(a) Residential treatment provides 24-hour per day, 7 days per week multidisciplinary professional clinical support to facilitate recovery from addiction. Clients are housed in a residential site. Comprehensive chemical dependency treatment services offer a structured therapeutic environment.
(b) The facility shall ensure access to the full continuum of treatment services and will ensure sufficient treatment intensity to achieve treatment plan goals. Intensity and content of treatment shall be appropriate to the client's needs and consistent with generally accepted placement guidelines and standards of care.
(c) Each individual admitted to intensive residential services shall be appropriate for this treatment setting, with written justification to support the admission.
(d) Intensive residential shall provide an average of at least 30 hours of services per week for each client, comprised of at least:
  (1) ten hours of chemical dependency counseling, (one hour of which shall be individual counseling);
  (2) ten hours of additional counseling, chemical dependency education, life skills training, relapse prevention education; and
  (3) ten hours of planned, structured activities monitored by staff. Five hours of these services shall occur on weekends and evenings.
(e) In adult intensive residential programs, the direct care staff-to-client ratio shall be at least 1:16 when clients are awake and 1:32 during sleeping hours.
(f) In intensive residential programs counselor caseloads shall not exceed ten clients for each counselor.
(g) Supportive residential shall provide at least six hours of treatment services per week for each client, comprised of at least :
  (1) three hours of chemical dependency counseling (one hour per month of which shall be individual counseling); and
  (2) three hours of additional counseling, chemical dependency education, life skills training, and relapse prevention education.
(h) In adult supportive residential programs, the direct care staff-to-client ratio shall be at least 1:20 when clients are awake and 1:50 during sleeping hours.
(i) Each supportive residential program shall set limits on caseload size that ensure effective, individualized treatment. The program shall justify the caseload size in writing based on the program design, characteristics and needs of the population served, and any other relevant factors.

Source Note: The provisions of this §564.903 adopted to be effective September 1, 2004, 29 TexReg 2020; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8842; transferred effective April 30, 2024, as published in the Texas Register April 5, 2024, 49 TexReg 2197