Section 29-2357. SPECIALITY SERVICES -- ADDITIONAL STANDARDS FOR PROGRAMS SERVING PARENTS AND THEIR CHILDREN

 

2357.1 In addition to core requirements and other standards described in this chapter, a substance abuse treatment facility or program providing rehabilitation services to parents and their children shall comply with this section for the delivery of care.

 

2357.2 A substance abuse treatment facility or program providing rehabilitation services to parents and their children shall provide services solely to one gender and their children if such gender specific programs are recommended by the Treatment Improvement Protocols of the Center for Substance Abuse Treatment (TIPs). Living arrangements for adult men shall be separate from women and their children if recommended by TIPs.

 

2357.3 Facilities or programs that serve parents and their children shall engage in all activities necessary to ensure priority admission and service delivery to women who are pregnant or postpartum.

 

2357.4 Facilities or programs that serve parents and their children shall admit adolescents who are pregnant or postpartum if the facility or program can provide evidence that the adolescent can appropriately participate in and benefit from the program services.

 

2357.5 Infants shall accompany their mothers when services are provided in a supervised residential setting, unless contraindicated by medical, legal or other reasons, which are documented in the patient’s record.

 

2357.6 In the event a newborn infant remains in a medical facility while the mother participates in services, the residential program shall ensure that there is a daily visit/contact between the mother and newborn infant.

 

2357.7 Any medical or therapeutic reasons that prevent such daily contact shall be documented in the patient’s record and shall be accompanied with plans to improve parent-child bonds during the separation and to restart contact.

 

2357.8 Children, other than newborn infants, shall accompany their parents to the facility or program when indicated or when appropriate care from other family members or resources are not available.

 

2357.9 Clinicians who prevent parents from regular contact with their children shall provide written justification to the Department as to why contact is detrimental for the parent or child.

 

2357.10 Clinicians shall also provide a detailed written plan and schedule of activity for strengthening the bond between parents and children during and after the end of the separation. These plans shall be provided even if the separation is with the consent of the parent and shall be documented in the parent’s record.

 

2357.11 Children of a homeless parent, independent of age and gender, shall not be separated from the parent during or because of treatment. If separation must occur, the facility or program shall provide the following to the Department:

 

(a) Justification for separation;

 

(b) Plans for strengthening parent/child bonds during and after the separation has ended; and

 

(c) Evidence of safe and developmentally appropriate housing for the children involved.

 

2357.12 Facilities or programs that serve parents with children shall address therapeutic issues relevant to parents and specific needs of the parents.

 

2357.13 Service delivery for facilities or programs that serve parents with children, shall include, but is not limited to, the following:

 

(a) At least one (1) hour of planned, supervised activities to promote parent-child bonding daily; and

 

(b) A minimum of the following instruction and hands on behavioral exercises weekly:

 

(1) One (1) hour regarding the effects of using alcohol and other drugs during pregnancy;

 

(2) One (1) hour regarding child development; and

 

(3) Two (2) hours regarding parenting skills.

 

2357.14 Children shall be supervised at all times and shall be provided age appropriate activities, training and guidance.

 

2357.15 A facility or program shall ensure that child care/day care is available for children, to be provided either directly or through contractual or other affiliation, while the parent participates in treatment and rehabilitation services.

 

2357.16 A facility or program that directly operates a child development facility shall be licensed in accordance with the District of Columbia Child Development Facilities, Chapter 3 of Title 29 of the District of Columbia Municipal Regulations.

 

2357.17 Facilities or programs that serve parents with children shall address therapeutic issues and specific needs of the children as specified in the parent’s rehabilitation plan. Age-appropriate activities, training and guidance shall be offered to facilitate the parent’s recovery goals as well as to meet the following goals:

 

(a) Building self-esteem;

 

(b) Learning to identify and express feelings;

 

(c) Building positive family relationships;

 

(d) Developing decision-making skills;

 

(e) Understanding chemical dependency and its effects on the family;

 

(f) Learning and practicing nonviolent ways to resolve conflict;

 

(g) Learning safety practices such as sexual abuse prevention; and

 

(h) Addressing developmental needs.

 

2357.18 Facilities or programs that serve parents with children shall ensure school age children are in regular attendance at a public, independent, private, or parochial school, or private instruction in accordance with the District of Columbia Compulsory School Attendance Amendment Act of 1990, effective March 8, 1991 (D.C. Law 8-247, D.C. Code, 2001 Ed. §38-201 et seq.).

 

2357.19 Facilities or programs that serve parents with children shall provide directly or otherwise make available tutoring programs to assist school age children who are having difficulty maintaining better than average school grades.

 

2357.20 Facilities or programs that serve parents with children shall develop policies and procedures describing the method for retaining and recording information collected on the children residing in or attending the program who are not formally admitted for treatment, linking information on the child to the course of treatment for the parent as clinically indicated.

 

2357.21 A facility or program shall develop policies and procedures for determining the need to formally admit a child as a discrete patient.

 

2357.22 A facility or program shall establish a separate record for each child when a clinical determination is made to formally admit the child as a discreet patient.

 

2357.23 The record shall document the child’s developmental assessment, to include but not be limited to the child’s history and current status physically emotionally, socially, educationally, and in relation to the family.

 

2357.24 An individualized treatment plan shall be developed for any child who is formally admitted to the facility or program as a discrete patient.

 

2357.25 The child’s parent or legal guardian shall sign the treatment plan and consent for treatment.

 

2357.26 During all hours of operation, there shall be a minimum of two (2) staff members on-duty within a residential support program.

 

2357.27 Additional staff may be required, depending upon the number of parents and children present and the type of activities offered.

 

2357.28 Services delivery staff and program administration shall demonstrate experience and training to address the needs of parents and children.

 

2357.29 All services delivery staff shall receive periodic training regarding therapeutic issues relevant to women and children. At least two (2) times per year the program shall provide or arrange training on each of the following topics

 

(a) Special considerations in the treatment of women, including pregnant and postpartum women;

 

(b) Child development and the appropriate care and stimulation of infants including drug-affected newborn infants;

 

(c) Treatment of patients who are victims of violence (including rape) or traumatized by observing violence; and

 

(d) Treatment of patients who have initiated or participated in violence against others.

 

2357.30 Service delivery staff shall maintain current training in first aid and cardiopulmonary resuscitation for infants and adults.

 

2357.31 A facility’s or program’s governing board shall include members with a special interest in the expertise related to the program or services for parent(s) and children, such as prospective referral sources, health care, child care, and social service providers.

 

2357.32 A facility or program that serves parents with children shall maintain a safe healthy environment, which is responsive to the physical and medical needs of parent(s) and children.

 

2357.33 A facility or program that serves parents with children shall maintain a smoke-free environment and shall assist patients in reducing and eliminating dependence on tobacco.

 

2357.34 A facility or program that serves parents with children shall have written affiliation agreement(s) and demonstrate effective working relationship(s) with a physician, hospital, and/or clinic to provide medical care for women, including pregnant and postpartum women, men, and their children.

 

2357.35 A facility or program that serves parents with children shall ensure that a medical evaluation is performed for each parent and child. The medical evaluation shall include:

 

(a) Current physical status, including vital signs and verification of childhood immunizations required by the Department;

 

(b) Recent substance use patterns, including the most recent substance use episode;

 

(c) Any symptoms of intoxication, impairment or withdrawal;

 

(d) Any history of being a victim or participating in violence against others; and

 

(e) The extent of violence in current relationships.

 

2357.36 A facility or program that serves parents with children shall provide or arrange detoxification services for any parent who presents symptoms of intoxication, impairment or withdrawal.

 

2357.37 A facility or program that serves pregnant women with symptoms of intoxication, impairment or withdrawal shall immediately provide or arrange for the patient to be:

 

(a) Evaluated by a physician, hospital, or medical clinic;

 

(b) Transported;

 

(c) Admitted for detoxification services in a hospital, when clinically indicated; and/or,

 

(d) Provided non-hospital detoxification services, if hospital services are not clinically indicated.

 

2357.38 A facility or program with supervised living shall not be required to accept applications for civil detention of intoxicated persons due to the presence of children within the facility.

 

2357.39 During the initial assessment, a facility or program shall ensure that each parent and child is medically stable, safe and fully able to participate in program services.

 

2357.40 A facility or program shall ensure that recommendations by a physician, or licensed health care provider are implemented regarding medical, physical and nutritional needs.

 

2357.41 A facility or program that serves parents with children shall work with the Department and other community agencies to:

 

(a) Link pregnant and postpartum clients with available case management services for high risk pregnancies; and

 

(b) Link clients with needed resources and services, such as Women, Infants and Children (WIC), Healthy Babies, and/or other appropriate programs.

 

2357.42 A facility or program that serves parents with children shall maintain primary responsibility for community support linkages until the patient no longer participates in its services.

 

 

source

Final Rulemaking published at 47 DCR 9341 (November 24, 2000), adopting Emergency and Proposed Rulemaking published at 47 DCR 7708, 7786 (September 22, 2000).