Date Issued: January 6, 2017
RECIPIENTS
- All Certified and/or Funded Providers
- Local Governmental Units (LGUs)
APPLICABILITY
This Local Services Bulletin (LSB) applies to OASAS certified and/or funded providers of substance use disorder treatment services allowing children in residence or attendance with their parents while in treatment.
BACKGROUND
- OASAS and its providers realize that a commitment to treatment can pose challenges to parents with small children and seeks to minimize disruption to a family unit during critical periods of treatment.
- In addition to all OASAS regulations and guidance applicable to the program certified modality, programs allowing children to accompany parents into treatment and/or visit their parent are required to ensure a child’s health and safety at all times a child is present in the program’s facility.
- Programs must determine whether a child should be admitted as a “significant other” as defined in Part 800 but while the child is in the facility, programs must ensure that the child:
- Is not abused or neglected
- Receives medication or medical treatment as needed
- Receives adequate nutrition
- The standards outlined below are minimum standards and should not be construed as exhaustive. Providers must develop policies and procedures that are responsive to their facility, unique patient population and consistent with laws, regulations and current child care standards.
General Safety:
- Children who are in care with their parent or who are visiting a parent must be in visual or auditory distance of that parent or staff at all times.
- At no time shall the child be left in the care of another resident or client.
- Programs must have policies and procedures prohibiting anyone except the legal guardian or a person authorized by the legal guardian to remove child from the facility. If an individual shows documentation of legal custody, staff must record the person’s identification before releasing the child.
- Corporal punishment is prohibited by any person on the premises. Behavior management must be fair, reasonable, consistent and developmentally appropriate.
- Parents/guardians must provide written authorization for emergency treatment of their children and for care of their child in the event of an emergency involving the parent/guardian; such authorization is kept in the parent’s case record.
- Plan and practice emergency evacuation procedures consistent with all state and local rules and regulations and identify procedures specific to children.
- Maintain one or more accessible telephones in working order; post emergency phone numbers next to all phones, including 911 and poison control.
Staffing (employees, and/or volunteers):
- All staff (volunteers, contractors, employees) are mandated reporters for purposes of reporting suspected child abuse and maltreatment to the State Central Registry (SCR) and incidents involving any service recipient or family member present in the program facility to the Justice Center (VPCR).
- Children must be supervised by an appropriately trained adult staff person during short-term, intermittent treatment-related activities when the child is not in the care of a parent.
- Providers choosing to provide on-site child care services must employ staff dedicated to meeting the needs of children of the parents in treatment.
- Program staff members interacting or working with children must receive ongoing training to increase knowledge and maintain skills related to child development and parenting.
Sanitary Facilities:
- Locate hand-washing facilities in or adjacent to rooms used for toileting; hand sanitizers should be kept out of reach of children; children should have their own soap and towels.
- Provide toileting privacy for opposite sex children age 6 or older and for any children demonstrating a need for privacy.
- Provide toilets, urinals and hand-washing sinks of appropriate height and size for the child or furnish safe, easily cleanable platforms impervious to moisture.
- Provide developmentally appropriate equipment for toilet training and toileting of the young child; caregivers must sanitize the equipment after each use.
Physical Spaces and other Considerations:
The provider must implement precautions to eliminate any conditions which pose a safety hazard in areas accessible to children including, but not limited to:
- Cleaning materials and other poisonous or toxic materials must be stored in their original containers in places inaccessible to children and used so as not to contaminate play surfaces, food or food preparation areas.
- Install protective gates at stairs or areas prohibited to unaccompanied children; locks on drawers and toilets in rooms accessible to children.
- Protective caps, covers or permanently installed obstructive devices on all electrical outlets accessible to young children.
- If child care is provided on floors above the first floor, windows on floors above the first floor must be protected by barriers or locking devices.
- Any closet door latch accessible to children must enable children to open the door from inside the closet and children must be trained to use this capability.
- Every bathroom door lock must permit opening of the locked door from the outside in case of an emergency.
- All window and door blind cords, ropes, wires and other strangulation hazards must be secured and inaccessible to children.
- Furniture (i.e., dressers, book case) in rooms accessible to children must be bolted to the walls or secured by other means.
- Considerations should be made for location of program parent/child areas in multi-program facilities. This includes access to areas by elevator and staircase.
Child Care:
- Programs must include designated child care staff in all clinical staffing meetings to discuss the health and well-being of a child and child-parent relationship. Significant findings/discussions/events must be noted in the parent case records.
- Offsite child care facilities where children are not under the care and supervision of their parent must be either licensed or licensure exempt.
- Meet the nutritional needs of each child, considering the age, developmental level, individual differences, cultural background, preferences and any disabling condition.
- If more than one child in the program is receiving breast milk, formula or other individualized food items, all containers or bottles must be clearly marked with the child’s first and last name and dated.
- Provide a clean, separate and firm mat, cot, bed, and mattress, play pen or crib for a child requiring a nap or rest period; all cribs must be incompliance with safety standards established by the Consumer Product Safety Commission.
Physical Health and Medical:
- Upon admission of a parent a risk assessment must be completed on the accompanying child to document at a minimum:
- Date of the last physical exam
- Allergies and reactions
- All known medical conditions
- Immunizations
- Children who are ill must be separated from other children. Parents must be contacted when the child is ill, injured or overly anxious or upset.
- Providers must establish a relationship with an appropriate medical provider and arrange for referrals to be made as necessary; any issues requiring a trip to an outside medical facility must be documented in the parent case record; documentation from children’s medical appointments should be maintained in a specified area in the parent’s case record. Medical information should be reviewed with the parent to ensure complete understanding.
- Providers must have a minimum of one staff person on all shifts documented to be certified in infant and child CPR; a list of all such staff must be posted to be accessible to anyone.
- Portable first aid supplies for emergency treatment must be readily available, but not accessible to children.
- Programs must have a written transfer policy to a hospital providing pediatric services.
- Establish and implement policies and procedures for medication administration to children consistent with state law, including documentation of children’s medication as prescribed and administered within the program.
Transportation:
- No child may be transported in a motor vehicle provided or arranged for by the parent unless such child is secured in child safety seats properly installed per manufacturers recommendations, or with safety belts, as appropriate for the age of the child in accordance with the requirements of the Vehicle and Traffic Law.