1. Administrative and Operational Domain
A. |
Core Principle: Operate with Integrity |
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Section 1 – Use mission and vision as guides for decision making | Level 1 | Level 2 | Level 3 | Level 4 | |
a. | A written mission that reflects a commitment to those served and identifies the population served which, at a minimum, includes persons in recovery from a substance use disorder. | X | X | X | X |
b. | A vision statement that is consistent with NARR’s core principles. | X | X | X | X |
X – Required | ® – Recommended
Section 2 – Adhere to legal and ethical codes and use best business practices | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Documentation of legal business entity (e.g. incorporation, LLC documents or business license). | X | X | X | X |
b. | Documentation that the owner/operator has current liability coverage and other insurance appropriate to the level of support. | X | X | X | X |
c. | Written permission from the property owner of record (if the owner is other than the recovery residence operator) to operate a recovery residence on the property. | X | X | X | X |
d. | A statement attesting to compliance with nondiscriminatory state and federal requirements. | X | X | X | X |
e. | Operator attests that claims made in the marketing materials and advertising will be honest and substantiated and that it does not employ any of the following:
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X | X | X | X |
f. | Policy and procedures that ensure that appropriate background checks (due diligence practices) are conducted for all staff who will have direct and regular interaction with residents. | ® | ® | X | |
g. | Policy and procedures that ensure the following conditions are met if the residence provider employs, contracts with or enters into a paid work agreement with residents:
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X | X | X | X |
h. | Staff must never become involved in residents’ personal financial affairs, including lending or borrowing money, or other transactions involving property or services, except that the operator may make agreements with residents with respect to payment of fees. | X | X | X | X |
i. | A policy and practice that provider has a code of ethics that is aligned with the LARR code of ethics. There is evidence that this document is read and signed by all those associated with the operation of the recovery residence, to include owners, operators, staff and volunteers. | X | X | X | X |
X – Required | ® – Recommended
Section 3 – Be financially honest and forthright | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Prior to the initial acceptance of any funds, the operator must inform applicants of all fees and charges for which they will be, or could potentially be, responsible. This information needs to be in writing and signed by the applicant. | X | X | X | X |
b. | Use of an accounting system which documents all resident financial transactions such as fees, payment and deposits.
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X | X | X | X |
c. | A policy and practice documenting that a resident is fully informed regarding refund policies prior to the individual entering into a binding agreement. | X | X | X | X |
d. | A policy and practice that residents be informed of payments from 3rd party payers for any fees paid on their behalf. | X | X | X | X |
X – Required | ® – Recommended
Section 4 – Collect data for continuous quality improvement | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Policies and procedures regarding collection of resident’s information. At minimum data collection will
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X | X | X | X |
X – Required | ® – Recommended
B. |
Core Principle: Uphold Resident’s Rights |
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Section 5 – Communicate rights and requirements before agreements are signed | Level 1 | Level 2 | Level 3 | Level 4 | |
a. | Documentation of a process that requires a written agreement prior to committing to terms that includes the following:
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X | X | X | X |
X – Required | ® – Recommended
Section 6 – Protect resident information | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Policies and procedures that keep residents’ records secure, with access limited to authorized staff. | X | X | X | X |
b. | Policies and procedures that comply with applicable confidentiality laws. | X | X | X | X |
c. | Policies and procedures, including social media, protecting resident and community privacy and confidentiality. | X | X | X | X |
X – Required | ® – Recommended
C. |
Core Principle: Create a culture of empowerment were residents engage in governance and leadership |
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Section 7 – Involve residents in governance | Level 1 | Level 2 | Level 3 | Level 4 | |
a. | Evidence that some rules are made by the residents and that the residents (not staff) implement them. | X | X | ® | ® |
b. | Grievance policy and procedures, include the right to take unresolved grievances to the operator’s oversight organization. | X | X | X | X |
c. | Verification that written resident’s rights and requirements (e.g. residence rules and grievance process) are posted or otherwise available in common areas. | X | X | X | X |
d. | Policies and procedures that promote resident-driven length of stay. | X | X | ® | ® |
e. | Evidence that residents have opportunities to be heard in the governance of the residence; however, decision making remains with the operator. | X | X | X |
X – Required | ® – Recommended
Section 8 – Promote resident involvement in a developmental approach to recovery | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Peer support interactions among residents are facilitated to expand responsibilities for personal and community recovery. | X | X | X | |
b. | Written responsibilities, role descriptions, guidelines and/or feedback for residence leaders. | ® | X | X | |
c | Evidence that residents/ recovery progress and challenges are recognized and strengths are celebrated. | X | X | X |
X – Required | ® – Recommended
D. |
Core Principle: Develop Staff Abilities to Apply the Social Model |
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Section 9 – Staff model and teach recovery skills and behaviors | Level 1 | Level 2 | Level 3 | Level 4 | |
a. | Evidence that management supports staff members maintaining self-care. | X | X | X | |
b. | Evidence that staff are supported in maintaining appropriate boundaries according to a code of conduct. | X | X | X | |
c. | Evidence that staff are encouraged to have a network of support. | X | X | X | |
d. | Evidence that staff are expected to model genuineness, empathy, respect, support and unconditional positive regard. | X | X | X |
X – Required | ® – Recommended
Section 10 – Ensure potential and current staff are trained or credentialed appropriate to the residence level | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Policies that value individuals chosen for leadership roles who are versed and trained in the Social Model of recovery and best practices of the profession. | X | X | X | |
b. | Policies and procedures for acceptance and verification of certification(s) when appropriate. | X | X | X | |
c. | Staffing plan that demonstrates continuous development for all staff. | ® | X | X |
X – Required | ® – Recommended
Section 11 – Staff are culturally responsive and competent | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Policies and procedures that serve the priority population, which at a minimum include persons in recovery from substance use but may also include other demographic criteria. | X | X | X | |
b. | Cultural responsiveness and competence training or certification are provided. | X | X | X |
X – Required | ® – Recommended
Section 12 – All staff positions are guided by written job descriptions that reflect recovery | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Job descriptions include position responsibilities and certification/licensure and/or lived experience credential requirements. | X | X | X | |
b. | Job descriptions require staff to facilitate access to local community-based resources. | X | X | X | |
c. | Job descriptions include staff responsibilities, eligibility, and knowledge, skills and abilities needed to deliver services. Ideally, eligibility to deliver services includes lived experience recovering from substance use disorders and the ability to reflect recovery principles. | X | X | X |
X – Required | ® – Recommended
Section 13 – Provide Social Model-Oriented Supervision of Staff | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Policies and procedures for ongoing performance development of staff appropriate to staff roles and residence level. | X | X | X | |
b. | Evidence that management and supervisory staff acknowledge staff achievements and professional development. | ® | X | X | |
c. | Evidence that supervisors (including top management) create a positive, productive work environment for staff. | X | X | X |
X – Required | ® – Recommended
2. Physical Environment Domain
E. |
Core Principle: Provide a Home-like Environment |
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Section 14 – The residence is comfortable, inviting, and meets residents’ needs | Level 1 | Level 2 | Level 3 | Level 4 | |
a. | Verification that the residence is in good repair, clean, and well maintained. | X | X | X | X |
b. | Verification that the furnishings are typical of those in single family homes or apartments as opposed to institutional settings. | X | X | X | X |
c. | Verification that entrances and exits are home-like vs. institutional or clinical. | X | X | X | X |
d. | Verification of 50+ sq. ft. per bed per sleeping room. | X | X | X | X |
e. | Verification that there is a minimum of one sink, toilet and shower per six residents. | X | X | X | X |
f. | Verification that each resident has personal item storage. | X | X | X | X |
g. | Verification that each resident has food storage space. | X | X | X | X |
h. | Verification that laundry services are accessible to all residents. | X | X | X | X |
i. | Verification that all appliances are in safe, working condition. | X | X | X | X |
X – Required | ® – Recommended
Section 15 – The living space is conducive to building community | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Verification that a meeting space is large enough to accommodate all residents. | X | X | X | X |
b. | Verification that a comfortable group area provides space for small group activities and socializing. | X | X | X | X |
c. | Verification that kitchen and dining area(s) are large enough to accommodate all residents sharing meals together. | X | X | X | X |
d. | Verification that entertainment or recreational areas and/or furnishings promoting social engagement are provided. | X | X | X | X |
X – Required | ® – Recommended
F. |
Core Principle: Promote a Safe and Healthy Environment |
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Section 16 – Provide an alcohol and illicit drug free environment | Level 1 | Level 2 | Level 3 | Level 4 | |
a. | Policy prohibits the use of alcohol and/or illicit drug use or seeking. | X | X | X | X |
b. | Policy lists prohibited items and states procedures for associated searches by staff. | X | X | X | X |
c. | Policy and procedures for drug screening and/or toxicology protocols. | X | X | X | X |
d. | Policy and procedures that address residents’ prescription and non-prescription medication usage and storage consistent with the residence’s level and with relevant state law. | X | X | X | X |
e. | Policies and procedures that encourage residents to take responsibility for their own and other residents’ safety and health. | X | X | X | X |
X – Required | ® – Recommended
Section 17 – Promote Home Safety | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Operator will attest that electrical, mechanical, and structural components of the property are functional and free of fire and safety hazards. | X | X | X | X |
b. | Operator will attest that the residence meets local health and safety codes appropriate to the type of occupancy (e.g. single family or other) OR provide documentation from a government agency or credentialed inspector attesting to the property meeting health and safety standards. | X | X | X | X |
c. | Verification that the residence has a safety inspection policy requiring periodic verification of
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X | X | X | X |
X – Required | ® – Recommended
Section 18 – Promote Health | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Policy regarding smoke-free living environment and/or designated smoking area outside of the residence. | X | X | X | X |
b. | Policy regarding exposure to bodily fluids and contagious disease. | X | X | X | X |
X – Required | ® – Recommended
Section 19 – Plan for emergencies including intoxication, withdrawal and overdose | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Verification that emergency numbers, procedures (including overdose and other emergency responses) and evacuation maps are posted in conspicuous locations. | X | X | X | X |
b. | Documentation that emergency contact information is collected from residents. | X | X | X | X |
c. | Documentation that residents are oriented to emergency procedures. | X | X | X | X |
d. | Verification that Naloxone (Narcan) is accessible at each location, and appropriate individuals are knowledgeable and trained in its use. | X | X | X | X |
X – Required | ® – Recommended
3. Recovery Support Domain
G. |
Core Principle: Facilitate Active Recovery and Recovery Community Engagement |
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Section 20 – Promote meaningful activities | Level 1 | Level 2 | Level 3 | Level 4 | |
a. | Documentation that residents are encouraged to do at least one of the following
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X | X | X | X |
X – Required | ® – Recommended
Section 21 – Engage residents in recovery planning and development of recovery capital | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Evidence that each resident develops and participates in individualized recovery planning that includes an exit plan/strategy. | X | X | X | X |
b. | Evidence that residents increase recovery capital through such things as recovery support and community service, work/employment, etc. | X | X | X | X |
c. | Written criteria and guidelines explain expectations for peer leadership and mentoring roles. | X | X | X | X |
X – Required | ® – Recommended
Section 22 – Promote access to community supports | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Resource directories, written or electronic, are made available to residents. | X | X | X | X |
b. | Staff and/or resident leaders educate residents about local community-based resources. | X | X | X | X |
X – Required | ® – Recommended
Section 23 – Provide mutually beneficial peer recovery support | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | A weekly schedule details recovery support services, events and activities. | X | X | X | |
b. | Evidence that resident-to resident peer support is facilitated:
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X | X | X | X |
X – Required | ® – Recommended
Section 24 – Provide recovery support and life skills development services | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Provide structured scheduled, curriculum-driven, and/or otherwise defined support services and life skills development. Trained staff (peer and clinical) provide learning opportunities. | X | X | ||
b. | Ongoing performance support and training are provided for staff. | X | X |
X – Required | ® – Recommended
Section 25 – Provide clinical services in accordance with state law | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Evidence that the program’s weekly schedule includes clinical | ® | X |
X – Required | ® – Recommended
H. |
Core Principle: Model Pro-Social Behaviors and Relationship Enhancements Skills |
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Section 26 – Maintain a respectful environment | Level 1 | Level 2 | Level 3 | Level 4 | |
a. | Evidence that staff and residents model genuineness, empathy and positive regard. | ® | X | X | X |
b. | Evidence that trauma informed or resilience-promoting practices are priority. | ® | ® | X | X |
c. | Evidence that mechanisms exist for residents to inform and help guide operations and advocate for community-building. | X | X | X | X |
X – Required | ® – Recommended
I. |
Core Principle: Cultivate the Resident’s Sense of Belonging and Responsibility for Community |
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Section 27 – Sustain a “functionally equivalent family” within the residence by meeting at least 50% of the following: | Level 1 | Level 2 | Level 3 | Level 4 | |
a. | Residents are involved in food preparation. | X | X | X | X |
b. | Residents have a voice in determining with whom they live. | X | X | X | X |
c. | Residents help maintain and clean the home (chores, etc.) | X | X | X | X |
d. | Residents share in household expenses. | X | X | X | X |
e. | Community or residence meetings are held at least once a week. | X | X | X | X |
f. | Residents have access to common areas of the home. | X | X | X | X |
X – Required | ® – Recommended
Section 28 – Foster ethical, peer-based mutually supportive relationships among residents and staff | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Engagement in informal activities is encouraged. | X | X | X | X |
b. | Engagement in formal activities is required. | X | X | X | X |
c. | Community gatherings, recreational events and/or other social activities occur periodically. | X | X | X | X |
d. | Transition (e.g. entry, phase movement and exit) rituals promote residents’ sense of belonging and confer progressive status and increasing opportunities within the recovery living environment and community. | X | X | X | X |
X – Required | ® – Recommended
Section 29 – Connect residents to the local community | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Residents are linked to mutual aid, recovery activities and recovery advocacy opportunities. | X | X | X | X |
b. | Residents find and sustain relationships with one or more recovery mentors or mutual aid sponsors. | ® | X | X | X |
c. | Residents attend mutual aid meetings or equivalent support services in the community. | ® | X | X | X |
d. | Documentation that residents are formally linked with the community such as job search, education, family services, health and/or housing programs. | ® | X | X | X |
e. | Documentation that resident and staff engage in community relations and interactions to promote kinship with other recovery communities and goodwill for recovery services. | ® | X | X | X |
f. | Residents are encouraged to sustain relationships inside the residence and with others in the external recovery community. | X | X | X | X |
X – Required | ® – Recommended
4. Good Neighbor Domain
J. |
Core Principle: Be a Good Neighbor |
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Section 30 – Be responsive to neighbor concerns | Level 1 | Level 2 | Level 3 | Level 4 | |
a. | Policies and procedures provide neighbors with the responsible person’s contact information upon request. | X | X | X | X |
b. | Policies and procedures that require the responsible person(s) to respond to neighbor’s concerns. | X | X | X | X |
c. | Resident and staff orientations include how to greet and interact with neighbors and/or concerned parties. | X | X | X | X |
X – Required | ® – Recommended
Section 31 – Have courtesy rules | Level 1 | Level 2 | Level 3 | Level 4 | |
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a. | Preemptive policies address common complaints regarding at least:
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X | X | X | X |
b. | Parking courtesy rules are documented. | X | X | X | X |
X – Required | ® – Recommended