10A NCAC 13B .5203      STAFFING FOR PSYCHIATRIC OR SUBSTANCE ABUSE SERVICES

(a)  General Requirements:

(1)           A physician shall be present in the facility or on call 24 hours per day. The medical appraisal and medical treatment of each patient shall be the responsibility of a physician;

(2)           Each facility shall determine its overall staffing requirements based upon the age categories (child, adolescent, adult, elderly), clinical characteristics, treatment requirements and numbers of patients;

(3)           There shall be a sufficient number of appropriately qualified clinical and support staff to assess and address the clinical needs of the patients;

(4)           Staff members shall have training or experience in the provision of care in each of the age categories assigned for treatment.

(b)  Psychiatric Services:

(1)           Staff coverage for psychiatric services shall include at least one each of the following: psychiatrist, psychiatric nurse, psychologist, and psychiatric social worker;

(2)           A qualified mental health professional shall be available by telephone or page and able to reach the facility within 30 minutes on a 24 hour basis;

(3)           Each clinical or direct care staff member who is not a qualified mental health professional shall receive professional supervision from a qualified mental health professional;

(4)           When detoxification services are provided, there shall be liaison and consultation with a qualified substance abuse professional prior to the discharge of a client.

(c)  Substance Abuse Services:

(1)           At least one registered nurse shall be on duty during each shift;

(2)           Certified substance abuse counselors or qualified substance abuse professionals shall be employed at the ratio of one staff member for each 10 inpatients or fraction thereof. In documented instances of bona fide shortages of certified persons, uncertified individuals expecting to become certified may be employed for a maximum of 38 months without qualifications;

(3)           The facility shall have a minimum of two staff members providing care, treatment and services directly to patients on duty at all times and maintain a shift ratio of one staff member for each 20 or less inpatients with the following exceptions:

(A)          When there are minor inpatients there shall be staff available on the ratio of one staff member for each five minor inpatients or fraction thereof during each shift from 7:00 a.m. - 11:00 p.m.;

(B)          When detox services are offered there shall be no less than one staff member for each nine inpatients or fraction thereof on each shift.

History Note:        Authority G.S. 131E-79;

Eff. January 1, 1996;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. July 22, 2017.