Cal. Code Regs. Tit. 9, § 531 - Program Standards and Requirements

(a) To be certified as a Short-Term Crisis Residential Treatment Program, a program shall provide:

(1) Services as specified in either subsection (e) or (f) of section 541 as an alternate to hospitalization for individuals experiencing an acute psychiatric episode or crisis. The planned length of stay in the program shall be in accordance with the client's assessed needs, but not to exceed thirty (30) days, unless circumstances require a longer length of stay to ensure successful completion of the treatment plan and appropriate referral. The reasons for a length of stay beyond thirty (30) days shall be documented in the client's case record. Under no circumstances may the length of stay exceed three (3) months.

(2) Scheduling of staff which provides for at least two (2) staff members to be on duty 24 hours a day, seven (7) days per week. If program design results in some clients not being in the facility during specific hours of the day, scheduling adjustments may be made so that coverage is consistent with and related to the number and needs of clients in the facility. During the night time hours, when clients are sleeping, only one of the two on duty staff members need be awake, providing the program does not accept admissions at that time. There shall be a staffing ratio of at least one (1) full-time equivalent direct service staff for each 1.6 clients served.

(b) To be certified as a Transitional Residential Treatment Program, a program shall provide:

(1) Services as specified in either subsection (h) or (i) of section 541 which shall provide a therapeutic environment in which clients are supported in their efforts to acquire and apply interpersonal and independent living skills. The program shall also assist the client in developing a personal community support system to substitute for the program's supportive environment and to minimize the risk of hospitalization and enhance the capability for independent living upon discharge from the program. The planned length of stay in the program shall be in accordance with the client's assessed need, but not to exceed one (1) year; however, a length of stay not exceeding a maximum total of 18 months is permitted to ensure successful completion of the treatment plan and appropriate referral. The reasons for a length of stay beyond one (1) year shall be documented in the client's case record.

(2) Greater number of staff shall be present during times when there are greater numbers of clients in programmed activities. Staff schedules shall be determined by the program based on the number of clients in the program during specific hours of the day, level of care provided by the program, and the range of services provided within the facility.

At least one staff member shall be present at any time there are clients at the facility. There shall be a staffing ratio of at least one (1) full-time equivalent direct service staff for each 2.5 clients served. All scheduled hours in the facility shall be considered part of this required full-time equivalent staffing ratio.

(c) To be certified as a Long-Term Residential Treatment Program, a program shall provide:

(1) Services as specified in subsection (j) of section 541 in order to provide a 24-hour therapeutic residential setting with a full range of social rehabilitation services, as defined in section 532 of these regulations, including day programming for individuals who require intensive support in order to avoid long-term hospitalization or institutionalization. The planned length of stay shall be in accordance with the client's assessed needs but under no circumstances may that length of stay be extended beyond eighteen (18) months.

(2) Scheduling of staff which provides for the maximum number of staff to be present during the times when clients are engaged in structured activities. At least one direct service staff shall be on the premises 24-hours a day, seven (7) days per week. Additional staff, including part-time or consulting services staff, shall be on duty during program hours to provide specialized services and structured evening services. When only one staff member is on the premises there shall be staff on call who can be contacted by telephone if an additional staff person is needed, and can be at the facility and on duty within 60 minutes after being contacted. There shall be a staffing ratio of at least one (1) full-time equivalent direct service staff member for each 2.8 clients served.

(d) "Direct service staff" shall mean employees whose duties include the treatment, training, care and/or supervision of the program's clients.

Notes

Cal. Code Regs. Tit. 9, § 531

1. New section filed 1-3-91; operative 2-2-91 (Register 91, No. 7).
2. Change without regulatory effect amending NOTE filed 8-12-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).
3. Governor Newsom issued Executive Order N-55-20 (2019 CA EO 55-20), dated April 22, 2020, which suspended certain provisions related the operation of treatment and rehabilitation facilities that could restrict staffing flexibility, due to the COVID-19 pandemic.

Note: Authority cited: Sections 4090 and 14700, Welfare and Institutions Code. Reference: Sections 4090, 4091, 5670, 5670.5 and 5671, Welfare and Institutions Code.

1. New section filed 1-3-91; operative 2-2-91 (Register 91, No. 7).
2. Change without regulatory effect amending Note filed 8-12-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).