Ariz. Admin. Code § 9-10-1803

Current through Register Vol. 30, No. 45, November 8, 2024

Section R9-10-1803 - Administration

A. A governing authority of an adult behavioral health therapeutic home:

1. Consists of no more than two providers, who live in the adult behavioral health therapeutic home;

2. Has the authority and responsibility to manage the adult behavioral health therapeutic home;

3. Has a documented agreement with a collaborating health care institution that establishes the responsibilities of the adult behavioral health therapeutic home and the collaborating health care institution, consistent with the requirements in this Chapter;

4. Shall establish, in writing, the adult behavioral health therapeutic home's scope of services, which are approved by the collaborating health care institution;

5. Shall designate a back-up provider to be present in the adult behavioral health therapeutic home and accountable for services provided by the adult behavioral health therapeutic home when the provider is not present at the adult behavioral health therapeutic home; and

6. Shall ensure that:

a. No more than three residents are accepted by the adult behavioral health therapeutic home;

b. Documentation required by this Article is provided to the Department within two hours after a Department request; and

c. When documentation or information is required by this Chapter to be submitted on behalf of the adult behavioral health therapeutic home, the documentation or information is provided to the unit in the Department that is responsible for licensing the adult behavioral health therapeutic home.

B. A provider or back-up provider:

1. Is at least 21 years of age;

2. Holds current certification in cardiopulmonary resuscitation and first aid training applicable to the ages of residents;

3. Has the skills and knowledge established by the collaborating health care institution as specified in R9-10-118;

4. Has documentation of completion of training in assistance in the self-administration of medication as specified in R9-10-118; and

5. Has documentation of evidence of freedom from infectious tuberculosis:

a. On or before the date the provider or back-up provider begins providing services at or on behalf of the adult behavioral health therapeutic home, and

b. As specified in R9-10-113.

C. A provider shall ensure that policies and procedures are:

1. Established, documented, and implemented to protect the health and safety of a resident that cover:

a. Recordkeeping;

b. Resident acceptance and release;

c. Resident rights;

d. The provision of services, including coordinating the provision of behavioral health services;

e. Residents' medical records, including electronic medical records;

f. Assistance in the self-administration of medication;

g. Infection control; and

h. How a provider will respond to a resident's sudden, intense, or out-of-control behavior to prevent harm to the resident or another individual;

2. Approved, in writing, by an adult behavioral health therapeutic home's collaborating health care institution before implementation and when the policies and procedures are reviewed or updated; and

3. Reviewed by the provider and an adult behavioral health therapeutic home's collaborating health care institution at least once every three years and updated as needed.

D. A provider shall provide written notification to the Department and the adult behavioral health therapeutic home's collaborating health care institution of a resident's:

1. Death, if the resident's death is required to be reported according to A.R.S. § 11-593, within one working day after the resident's death; and

2. Self-injury, within two working days after the resident inflicts a self-injury that requires immediate intervention by an emergency medical services provider.

E. If abuse, neglect, or exploitation of a resident is alleged or suspected to have occurred before the resident was accepted or while the resident is not at an adult behavioral health therapeutic home and not receiving services from the adult behavioral health therapeutic home, a provider shall report the alleged or suspected abuse, neglect, or exploitation of the resident according to A.R.S. § 46-454.

F. If a provider has a reasonable basis, according to A.R.S. § 46-454, to believe abuse, neglect, or exploitation has occurred on the premises or while a resident is receiving adult behavioral health therapeutic services, the provider shall:

1. If applicable, take immediate action to stop the suspected abuse, neglect, or exploitation;

2. Immediately report the suspected abuse, neglect, or exploitation of the resident as follows:

a. To the adult behavioral health therapeutic home's collaborating health care institution; and

b. According to A.R.S. § 46-454;

3. Document:

a. The suspected abuse, neglect, or exploitation;

b. Any action taken according to subsection (F)(1); and

c. The report in subsection (F)(2);

4. Maintain the documentation in subsection (F)(3) for at least 12 months after the date of the report in subsection (F)(2);

5. Initiate an investigation of the suspected abuse, neglect, or exploitation and document the following information within five working days after the report required in subsection (F)(2):

a. The dates, times, and description of the suspected abuse, neglect, or exploitation;

b. A description of any injury to the resident related to the suspected abuse or neglect and any change to the resident's physical, cognitive, functional, or emotional condition;

c. The names of witnesses to the suspected abuse, neglect, or exploitation; and

d. The actions taken by the provider to prevent the suspected abuse, neglect, or exploitation from occurring in the future; and

6. Maintain a copy of the documented information required in subsection (F)(5) and any other information obtained during the investigation for at least 12 months after the date the investigation was initiated.

G. A provider shall maintain a record for each provider and backup provider that includes:

1. For the provider and the backup provider:

a. Name;

b. Date of birth;

c. Contact telephone number; and

d. Documentation of:

i. Verification of skills and knowledge, completed by the adult behavioral health therapeutic home's collaborating health care institution;

ii. Certification in cardiopulmonary resuscitation and first aid training;

iii. Completion of training in assistance in the self-administration of medication, provided by the adult behavioral health therapeutic home's collaborating health care institution;

iv. If the provider or backup provider provides behavioral health services, clinical oversight as required in R9-10-1805(C); and

v. Evidence of freedom from infectious tuberculosis; and

2. For the backup provider, home address.

Ariz. Admin. Code § R9-10-1803

New Section made by exempt rulemaking at 20 A.A.R. 1409, effective 7/1/2014.