Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 10 - DEPARTMENT OF HEALTH SERVICES - HEALTH CARE INSTITUTIONS: LICENSING › Article 3 - BEHAVIORAL HEALTH INPATIENT FACILITIES › Section R9-10-318 - Child and Adolescent Residential Treatment Services

Current through Register Vol. 30, No. 28, July 12, 2024
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.