Current through Register Vol. 30, No. 38, September 20, 2024
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.
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).