3.G.25.a. Clinical services

Rule

Evidence that the program’s weekly schedule includes clinical services.

Levels

I	II	III	IV
N/A	N/A	N/A	✔

This rule applies to Level IVs.

Guidance

This is a key standard because it delineates Level IVs from all other levels.

How many hours of clinical services are required to be eligible for a Level IV accreditation? NARR has not established the minimum number of clinical hours that must be provided to be eligible for a Level IV accreditation. State affiliates may establish a threshold and/or point to minimum hours established by the state and/or by the ASAM Criteria.

What is the definition of clinical services? Clinical services are defined by state government and varies across the nation.
What if staff are clinicians? Just because a recovery residence has staff (employee, contractor or volunteer) with a clinical license does not mean that it is providing clinical services. Recovery residences that do not provide clinical services should not market staff with clinical degrees in a way that would lead the average person to assume that clinical services will be provided. (See standard and ethics related to marketing)
What if, the property is a licensed residential treatment center? Licensed residential treatment centers may or may not be a NARR Level IV, depending on whether they meet ALL of the required standards. This includes the standards related to the social model. Note, some states (e.g. Texas) restrict licensed facilities from being NARR accredited.
What if, residents are enrolled in an outpatient treatment program? Just because one or more of the residents are enrolled or are required to enroll in outpatient clinical services while living in the recovery residence does not mean the recovery residence itself provides clinical services. To be eligible for a Level IV accreditation, applicants must prove that clinical services are legally and ethically provided as part of a bundled service packet. Organizations without a license and proper liability insurance should seek legal advice before contracting clinical services for their residents. Licensed providers should seek legal council before contracting recovery housing for their residents.

Evaluation

How many hours of clinical services do residents weekly receive in a manner that is legal and ethical?

Evidence

Evidence that this rule is upheld is documented in the resident packet and leadership manual.

Resources

Course Syllabus

Not Enrolled

Measure Up: A Guide to the NARR Standard and Code of Ethics

	1. ADMINISTRATIVE AND OPERATIONAL
	1.A. Operate with Integrity
	1.A.1. Use mission and vision as guides for decision making
	1.A.1.a. Mission
	1.A.1.b. Vision
	1.A.2. Adhere to legal and ethical codes and use best business practices
	1.A.2.a. Business entity
	1.A.2.b. Insurance
	1.A.2.c. Property permission
	1.A.2.d. Legal compliance
	1.A.2.e. Ethical marketing
	1.A.2.f. Background checks
	1.A.2.g. Paying residents
	1.A.2.h. Financial boundaries
	1.A.2.i. Code of Ethics
	1.A.3. Financial accounting
	1.A.3.a. Fee transparency
	1.A.3.b. Accounting system
	1.A.3.c. Refund policies
	1.A.3.d. 3rd party payments
	1.A.4. Data collection
	1.A.4.a. Resident information
	1.B. Uphold Residents’ Rights
	1.B.5. Rights and Requirements
	1.B.5.a. Applicant orientation
	1.B.6. Resident information
	1.B.6.a. Secured records
	1.B.6.b. Confidentiality
	1.B.6.c. Social media policy
	1.C. Culture of Empowerment
	1.C.7. Peer governance
	1.C.7.a. Resident driven
	1.C.7.b. Grievance policy
	1.C.7.c. Community posts
	1.C.7.d. Length of stay
	1.C.7.e. Resident voice
	1.C.8. Resident involvement
	1.C.8.a. Reciprocal responsibility
	1.C.8.b. Leadership roles
	1.C.8.c. Recovery process
	1.D. Develop Staff Abilities
	1.D.9. Role modeling
	1.D.9.a. Self-care
	1.D.9.b. Boundaries
	1.D.9.c. Staff support
	1.D.9.d. Positive regard
	1.D.10. Staff qualifications
	1.D.10.a. Social model skills
	1.D.10.b. Credentials
	1.D.10.c. Staff development
	1.D.11. Culturally responsive
	1.D.11.a. Priority population
	1.D.11.b. Cultural training
	1.D.12. Job descriptions
	1.D.12.a. Roles and qualifications
	1.D.12.b. Resource linkage
	1.D.12.c. KSA
	1.D.13. Staff supervision
	1.D.13.a. Performance development
	1.D.13.b. Acknowledgements
	1.D.13.c. Work environment
	2. PHYSICAL ENVIRONMENT
	2.E. Home-like Environment
	2.E.14. Individual needs
	2.E.14.a. Clean and maintained
	2.E.14.b. Home-like furnishings
	2.E.14.c. Entrances and exits
	2.E.14.d. 50+ sq. ft. per bed
	2.E.14.e. Sink-toilet-shower
	2.E.14.f. Personal storage
	2.E.14.g. Food Storage
	2.E.14.h. Laundry
	2.E.14.i. Appliances
	2.E.15. Community building
	2.E.15.a. Meeting space
	2.E.15.b. Group space
	2.E.15.c. Dining area
	2.E.15.d. Recreational area
	2.F. Safe Healthy Environment
	2.F.16. Sober living
	2.F.16.a. Prohibited substances
	2.F.16.b. Prohibited items
	2.F.16.c. Drug screening
	2.F.16.d. Medication storage
	2.F.16.e. Peer accountability
	2.F.17. Home safety
	2.F.17.a. Functional and hazard free
	2.F.17.b. Health & safety codes
	2.F.17.c. Inspections & drills
	2.F.18. Promote health
	2.F.18.a. Smoking
	2.F.18.b. Universal precautions
	2.F.19. Emergency plan
	2.F.19.a. Procedures & postings
	2.F.19.b. Emergency contacts
	2.F.19.c. Emergency orientation
	2.F.19.d. Overdose readiness
	3. RECOVERY SUPPORT
	3.G. Facilitate Recovery
	3.G.20. Promote purpose
	3.G.20.a. Meaningful activities
	3.G.21. Recovery planning
	3.G.21.a. Person-centered plan
	3.G.21.b. Recovery capital
	3.G.21.c. Peer roles
	3.G.22. Community supports
	3.G.22.a. Resource directory
	3.G.22.b. Resource linkage
	3.G.23. Mutual support
	3.G.23.a. Weekly schedule
	3.G.23.b. Mutual aid
	3.G.24. Recovery support services
	3.G.24.a. RSS
	3.G.24.b. RSS Staff
	3.G.25. Clinical services
	3.G.25.a. Clinical services
	3.H. Model Prosocial Behaviors
	3.H.26. Respectful environment
	3.H.26.a. Model recovery
	3.H.26.b. Trauma informed
	3.H.26.c. Resident input
	3.I. Sense of Community
	3.I.27. Family-like
	3.I.27.a. Food preparation
	3.I.27.b. Housing choice
	3.I.27.c. Chores
	3.I.27.d. Household expenses
	3.I.27.e. Household meetings
	3.I.27.f. Common areas
	3.I.28. Internal community
	3.I.28.a. Informal activities
	3.I.28.b. Formal activities
	3.I.28.c. Social activities
	3.I.28.d. Milestone rituals
	3.I.29. External community
	3.I.29.a. Recovery linkage
	3.I.29.b. Recovery mentor
	3.I.29.c. Mutual aid meetings
	3.I.29.d. Resource linkage
	3.I.29.e. Multi-membership
	3.I.29.f. Social bonds
	4. GOOD NEIGHBOR
	4.J. Be a Good Neighbor
	4.J.30. Responsive neighbor
	4.J.30.a. Contact information
	4.J.30.b. Complaint response
	4.J.30.c. Neighbor interaction
	4.J.31. Courtesy rules
	4.J.31.a. Preemptive policies
	4.J.31.b. Parking