Alaska Administrative Code
Title 7 - Health and Social Services
Part 1 - Administration
Chapter 12 - Facilities and Local Units
Article 4 - Specialized Hospitals
7 AAC 12.215 - Psychiatric hospitals
Universal Citation: 7 AK Admin Code 12.215
Current through August 30, 2024
(a) A hospital which is primarily engaged in providing to inpatients psychiatric services for the diagnosis and treatment of mental illness is a psychiatric hospital and must comply with the provisions of this section.
(b) A psychiatric hospital must have the following minimum staff and on-site services, in addition to those required by 7 AAC 12.205:
(1) a
medical service, supervised by a physician;
(2) a psychiatric service, supervised by a
psychiatrist;
(3) a psychological
service, which includes one or more psychologists employed on a full-time,
regular part-time, or consulting basis;
(4) a social work service which includes one
or more social workers employed on a full-time, part-time or consulting basis,
under the direction of the medical staff;
(5) a nursing service, under the direction of
a registered nurse who has the following qualifications:
(A) a master's degree in psychiatric nursing
or a related field with one year of experience in nursing administration;
or
(B) a baccalaureate degree in
nursing with 2 years of experience in psychiatric nursing and two years of
experience in nursing administration; and
(6) sufficient registered nursing personnel
to give direct nursing care, and to plan, supervise, and coordinate care given
by other mental health workers.
(c) In addition to the services listed in (b) of this section, a psychiatric hospital must provide the following services, either directly or through a contract with outside providers:
(1) psychological testing and
counseling;
(2) assessment,
screening and diagnostic services;
(3) individual psychotherapy;
(4) group therapy;
(5) family therapy; and
(6) therapeutic occupational and activity
programs.
(d) A psychiatric hospital must have policies and procedures which require that it
(1) have a transfer agreement with a general
acute care hospital which includes provision for transfer of a patient's
records upon transfer of the patient;
(2) admit and discharge patients in
accordance with AS 47.30;
(3)
provide for each patient a written treatment plan, developed with the patient's
participation as far as practicable, which incorporates a comprehensive
interdisciplinary approach based on the patient's medical, social, and
psychiatric or psychological evaluations;
(4) include as part of each patient's
evaluation
(A) a medical history;
(B) a history of the current onset of
illness, including the circumstances leading to admission;
(C) a description of the patient's current
mental status, including attitudes, behavior, intellectual and memory
functioning, and orientation;
(D) a
descriptive inventory of the patient's assets; and
(E) if the patient is a child or adolescent,
a report on the patient's developmental as well as chronological age;
(5) provide organized therapeutic
activities with consideration for the interests and needs of the
patients;
(6) document in each
patient's medical record the patient's attitude and response to
treatment;
(7) establish and
implement guidelines for use of physical restraints and seclusion rooms which
include the following requirements:
(A) the
location of a seclusion room which allows for direct supervision and
observation by staff;
(B)
construction of a seclusion room which minimizes opportunity for concealment,
escape, injury, or suicide, including locks and doors which open
outwards;
(C) recording in a
patient's medical record the time the patient spent in seclusion or
restraints;
(D) visiting a patient
who is in restraints or seclusion at least hourly, and providing the patient
with adequate opportunity for exercise, access to bathroom facilities, and time
out of restraints or seclusion;
(E)
limiting the use of restraints or seclusion to situations in which alternative
means will not protect the patient or others from injury; and
(F) when practicable, consultation with the
patient regarding the patient's preference among available forms of adequate,
medically advisable restraints, including medication;
(8) establish and implement guidelines for
administration of a drug when given in an unusually high dose or when given for
a purpose other than that for which the drug is customarily used, and for
circumstances under which electroconvulsive shock therapy may be
administered;
(9) provide that each
treatment unit within the hospital keeps a confidential log of all referrals it
initiates or receives;
(10) provide
an area in which a patient can meet with an outside community service provider
and other hospital personnel who assist in fulfilling the goals and objectives
of the treatment plan;
(11) have a
committee of the medical staff periodically evaluate the services provided and
make appropriate recommendations to the medical staff and administration;
and
(12) establish and implement
(A) controls for contraband;
(B) security controls and management for
potentially dangerous individuals, and for patients committed before October 1,
1982 under AS 12.45 and after September 30, 1982 under AS 12.47;
(C) preventive measures for suicide or
self-harm;
(D) admission criteria
for a psychiatric security unit; and
(E) controls for storage and handling of
police officers' weapons.
(e) If a psychiatric hospital permits human subject research, it must
(1) have written
policies which describe the purpose and conduct of all research using the
hospital's staff, patients, or services, and which require that
(A) written agreements entered into by
subjects do not include exculpatory language through which the subject waives
any legal rights or which releases the hospital or its staff from liability for
negligence;
(B) when research
findings are made public, the anonymity of individual patients is assured;
and
(C) when bodily integrity is
violated, including by the use of electroconvulsive shock therapy and
chemotherapy, supervision be provided by a physician; and
(2) establish an interdisciplinary review
committee comprised of both hospital staff members and other knowledgeable
persons, for the purpose of reviewing research activities within the
facility.
(f) If a psychiatric hospital provides aftercare service, that service must include a written individualized treatment plan designed to establish continuing contact for the care of each patient and explain the risks, benefits, and side effects of medication programs to the patient.
(g) A psychiatric hospital must provide for educational or training programs for all children of school age who are educable or trainable and who are expected to be patients for longer than one month. The programs must
(1) conform to
educational requirements established by law and be under direction of teachers
certified to teach in Alaska; and
(2) if provided by a public school system,
include provisions for transportation of the patients to and from school and
supervision of them during the transportation.
Authority:AS 18.20.010
AS 18.20.060
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