least 50 percent of the clinical staff hours shall be provided by full-time employees.

(d) For purposes of this Part, professional staff are individuals who are qualified by training and experience to provide direct treatment services under minimal supervision.

(1) Professional staff shall include the following as defined in section 584.4(c) of this Part:

(i) nurse;

(ii) occupational therapist;

(iii) physician;

(iv) psychiatrist;

(v) psychologist;

(vi) rehabilitation counselor;

(vii) social worker;

(viii) teacher;

(ix) therapeutic recreation specialist; and

(x) speech pathologist.

(2) Other professional disciplines may be included as professional staff, provided that the discipline is acceptable to the Office of Mental Health and is approved as part of the staffing plan by the Office of Mental Health. The discipline shall be from a field related to the treatment of mental illness. The individual shall be licensed in such discipline by the New York State Education Department, or have a master's degree in such discipline from a program approved by the New York State Education Department, and shall have specialized training or experience in treating persons with mental illness.

(e) In order to assure that the residential treatment facility employ an adequate number and mix of professional staff who meet the qualifications provided in section 584.4(c) of this Part, the staffing plan shall meet each of the following requirements. A single staff member may be counted against more than one requirement.

(1) At least two persons representing different professional staff categories as delineated in subdivision (f) of this section shall be employed on a full-time basis.

(2) Persons representing each of the following professional staff categories shall be employed at least one fifth of the hours of a full-time employee: nurse, psychiatrist, psychologist, social worker, and recreation therapist.

(3) One full-time equivalent professional staff member shall be employed for each seven residents.

(f) In order to assure that an adequate number of professional staff are qualified by training and experience to provide clinical supervision of other staff and to provide programmatic direction, at least 25 percent of the professional staff required to comply with paragraph (e)(3) of this section in each residential treatment facility shall meet the following qualifications:

(1) a nurse who has a bachelor's degree and at least three years post-licensure experience in treating mentally ill children or youth;

(2) a physician who has at least one year of post-medical degree experience in treating mentally ill children or youth;

(3) a psychiatrist who has at least one year of post-medical degree experience in treating mentally ill children or youth;

(4) a psychologist who has specialized training in school psychology, clinical psychology or counseling psychology and at least two years of post- -graduate experience in treating mentally ill children or youth;

(5) a rehabilitation counselor who has a master's degree in rehabilitation counseling from a program approved by the New York State Education Department, current certification by the Commission on Rehabilitation Counselor Certification and two years of post- graduate experience in treating mentally ill children or youth;

(6) a social worker who has specialized training in clinical practice and two years post-graduate experience in treating mentally ill children or youth ; and/or

(7) a therapeutic recreation specialist who has a master's degree in therapeutic recreation from a program approved by the New York State Education Department, current registration as a therapeutic recreation specialist by the National Therapeutic Recreation Society and two years of post- graduate experience in treating mentally ill children or youth.

(g) In order to assure that the residents are adequately supervised and are cared for in a safe and therapeutic manner, the staffing plan shall meet each of the following requirements:

(1) At least two clinical staff members shall be assigned to direct care responsibilities for each living unit during all hours the residents are awake and not in school.

(2) At least one clinical staff member shall be assigned to direct care responsibilities for each living unit for each five residents during all hours the residents are awake and not in school.

(3) At least one clinical staff member shall be assigned direct care responsibility, be awake, and be continuously available to the children or youth on each living unit during all hours the residents are asleep. A minimum of one additional clinical staff member for each 14 children or youth shall be immediately available onsite to assist with emergencies or problems which might arise.

(4) Appropriate professional staff shall be available to assist in emergencies on at least an on-call basis at all times.

(5) A physician shall be available on at least an on-call basis at all times.

(h) In order to assure the appropriate supervision of the nutritional aspects of dietetic services, a qualified dietitian shall be available on at least a consultation basis.

(1) The amount of time a qualified dietitian is available shall be sufficient to permit the dietitian to direct nutritional aspects of patient care, assure that dietetic instructions are carried out and assist in the evaluation of the dietetic service.

(2) When a qualified dietitian is only available on a consultation basis, regular written reports shall be submitted to the director regarding the implementation and evaluation of dietetic services.

(i) All staff shall have qualifications appropriate to assigned responsibilities as set forth in the staffing plan and shall practice within the scope of their professional discipline.

(1) All staff shall submit documentation of their training and experience to the provider of services. Such documentation shall be retained on file by the residential treatment facility.

(2) Psychological testing and evaluation procedures may only be provided by or under the supervision of a licensed psychologist.

(j) Students or trainees may qualify as clinical staff under the following conditions:

(1) The students and trainees are actively participating in a program leading to attainment of a recognized degree or certificate in a field related to mental health at an institution chartered or approved by the New York State Education Department. Limited permit physicians are considered students or trainees.

(2) The students or trainees are supervised and trained by professional staff meeting the qualifications specified in subdivision (f) of this section and limited permit physicians are trained by physicians.

(3) The students or trainees receive at least one hour of supervision for every five hours of treatment services provided. Limited permit physicians must work under the direct supervision of physicians.

(4) The students or trainees use titles that clearly indicate their status.

(5) Written policies and procedures pertaining to the integration of students and trainees within the overall operation of the residential treatment facility receive prior approval by the Office of Mental Health.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 584.10

Amended New York State Register August 17, 2016/Volume XXXVIII, Issue 33, eff. 8/17/2016

Amended New York State Register July 3, 2024/Volume XLVI, Issue 27, eff. 7/3/2024