Section R9-10-1011. Behavioral Health Services

A.      An administrator of an outpatient treatment center that is authorized to provide behavioral health services shall ensure that:

1.        The outpatient treatment center does not provide a behav- ioral health service the outpatient treatment center is not authorized to provide;

2.        The behavioral health services provided by or at the out- patient treatment center:

a.         Are provided under the direction of a behavioral health professional; and

b.        Comply with the requirements:

i.         For behavioral health paraprofessionals and behavioral health technicians, in R9-10-115, and

ii.        For an assessment, in subsection (B);

3.        A personnel member who provides behavioral health ser- vices is:

a.         At least 21 years of age; or

b.        At least 18 years of age and is licensed or certified under A.R.S. Title 32 and providing services within the personnel member’s scope of practice; and

4.        If an outpatient treatment center provides behavioral health services to a patient who is less than 18 years of age, the owner and an employee or a volunteer comply with the fingerprint clearance card requirements in A.R.S. § 36-425.03.

B.       An administrator of an outpatient treatment center that is authorized to provide behavioral health services shall ensure that:

1.        Except as provided in subsection (B)(2), a behavioral health assessment for a patient is completed before treat- ment for the patient is initiated;

2.        If a behavioral health assessment that complies with the requirements in this Section is received from a behavioral health provider other than the outpatient treatment center or the outpatient treatment center has a medical record for the patient that contains an assessment that was com- pleted within 12 months before the date of the patient’s current admission:

a.         The patient’s assessment information is reviewed and updated if additional information that affects the patient’s assessment is identified, and

b.        The review and update of the patient’s assessment information is documented in the patient’s medical record within 48 hours after the review is completed;

3.        If a behavioral health assessment is conducted by a:

a.         Behavioral health technician or a registered nurse, within 72 hours a behavioral health professional cer- tified or licensed to provide the behavioral health services needed by the patient reviews and signs the behavioral health assessment to ensure that the behavioral health assessment identifies the behav- ioral health services needed by the patient; or

b.        Behavioral health paraprofessional, a behavioral health professional certified or licensed to provide the behavioral health services needed by the patient supervises the behavioral health paraprofessional during the completion of the behavioral health assessment and signs the behavioral health assess- ment to ensure that the assessment identifies the behavioral health services needed by the patient;

4.        A behavioral health assessment:

a.         Documents a patient’s:

i.         Presenting issue;

ii.        Substance abuse history;

iii.      Co-occurring disorder;

iv.       Medical condition and history;

v.        Legal history, including:

(1)     Custody,

(2)     Guardianship, and

(3)     Pending litigation;

vi.       Criminal justice record;

vii.     Family history;

viii.    Behavioral health treatment history; and

ix.       Symptoms reported by the patient and referrals needed by the patient, if any;

b.        Includes:

i.         Recommendations for further assessment or examination of the patient’s needs;

ii.        The behavioral health services, physical health services, or ancillary services that will be pro- vided to the patient; and

iii.      The signature and date signed of the personnel member conducting the behavioral health assessment; and

c.         Is documented in patient’s medical record;

5.        A patient is referred to a medical practitioner if a determi- nation is made that the patient requires immediate physi- cal health services or the patient’s behavioral health issue may be related to the patient’s medical condition;

6.        A request for participation in a patient’s behavioral health assessment is made to the patient or the patient’s repre- sentative;

7.        An opportunity for participation in the patient’s behav- ioral health assessment is provided to the patient or the patient’s representative;

8.        Documentation of the request in subsection (B)(6) and the opportunity in subsection (B)(7) is in the patient’s medical record;

9.        A patient’s behavioral health assessment information is documented in the medical record within 48 hours after completing the assessment;

10.     If information in subsection (B)(4)(a) is obtained about a patient after the patient’s behavioral health assessment is completed, an interval note, including the information, is documented in the patient’s medical record within 48 hours after the information is obtained;

11.     Counseling is:

a.         Offered as described in the outpatient treatment cen- ter’s scope of services,

b.        Provided according to the frequency and number of hours identified in the patient’s assessment, and

c.         Provided by a behavioral health professional or a behavioral health technician;

12.     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

13.     Each counseling session is documented in the patient’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 ses- sion; and

e.         The signature of the personnel member who pro- vided the counseling and the date signed.

C.      An administrator of an outpatient treatment center authorized to provide behavioral health services may request to provide any of the following to individuals required to attend by a referring court:

1.        DUI screening,

2.        DUI education,

3.        DUI treatment, or

4.        Misdemeanor domestic violence offender treatment.

D.      An administrator of an outpatient treatment center authorized to provide the services in subsection (C):

1.        Shall comply with the requirements for the specific ser- vice in 9 A.A.C. 20, and

2.        May have a behavioral health technician who has the appropriate skills and knowledge established in policies and procedures provide the services.

Historical Note

Adopted as an emergency effective November 17, 1983, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 83-6). Former Section R9-10-1011 adopted as an emergency now adopted and amended as a permanent rule effective February 15, 1984 (Supp. 84-1). Repealed by summary action, interim effective date July 21, 1995 (Supp. 95-3). The proposed summary action repealing R9-10-1011 was remanded by the Governor’s Regulatory Review Council which revoked the interim effectiveness of the summary rule. The Section in effect before the pro- posed summary action has been restored (Supp. 97-1).

Section repealed by final rulemaking at 5 A.A.R. 1222, effective April 5, 1999 (Supp. 99-2). New Section made by final rulemaking at 14 A.A.R. 294, effective March 8, 2008 (Supp. 08-1). Section repealed; new Section made by exempt rulemaking at 19 A.A.R. 2015, effective Octo- ber 1, 2013 (Supp. 13-2). Amended by exempt rulemak-

ing at 20 A.A.R. 1409, pursuant to Laws 2013, Ch. 10, §

13; effective July 1, 2014 (Supp. 14-2).