“14. Minimum standards. – The Centres shall be of the following types, namely: - (I) Substance use disorder Treatment Centre (indoor and outpatient facility);
(II) Substance use disorder Treatment Centre (Outpatient facility only);
(III) Substance use disorder Treatment Centre (indoor facility with both deaddiction and rehabilitation); and (IV) Substance use disorder counseling and rehabilitation Centres, which shall maintain the minimum standards of care as specified below, namely: - A. PHYSICAL STANDARDS CENTRES WITH INDOOR FACILITY
(1) Each Centre with indoor facility which falls in category (I),(III)and (IV) mentioned above, shall, - 462 PUNJAB GOVT. GAZ., SEPTEMBER 11, 2020 (BHDR 20, 1942 SAKA) RM
(i) have requisite number of beds (one for each patient), adequate accommodation and proper spacing between the beds;
(ii) have sufficient ventilation and shall be pollution free in the entire area;
(iii) have potable drinking water facility and running water for washing, bathing and cleaning purposes;
(iv) have proper sanitation i.e. clean and adequate number of bathrooms, toilets and sinks;
(v) provide clean bed linen, utensils and articles for personal hygiene of the patients;
(vi) provide fresh, nutritious and adequate meals to the admitted patients;
(vii) have adequate recreational facilities for the patients;
(viii) reception, enquiry, registration counter, waiting space with seating arrangements at least for five persons;
(ix) cubicle room for providing individual counseling, group therapy and family counseling;
(x) space to store records of patients to ensure confidentiality and a system of easy retrieval;
(xi) related educational material such as posters to be prominently displayed at strategic points in the Centres;
(xii) Pamphlets, hand bills and other educational materials in vernacular shall be made freely available for the public;
(xiii) no centre shall keep the patients in basement; and
(xiv) shall have a prominent board/signage displaying the name of the facility in local language at the gate or on the building of the Centre.
(2) In each Centre with indoor facility which falls in category (I),(III) and (IV) of rule 14 mentioned above, the name of the doctors (with registration number), fee structure, timings and the services provided at the Centre, shall be well displayed in the language understood by the local public in the area.
(3) A Substance Use Disorder Counselling and Rehabilitation Centre, (i.e Category (IV) shall have minimum area of at least 500 Sq. yards, to provide indoor residential and outdoor recreational activities. Provision of library, gym, outdoor and indoor games, newspaper and modes of communication with the family, for the admitted 463 PUNJAB GOVT. GAZ., SEPTEMBER 11, 2020 (BHDR 20, 1942 SAKA) LM patients in the Centres, shall be made available to the patients. The District Level Committee shall ensure compliance of the above conditions before recommending for license to a Centre.
CENTRES WITH OUTPATIENT FACILITY ONLY
(4) Each Centre with Outpatient facility only i.e which falls in category (II) as mentioned in rule 14 above: -
(i) shall be developed and maintained to provide safe and secure environment for patients, their families, staff and visitors;
(ii) shall have a prominent board or signage displaying the name of the Centre in local language, the name of the doctors with their registration number, fee structure of the Centre, timings and the services provided within the Centre, in the language understood by the local public in the area, on the said board;
(iii) shall have adequate lighting and ventilation, shall take all precautions to control infections like practicing hand hygiene, shall follow Biomedical waste management rules; and
(iv) shall have, -
(a) the Doctor Rooms of not less than 100 Square feet;
(b) dispensing room with sufficient storage capacity;
(c) rooms for counselling of the patients (in case a separate counsellor is recruited for counselling);
(d) waiting area with provision of drinking water and rest room for OPD more than 50 per day;
(e) adequate space for storage of equipment and medicines as per manufacturer’s guidelines;
(f) Provision of 2 beds is must to handle the emergency cases.
B. MEDICAL STANDARDS
(i) Any Centre shall not compel any patient, to undergo detoxification treatment without explaining him the range of treatment options available to him including substitution, maintenance therapy, psychosocial interventions, for deaddiction;
(ii) Each Centre shall follow the treatment protocol with established and evidence based medical practice and guidelines published by the World Health Organization (WHO), Government of India, and the Indian Psychiatric 464 PUNJAB GOVT. GAZ., SEPTEMBER 11, 2020 (BHDR 20, 1942 SAKA) RM Society (IPS), including the harm minimization practices advocated from time to time;
(iii) Each Centre with indoor facility shall have the duly qualified nursing and other staff as per their job requirement which is competent to handle the work assigned to them. The Core Staff (doctors and nurses), shall have received the training in Substance Use Disorder treatment from a recognized institution;
(iv) Each Centre which falls in category (I), (II) and (III) as mentioned in rule 14 above shall have a duly qualified Psychiatrist as officer in-charge of a Centre. In case of a substance use disorder counseling and Rehabilitation Centre i.e category (IV) mentioned above, the presence of an MBBS doctor, not less than four hours in a day, is must;
(v) Each Centre shall display the arrangements on the notice board, for providing support and emergency services to the patients, if needed;
(vi) Each Centre shall ensure adequate transport facility or ambulance for patients;
(vii) Each Centre which falls in category (I), (III) and (IV) as mentioned in rule 1 above shall ensure round the clock medical nursing care of indoor patients;
and
(viii) Each Centre shall have adequate medicines available required for treatment of physical and psychiatric co-morbidities.
C. STAFF NORMS
(1) Each Centre which falls in category (I) as mentioned above:
(i) shall have one full time Psychiatrist;
(ii) Shall have the Social Workers or Counsellors (with counsellor-patient ratio of 1:10), who are M.Phil. or M.A. in Psychology, Sociology or Social Work, preferably having training in Substance Use Disorder Treatment from a recognized institution;
(iii) shall have staff nurses (nurse-patient ratio of 1:20), for round the clock services, who are B.Sc. or Diploma in Nursing with training in Substance Use Disorder Treatment, from a recognized institution;
(iv) shall have Ward Attendants for round the clock services (Ward Attendantpatient ratio 1:20 ratio), who have passed 10+2 examination from a recognized 465 PUNJAB GOVT. GAZ., SEPTEMBER 11, 2020 (BHDR 20, 1942 SAKA) LM Board or institution, as the case may be, with orientation to handle Substance Use Disorder patients at the Centre;
(v) shall have adequate Safai Karamcharis for round the clock cleanliness;
(vi) shall have adequate Cook-cum-Helper or regular arrangement for fresh nutritious food from outside;
(vii) shall have adequate Peer educator (Optional ); and
(viii) Shall have adequate security guards for round the clock duty.
(2) Each Centre which falls in category (III) and (IV) as mentioned above shall have additional staff in addition to that mentioned in (1) above:
(i) One Project Director with graduation in any stream.
(ii) One MBBS doctor for at least 4 hours a day.
(3) Centres with Outpatient facility only i.e which fall under category (II) as mentioned above, shall have :
(i) Full time psychiatrist -1
(ii) Counselor-1 (Counseling service is mandatory. In case counseling is done by the psychiatrist himself/herself, this should be submitted at the time of application with self declaration). If daily OPD is more than 50 a separate counselor should be recruited.
(iii) Sweeper/ security/ helper/Staff nurse/Pharmacist may be recruited as per requirement.
D. SUPPORT SERVICES
(1) Each centre which falls in category (I),(III) and (IV) as mentioned above, shall provide the following support services, namely: -
(i) Emergency Medical Care;
(ii) Recreational/ rehabilitation facilities and outdoor activities;
(iii) Regular daily outpatient service;
(iv) Referral linkage for specialist medical services, laboratory services, HIV/ AIDS centres, RNTCP centres; and
(v) Adequate transport facilities for patients for the purpose of linkage activities and Emergency Medical Care.
466 PUNJAB GOVT. GAZ., SEPTEMBER 11, 2020 (BHDR 20, 1942 SAKA) RM
(2) Centres with outpatient facility only ie. which fall under category (II) as mentioned above shall have a referral linkage with a nearby health facility for providing Emergency and other support services and an undertaking in this regard shall be given at the time of submission of application for grant of license.
E. RECORD MAINTENANCE AND DISSEMINATION
(i) Every Centre shall maintain personal and treatment record of all the patients.
(ii) Every Centre shall enter data online on the portal of Government at www.pddrc.in, failing which license shall be immediately suspended and doctor shall be debarred from practice for a period as prescribed by Government;
(iii) Every Centre shall maintain the confidentiality of the patients and show patient’s records only to the authorized persons, on request, with the permission of Officer-in-charge of the Centre;
(iv) Every Centre shall maintain medical records of patients as per provisions of Indian Medical Council Regulations 2002;
(v) Every Centre shall maintain record of each purchase of the Opioid Drugs in the Central Consumable Stock Register (Separate Register or Pages for each medicine); and
(vi) Every Centre shall maintain a separate page in a Register for each patient.
F. TREATMENT PROTOCOL Every Centre shall follow the treatment guidelines or any other instructions issued by the Department of Health and Family Welfare, Punjab.
G. MONITORING EVALUATION
(i) Every centre shall make available the data of the Centre for inspection in case of any complaints;
(ii) Every centre shall ensure that the manufacturer who supplies any medicine to the Centre gets the batch being supplied, tested from the State Food and Drug Testing Laboratory, Kharar, S.A.S. Nagar; and should not dispense any batch of medicine which has not been tested.
(iii) Every centre shall comply any other instructions in this regard as and when issued by the Government.
467 PUNJAB GOVT. GAZ., SEPTEMBER 11, 2020 (BHDR 20, 1942 SAKA) LM H. ANNUAL REPORT Every Centre shall submit the Annual Report to the State Mental Health Authority constituted under the Mental Health Care Act, 2017, for the duration between 1st January to 31st December of every year. Such report must be submitted by 31st January in a format as prescribed by the Punjab State Mental Health Authority.