Recovery Residences Guidance

Expectations

• When admitting a new resident, providers are expected to document the admission and all corresponding information. Providers of certified recovery residences must report all resident admissions to OASAS, through official data reporting systems.
• Providers will develop admission criteria, as well as the specific process for engagement and interviewing of applicants. These criteria must be in accordance with OASAS 14 NYCRR Part 860.
• The interview and admission process does not require clinical assessment, medical diagnosis, or level of care determinations. Through this process, both the individual and the residence can determine whether moving into this environment is the right choice or fit.
• During the admission process, information about the applicant will be collected, including general demographic information, details about the applicant’s substance use disorder, past treatment history, legal involvement, medical history, mental health history, current medications, the resident’s relationships with significant others, social supports, educational strengths and barriers, and leisure activities.
• Upon admission, certified recovery residences are required to provide residents with:
  • (1) a residency agreement, or equivalent document
  • (2) documents outlining expenses to be collected from the resident, with a clearly defined collection schedule
  • (3) resident rights and responsibilities
  • (4) residence policies and procedures
  • (5) confidentiality agreements, and
  • (6) copies of any documents or forms signed by the resident.
• Providers must be fully transparent on all rules, practices, regulations, and/or obligations, so that the resident is aware of them. Residents will also be informed of emergency procedures in place, including but not limited to procedures for fire safety, environmental hazards, and substance use crises.

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Expectations

• When discharging a resident, providers are expected to document the discharge, including events which led to the resident’s departure or dismissal. The documentation must include the reason(s) for discharge, recovery status, assertive linkage referrals, and new living situation to include the individual’s destination (if known) following discharge. Providers must report all resident discharges to OASAS, through official data reporting systems.
  • Discharge Types:
    o    Involuntary Termination
    o    Successful Completion of Stay
    o    Against Suggested Advice Discharge
    o    Abandonment Discharge
• If a discharge qualifies as, or coincides with an incident, the appropriate incident report and incident management process must be initiated.
• Providers will develop discharge criteria, in accordance with OASAS 14 NYCRR Part 860, and developed with the understanding that good judgment be exercised, and all extenuating circumstances be examined before determining if violations are severe enough to warrant termination from the residence.
• Involuntary termination of an individual’s residency may be immediately warranted if a resident’s actions significantly jeopardize the safety, health, or wellbeing of other residents, the recovery environment, or the residence property itself.
• Certified recovery residences may only move to terminate residency of a resident consistent with the terms of their residency agreement or similar document, the New York State Real Property Actions and Proceedings Law, and all other applicable laws and regulations. If terminating outside of the residency agreement, proper written notice as defined by NYS Real Property Actions and Proceedings Law must be provided.
• Residents possess a right to appeal any decision to terminate residency, consistent with guidance issued by OASAS and New York State Real Property Actions and Proceedings Law, if applicable. If a residency termination is initiated, operators must provide a written notice to the resident that indicates the reason(s) for the recommended discharge as well as required information on how to appeal.
• If discharge is initiated, providers must facilitate assertive linkages and provide essential recovery information and resources to the discharged resident, in accordance with OASAS 14 NYCRR Part 860.

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Expectations

• All certified recovery residences shall have a residence manager who is responsible for the management of the certified recovery residence, including additional staff. Experience requirements for residences managers are delineated in OASAS 14 NYCRR Part 860.
• Residence managers are required to possess or obtain a Certified Recovery Peer Advocate (CRPA) credential within one year of employment.
• Ancillary staff including volunteers, peers, and interns will be employed as needed to meet the needs of the residents served. For providers with multiple residences, sufficient staff must be employed, including enough residence managers for multiple residences to meet the needs of the residents served.
• All staff, including residence managers, peers, volunteers, and interns must receive supervision. Supervision is provided by an individual who has received training and has professional experience involving peer supervision competencies.
• All staff are required to complete specific trainings during the onboarding process, and at least annually thereafter. Training topics will be identified by OASAS and distributed to providers.
• All providers who contract or certify with OASAS are required to comply with the criminal background check process. Prospective employees, peers, and volunteers within a certified recovery residence must undergo criminal background checks if they will have any regular contact with residents.

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Expectations

• Providers must develop and adhere to maintenance schedules, and plan routine inspections of safety features, including but not limited to, fire systems (e.g., smoke detectors, sprinkler systems, fire extinguishers), carbon monoxide detectors, access to exits, and emergency lighting systems.
• Regular maintenance on entryways, exits, walkways, windows, and roofs must be conducted, regardless of property ownership. Proper maintenance of utility provisions, such as heating, cooling, plumbing, and electric systems must be conducted.
• Paths and walking areas must be kept clear of obstructions, spills, and trip hazards. Residences must be clean, well-maintained, and uphold hygiene standards. Residences must be maintained in a state of repair that protects the health and safety of all residents.
• All providers must adhere to applicable building codes, and any other relevant local and state occupancy, use, building, and zoning laws.
• Providers must be compliant with all applicable requirements of Federal, State, and Local laws. Additionally, all providers must adhere to OASAS 14 NYCRR Part 814, with certified recovery residences deemed residential facilities but exempt from certain specific requirements, identified in OASAS 14 NYCRR Part 860.
• Certified recovery residences must contain a minimum of one toilet, one sink, and one tub or shower for every six residents. Bathrooms must be kept hygienic and afford privacy for individuals.
• The residence’s operating certificate will identify occupancy limits, which cannot be increased without approval from the OASAS Certification Unit.
• Sleeping accommodations must provide a minimum of 60 square feet per resident in areas with more than one bed, and bedrooms must afford privacy for residents. All beds must be furnished with clean, functional mattresses.

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Expectations

• Providers must inform residents of any and all financial obligations they will be responsible for during the admission process. Providers must also make the residents aware of the collection schedule for all funds due, as well as policies of the residence surrounding late payments and missed payments.
• Providers must develop clear policies on purchasing and sharing of food and household supplies among residents. This will include utilization of SNAP/EBT benefits (if applicable), and allocations of funds toward food, groceries, and supplies. Resident pooling of SNAP/EBT benefits will be determined according to residence policies and procedures.
• Providers are prohibited from requiring a resident to sign a document relinquishing their public assistance benefits, including medical assistance benefits, cash assistance, SSI/SSDI, SNAP/EBT benefits, or any personal payments in the name of the resident.

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Expectations

• In the event of a resident return to use, providers must examine all surrounding factors and extenuating circumstances, and utilize harm reduction strategies as an intervention.
• If it is determined that residency will be terminated due to a return to use, providers must comply with requirements in the discharge section, as well as OASAS 14 NYCRR Part 860.
• Residents must be provided support in the event of a return to use and should be provided the potential opportunity to return to the residence at a later date.
• If it is determined that a referral to alternative housing or other recovery service is warranted, support must be provided in the form of assertive linkages that ensure resident safety, and may include crisis, medical, mental health, or substance use services.
• Assertive linkages (or warm handoffs) are the process of connecting a resident to the appropriate services in a timely manner, which goes beyond just providing a phone number, address, or brochure of available services. Providers must directly assist in coordinating and linking the resident to the necessary services to maintain their safety and wellbeing.
• Through the process of assertive linkages, providers must arrange for transportation of the individual to facilitate the transition. Providers must also communicate with resident emergency contacts if consent was previously granted.

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Expectations

• Providers must develop policies and procedures surrounding guests and guest visitation in the residence. Common areas will be utilized to accommodate visits and interactions with guests such as family, children, and friends.
• Providers must assure that each resident develops a recovery plan that is supported by both staff and peers. Recovery plans identify long term milestones and short-term measurable objectives that guide an individual in achieving their desired outcomes. Development of recovery plans will be a collaborative process between the resident and staff but will be self-directed by the resident according to their needs.
• Monitoring of the recovery environment must be person-centered.
• Testing for substance use is permissible in cases of:
  • (1) Support following a return to use.
  • (2) Suspicion of substance use.
• Policies and procedures on testing must be person-centered, strength-based, and maintain dignity for the individual. Conducting drug testing with respect for the individual is essential. This approach includes:
  • (1) Transparency: clearly explain the purpose and process of drug testing to residents. Ensure they understand that the goal is to support their recovery, not to be punitive.
  • (2) Consent: always obtain informed consent before conducting any drug test. Residents should never feel coerced or pressured.
  • (3) Privacy: conduct drug tests in a private and respectful manner. Choose a discreet location to maintain the resident’s dignity.
  • (4) Non-Punitive Approach: focus on support rather than punishment.
• Policies and procedures on searches for hazards must be developed, including:
  • (1) Informing residents at admission about efforts to reduce items that may create an unsafe environment.
  • (2) Implementing trauma-informed screening and search practices and protocols, including safe and person-centered alternatives to invasive searches.
  • (3) Providing opportunities for residents to report concerns about community safety to staff confidentially.
  • (4) Staff must take trainings and receive supervision in this area.
• Policies and procedures on gambling being prohibited in the residence must be developed.
• Smoking by residents or staff is also prohibited indoors, due to health and safety risks. A designated smoking area should be identified outside the residence.

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Expectations

• Upon admission, providers will collect information from residents about their prescribed medications so they can support the resident in complying with physician orders and provide vital information in the event of a medical emergency. Residents must self-administer all medications, refill all medications, and inform the staff of any changes to their medications so that it may be updated in the resident’s file.
• Providers must permit the use of lawfully prescribed medications, including those for addiction treatment (MAT), sometimes referred to as Medication for Addiction and Recovery (MAR), in accordance with OASAS 14 NYCRR Part 860. Supporting the use of MAT helps individuals manage withdrawal symptoms and cravings, significantly improving their chances of successful recovery.
• Providers must develop policies and procedures on safe storage of medication within the residence. All medications must be kept in their original containers with labels intact. Providers must supply residents with medication lock boxes, for the storing and safeguarding of medication and personal medical supplies. These lock boxes will be kept out of plain view to protect the privacy of the resident and to limit the potential for theft and diversion. After self-administering their medication, residents must return the medication and any medical supplies to the lock box to prevent any mishandling or misuse.
• Providers must also develop policies and procedures that prohibit the sharing of any medications among residents, and for the safe disposal of expired medications or medications left behind by former residents. This will help prevent misuse and ensure that medications are taken by the individuals to whom they were prescribed.

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Expectations

• Providers must have emergency preparedness plans in place to implement in the event of emergencies. Plans will reflect connections to or partnerships with local behavioral health partners and emergency services. All staff and residents must be prepared to take immediate actions when an emergency arises.
• Fire safety and preparation are essential. Adequate installation of smoke detectors and carbon monoxide detectors, and storage of fire extinguishers are priorities that must be assured in all residences. All staff and residents must be trained on use of fire extinguishers, and periodic fire drills should be implemented on a regular basis.
• Providers must maintain emergency medical kits at each certified location and all staff must receive first aid training. The kits must include basic first aid and naloxone in quantities sufficient to meet the needs of the residence. It is recommended to have multiple naloxone kits available throughout the residence. Staff and residents must also be trained in naloxone administration.
• Providers must be prepared for any environmental emergencies that may occur. Environmental emergencies may include weather emergencies that threaten the safety of the residents or property, fires, gas leaks, emergency maintenance issues (such as water leaks causing property damage). These emergencies pose a serious, immediate threat to the environment or to the health or safety of the physical location and/or residents and requires immediate corrective action. Providers must follow their documented emergency procedures. If an environmental emergency qualifies as, or coincides with an incident, the appropriate incident report and incident management process must be initiated.
• Providers must be prepared for any medical emergencies. Emergency plans will include training staff at least annually in first aid and CPR. Emergency phone numbers for local emergency medical services (EMS), local hospital, police department, fire department, and poison control must be posted in a visible location in the residence to ensure a rapid response to a medical emergency. If a medical emergency qualifies as, or coincides with an incident, the appropriate incident report and incident management process must be initiated.

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Expectations

• Providers must collect resident data, both for internal purposes and for reporting to OASAS.
• Data collection and reporting on admissions and discharges are required and referenced in previous sections. Providers must also collect ongoing data for monthly reports that must be submitted to OASAS. Data must be submitted in an accurate and timely fashion.
• All staff, peers, and volunteers must adhere to confidentiality laws and procedures as outlined in federal law 42 C.F.R., Part 2, or confidentiality practices determined by individual legal counsel. The confidentiality of recovering persons living in a certified recovery residence is protected. 42 C.F.R., Part 2 protects individuals from anyone outside of the residence knowing their participation and living situation without the resident’s specific permission.
• Federal law does not protect a resident if they commit a crime against anyone at the residence. Also, federal law does not restrict the sharing of information regarding reported child abuse/neglect to appropriate State and local authorities. These confidentiality laws apply not only to the residence owner/operator, residence manager, and volunteers, but to the residents as well.
• Residents must be informed upon admission of their rights to confidentiality, personal information cannot be released absent a signed consent form. Residents may revoke a Release of Information at any time. Providers must have written policies and procedures surrounding disclosure of resident personal information.
• Providers must also institute policies and procedures to safeguard personal information and records about residents. A designated area must be made available for the locked storage and maintenance of resident records. Location, design, and equipment must be appropriate to secure records from traffic, theft, and unauthorized access as well as environmental damage. Resident records must be retained for ten years after the date of discharge or last contact.

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