Section 1229 — [OSHPD 6] — CHEMICAL DEPENDENCY RECOVERY HOSPITALS

The provisions of this section shall apply to chemical dependency recovery hospitals licensed under California Health and Safety Code Section 1250.3. General acute care hospitals and acute psychiatric hospitals licensed under Health and Safety Code Section 1250 may provide chemical dependency services as a supplemental service located within a distinct part as a separate unit.

1229.1.1 Distinct part. Beds in a general acute care hospital, or acute psychiatric hospital, classified as chemical dependency recov- ery beds shall be within a distinct part. “Distinct part” means an identifiable unit of a hospital or a freestanding facility

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accommodating beds, and related services, including, but not limited to, contiguous rooms, a wing, a floor, or a building that is approved by the California Department of Public Health for a specific purpose.

New buildings and additions, alterations, or repairs to existing buildings shall comply with applicable provisions of the California Electrical Code, California Mechanical Code, California Plumbing Code, California Energy Code, California Fire Code (Parts 3, 4, 5, 6 and 9 of Title 24) and this section.

Note: Refer to the applicable exceptions under Section 1224.2.

1229.2.1 Functional program. General acute care hospitals and acute psychiatric hospitals providing chemical dependency recov- ery services as a supplemental service on their hospital license shall include a Patient Safety Risk Assessment as defined in California Administrative Code Section 7-119.

The definitions provided under Section 1224.3 apply to this section except as modified below:

BASIC SERVICES. Basic services mean those essential services required by law for licensure as a chemical dependency recovery hospital, including medical, nursing, rehabilitative, pharmaceutical, dietary and support services.

CHEMICAL DEPENDENCY RECOVERY HOSPITAL. Chemical dependency recovery hospital means a health facility that provides 24-hour inpatient chemical dependency recovery services for persons who have a dependency on alcohol or other drugs, or both alcohol and other drugs.

HOSPITAL. Hospital, where used in this section, means a chemical dependency recovery hospital, unless noted otherwise as a general acute care hospital or acute psychiatric hospital.

Chemical dependency recovery units provided in general acute care hospitals shall comply with the provi- sions under Section 1224.4, General Construction, and chemical dependency recovery units provided in acute psychiatric hospitals shall comply with the provisions under Section 1228.4, General Construction, where applicable. Chemical dependency recovery hospitals under H&SC Section 1250.3 shall comply with the following requirements:

1229.4.1 Reserved.

1229.4.2 Reserved.

1229.4.3 Reserved.

1229.4.4 Support areas for patients.

1229.4.4.1 Examination and treatment rooms.

1229.4.4.1.1 Examination room. Examination rooms in chemical dependency recovery units shall meet the requirements of Section 1224.4.4.1.1 as amended below:

1229.4.4.1.1.1 Location. Examination rooms shall be permitted to serve several chemical dependency units and shall be permitted to be on a different floor. 1229.4.4.1.1.2 Space requirements. Examination rooms shall have a minimum clear floor area of 80 square feet (11.15 m [2] ).

1229.4.4.1.2 Treatment room. Where provided, refer to Section 1224.4.4.1.2.

1229.4.5 Outpatient waiting rooms. Where provided, refer to Section 1224.4.5.

1229.4.6 Reserved.

1229.4.7 Corridors. Refer to Section 1224.4.7. Minimum width of corridors and hallways shall be 5 feet (1524 mm); refer to restrictions under Section 435.

Exceptions: 1. Chemical dependency recovery units provided as distinct part units of a General Acute-Care Hospital must provide a minimum width of 8 feet subject to exemptions under Section 1224.4.7. 2. Chemical dependency recovery units provided as distinct part units of an Acute Psychiatric Hospital must provide a mini- mum width of 6 feet subject to exemptions under Section 1224.4.7.

1229.4.8 Doors and door openings. Refer to Section 1224.4.8.

1229.4.9 Windows and screens.

1. A minimum net glazed area of not less than 8 percent of the floor area of each indoor activity space and dining space shall be provided.

1229.4.10 Ceiling heights. Refer to Section 1224.4.10.

1229.4.11 Interior finishes. Interior finishes shall comply with Section 1224.4.11.

1229.4.12 Noise control. Refer to Section 1224.4.19.

BASIC SERVICES.

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1229.8.1 Patient counseling shall include space to conduct an interview or series of interviews with the patient to address the needs identified in the patient’s recovery plan. Also refer to Section 1229.14.7.

1229.9.1 Service area(s) shall be provided for sessions conducted by the professional staff designed to promote the interaction of the individuals within the session for the purpose of alleviating, or changing, personal and/or family situations, attitudes and beliefs which present a threat to the recovery or stability of the patient or the family. Refer to Sections 1229.13 and 1229.14.9.

1229.10.1 Service area(s) shall be provided for patients’ participation in an organized program of physical activities designed to improve the patient’s wellbeing and as defined in the patient’s individual recovery plan. See Section 1229.13.

1229.11.1 Family therapy shall include space(s) for individual counseling, group counseling, conjoint counseling and/or other appropri- ate activities provided for consenting family members and/or consenting significant others. Also refer to Section 1229.14.7.

1229.12.1 Outpatient services means outreach programs, intervention, after care services, individual or group service and any other service provided for persons who are outpatients in the chemical dependency recovery unit.

The activity areas may be centralized for common use or may be located in each residential unit. The following areas are required in support of the chemical dependency recovery group therapy and physical conditioning basic services:

1229.13.1 Patient care areas.

1229.13.1.1 Indoor activity rooms. 1. At least two separate activity rooms, one appropriate for group recreation and one for quiet activities to serve as a patient lounge, shall be provided. 2. Space requirements. The combined area of these rooms shall have a minimum of 25 square feet (2.32 m [2] ) per patient bed, with at least 120 square feet (11.15 m [2] ) of clear floor area for each of the two spaces. 1229.13.1.2 Outdoor activity area. If provided, an outdoor activity area shall be sized to meet the appropriate needs of the occu- pants and maintain egress.

Resident areas within chemical dependency hospital shall comply with the requirements of Sections 1202, 1203, 1204, 1205, 1206, 1207, 1209 and 1211 and the requirements of this section. Distinct part units within a General Acute Care Hospital shall comply with the requirements in Section 1224.14. Distinct part units within an Acute Psychiatric Hospital shall comply with the requirements in Section 1228.14.

1229.14.1 Patient rooms. Each patient bedroom shall meet the following standards:

1229.14.1.1 Capacity. Maximum room capacity shall be two patients. 1229.14.1.2 Space requirements. Patient bedrooms shall have a minimum clear floor area of 100 square feet (10.2 m [2] ) for single- bed rooms and 80 square feet (7.43 m [2] ) per bed for multiple-bed rooms.

1229.14.1.3 Windows. Each patient bedroom shall have a window in accordance with Section 1229.4.9.

1229.14.1.4 Reserved.

1229.14.1.5 Outside exposure. Refer to Section 1224.14.1.5.

1229.14.1.6 Reserved.

1229.14.1.7 Patient toilet room.

1. Each patient shall have access to a toilet room without having to enter a corridor. Exception: Corridor access to the patient toilet room shall be permitted at adolescent patient bedrooms and in specific patient bedrooms where the use of corridor access is part of the hospital’s written Patient Safety Risk Assessment and management program. 2. One toilet room shall serve no more than two patient bedrooms and no more than four patients. 3. The toilet room shall contain a toilet and a handwashing station.

1229.14.1.8 Bathroom facilities. Showers shall be provided at a ratio of 1:20 patients, and for each major fraction thereof.

1229.14.1.9 Patient storage. Each patient room shall include a separate wardrobe, locker or closet for storing clothing and personal effects.

1229.14.2 Service areas. Provision for the services listed below shall be in or immediately accessible to each chemical dependency recovery unit. The size and location of each service area will depend upon the numbers and types of beds served. Identifiable spaces are required for each of the indicated functions. If a service area is specifically permitted to serve more than one nursing unit, there shall be at least one such service area located on each nursing unit floor.

1229.14.2.1 Administrative center(s) or nurse station(s). Refer to Section 1224.4.4.2. A separate charting area with provisions for acoustic and patient file privacy shall be provided.

1229.14.2.2 Office(s) for staff. Office(s) for staff shall be provided.

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PATIENT CARE SUPPORT AREAS.

1229.14.3 Visitor/consultation room(s). Service support space shall be provided for Patient Counseling and Family Therapy Basic Services. Visitor/consultation rooms shall be provided at a room-to-bed ratio of one consultation room for each 12 beds, or major fraction thereof with a minimum of one, in each residential unit. Additionally, the following requirements shall be met: 1. Visitor/consultation room(s) shall have a minimum clear floor area of 100 square feet (9.29 m [2] ). 2. The room(s) shall be designed for acoustical and visual privacy. Refer to Table 1224.4.19, Sound Transmission Limitations in Hospitals.

1229.14.4 Conference room. A conference and treatment planning room shall be provided for use by the chemical dependency recovery unit.

1229.14.5 Space for group therapy. Service support space shall be provided for Group Therapy Basic Services. An enclosed private space with a minimum clear floor area of at least 225 square feet (20.90 m [2] ) shall be available for group therapy activities.

Pharmaceutical service space shall comply with the provisions of Section 1224.19.1.2.1.

1229.19.1 Shared services. Chemical Dependency Recovery units provided as Distinct Parts of General Acute Care Hospitals or Acute Psychiatric Hospitals may share pharmaceutical service space provided under Section 1224.19.

Refer to Section 1224.20, Dietetic Service Space for requirements, as modified below:

1229.20.1 Dining area. Provide dining space(s) for ambulatory patients, staff and visitors. Provide patient dining room(s) of 20 square feet (1.86 m [2] ) per patient bed separate from staff dining. These spaces shall be separate from the food preparation and distri- bution areas.

1229.20.2 Multi-use dining room. If minimum space requirements are met for dining, the dining area may serve as required group therapy room and/or as one of two required indoor activity spaces when not be used for dining.

1229.20.3 Shared services. Chemical Dependency Recovery units provided as Distinct Parts of General Acute Care Hospitals or Acute Psychiatric Hospitals may share dietetic service space provided under Section 1224.20.

SUPPORT SERVICES.

1229.23.1 General storage. Provide general storage space of at least 10 square feet (0.93 m [2] ) per bed in addition to specialized stor- age spaces. All storage spaces shall be located within the hospital building.

1229.23.2 Specialized storage. Specialized storage spaces shall include the following:

1229.23.2.1 Linen. Provide separate and enclosed facilities for clean and soiled linen in each residential unit. The clean linen stor- age space shall have a minimum area of 10 square feet (0.93 m [2] ). The soiled linen collection space shall have a minimum area of 10 square feet (0.93 m [2] ), except where linen chutes are provided. 1229.23.2.2 Supply. One supply storage space having a minimum area of 15 square feet (1.39 m [2] ) shall be provided in each resi- dential unit.

1229.23.2.3 Reserved.

1229.23.2.4 Reserved.

1229.23.2.5. Food storage shall be as described in Section 1224.20.

1229.23.3 Patient storage facilities. A staff-controlled secured storage area shall be provided for patients’ effects that are deter- mined to be potentially harmful (e.g., razors, nail files, cigarette lighters).

OPTIONAL SERVICES.

Adolescent service space patient areas shall be separate and distinct from adult service space patient areas. The requirements of Section 1229.14 shall apply to adolescent units as amended below:

1229.30.1 Patient bedroom.

1229.30.1.1 Capacity. Maximum bedroom capacity shall be two patients.

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1229.30.1.2 Space requirements. Patient bedroom areas shall meet the following requirements: 1. For single-bed rooms, a minimum clear floor area of 100 square feet (9.29 m [2] ). 2. For multiple-bed rooms, a minimum clear floor area of 80 square feet (7.43 m [2] ) per bed.

1229.30.2 Patient toilet room.

1. Each patient shall have access to a toilet room, either from the patient room or from the corridor outside the patient room. 2. Where access is provided via a corridor, the following requirements shall be met:

2.1. The toilet room shall be located in the unit.

2.2. The toilet room shall be located no more than 150 feet (45.72 m) from the bedroom.

1229.30.3 Bathroom facilities. Showers shall be provided at a ratio of 1:20 patients, and for each major fraction thereof.

1229.30.4 Activity areas. The adolescent activities space may be centralized for common use by multiple adolescent units or may be located in each individual unit. Centralized activity areas shall be readily accessible without traversing adult patient areas.

1229.30.4.1 Space requirements. 1. The combined area for activity space shall have 35 square feet (3.25 m [2] ) of clear floor area per patient bed. 2. A separate dining space shall be provided and shall have a minimum of 15 square feet (1.39 m [2] ) of clear floor area per patient bed.

1229.30.4.2 Outdoor areas. Adolescent outdoor areas shall be separate from adult outdoor areas. Refer to Section 1229.13.1.2.

1229.30.5 Support areas for the adolescent unit. Storage space shall be provided for equipment, extra beds and cots or recliners for parents who may stay overnight.

1229.30.6 Education. If a unit treats children of school age over a period of one month or more, it shall provide physical facilities for an educational program, such as classrooms and an office for the teacher.

Any other service space(s) not addressed in Section 1229 shall comply with the applicable provisions in Section 1224 or 1228. These services shall have prior approval from the California Department of Public Health.