All defendants admitted to residential or intensive outpatient treatment shall be able to function with limited supervision and support, and shall not have: 1. a documented, reported, or observed medical condition that requires immediate medical treatment or continuous medical supervision (as determined by a prudent lay person) or 2. an observable physical or mental impairment that prevents the client from participating in the treatment. b. The program shall have enough staff to meet treatment needs within the context of the program description, even if this requires more staff than indicated by the minimum staff-toclient ratios listed in this section. c. Counselor caseloads shall not to exceed sixteen (16) clients per counselor.. d. . Direct care staff shall be awake and on site during all program hours. 1. In outpatient programs, the direct care staff- to- client ratio shall be at least 1:16 during the hours clients are awake, and 1:32 when clients are asleep. 2. In residential programs the direct care staff-to-client ratio shall be at least 1:16 while during hours clients are awake and 1:32 when clients are asleep. 3. Night staff shall conduct and document at least three (3) checks while clients are sleeping. e. For defendants transferred from TDSHS Level I treatment, or its equivalent, or admitted directly to this level of treatment, counselors shall complete a comprehensive client assessment and initial treatment recommendations. f. All clients shall have an written individualized treatment plan. g. The facility shall deliver an average of ten (10) hours of structured activities per week for each defendant, including at least two (2) hours of chemical dependency counseling [with at least one (1) hour of individual counseling every two (2) weeks] and eight (8) hours of additional counseling, chemical dependency education, or life skills training.
