Title 908 | Chapter 001 | Regulation 410REG
PROPOSED
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CABINET FOR HEALTH AND FAMILY SERVICES
Department for Behavioral Health, Developmental and Intellectual Disabilities
Division of Substance Use Disorder
(Amendment)
908 KAR 1:410.Recovery housing.
Section 1.
Definitions.(1)
"Applicant" means the owner, operator, or agency that submits an application for the certification of a recovery residence.(2)
"Cabinet" is defined by KRS 222.500(1).(3)
"Certified recovery residence" means a recovery residence that has met the required standards recognized and approved by the Cabinet for Health and Family Services.(4)
"Certifying organization" is defined by KRS 222.500(2).(5)
"Certification" means evidence of confirmation of compliance by a Cabinet for Health and Family Services recognized certifying organization, the Kentucky Recovery Housing Network, or Kentucky state affiliate recognized by the National Alliance for Recovery Residences."(6)(5)
"Department" means the Department for Behavioral Health, Developmental and Intellectual Disabilities.(6)
(7)
"Local government" is defined by KRS 222.500 (3).(8)
"National Alliance for Recovery Residence Standards" or "NARR standards" means the current version of the(9)
"Recovery residence" is defined by KRS 222.500(5).(10)
"Recovery support services" is defined by KRS 222.500(6).(11)
"Resident-driven length of stay" is defined by KRS222.500(7).Section 2.
Application Process for Certification of Recovery Residences and Fees.(1)
Entities required by KRS 222.502 to obtain certification as a recovery residence shall submit:(a)
A Recovery Housing Certification Application that includes full, complete, and accurate information for each residence;(b)
An initial certification fee of $250 for one recovery residence, plus $50 for each additional site owned and operated by the same entity and included in the application;(c)(b)
A completed Recovery Housing Attestations(d)(c)
A signed Recovery Housing Code of Ethics;(e)(d)
A signed, notarized statement granting permission by the property owner of record, if other than the applicant, to operate a recovery residence on the owner's property;(f)(e)
Proof of adequate commercial general liability insurance(g)(f)
Proof of current registration and good standing with the Kentucky Secretary of State;(h)
Evidence of compliance with applicable zoning and other ordinances and building codes, which may include certificate of occupancy, for each residence;(i)(g)
A copy of resident program policies that include:1.
Terms of occupancy, including policies related to residents' prescription and non-prescription medication usage and storage;2.
Financial obligations, including any fees, charges, or rents that may accrue to the resident and the process, time frame, and requirements for the collection of the obligations;3.
Financial deposits that may be collected, if any, and the time frame process, and requirements for the return of the deposits;4.
Any circumstances under which the resident may be entitled to a refund of any amount for financial obligations collected by the recovery residence, if applicable; and5.
All relevant policies for NARR standards.(j)(h)
A copy of the emergency preparedness plan for the recovery house, that includes:1.
Emergency contact numbers;2.
An evacuation plan and map;3.
An emergency relocation plan that specifies where residents may live temporarily; and4.
A continuity of operations plan; and(k)(i)
If applicable, any forms, documents, and guides used to mentor each resident or monitor each resident's participation in the development of the resident's recovery plan.(2)
If an application is incomplete(a)
Shall return the application within ten (10) business days to the applicant with written instructions regarding proper completion and resubmission of the application within a specified time frame; and(b)
May conduct a pre-inspection site visit.(3)
The cabinet or certifying organization may conduct an inspection of the residence at any time without prior notice, including inspecting and copying financial and resident records.(4)
Required entities, as established by KRS 222.502, shall submit a Kentucky Recovery Housing Application with the required supporting documentation identified in Section 2(1) to the Department for Behavioral Health, Developmental, and Intellectual Disabilities, attention: Kentucky Recovery Housing Certification Program by:(a)
Electronic mail to kyrecoveryhousing@ky.gov; or(b)
Written mail to 275 E. Main Street, 4W, Frankfort, Kentucky 40621.Section 3.
Approval or Denial of the Application for Recovery Residence Certification.(1)
The certifying organization shall conduct a site visit after the completed application and required documentation is received to determine if the application for certification for a recovery residence is:(a)
Approved;(b)
Provisionally approved; or(c)
Denied.(2)
The certifying organization shall grant approval for certification for a period of twelve (12) months if the applicant is in compliance with the NARR standards.(3)
The certifying organization may grant provisional approval of the application for initial certification of a recovery residence if:(a)
The certifying organization has identified deficiencies with respect to specific NARR standards; and(b)
The identified deficiencies do not pose an imminent risk to the health, safety, or welfare of a resident.(4)
The certifying organization shall deny the application for certification of a recovery residence if:(a)
The applicant is in noncompliance with the NARR standards;(b)
The documents submitted by the entity contain inaccurate information that grossly misrepresents the entity's qualifications to provide defined services;(c)
The entity does not meet application process deadlines set by the certifying organization;(d)(b)
One (1) or more deficiencies have been identified that pose an imminent risk to the health, safety, or welfare of the residents; or(e)(c)
Information contained on the application reveals that there would be an unreasonable risk of harm to the residents if certification were granted.(5)
The certifying organization may deny the application for certification of a recovery residence if the applicant has previously discontinued operations of a recovery residence without prior notification of 60 days' or more to staff, residents, and the certifying organization, and without implementation of a transition plan for residents to alternative living arrangements.(6)
If provisional approval is granted, it shall:(a)
Be for a period of six (6) months from the date of the issuance of the provisional approval;(b)
Require the entity to request the certifying organization to conduct a site visit for reconsideration of certification prior to the expiration of the provisional approval; and(c)
Require the entity to submit documentation that demonstrates that the identified deficiencies have been eliminated.(7)
(a)
Provisional approval may be granted two consecutive times, for a maximum of twelve (12) months, at the end of which time the application for certification shall be denied;(b)
The entity shall have up to thirty (30) days to continue to operate and assist residents in securing alternative housing;(c)
The entity shall cease all operations by the thirty-first day after the date of notification of denial; and(d)
The entity shall not submit a new application for certification as a recovery residence without proof of completion of corrective action for the identified deficiencies.(8)
Certification, if granted, shall be valid for the residence and address for which the original certification is issued.(9)
Recovery residence certification is not transferable, if the sale or transfer of a recovery residence causes a change in at least twenty-five (25) percent of ownership, the new owner shall apply for certification as established in Section 2 of this administrative regulation.Section 4.
Recertification and Fees.(1)
An entity that has been granted certification as a recovery residence, shall submit an application for recertification to the certifying organization at least sixty (60) days prior to the expiration date of the current certification. The recertification application shall include a fee of $100 for the first site operated, plus $20 for each additional site owned and operated by the same entity and included in the recertification application.(2)
The certifying organization shall conduct a site visit as part of the recertification process.(3)
(a)
Recertification shall be granted for a period of two (2) years if the applicant is currently certified and is in compliance with the NARR standards; or(b)
Subsequent to the issuance of provisional recovery residence certification, the identified deficiencies on the basis of which the provisional certification was granted have been fully and satisfactorily remediated.(4)
Provisional approval shall be granted of the application for recertification of a recovery residence if:(a)
The certifying organization has identified deficiencies with respect to specific NARR standards;(b)
The identified deficiencies do not pose an imminent risk to the health, safety, or welfare of a resident; and(c)
The entity shall not submit a new application for recertification as a recovery residence without proof of completion of corrective action for the identified deficiencies.(5)
If provisional approval is granted during recertification, it shall be granted once and for a period not to exceed six (6) months.(6)
If an applicant is granted provisional approval during the recertification process before being granted certification, then certification shall be for a period of one (1) year.(7)
An application for recertification shall be denied if:(a)
The applicant is in noncompliance with the NARR standards;(b)
One (1) or more deficiencies have been identified that pose an imminent risk to the health, safety, or welfare of the residents; or(c)
The application reveals that there would be an unreasonable risk of harm to the residents if certification were granted.(d)
The entity has not provided proof of completion of corrective action for previously identified deficiencies.(8)
If the applicant has discontinued operations of a recovery residence without complying with the provisions of this administrative regulation an application for recertification may be denied.(9)
If the certifying organization does not conduct a site visit before the expiration of certification, the certifying organization shall issue a written notification to the owner or operator of the recovery residence that extends certification for a period of up to ninety (90) days or until the certifying organization is able to conduct a site visit of the recovery residence.(10)
The certifying organization shall notify the department of the organization'sSection 5.
Department Responsibilities.(1)
The department shall:(a)
Require certified recovery residences to provide proof of certification at least annually;(b)
Require certified recovery residences to notify the department of any change in their certification status by a certifying organization;(c)
Require separate proof of certification for each recovery residence owned or operated by an individual or entity in the commonwealth;(d)
Post on its Web site the name, telephone number, and location by local jurisdiction of each certified recovery residence and shall update the list at least quarterly;(e)
Post on its Web site the name of each certifying organization approved by the cabinet; and(f)
Notify local governments with appropriate jurisdiction of receipt of proof of certification from a recovery residence within thirty (30) days of receipt of proof of certification.(2)
The department or certifying organization may conduct an inspection of the residence at any time without prior notice, including inspecting and copying financial and resident records.(3)
The department or local government with appropriate jurisdiction may seek legal action, up to and including cessation of operations and monetary penalties, against a recovery residence that fails to meet the requirements of this administrative regulation.(4)(3)
The department, or certifying organization, shall not disclose the address of a recovery residence except to local governments, local law enforcement, and emergency personnel.Section 6.
Recovery Residence Owner or Operator Responsibilities. The owner or operator of a certified recovery residence shall ensure:(1)
The residence and its operations are in compliance with the NARR standards;(2)
The residence develops and adheres to a written policy regarding the criminal history, including substantiated abuse or neglect of a child or vulnerable adult, of any staff member, employee, peer, or volunteer who serves in a staff capacity with the recovery residence and, in that capacity, has direct and regular interaction with residents;(3)
If the certified recovery residence plans to discontinue operations, the owner or operator submits, at least sixty (60) calendar days before the residence intends to cease operations, to the certifying organization, a written plan that includes:(a)
Date operations will cease; and(b)
Notification to residents of the planned discontinuation of operations and of other certified recovery residences and housing options;(4)
If the certified recovery residence must temporarily discontinue operations due to emergency condition(s) (such as fire, flood, or other catastrophic situation), the owner or operator must:(a)
implement the emergency preparedness plan defined in Section 2; and(b)
notify the certifying organization and the department within twenty-four (24) hours of the onset of the emergency condition(s).Section 7.
Background Checks.(1)
All staff of a recovery residence who have job duties that involve providing services to a client, or who may have one-on-one contact with a client, shall:(a)
Have a criminal record check performed upon initial hire through the Administrative Office of the Courts or the Kentucky State Police; and(b)
Not have a criminal conviction,1.
Sex crime as specified in KRS 17.500;2.
Criminal offense against a minor as specified in KRS 17.500;3.
Felony offense related to health care fraud, neglect, physical abuse, sexual abuse, or exploitation of a child or adult; or4.
Violent offense as specified in KRS 439.3401.(2)
A recovery residence that houses individuals under the age of eighteen (18) shall not employ anyone listed on the central registry established by 922 KAR 1:470.(3)
A recovery residence shall perform annual criminal records checks as described in this subsection on a random sample of at least twenty-five (25) percent of all personnel.Section 8.
Request for Reconsideration.(1)
An applicant for certification dissatisfied by a decision of the cabinet, or certifying agency, may submit a request for reconsideration, in writing, to the commissioner for the department, or designee, within ten (10) days following notice of the decision.(2)
The written request shall include:(a)
The application for certification that was denied; and(b)
Documentation that addresses the reasons the application for certification was denied.(3)
Upon receipt of a request for reconsideration, the commissioner or designee, shall:(a)
Review the request; and(b)
Render a written decision on the request for reconsideration within thirty (30) calendar days unless an extension is granted by the commissioner or designee:1.
Due to extenuating circumstances that prolong the review; and2.
With notice provided to the applicant for certification.Section 9.
Fines and Penalties. Whoever knowingly establishes, maintains, or operates a recovery residence without a certification granted pursuant to this section shall, for a first offense, be subject to a fine of not more than fifty dollars ($50) per day and for each subsequent offense by a fine of not more than one hundred dollars ($100) per day.Section 10.
Recovery Residences Exempt from Certification. Upon request by the cabinet or local government with appropriate jurisdiction, an entity that meets the statutory definition of recovery residence as defined in KRS 222.500(5) but claims exemption pursuant to KRS 222.502(1)(b) shall provide evidence of the claimed status.Section 11.
Exceptions to Prohibition Against Provision of On-Site Medical and Clinical Services.(1)
A recovery residence may provide on-site medical or clinical services, including telehealth services, in the following situations only:(a)
The recovery residence is operated by, or is a direct subsidiary of, an appropriately licensed provider;(b)
The services are provided as a part of the continuum of care; and1.
The recovery residence can demonstrate resident driven length of stay or referral to another recovery residence with resident driven length of stay.2.
Referral may be demonstrated by either:a.
The entity owns additional recovery residences with resident driven length of stay; orb.
The recovery residence employs written policies around: (i.) Educating clients on the importance of stepping down to a recovery residence with resident driven length of stay; (ii.) Developing relationships with recovery residences that have resident driven length of stay;c.
Assisting clients in making contact with recovery residences that have resident driven length of stay; ord.
Providing transportation for discharging clients to recovery residences with resident driven length of stay.(2)
A recovery residence may contract with a separate organization to provide on-site medical or clinical services, including telehealth services, in the following situations only if;(a)
There has been no exchange of consideration between the recovery residence and the contracted provider; or(b)
If the contract does include an exchange of consideration, the following conditions must be met the amount is fixed and is:1.
Not dependent on number of residents in services;2.
Not dependent on amount of services provided to residents; and3.
Residents retain the right to receive services from any other qualified provider of their choosing.Section 12.Section 9.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"Kentucky Recovery Housing Attestations(b)
"Kentucky Recovery Housing Certification Application", 07/24; and(c)
"Kentucky Recovery Housing Code of Ethics", 10/24(d)
(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department for Behavioral Health, Developmental and Intellectual Disabilities(3)
This material is also available at https://narronline.org/affiliate-services/standards-and-certification-program/.KATHERINE R. MARKS, Ph. D., Commissioner
CARRIE BANAHAN, Deputy Secretary
APPROVED BY AGENCY: December 5, 2024
FILED WITH LRC: December 11, 2024 at 2:20 p.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall, if requested, be held on February 24, 2025, using the CHFS Office of Legislative and Regulatory Affairs Zoom meeting room. The Zoom invitation will be emailed to each requestor the week prior to the scheduled hearing. Individuals interested in attending this virtual hearing shall notify this agency in writing by February 17, 2025, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who attends virtually will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on this proposed administrative regulation until February 28, 2025. Send written notification of intent to attend the public hearing or written comments on the proposed administrative regulation to the contact person. Pursuant to KRS 13A.280(8), copies of the statement of consideration and, if applicable, the amended after comments version of the administrative regulation shall be made available upon request.
CONTACT PERSON: Krista Quarles, Policy Analyst, Office of Legislative and Regulatory Affairs, 275 East Main Street 5 W-A, Frankfort, Kentucky 40621; Phone: 502-564-6746; Fax: 502-564-7091; CHFSregs@ky.gov.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
(s): Tanya Dickinson and Krista Quarles
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation establishes the requirements and standards for the administration of recovery housing certification.
(b) The necessity of this administrative regulation:
This administrative regulation establishes the requirements and standards for the administration of recovery housing certification.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation conforms to the authorizing statutes through fulfilling the requirements in KRS 222.502 establishing the requirements and standards for the administration of recovery housing certification.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation conforms to the authorizing statutes through fulfilling the requirements in KRS 222.502 by establishing the standards and requirements for the certification of recovery housing. (2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
The amendment clarifies the certification and recertification applications’ contents and process, incorporates fees for applications; introduces fines for operation of a noncertified, nonexempt recovery house; and establishes guidelines for provision of on-site medical and clinical services to recovery house residents consistent with best practices and other department regulations.
(b) The necessity of the amendment to this administrative regulation:
The amendment provides clarifications for administration of the recovery house administration process and establishes minimal funding to ensure adequate on-going resources.
(c) How the amendment conforms to the content of the authorizing statutes:
The amendment provides clarifications for administration of the recovery house administration process and clarifies confirmation of exempt programs.
(d) How the amendment will assist in the effective administration of the statutes:
The amendment clarifies protections and safeguards for local jurisdictions and recovery house residents and ensures adequate funding for administration of the certification process, consistent with department expectations discussed in the original regulation’s impact analysis statement.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
As of October 8, 2024, there are currently 256 certified recovery residences with a total of 3550 available beds for residents. There are 343 pending applications for recovery housing certification with another potential 3736 beds available to residents. All of the applications for recovery housing certification have been submitted by 113 unique applicants.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
The regulated entities will be required to meet the criteria established in the statute and submit the required application, fee, and supporting documentation required to meet the standards established to be certified as a recovery residence.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
If not already certified, the initial application will cost $250, plus $50 for each additional site maintained by the same operator; application for recertification will be charged at the same ratio of $100, plus $20 for each additional site maintained. The higher cost for the initial certification application reflects the more extensive document and site review required to establish a baseline for compliance by the provider and recovery house(s).
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
The regulated entities will experience certification and an increased opportunity for funding for programming designed for individuals who experience substance use disorder and are in recovery.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
The Department for Behavioral Health, Developmental, and Intellectual Disabilities estimates it will cost approximately $450,000 to implement the recovery house certification program in the first year.
(b) On a continuing basis:
The Department for Behavioral Health, Developmental, and Intellectual Disabilities estimates it will cost approximately $450,000 annually, on a continuing basis.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
This administrative regulation will be funded through a combination of state general funds, related application fees, and federal grant funds (when available).
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
Consistent with department expectations discussed in the original regulation’s impact analysis, administration of the program has highlighted the current and future need for dedicated funding, including establishment of certification fees to address current and anticipated future demand.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This amendment establishes certification application fees in the amount of $250, plus $50 for each additional site maintained by the same operator and recertification application fees (at the same ratio) in the amount of $100, plus $20 for each additional site maintained. The higher cost for the initial certification application reflects the more extensive document and site review required to establish a baseline for compliance by the provider and recovery house(s).
(9) TIERING: Is tiering applied?
Tiering is not applied because this administrative regulation will be applied in a like manner statewide.
FISCAL IMPACT STATEMENT
(1) Identify each state statute, federal statute, or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 194A.050, KRS 222.502, KRS 222.504
(2) Identify the promulgating agency and any other affected state units, parts, or divisions:
Department for Behavioral Health, Developmental and Intellectual Disabilities is the promulgating agency, other agencies have not been identified.
(a) Estimate the following for the first year:
Expenditures:
$450,000 to implement the full recovery house certification program in the first year of this amendment (the current program operating cost). Funds are needed to support salaries of at least 8 full-time staff to implement the certification process, travel reimbursement to perform recovery residence site visits, training and technical assistance, community outreach and education. These costs also include the funds necessary to purchase, implement, and utilize a data management platform.
Revenues:
$11,500 (estimated 20 new certification applications at $250 each, plus an estimated 65 recertification applications at $100 each).
Cost Savings:
$11,500
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
This amendment will generate an estimated $24,200 in subsequent years (estimated 20 new certification applications at $250 each, plus an estimated 192 recertification applications at $100 each). The expected expenditures of $450,000 will remain similar.
(3) Identify affected local entities (for example: cities, counties, fire departments, school districts):
(a) Estimate the following for the first year:
Expenditures:
$0
Revenues:
$0
Cost Savings:
$0
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
They will not.
(4) Identify additional regulated entities not listed in questions (2) or (3):
(a) Estimate the following for the first year:
Expenditures:
$11,500 (estimated 20 new certification applications at $250 each, plus an estimated 65 recertification applications at $100 each).
Revenues:
$0
Cost Savings:
$0
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
This amendment will cost regulated entities an estimated $24,200 in subsequent years (estimated 20 new certification applications at $250 each, plus an estimated 192 recertification applications at $100 each).
(5) Provide a narrative to explain the:
(a) Fiscal impact of this administrative regulation:
The majority of existing affected providers will have been certified at no cost prior to the implementation of this amendment. Therefore, revenue from initial applications for certification will be minimized, and the estimated revenue from recertification application fees will represent a more accurate expectation for future years, plus the addition of a more limited number of new providers and sites (accounting for those already in operation).
(b) Methodology and resources used to determine the fiscal impact:
proposed cost of certification or recertification multiplied by number of estimated affected entities requiring certification.
(6) Explain:
(a) Whether this administrative regulation will have an overall negative or adverse major economic impact to the entities identified in questions (2) - (4). ($500,000 or more, in aggregate)
The administrative regulation will not have a major economic impact – as defined by KRS 13A.010 – on regulated entities.
(b) The methodology and resources used to reach this conclusion:
The sum of the proposed cost of certification or recertification multiplied by number of estimated affected entities requiring certification is well below this threshold.
CABINET FOR HEALTH AND FAMILY SERVICES
Department for Behavioral Health, Developmental and Intellectual Disabilities
Division of Substance Use Disorder
(Amendment)
908 KAR 1:410.Recovery housing.
Section 1.
Definitions.(1)
"Applicant" means the owner, operator, or agency that submits an application for the certification of a recovery residence.(2)
"Cabinet" is defined by KRS 222.500(1).(3)
"Certified recovery residence" means a recovery residence that has met the required standards recognized and approved by the Cabinet for Health and Family Services.(4)
"Certifying organization" is defined by KRS 222.500(2).(5)
"Certification" means evidence of confirmation of compliance by a Cabinet for Health and Family Services recognized certifying organization, the Kentucky Recovery Housing Network, or Kentucky state affiliate recognized by the National Alliance for Recovery Residences."(6)
"Department" means the Department for Behavioral Health, Developmental and Intellectual Disabilities.(7)
"Local government" is defined by KRS 222.500 (3).(8)
"National Alliance for Recovery Residence Standards" or "NARR standards" means the current version of the published national standards for all levels of recovery residences and is available on the NARR Web site at https://narronline.org/affiliate-services/standards-and-certification-program/.(9)
"Recovery residence" is defined by KRS 222.500(5).(10)
"Recovery support services" is defined by KRS 222.500(6).(11)
"Resident-driven length of stay" is defined by KRS222.500(7).Section 2.
Application Process for Certification of Recovery Residences and Fees.(1)
Entities required by KRS 222.502 to obtain certification as a recovery residence shall submit:(a)
A Recovery Housing Certification Application that includes full, complete, and accurate information for each residence;(b)
An initial certification fee of $250 for one recovery residence, plus $50 for each additional site owned and operated by the same entity and included in the application;(c)
A completed Recovery Housing Attestations for each residence;(d)
A signed Recovery Housing Code of Ethics;(e)
A signed, notarized statement granting permission by the property owner of record, if other than the applicant, to operate a recovery residence on the owner's property;(f)
Proof of adequate commercial general liability insurance on the building in which the residence is located;(g)
Proof of current registration and good standing with the Kentucky Secretary of State;(h)
Evidence of compliance with applicable zoning and other ordinances and building codes, which may include certificate of occupancy, for each residence;(i)
A copy of resident program policies that include:1.
Terms of occupancy, including policies related to residents' prescription and non-prescription medication usage and storage;2.
Financial obligations, including any fees, charges, or rents that may accrue to the resident and the process, time frame, and requirements for the collection of the obligations;3.
Financial deposits that may be collected, if any, and the time frame process, and requirements for the return of the deposits;4.
Any circumstances under which the resident may be entitled to a refund of any amount for financial obligations collected by the recovery residence, if applicable; and5.
All relevant policies for NARR standards.(j)
A copy of the emergency preparedness plan for the recovery house, that includes:1.
Emergency contact numbers;2.
An evacuation plan and map;3.
An emergency relocation plan that specifies where residents may live temporarily; and4.
A continuity of operations plan; and(k)
If applicable, any forms, documents, and guides used to mentor each resident or monitor each resident's participation in the development of the resident's recovery plan.(2)
If an application is incomplete, the certifying organization:(a)
Shall return the application within ten (10) business days to the applicant with written instructions regarding proper completion and resubmission of the application within a specified time frame; and(b)
May conduct a pre-inspection site visit.(3)
The cabinet or certifying organization may conduct an inspection of the residence at any time without prior notice, including inspecting and copying financial and resident records.(4)
Required entities, as established by KRS 222.502, shall submit a Kentucky Recovery Housing Application with the required supporting documentation identified in Section 2(1) to the Department for Behavioral Health, Developmental, and Intellectual Disabilities, attention: Kentucky Recovery Housing Certification Program by:(a)
Electronic mail to kyrecoveryhousing@ky.gov; or(b)
Written mail to 275 E. Main Street, 4W, Frankfort, Kentucky 40621.Section 3.
Approval or Denial of the Application for Recovery Residence Certification.(1)
The certifying organization shall conduct a site visit after the completed application and required documentation is received to determine if the application for certification for a recovery residence is:(a)
Approved;(b)
Provisionally approved; or(c)
Denied.(2)
The certifying organization shall grant approval for certification for a period of twelve (12) months if the applicant is in compliance with the NARR standards.(3)
The certifying organization may grant provisional approval of the application for initial certification of a recovery residence if:(a)
The certifying organization has identified deficiencies with respect to specific NARR standards; and(b)
The identified deficiencies do not pose an imminent risk to the health, safety, or welfare of a resident.(4)
The certifying organization shall deny the application for certification of a recovery residence if:(a)
The applicant is in noncompliance with the NARR standards;(b)
The documents submitted by the entity contain inaccurate information that grossly misrepresents the entity's qualifications to provide defined services;(c)
The entity does not meet application process deadlines set by the certifying organization;(d)
One (1) or more deficiencies have been identified that pose an imminent risk to the health, safety, or welfare of the residents; or(e)
Information contained on the application reveals that there would be an unreasonable risk of harm to the residents if certification were granted.(5)
The certifying organization may deny the application for certification of a recovery residence if the applicant has previously discontinued operations of a recovery residence without prior notification of 60 days' or more to staff, residents, and the certifying organization, and without implementation of a transition plan for residents to alternative living arrangements.(6)
If provisional approval is granted, it shall:(a)
Be for a period of six (6) months from the date of the issuance of the provisional approval;(b)
Require the entity to request the certifying organization to conduct a site visit for reconsideration of certification prior to the expiration of the provisional approval; and(c)
Require the entity to submit documentation that demonstrates that the identified deficiencies have been eliminated.(7)
(a)
Provisional approval may be granted two consecutive times, for a maximum of twelve (12) months, at the end of which time the application for certification shall be denied;(b)
The entity shall have up to thirty (30) days to continue to operate and assist residents in securing alternative housing;(c)
The entity shall cease all operations by the thirty-first day after the date of notification of denial; and(d)
The entity shall not submit a new application for certification as a recovery residence without proof of completion of corrective action for the identified deficiencies.(8)
Certification, if granted, shall be valid for the residence and address for which the original certification is issued.(9)
Recovery residence certification is not transferable, if the sale or transfer of a recovery residence causes a change in at least twenty-five (25) percent of ownership, the new owner shall apply for certification as established in Section 2 of this administrative regulation.Section 4.
Recertification and Fees.(1)
An entity that has been granted certification as a recovery residence, shall submit an application for recertification to the certifying organization at least sixty (60) days prior to the expiration date of the current certification. The recertification application shall include a fee of $100 for the first site operated, plus $20 for each additional site owned and operated by the same entity and included in the recertification application.(2)
The certifying organization shall conduct a site visit as part of the recertification process.(3)
(a)
Recertification shall be granted for a period of two (2) years if the applicant is currently certified and is in compliance with the NARR standards; or(b)
Subsequent to the issuance of provisional recovery residence certification, the identified deficiencies on the basis of which the provisional certification was granted have been fully and satisfactorily remediated.(4)
Provisional approval shall be granted of the application for recertification of a recovery residence if:(a)
The certifying organization has identified deficiencies with respect to specific NARR standards;(b)
The identified deficiencies do not pose an imminent risk to the health, safety, or welfare of a resident; and(c)
The entity shall not submit a new application for recertification as a recovery residence without proof of completion of corrective action for the identified deficiencies.(5)
If provisional approval is granted during recertification, it shall be granted once and for a period not to exceed six (6) months.(6)
If an applicant is granted provisional approval during the recertification process before being granted certification, then certification shall be for a period of one (1) year.(7)
An application for recertification shall be denied if:(a)
The applicant is in noncompliance with the NARR standards;(b)
One (1) or more deficiencies have been identified that pose an imminent risk to the health, safety, or welfare of the residents; or(c)
The application reveals that there would be an unreasonable risk of harm to the residents if certification were granted.(d)
The entity has not provided proof of completion of corrective action for previously identified deficiencies.(8)
If the applicant has discontinued operations of a recovery residence without complying with the provisions of this administrative regulation an application for recertification may be denied.(9)
If the certifying organization does not conduct a site visit before the expiration of certification, the certifying organization shall issue a written notification to the owner or operator of the recovery residence that extends certification for a period of up to ninety (90) days or until the certifying organization is able to conduct a site visit of the recovery residence.(10)
The certifying organization shall notify the department of the organization's determination of an application for certification within ten (10) business days from the date of notification to the applicant.Section 5.
Department Responsibilities.(1)
The department shall:(a)
Require certified recovery residences to provide proof of certification at least annually;(b)
Require certified recovery residences to notify the department of any change in their certification status by a certifying organization;(c)
Require separate proof of certification for each recovery residence owned or operated by an individual or entity in the commonwealth;(d)
Post on its Web site the name, telephone number, and location by local jurisdiction of each certified recovery residence and shall update the list at least quarterly;(e)
Post on its Web site the name of each certifying organization approved by the cabinet; and(f)
Notify local governments with appropriate jurisdiction of receipt of proof of certification from a recovery residence within thirty (30) days of receipt of proof of certification.(2)
The department or certifying organization may conduct an inspection of the residence at any time without prior notice, including inspecting and copying financial and resident records.(3)
The department or local government with appropriate jurisdiction may seek legal action, up to and including cessation of operations and monetary penalties, against a recovery residence that fails to meet the requirements of this administrative regulation.(4)
The department, or certifying organization, shall not disclose the address of a recovery residence except to local governments, local law enforcement, and emergency personnel.Section 6.
Recovery Residence Owner or Operator Responsibilities. The owner or operator of a certified recovery residence shall ensure:(1)
The residence and its operations are in compliance with the NARR standards;(2)
The residence develops and adheres to a written policy regarding the criminal history, including substantiated abuse or neglect of a child or vulnerable adult, of any staff member, employee, peer, or volunteer who serves in a staff capacity with the recovery residence and, in that capacity, has direct and regular interaction with residents;(3)
If the certified recovery residence plans to discontinue operations, the owner or operator submits, at least sixty (60) calendar days before the residence intends to cease operations, to the certifying organization, a written plan that includes:(a)
Date operations will cease; and(b)
Notification to residents of the planned discontinuation of operations and of other certified recovery residences and housing options;(4)
If the certified recovery residence must temporarily discontinue operations due to emergency condition(s) (such as fire, flood, or other catastrophic situation), the owner or operator must:(a)
implement the emergency preparedness plan defined in Section 2; and(b)
notify the certifying organization and the department within twenty-four (24) hours of the onset of the emergency condition(s).Section 7.
Background Checks.(1)
All staff of a recovery residence who have job duties that involve providing services to a client, or who may have one-on-one contact with a client, shall:(a)
Have a criminal record check performed upon initial hire through the Administrative Office of the Courts or the Kentucky State Police; and(b)
Not have a criminal conviction, plea of guilty, release from incarceration due to expiration of sentence, or be under any level of probation or parole supervision other than administrative as defined in Kentucky Corrections Policies and Procedures (CPP) 27-12-01 for a minimum of five (5) years for a:1.
Sex crime as specified in KRS 17.500;2.
Criminal offense against a minor as specified in KRS 17.500;3.
Felony offense related to health care fraud, neglect, physical abuse, sexual abuse, or exploitation of a child or adult; or4.
Violent offense as specified in KRS 439.3401.(2)
A recovery residence that houses individuals under the age of eighteen (18) shall not employ anyone listed on the central registry established by 922 KAR 1:470.(3)
A recovery residence shall perform annual criminal records checks as described in this subsection on a random sample of at least twenty-five (25) percent of all personnel.Section 8.
Request for Reconsideration.(1)
An applicant for certification dissatisfied by a decision of the cabinet, or certifying agency, may submit a request for reconsideration, in writing, to the commissioner for the department, or designee, within ten (10) days following notice of the decision.(2)
The written request shall include:(a)
The application for certification that was denied; and(b)
Documentation that addresses the reasons the application for certification was denied.(3)
Upon receipt of a request for reconsideration, the commissioner or designee, shall:(a)
Review the request; and(b)
Render a written decision on the request for reconsideration within thirty (30) calendar days unless an extension is granted by the commissioner or designee:1.
Due to extenuating circumstances that prolong the review; and2.
With notice provided to the applicant for certification.Section 9.
Fines and Penalties. Whoever knowingly establishes, maintains, or operates a recovery residence without a certification granted pursuant to this section shall, for a first offense, be subject to a fine of not more than fifty dollars ($50) per day and for each subsequent offense by a fine of not more than one hundred dollars ($100) per day.Section 10.
Recovery Residences Exempt from Certification. Upon request by the cabinet or local government with appropriate jurisdiction, an entity that meets the statutory definition of recovery residence as defined in KRS 222.500(5) but claims exemption pursuant to KRS 222.502(1)(b) shall provide evidence of the claimed status.Section 11.
Exceptions to Prohibition Against Provision of On-Site Medical and Clinical Services.(1)
A recovery residence may provide on-site medical or clinical services, including telehealth services, in the following situations only:(a)
The recovery residence is operated by, or is a direct subsidiary of, an appropriately licensed provider;(b)
The services are provided as a part of the continuum of care; and1.
The recovery residence can demonstrate resident driven length of stay or referral to another recovery residence with resident driven length of stay.2.
Referral may be demonstrated by either:a.
The entity owns additional recovery residences with resident driven length of stay; orb.
The recovery residence employs written policies around: (i.) Educating clients on the importance of stepping down to a recovery residence with resident driven length of stay; (ii.) Developing relationships with recovery residences that have resident driven length of stay;c.
Assisting clients in making contact with recovery residences that have resident driven length of stay; ord.
Providing transportation for discharging clients to recovery residences with resident driven length of stay.(2)
A recovery residence may contract with a separate organization to provide on-site medical or clinical services, including telehealth services, in the following situations only if;(a)
There has been no exchange of consideration between the recovery residence and the contracted provider; or(b)
If the contract does include an exchange of consideration, the following conditions must be met the amount is fixed and is:1.
Not dependent on number of residents in services;2.
Not dependent on amount of services provided to residents; and3.
Residents retain the right to receive services from any other qualified provider of their choosing.Section 12.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"Kentucky Recovery Housing Attestations", 10/24;(b)
"Kentucky Recovery Housing Certification Application", 07/24; and(c)
"Kentucky Recovery Housing Code of Ethics", 10/24.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department for Behavioral Health, Developmental and Intellectual Disabilities, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m. This material may also be viewed on the department's Web site at https://www.chfs.ky.gov/agencies/dbhdid/Pages/default.aspx.(3)
This material is also available at https://narronline.org/affiliate-services/standards-and-certification-program/.KATHERINE R. MARKS, Ph. D., Commissioner
CARRIE BANAHAN, Deputy Secretary
APPROVED BY AGENCY: December 5, 2024
FILED WITH LRC: December 11, 2024 at 2:20 p.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall, if requested, be held on February 24, 2025, using the CHFS Office of Legislative and Regulatory Affairs Zoom meeting room. The Zoom invitation will be emailed to each requestor the week prior to the scheduled hearing. Individuals interested in attending this virtual hearing shall notify this agency in writing by February 17, 2025, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who attends virtually will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on this proposed administrative regulation until February 28, 2025. Send written notification of intent to attend the public hearing or written comments on the proposed administrative regulation to the contact person. Pursuant to KRS 13A.280(8), copies of the statement of consideration and, if applicable, the amended after comments version of the administrative regulation shall be made available upon request.
CONTACT PERSON: Krista Quarles, Policy Analyst, Office of Legislative and Regulatory Affairs, 275 East Main Street 5 W-A, Frankfort, Kentucky 40621; Phone: 502-564-6746; Fax: 502-564-7091; CHFSregs@ky.gov.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
(s): Tanya Dickinson and Krista Quarles
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation establishes the requirements and standards for the administration of recovery housing certification.
(b) The necessity of this administrative regulation:
This administrative regulation establishes the requirements and standards for the administration of recovery housing certification.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation conforms to the authorizing statutes through fulfilling the requirements in KRS 222.502 establishing the requirements and standards for the administration of recovery housing certification.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation conforms to the authorizing statutes through fulfilling the requirements in KRS 222.502 by establishing the standards and requirements for the certification of recovery housing. (2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
The amendment clarifies the certification and recertification applications’ contents and process, incorporates fees for applications; introduces fines for operation of a noncertified, nonexempt recovery house; and establishes guidelines for provision of on-site medical and clinical services to recovery house residents consistent with best practices and other department regulations.
(b) The necessity of the amendment to this administrative regulation:
The amendment provides clarifications for administration of the recovery house administration process and establishes minimal funding to ensure adequate on-going resources.
(c) How the amendment conforms to the content of the authorizing statutes:
The amendment provides clarifications for administration of the recovery house administration process and clarifies confirmation of exempt programs.
(d) How the amendment will assist in the effective administration of the statutes:
The amendment clarifies protections and safeguards for local jurisdictions and recovery house residents and ensures adequate funding for administration of the certification process, consistent with department expectations discussed in the original regulation’s impact analysis statement.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
As of October 8, 2024, there are currently 256 certified recovery residences with a total of 3550 available beds for residents. There are 343 pending applications for recovery housing certification with another potential 3736 beds available to residents. All of the applications for recovery housing certification have been submitted by 113 unique applicants.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
The regulated entities will be required to meet the criteria established in the statute and submit the required application, fee, and supporting documentation required to meet the standards established to be certified as a recovery residence.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
If not already certified, the initial application will cost $250, plus $50 for each additional site maintained by the same operator; application for recertification will be charged at the same ratio of $100, plus $20 for each additional site maintained. The higher cost for the initial certification application reflects the more extensive document and site review required to establish a baseline for compliance by the provider and recovery house(s).
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
The regulated entities will experience certification and an increased opportunity for funding for programming designed for individuals who experience substance use disorder and are in recovery.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
The Department for Behavioral Health, Developmental, and Intellectual Disabilities estimates it will cost approximately $450,000 to implement the recovery house certification program in the first year.
(b) On a continuing basis:
The Department for Behavioral Health, Developmental, and Intellectual Disabilities estimates it will cost approximately $450,000 annually, on a continuing basis.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
This administrative regulation will be funded through a combination of state general funds, related application fees, and federal grant funds (when available).
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
Consistent with department expectations discussed in the original regulation’s impact analysis, administration of the program has highlighted the current and future need for dedicated funding, including establishment of certification fees to address current and anticipated future demand.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This amendment establishes certification application fees in the amount of $250, plus $50 for each additional site maintained by the same operator and recertification application fees (at the same ratio) in the amount of $100, plus $20 for each additional site maintained. The higher cost for the initial certification application reflects the more extensive document and site review required to establish a baseline for compliance by the provider and recovery house(s).
(9) TIERING: Is tiering applied?
Tiering is not applied because this administrative regulation will be applied in a like manner statewide.
FISCAL IMPACT STATEMENT
(1) Identify each state statute, federal statute, or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 194A.050, KRS 222.502, KRS 222.504
(2) Identify the promulgating agency and any other affected state units, parts, or divisions:
Department for Behavioral Health, Developmental and Intellectual Disabilities is the promulgating agency, other agencies have not been identified.
(a) Estimate the following for the first year:
Expenditures:
$450,000 to implement the full recovery house certification program in the first year of this amendment (the current program operating cost). Funds are needed to support salaries of at least 8 full-time staff to implement the certification process, travel reimbursement to perform recovery residence site visits, training and technical assistance, community outreach and education. These costs also include the funds necessary to purchase, implement, and utilize a data management platform.
Revenues:
$11,500 (estimated 20 new certification applications at $250 each, plus an estimated 65 recertification applications at $100 each).
Cost Savings:
$11,500
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
This amendment will generate an estimated $24,200 in subsequent years (estimated 20 new certification applications at $250 each, plus an estimated 192 recertification applications at $100 each). The expected expenditures of $450,000 will remain similar.
(3) Identify affected local entities (for example: cities, counties, fire departments, school districts):
(a) Estimate the following for the first year:
Expenditures:
$0
Revenues:
$0
Cost Savings:
$0
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
They will not.
(4) Identify additional regulated entities not listed in questions (2) or (3):
(a) Estimate the following for the first year:
Expenditures:
$11,500 (estimated 20 new certification applications at $250 each, plus an estimated 65 recertification applications at $100 each).
Revenues:
$0
Cost Savings:
$0
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
This amendment will cost regulated entities an estimated $24,200 in subsequent years (estimated 20 new certification applications at $250 each, plus an estimated 192 recertification applications at $100 each).
(5) Provide a narrative to explain the:
(a) Fiscal impact of this administrative regulation:
The majority of existing affected providers will have been certified at no cost prior to the implementation of this amendment. Therefore, revenue from initial applications for certification will be minimized, and the estimated revenue from recertification application fees will represent a more accurate expectation for future years, plus the addition of a more limited number of new providers and sites (accounting for those already in operation).
(b) Methodology and resources used to determine the fiscal impact:
proposed cost of certification or recertification multiplied by number of estimated affected entities requiring certification.
(6) Explain:
(a) Whether this administrative regulation will have an overall negative or adverse major economic impact to the entities identified in questions (2) - (4). ($500,000 or more, in aggregate)
The administrative regulation will not have a major economic impact – as defined by KRS 13A.010 – on regulated entities.
(b) The methodology and resources used to reach this conclusion:
The sum of the proposed cost of certification or recertification multiplied by number of estimated affected entities requiring certification is well below this threshold.