Ariz. Admin. Code § 9-10-716

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

Section R9-10-716 - Behavioral Health Services

A. An administrator shall ensure that:

1. If a behavioral health residential facility is authorized to provide court-ordered evaluation or court-ordered treatment:

a. Court-ordered evaluation is provided in compliance with the requirements in A.R.S. Title 36, Chapter 5, Article 4; and

b. Court-ordered treatment is provided in compliance with the requirements in A.R.S. Title 36, Chapter 5, Article 5;

2. If a behavioral health residential facility is authorized to provide behavioral health services to individuals whose behavioral health issue limits the individuals' ability to function independently, a resident admitted to the behavioral health residential facility with limited ability to function independently receives:

a. Behavioral health services and personal care services as indicated in the resident's treatment plan, and

b. Continuous protective oversight;

3. A resident admitted to the behavioral health residential facility who needs behavioral health services to maintain or enhance the resident's ability to function independently:

a. Receives behavioral health services, and, if indicated in the resident's treatment plan, personal care services; and

b. Is provided an opportunity to participate in activities designed to maintain or enhance the resident's ability to function independently while:

i. The resident receives services to maintain the resident's health, safety, or personal hygiene; or

ii. Homemaking functions are performed for the resident;

4. Behavioral health services are provided to meet the needs of a resident and are consistent with a behavioral health residential facility's scope of services;

5. Behavioral health services listed in the behavioral health residential facility's scope of services are provided on the premises;

6. Before a resident participates in behavioral health services provided in a setting or activity with more than one resident participating, the diagnoses, treatment needs, developmental levels, social skills, verbal skills, and personal histories, including any history of physical or sexual abuse, of the residents participating are reviewed to ensure that the:

a. Health and safety of each resident is protected, and

b. Treatment needs of each resident participating are being met; and

7. A resident does not:

a. Use or have access to any materials, furnishings, or equipment or participate in any activity or treatment that may present a threat to the resident's health or safety based on the resident's documented diagnosis, treatment needs, developmental levels, social skills, verbal skills, or personal history; or

b. Share any space, participate in any activity or treatment, or verbally or physically interact with any other resident that may present a threat to the resident's health or safety, based on the other resident's documented diagnosis, treatment needs, developmental levels, social skills, verbal skills, and personal history.

B. An administrator shall ensure that counseling is:

1. Offered as described in the behavioral health residential facility's scope of services,

2. Provided according to the frequency and number of hours identified in the resident's treatment plan, and

3. Provided by a behavioral health professional or a behavioral health technician.

C. An administrator shall ensure that:

1. A personnel member providing counseling that addresses a specific type of behavioral health issue has the skills and knowledge necessary to provide the counseling that addresses the specific type of behavioral health issue; and

2. Each counseling session is documented in a resident's medical record to include:

a. The date of the counseling session;

b. The amount of time spent in the counseling session;

c. Whether the counseling was individual counseling, family counseling, or group counseling;

d. The treatment goals addressed in the counseling session; and

e. The signature of the personnel member who provided the counseling and the date signed.

D. An administrator of a behavioral health residential facility authorized to provide behavioral health services to individuals under 18 years of age:

1. May continue to provide behavioral health services to a resident who is 18 years of age or older:

a. If the resident:

i. Was admitted to the behavioral health residential facility before the resident's 18th birthday;

ii. Is not 21 years of age or older; and

iii. Is:

(1) Attending classes or completing coursework to obtain a high school or a high school equivalency diploma, or

(2) Participating in a job training program; or

b. Through the last calendar day of the month of the resident's 18th birthday; and

2. Shall ensure that:

a. A resident does not receive the following from other residents at the behavioral health residential facility:

i. Threats,

ii. Ridicule,

iii. Verbal harassment,

iv. Punishment, or

v. Abuse;

b. The interior of the behavioral health residential facility has furnishings and decorations appropriate to the ages of the residents receiving services at the behavioral health residential facility;

c. A resident older than three years of age does not sleep in a crib;

d. Clean and non-hazardous toys, educational materials, and physical activity equipment are available and accessible to residents on the premises in a quantity sufficient to meet each resident's needs and are appropriate to each resident's age, developmental level, and treatment needs; and

e. A resident's educational needs are addressed according to A.R.S. Title 15, Chapter 7, Article 4

.

E. An administrator shall ensure that:

1. An emergency safety response is:

a. Only used:

i. By a personnel member trained to use an emergency safety response,

ii. For the management of a resident's violent or self-destructive behavior, and

iii. When less restrictive interventions have been determined to be ineffective; and

b. Discontinued at the earliest possible time, but no longer than five minutes after the emergency safety response is initiated;

2. Within 24 hours after an emergency safety response is used for a resident, the following information is entered into the resident medical record:

a. The date and time the emergency safety response was used;

b. The name of each personnel member who used an emergency safety response;

c. The specific emergency safety response used;

d. The personnel member or resident behavior, event, or environmental factor that caused the need for the emergency safety response; and

e. Any injury that resulted from the use of the emergency safety response;

3. Within 10 working days after an emergency safety response is used for a resident, the administrator or clinical director reviews the information in subsection (E)(2); and

4. After the review required in subsection (E)(3), the following information is entered, according to policies and procedures, into the resident's medical record:

a. Actions taken or planned actions to prevent the need for the use of an emergency safety response for the resident,

b. A determination of whether the resident is appropriately placed at the behavioral health residential facility, and

c. Whether the resident's treatment plan was reviewed or needs to be reviewed and amended to ensure that the resident's treatment plan is meeting the resident's treatment needs.

F. An administrator shall ensure that:

1. A personnel member whose job description includes the ability to use an emergency safety response:

a. Completes training in crisis intervention that includes:

i. Techniques to identify personnel member and resident behaviors, events, and environmental factors that may trigger the need for the use of an emergency safety response;

ii. The use of nonphysical intervention skills, such as de-escalation, mediation, conflict resolution, active listening, and verbal and observational methods; and

iii. The safe use of an emergency safety response including the ability to recognize and respond to signs of physical distress in a client who is receiving an emergency safety response; and

b. Completes training required in subsection (F)(1)(a):

i. Before providing behavioral health services, and

ii. At least once every 12 months after the date the personnel member completed the initial training;

2. Documentation of the completed training in subsection (F)(1)(a) includes:

a. The name and credentials of the individual providing the training,

b. Date of the training, and

c. Verification of a personnel member's ability to use the training; and

3. The materials used to provide the completed training in crisis intervention, including handbooks, electronic presentations, and skills verification worksheets, are maintained for at least 12 months after each personnel member who received training using the materials no longer provides services at the behavioral health residential facility.

Ariz. Admin. Code § R9-10-716

Adopted effective November 1, 1998, under an exemption from the provisions of the Administrative Procedure Act pursuant to Laws 1998, Ch. 178, §17; filed with the Office of the Secretary of State October 2, 1998 (Supp. 98-4). Section repealed; new Section made by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, effective 7/1/2014. Amended by final rulemaking at 25 A.A.R. 1583, effective 10/1/2019. Amended by final expedited rulemaking at 26 A.A.R. 551, effective 3/3/2020.

The following Section was adopted under an exemption from the provisions of the Administrative Procedure Act which means these rules were not reviewed by the Governor's Regulatory Review Council; the Department did not submit notice of proposed rulemaking to the Secretary of State for publication in the Arizona Administrative Register; and the Department was not required to hold public hearings on these rules (Supp. 98-4).