Ariz. Admin. Code § 9-10-318

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

Section R9-10-318 - Child and Adolescent Residential Treatment Services

A. An administrator of a behavioral health inpatient facility authorized to provide child and adolescent residential treatment services shall:

1. If abuse, neglect, or exploitation of a patient under 18 years of age is alleged or suspected to have occurred before the patient was accepted or while the patient is not on the premises and not receiving services from an employee or personnel member of the behavioral health inpatient facility, report the alleged or suspected abuse, neglect, or exploitation of the patient according to A.R.S. § 13-3620;

2. If the administrator has a reasonable basis, according to A.R.S. § 13-3620, to believe that abuse, neglect, or exploitation of a patient under 18 years of age has occurred on the premises or while the patient is receiving services from an employee or a personnel member:

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

b. Report the suspected abuse, neglect, or exploitation of the patient according to A.R.S. § 13-3620;

c. Document:

i. The suspected abuse, neglect, or exploitation;

ii. Any action taken according to subsection (A)(2)(a); and

iii. The report in subsection (A)(2)(b);

d. Maintain the documentation in subsection (A)(2)(c) for at least 12 months after the date of the report in subsection (A)(2)(b);

e. 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 (A)(2)(b):

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

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

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

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

f. Maintain a copy of the documented information required in subsection (A)(2)(e) and any other information obtained during the investigation for at least 12 months after the date the investigation was initiated;

3. If a patient who is under 18 years of age is absent and the absence is unauthorized as determined according to the criteria in R9-10-303(H), within an hour after determining that the patient's absence is unauthorized, notify:

a. Except as provided in subsection (A)(3)(b), the patient's parent or legal guardian; and

b. For a patient who is under a court's jurisdiction, the appropriate court or a person designated by the appropriate court;

4. Document the notification in subsection (A)(3) in the patient's medical record and the written log required in R9-10-303(I)(3);

5. In addition to the personnel records requirements in R9-10-306(F), ensure that a personnel record for each employee, volunteer, and student contains documentation of the individual's compliance with the finger-printing requirements in A.R.S. § 36-425.03;

6. Ensure that the patient's representative for a patient who is under 18 years of age:

a. Except in an emergency, either consents to or refuses treatment;

b. May refuse or withdraw consent to treatment before treatment is initiated, unless the treatment is ordered by a court according to A.R.S. Title 36, Chapter 5 or A.R.S. § 8-341.01; is necessary to save the patient's life or physical health; or is provided according to A.R.S. § 36-512;

c. Except in an emergency, is informed of alternatives to a proposed psychotropic medication and the associated risks and possible complications of the proposed psychotropic medication;

d. Is informed of the following:

i. The policy on health care directives, and

ii. The patient complaint process; and

e. Except as otherwise permitted by law, provides written consent to the release of information in the patient's:

i. Medical record, or

ii. Financial records;

7. In addition to the restrictions provided in R9-10-311(C), ensure that a parent of a patient under 18 years of age is allowed to restrict the patient from:

a. Associating with individuals of the patient's choice, receiving visitors, and making telephone calls during the hours established by the behavioral health inpatient facility;

b. Having privacy in correspondence, communication, visitation, financial affairs, and personal hygiene; and

c. Sending and receiving uncensored and unopened mail;

8. Establish, document, and implement policies and procedures to ensure that a patient is protected from the following from other patients at the behavioral health inpatient facility:

a. Threats,

b. Ridicule,

c. Verbal harassment,

d. Punishment, or

e. Abuse;

9. Ensure that:

a. The interior of the behavioral health inpatient facility has furnishings and decorations appropriate to the ages of the patients receiving services at the behavioral health inpatient facility;

b. A patient older than three years of age does not sleep in a crib;

c. Clean and non-hazardous toys, educational materials, and physical activity equipment are available and accessible to patients in a quantity sufficient to meet each patient's needs and are appropriate to each patient's age, developmental level, and treatment needs; and

d. A patient's educational needs are addressed according to A.R.S. Title 15, Chapter 7, Article 4;

10. In addition to the requirements for seclusion or restraint in R9-10-316, ensure that:

a. An order for restraint or seclusion is limited to the duration of the emergency situation and does not exceed:

i. Two continuous hours for a patient who is between the ages of nine and 17, or

ii. One continuous hour for a patient who is younger than nine; and

b. Requirements are established for notifying the parent or guardian of a patient who is under 18 years of age and who is restrained or secluded; and

11. Prohibit a patient under 18 years of age from possessing or using tobacco products on the premises.

B. An administrator of a behavioral health inpatient facility authorized to provide child and adolescent residential treatment services may continue to provide behavioral health services to a patient who is 18 years of age or older:

1. If the patient:

a. Was admitted to the behavioral health inpatient facility before the patient's 18th birthday,

b. Is not 21 years of age or older, and

c. Is completing high school or a high school equivalency diploma or participating in a job training pro-gram; or

2. Through the last calendar day of the month of the patient's 18th birthday.

Ariz. Admin. Code § R9-10-318

Section R9-10-318, formerly numbered as R9-10-222, renumbered as an emergency effective February 22, 1979, pursuant to A.R.S § 41-1003, valid for only 90 days (Supp. 79-1). Adopted effective June 14, 1979 (Supp. 79-3). Former Section R9-10-318 repealed, new Section R9-10-318 adopted effective February 4, 1981 (Supp. 81-1). Section repealed by final rulemaking at 8 A.A.R. 2785, effective October 1, 2002 (Supp. 02-2). New Section R9-10-318made by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). New Section made by exempt rulemaking at 20 A.A.R. 1409, effective 7/1/2014. Amended by final expedited rulemaking at 26 A.A.R. 551, effective 3/3/2020.