This chapter establishes operating standards for Crisis Receiving Centers (CRCs) in Louisiana, including safety and emergency preparedness requirements, infection control protocols, license inactivation and reinstatement procedures during declared and non-declared disasters, and a voluntary-only CRC (VO-CRC) designation. Operators must maintain physical safety measures, conduct regular drills, implement infection control programs, and follow detailed emergency preparedness planning. Facilities seeking to inactivate their license due to a disaster must meet specific notification, documentation, and reinstatement requirements. VO-CRCs must comply with all standard CRC licensing requirements with limited substitutions related to voluntary admission procedures.
View official sourceChapter 54.Crisis Receiving Centers Subchapter A.Safety and Emergency Preparedness §5401.General Safety Provisions A.The CRC shall provide additional supervision when necessary to provide for the safety of all clients. B.The CRC shall: 1.prohibit weapons of any kind on-site; 2.prohibit glass, hand sanitizer, plastic bags in client-care areas; 3.ensure that all poisonous, toxic and flammable materials are: a.maintained in appropriate containers and labeled as to the contents; b.securely stored in a locked cabinet or closet; c.are used in such a manner as to ensure the safety of clients, staff and visitors; and d.maintained only as necessary; 4.ensure that all equipment, furnishing and any other items that are in a state of disrepair are removed and inaccessible to clients until replaced or repaired; and 5.ensure that when potentially harmful materials such as cleaning solvents and/or detergents are used, training is provided to the staff and they are used by staff members only. C.The CRC shall ensure that a first aid kit is available in the facility and in all vehicles used to transport clients. D.The CRC shall simulate fire drills and other emergency drills at least once a quarter while maintaining client safety and security during the drills. E.Required Inspections. The CRC shall pass all required inspections and keep a current file of reports and other documentation needed to demonstrate compliance with applicable laws and regulations. F.The CRC shall have an on-going safety program to include: 1.continuous inspection of the facility for possible hazards; 2.continuous monitoring of safety equipment and maintenance or repair when needed; 3.investigation and documentation of all accidents or emergencies; and 4.fire control, evacuation planning and other emergency drills. AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and R.S. 40:2180.14. HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 41:123 (January 2015). §5403.Infection Control A.The CRC shall provide a sanitary environment to avoid sources and transmission of infections and communicable diseases. B.The CRC shall have an active Infection Control Program that requires: 1.reporting of infectious disease in accordance with current OPH and federal guidelines; 2.monitoring of: a.the spread of infectious disease; b.hand washing; c.staff and client education; and d.incidents of specific infections in accordance with OPH guidelines; 3.corrective actions; 4.a designated infection control coordinator who: a.has education and/or experience in infection control; b.develops and implements policies and procedures governing the infection control program that is compliant with most recently published/current state and federal infection control guidelines in preparation for, during, and after a public health emergency or disaster; c.takes universal precautions, including proper handwashing and face masks, as needed; and d.strictly adheres to all sanitation requirements; 5.the CRC shall maintain a clean and sanitary environment and shall ensure that: a.supplies and equipment are available to staff; b.there is consistent and constant monitoring and cleaning of all areas of the facility; c.the methods used for cleaning, sanitizing, handling and storing of all supplies and equipment prevent the transmission of infection; d.directions are posted for sanitizing both kitchen and bathroom and laundry areas; e.showers and bathtubs are to be sanitized by staff between client usage; f.clothing belonging to clients must be washed and dried separately from the clothing belonging to other clients; and g.laundry facilities are used by staff only; h.food and waste are stored, handled, and removed in a way that will not spread disease, cause odor, or provide a breeding place for pests. C.The CRC may enter into a written contract for housekeeping services necessary to maintain a clean and neat environment. D.Each CRC shall have an effective pest control plan. E.After discharge of a client, the CRC shall: 1.clean the bed, mattress, cover, bedside furniture and equipment; 2.ensure that mattresses, blankets and pillows assigned to clients are intact and in a sanitary condition; and 3.ensure that the mattress, blankets and pillows used for a client are properly sanitized before assigned to another client. AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and R.S. 40:2180.14. HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 41:123 (January 2015), amended by the Department of Health, Bureau of Health Services Financing, LR 47:475 (April 2021). §5405.Emergency Preparedness A.The CRC shall have a written emergency preparedness plan to: 1.maintain continuity of the center's operations in preparation for, during and after an emergency or disaster; 2.manage the consequences of all disasters or emergencies that disrupt the center's ability to render care and treatment, or threaten the lives or safety of the clients; and 3.comply with recently published/current state and federal infection control guidelines in preparation for, during, and after a public health emergency or disaster. B.The CRC shall: 1.post exit diagrams describing how to clear the building safely and in a timely manner; 2.have a clearly labeled and legible master floor plan(s) that indicates: a.the areas in the facility that are to be used by clients as shelter or safe zones during emergencies; b.the location of emergency power outlets and whether they are powered; c.the locations of posted, accessible, emergency information; and d.what will be powered by emergency generator(s), if applicable; 3.train its employees in emergency or disaster preparedness. Training shall include orientation, ongoing training and participation in planned drills for all personnel. C.The CRC's emergency preparedness plan shall include the following information, at a minimum: 1.if the center evacuates, the plan shall include: a.provisions for the evacuation of each client and delivery of essential services to each client; b.the center's method of notifying the client's family or caregiver, if applicable, including: i.the date and approximate time that the facility or client is evacuating; ii.the place or location to which the client(s) is evacuating which includes the name, address and telephone number; and iii.a telephone number that the family or responsible representative may call for information regarding the client's evacuation; c.provisions for ensuring that supplies, medications, clothing and a copy of the treatment plan are sent with the client, if the client is evacuated; d.the procedure or methods that will be used to ensure that identification accompanies the client including: i.current and active diagnosis; ii.medication, including dosage and times administered; iii.allergies; iv.special dietary needs or restrictions; and v.next of kin, including contact information if applicable; e.transportation or arrangements for transportation for an evacuation; 2.provisions for staff to maintain continuity of care during an emergency as well as for distribution and assignment of responsibilities and functions; 3.the delivery of essential care and services to clients who are housed in the facility or by the facility at another location, during an emergency or disaster; 4.the determination as to when the facility will shelter in place and when the facility will evacuate for a disaster or emergency and the conditions that guide these determinations in accordance with local or parish OSHEP; 5.if the center shelters in place, provisions for seven days of necessary supplies to be provided by the center prior to the emergency, including drinking water or fluids and non-perishable food. D.The center shall: 1.follow and execute its emergency preparedness plan in the event of the occurrence of a declared disaster or other emergency; 2.if the state, parish or local OHSEP orders a mandatory evacuation of the parish or the area in which the agency is serving, shall ensure that all clients are evacuated according to the facility's emergency preparedness plan; 3.not abandon a client during a disaster or emergency; 4.review and update its emergency preparedness plan at least once a year; 5.cooperate with the department and with the local or parish OHSEP in the event of an emergency or disaster and shall provide information as requested; 6.monitor weather warnings and watches as well as evacuation order from local and state emergency preparedness officials; 7.upon request by the department, submit a copy of its emergency preparedness plan for review; 8.upon request by the department, submit a written summary attesting to how the plan was followed and executed to include, at a minimum: a.pertinent plan provisions and how the plan was followed and executed; b.plan provisions that were not followed; c.reasons and mitigating circumstances for failure to follow and execute certain plan provisions; d.contingency arrangements made for those plan provisions not followed; and e.a list of all injuries and deaths of clients that occurred during execution of the plan, evacuation or temporary relocation including the date, time, causes and circumstances of the injuries and deaths. AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and R.S. 40:2180.14. HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 41:124 (January 2015), amended by the Department of Health, Bureau of Health Services Financing, LR 47:475 (April 2021). §5407.Inactivation of License due to a Declared Disaster or Emergency A.A CRC located in a parish which is the subject of an executive order or proclamation of emergency or disaster issued in accordance with R.S. 29:724 or R.S. 29:766, may seek to inactivate its license for a period not to exceed one year, provided that the center: 1.submits written notification to HSS within 60 days of the date of the executive order or proclamation of emergency or disaster that: a.the CRC has experienced an interruption in the provisions of services as a result of events that are the subject of such executive order or proclamation of emergency or disaster issued in accordance with R.S. 29:724 or R.S. 29:766; b.the CRC intends to resume operation as a CRC in the same service area; and c.the CRC attests that the emergency or disaster is the sole causal factor in the interruption of the provision of services; NOTE: Pursuant to these provisions, an extension of the 60-day deadline for initiation of request may be granted at the discretion of the department. d.includes an attestation that all clients have been properly discharged or transferred to another facility; and e.lists the clients and the location of the discharged or transferred clients; 2.resumes operating as a CRC in the same service area within one year of the issuance of an executive order or proclamation of emergency or disaster in accordance with R.S. 29:724 or R.S. 29:766; 3.continues to pay all fees and cost due and owed to the department including, but not limited to, annual licensing fees and outstanding civil fines; and 4.continues to submit required documentation and information to the department. B.Upon receiving a completed request to inactivate a CRC license, the department shall issue a notice of inactivation of license to the CRC. C.In order to obtain license reinstatement, a CRC with a department-issued notice of inactivation of license shall: 1.submit a written license reinstatement request to HSS 60 days prior to the anticipated date of reopening that includes: a.the anticipated date of reopening, and a request to schedule a licensing survey; b.a completed licensing application and other required documents with licensing fees, if applicable; and c.written approvals for occupancy from OSFM and OPH recommendation for license. 2.The CRC shall resume operating in the same service area within one year of the issuance of an executive order or proclamation of emergency or disaster in accordance with R.S. 29:724 or R.S. 29:766. D.Upon receiving a completed written request to reinstate a CRC license and other required documentation, the department shall conduct a licensing survey. E.If the CRC meets the requirements for licensure and the requirements under this Subsection, the department shall issue a notice of reinstatement of the center's license. F.During the period of inactivation, the department prohibits: 1.a change of ownership (CHOW) in the CRC; and 2.an increase in the licensed capacity from the CRC's licensed capacity at the time of the request to inactivate the license. G.The provisions of this Section shall not apply to a CRC which has voluntarily surrendered its license. H.Failure to comply with any of the provisions of this Section shall be deemed a voluntary surrender of the CRC license. AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and R.S. 40:2180.14. HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 41:124 (January 2015), amended by the Department of Health, Bureau of Health Services Financing, LR 47:475 (April 2021). §5409.Inactivation of License due to a Non-Declared Emergency or Disaster A.A CRC in an area or areas which have been affected by a non-declared emergency or disaster may seek to inactivate its license, provided that the following conditions are met: 1.the CRC shall submit written notification to the HSS within 30 days of the date of the non-declared emergency or disaster stating that: a.the CRC has experienced an interruption in the provisions of services as a result of events that are due to a non-declared emergency or disaster; b.the facility intends to resume operation as a CRC in the same service area; c.the CRC attests that the emergency or disaster is the sole causal factor in the interruption of the provision of services; and d.the inactivation due to a non-declared emergency or disaster does not exceed one year receipt of notice of approval of renovation/construction plans by OSFM and OPH as required; NOTE: Pursuant to these provisions, an extension of the 30-day deadline for initiation of request may be granted at the discretion of the department. EXCEPTION: If the CRC requires an extension of this timeframe due to circumstances beyond the CRC’s control, upon written request, the department may consider an extended time period to complete construction or repairs. Such written request for extension shall show the CRC’s active efforts to complete construction or repairs and the reasons for request for extension of the CRC’s inactive license. Any approvals for extension are at the sole discretion of the department. 2.the CRC continues to pay all fees and costs due and owed to the department including, but not limited to, annual licensing fees and outstanding civil monetary penalties and/or civil fines; and 3.the CRC continues to submit required documentation and information to the department, including but not limited to, cost reports. B.Upon receiving a completed written request to temporarily inactivate the CRC license due to a non-declared emergency or disaster, the department shall issue a notice of inactivation of license to the CRC. C.Upon the CRC’s receipt of the department’s approval of request to inactivate the license, the CRC shall have 90 days to submit plans for the repairs, renovations, rebuilding, or replacement of the CRC to OSFM and OPH as required. D.The CRC shall resume operating as a CRC in the same service area within one year of the approval of renovation/construction plans by OSFM and OPH as required. E.Upon completion of repairs, renovations, rebuilding, or replacement of the CRC, a CRC which has received a notice of inactivation of its license from the department shall be allowed to reinstate its license upon the following conditions being met: 1.the CRC shall submit a written license reinstatement request to the licensing agency of the department; 2.the license reinstatement request shall inform the department of the anticipated date of re-opening and shall request scheduling of a licensing or physical environment survey; and 3.the license reinstatement request shall include a completed licensing application with appropriate licensing fees. F.Upon receiving a completed written request to reinstate a CRC license, the department may conduct a licensing or physical environment survey. The department may issue a notice of reinstatement if the CRC has met the requirements for licensure including the requirements of this Subsection. G.No change of ownership of the CRC shall occur until such CRC has completed repairs, renovations, rebuilding, or replacement construction and has resumed operations as a CRC. H.The provisions of this Section shall not apply to a CRC that has voluntarily surrendered its license and ceased operation. I.Failure to comply with any of the provisions of this Section shall be deemed a voluntary surrender of the CRC license. AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and R.S. 40:2180.14. HISTORICAL NOTE: Promulgated by the Department of Health, Bureau of Health Services Financing, LR 47:476 (April 2021). Subchapter B.Voluntary-Only Crisis Receiving Center §5415Voluntary-Only Crisis Receiving Center A.Any entity, organization, or person applying to be licensed as a CRC has the option to be licensed as a voluntary-only crisis receiving center (VO-CRC), wherein the licensed entity shall only admit or receive individuals who present voluntarily to the facility. B.Individuals presenting to a VO-CRC shall have the ability to come and go to the facility for services as the individual deems appropriate; individuals shall not be required to sign a formal voluntary admission form under R.S. 28:52 or successor statute. C.A VO-CRC shall adhere to all the licensing requirements for CRCs, including Chapter 53 and Chapter 54 of this licensing Rule, with the following substitutions: 1.for §5367.C, a VO-CRC shall only receive individuals who present voluntarily to the unit/facility; 2.for §5367.F.1.b, a VO-CRC does not need to establish legal authority for the individual; 3.for §5397.A.8, the VO-CRC does not need to maintain separate spaces for involuntary and voluntary admissions or individuals, since the VO-CRC will only serve voluntary admissions or individuals; and 4.for §5397.G, a VO-CRC shall not have a seclusion room. AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and R.S. 40:2180.14. HISTORICAL NOTE:Promulgated by the Department of Health, Bureau of Health Services Financing, LR 48:302 (February 2022).