This chapter establishes the approval requirements for community behavioral health services providers in Alaska, covering outpatient behavioral health clinic services, behavioral health rehabilitation services, withdrawal management (detox) services at multiple ASAM levels, residential substance use disorder treatment, opioid use disorder treatment programs, and day treatment services for children. Providers must obtain department approval before operating, meet organizational and clinical standards, maintain recipient records, and comply with applicable Medicaid billing and reporting requirements. Inpatient psychiatric hospitals, independent licensed practitioners, and behavior analysts are explicitly excluded from this chapter's scope.
View official source7 AAC 70.010. Applicability. (a) This chapter applies to (1) a community behavioral health services provider, including a (A) community mental health services provider receiving money from the department under AS 47.30.520 - 47.30.620; (B) substance use disorder treatment provider receiving money from the department under AS 47.30.475 or AS 47.37.045 ; (C) health facility or other legal entity that provides behavioral health services under this chapter and 7 AAC 105 - 7 AAC 160 , and does not receive money from the department under AS 47.30.520 - 47.30.620; and (D) health facility or other legal entity that provides substance use disorder treatment services under AS 47.37 , but does not receive money from the department under AS 47.37 ; (2) a substance use disorder treatment provider that is subject to the requirements of AS 47.37 , but does not receive money under AS 47.37 , including an opioid use disorder treatment program or a substance use disorder treatment provider that provides treatment to recipients referred by an alcohol safety action program; in this paragraph, "treatment" does not include services designed solely to provide support, advocacy, education, referral, or other assistance navigating the behavioral health services available to the recipient; and (3) a substance use disorder treatment program operated for the Department of Corrections under AS 33.30 . (b) This chapter does not apply to (1) an independent mental health practitioner providing diagnostic testing and evaluation services for which the practitioner is billing Medicaid under AS 47.07 and 7 AAC 105 - 7 AAC 160 ; (2) a mental health physician clinic providing mental health clinic services for which the provider is billing Medicaid under AS 47.07 and 7 AAC 105 - 7 AAC 160 ; (3) an inpatient psychiatric hospital; (4) a behavior analyst or assistant behavior analyst licensed under AS 08.15 , or a behavior analyst group practice enrolled under 7 AAC 105.210 ; (5) a psychologist licensed under AS 08.86 ; (6) a social worker licensed under AS 08.95 ; (7) a marital and family therapist licensed under AS 08.63 ; or (8) a professional counselor licensed under AS 08.29 . (c) In this section, (1) "alcohol safety action program" has the meaning given in AS 28.35.039 ; (2) "health facility" (A) includes any profit or not-for-profit business or corporation that (i) provides behavioral health clinic services, behavioral health rehabilitation services, or substance use disorder treatment services; (ii) is organized in part as a subsidiary to provide behavioral health clinic services, behavioral health rehabilitation services, or substance use disorder treatment services; or (iii) operates a program designed to provide behavioral health clinic services, behavioral health rehabilitation services, or substance use disorder treatment services; (B) does not include an entity operated by a municipality, borough, or other government entity; (3) "inpatient psychiatric hospital" has the meaning given in 7 AAC 160.990 (b). (d) A community behavioral health services provider listed in this section may not represent itself as a behavioral health service provider or provide services described in this chapter without first obtaining a department approval under 7 AAC 70.030 . 7 AAC 70.030 Department approval of a provider of behavioral health services. (a) The department will approve an organization to provide behavioral health services in this state only if that organization meets the requirements for a community behavioral health services provider under 7 AAC 70.100 or 7 AAC 70.130 and provides one or more of the following: (1) behavioral health clinic services under 7 AAC 135.010 (b); (2) behavioral health rehabilitation services under 7 AAC 135.010 (c); (3) day treatment services for children under 7 AAC 135.250 ; (4) 1115 substance use disorder waiver services under 7 AAC 138 ; (5) one or more withdrawal management services under 7 AAC 70.110 ; (6) one or more residential substance use disorder treatment services under 7 AAC 70.120 ; (7) opioid use disorder treatment services under 7 AAC 70.125 ; (8) behavioral health services to a recipient referred by the alcohol safety action program under 7 AAC 70.145 ; or (9) autism services under 7 AAC 135.350 . (b) In an approval issued under this section, the department will identify (1) one or more of the services identified in (a) of this section for which the provider is approved; (2) the service area for which the provider is approved; (3) the physical location approved by the department for each facility operated by the provider where an individual in the community can access behavioral health services; (4) the local school district that has a written agreement with a community behavioral health services provider for day treatment services, in accordance with 7 AAC 135.250 (d); and (5) the total number of alcohol and other drug withdrawal management beds or the total number of residential substance use disorder treatment service beds regardless of the funding source. (c) If a behavioral health services provider is accredited under 7 AAC 70.150 , the department will issue a department approval for a fixed period of time not to exceed 180 days from the expiration date of the provider's certificate of accreditation, except as provided in (f) and (k) of this section. A provider must seek renewal of a department approval before the expiration date of a current department approval. (d) The department will issue a provisional department approval to a community behavioral health services provider who otherwise meets the requirements of this chapter to allow the provider sufficient time to obtain national accreditation in accordance with 7 AAC 70.150 if the provider (1) is seeking initial department approval that complies with the interim standards set out in 7 AAC 70.200 , and is currently working to get national accreditation; (2) has a current department approval and is accredited, but is adding a location or service category; or (3) has a current department approval and is accredited, but the accreditation is not applicable to the services provided. (e) The department will issue a provisional approval under (d) of this section for up to two years from the date the department issued the provisional approval. However, the department will issue an opioid use disorder treatment program a provisional approval for a maximum of only one year. (f) As it considers necessary for compliance by the provider with 7 AAC 70.100 or 7 AAC 70.130 , or as it considers necessary to protect the health, safety, or well-being of a recipient of the provider's services, the department will impose a temporary or permanent special condition on an approval issued under this section. (g) A department approval issued under this section is not transferable. (h) A behavioral health services provider shall display the department approval in a prominent location that is visible to the public in the provider's primary workplace. (i) If the department denies an approval under this section, the department will notify the provider in writing. (j) To appeal the denial of an approval under this section, or to appeal a temporary or permanent special condition placed on the approval, a provider must submit a timely notice of appeal in writing to the department. A notice of appeal is timely if the department receives it no later than 30 days after the date that the department issues the notice of denial or the approval with the condition. The appeal will be conducted in accordance with AS 44.62.330 - 44.62.630. (k) If during the approval period the department finds that the provider is out of compliance with the requirements of this chapter, the department will take action under 7 AAC 70.900 . 7 AAC 70.050. Recipient eligibility for state-financed behavioral health services. Money that the department provides to a community behavioral health services provider under AS 47.30.475 , 47.30.530 - 47.30.620, or AS 47.37 may be used only to provide services to an individual who (1) is experiencing a short-term crisis; (2) has (A) a maladaptive pattern of substance use, including use of a narcotic drug that may require opioid use disorder treatment services; or (B) cognitive, behavioral, or physiological symptoms indicating that the individual continues to use a substance despite significant substance-related problems; (3) is a child experiencing a severe emotional disturbance; (4) is at least 18 years of age and under 21 years of age, (A) who, except for age, is an adult experiencing a serious mental illness; and (B) whom the provider has determined is best serviced by receiving behavioral health services for adults in the community; (5) is an adult experiencing a serious mental illness; or (6) meets the criteria for autism services under 7 AAC 135.020 (b)(4). 7 AAC 70.060. Recipient rights. (a) A community behavioral health services provider shall prepare a "bill of recipient's rights" that must be prominently posted in places of treatment. (b) The "bill of recipient's rights" must contain the following information: (1) a recipient is entitled to participate in formulating, evaluating, and periodically reviewing the recipient's individualized written treatment plan, including requesting specific forms of treatment, be informed why requested forms of treatment are not made available, refuse specific forms of treatment that are offered, and be informed of treatment prognosis; (2) a recipient has the right to review with a staff member, at a reasonable time, the recipient's treatment record; however, information confidential to other individuals may not be reviewed by the recipient; (3) a recipient will be informed by the prescribing physician of the name, purpose, and possible side effects of medication prescribed as part of the recipient's treatment plan at the community behavioral health services provider; (4) a recipient may request a written summary of the recipient's treatment; that summary must include discharge and transition plans; (5) a recipient has a right to confidential maintenance of all information pertaining to the recipient and the right of prior written approval for the release of identifiable information. 7 AAC 70.100. Qualifications of a community behavioral health services provider receiving money from the department. (a) To be approved by the department as a community behavioral health services provider listed in 7 AAC 70.010 (a)(1)(A) and (B), a provider (1) must be a city, borough, or other political subdivision of the state or a nonprofit corporation; (2) must be receiving money from the department under AS 47.30.475 or 47.30.520 - 47.30.620; (3) if providing behavioral health clinic services, must have a documented formal agreement with a physician to provide general direction and direct clinical services as needed; (4) must collect and report the statistics, service data, and other information requested by the department under AS 47.30.477 , 47.30.530, AS 47.37.040 , or 47.37.140; (5) must participate in the department's service delivery planning as required under AS 47.30.540 or AS 47.37.140 (d); (6) must maintain a clinical record for each recipient in accordance with the standards used for the Medicaid program under 7 AAC 105.230 and 7 AAC 135.130 ; (7) must have policies and procedures in place that incorporate the recipient's personal financial circumstances when determining the amount a recipient is required to pay for services; (8) may not deny treatment to an otherwise eligible recipient due to the recipient's inability to pay for the service; (9) may not supplant local funding available to pay for behavioral health services or programs with money received under AS 47.30.475 , 47.30.520 - 47.30.620, or AS 47.37 ; (10) must be a dual diagnosis capable program or dual diagnosis enhanced program; (11) if providing withdrawal management services, must meet the additional requirements of 7 AAC 70.110 ; (12) if providing residential substance use disorder treatment services, must meet the additional requirements of 7 AAC 70.120 ; (13) if providing opioid use disorder treatment services, must meet the additional requirements of 7 AAC 70.125 ; (14) if providing behavioral health services to a recipient referred by the alcohol safety action program under 7 AAC 70.145 , must meet the additional requirements of that section; (15) must ensure that all recipients have given informed consent; (16) must report to the department any recipient who is missing or deceased; (17) must comply with the requirements of AS 47.05.300 - 47.05.390 and 7 AAC 10.900 - 7 AAC 10.990 as applicable for each individual described in 7 AAC 10.900 (b) associated with the provider; and (18) must submit to the department a record of a criminal history background check for each member of the provider's staff upon request. (b) Money from the department under AS 47.30.475 , 47.30.520 - 47.30.620, or AS 47.37 must be used to provide services to a recipient and may not be used to pay for capital expenditures. (c) A community behavioral health services provider may contract with another provider to provide behavioral health services or programs directly to a recipient. 7 AAC 70.110. Additional requirements for providing alcohol and drug withdrawal management services. (a) The department will approve a community behavioral health services provider under 7 AAC 70.010 (a)(1) or a substance use disorder treatment provider not receiving money from the department under 7 AAC 70.010 (a)(2) that meets the requirements of this section to provide one or more of the withdrawal management services listed in this subsection if the provider uses the service criteria described in the ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, adopted by reference in 7 AAC 70.910 , for each recipient according to need as follows: (1) level 1 withdrawal management: ambulatory withdrawal management services without extended on-site monitoring; (2) level 2 withdrawal management: ambulatory withdrawal management services with extended on-site monitoring; (3) level 3.2 withdrawal management: clinically managed residential withdrawal management services; (4) level 3.7 withdrawal management: medically monitored inpatient withdrawal management services. (b) All withdrawal management services must be medically necessary, must be clinically appropriate, and must comply with one or more of the following: (1) the Diagnostic and Statistical Manual of Mental Disorders, adopted by reference in 7 AAC 70.910 ; (2) the International Classification of Diseases, adopted by reference in 7 AAC 70.910 ; (3) the Revised Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar), adopted by reference in 7 AAC 70.910 ; and (4) the Clinical Opiate Withdrawal Scale (COWS), adopted by reference in 7 AAC 70.910 . 7 AAC 70.120. Additional requirements for providing residential substance use disorder treatment services. (a) The department will approve a community behavioral health services provider that meets the requirements of this section to provide clinically managed low-intensity, medium-intensity, or high-intensity residential substance use disorder treatment services. (b) All residential substance use disorder treatment services must include, at admission and during the course of active treatment as needed, (1) a substance use intake assessment conducted in accordance with 7 AAC 135.110 (c), or an integrated mental health and substance use intake assessment conducted in accordance with 7 AAC 135.110 (d); if the assessment conducted under this paragraph is an integrated mental health and substance use intake assessment, and of the individuals listed in (f)(6), (g)(5), or (h)(5) of this section, only a physician, a physician assistant, an advanced practice registered nurse, or a mental health professional clinician may provide that assessment; and (2) development and maintenance of an individualized treatment plan that includes measurable short-term goals and objectives as needed in the areas of (A) case management; (B) addiction treatment; (C) health care; (D) mental health; (E) social services; (F) vocational services; and (G) housing services. (c) Residential substance use disorder treatment services may be administered to an individual or a group, or on a family basis, but must include the following component services: (1) life skills development designed to restore or improve the recipient's overall functioning relative to the recipient's substance use disorder; (2) counseling to promote successful initial involvement in regular productive daily activity, including going to work or school, and successful reintegration into family living; (3) motivational and engagement strategies appropriate to the recipient's treatment plan; (4) medication administration services; of the individuals listed in (f)(6), (g)(5), or (h)(5) of this section, only a physician, a physician assistant, an advanced practice registered nurse, a registered nurse supervised by a physician or advanced practice registered nurse, or a licensed practical nurse supervised by a physician or advanced practice registered nurse may provide medication administration services; (5) referrals to other agencies, as needed; (6) discharge or transfer planning; (7) repealed 6/30/2021; (8) crisis or relapse prevention planning; (9) management of a recipient's chronic disease, if medically necessary and clinically appropriate; (10) urinalysis and breathalyzer testing to reinforce treatment gains as appropriate to the treatment plan; (11) development of a social network that is supportive to recovery; (12) services provided to the recipient's family and significant other to support recovery and prevention; (13) didactic motivational interventions to assist the recipient in understanding the relationship between substance use disorder and attendant life issues; (14) development of coping skills in the recovery environment. (d) All residential substance use disorder treatment services must be medically necessary, clinically appropriate, and provided in accordance with (1) the ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, adopted by reference in 7 AAC 70.910 ; and (2) one or more of the following: (A) the Diagnostic and Statistical Manual of Mental Disorders, adopted by reference in 7 AAC 70.910 ; (B) the International Classification of Diseases, adopted by reference in 7 AAC 70.910 . (e) In addition to being delivered during regular business hours, all residential substance use disorder treatment services must be delivered as needed during evening hours and on weekends. (f) Clinically managed low-intensity residential substance use disorder treatment services must (1) be delivered as a residential service on the premises of a community behavioral health services provider; (2) include five or more hours of clinical and therapeutic rehabilitative services per week; (3) be delivered in a structured recovery environment, staffed 24 hours a day, that provides sufficient stability to prevent or minimize the potential for recipient relapse or level of substance use that creates problems for the recipient; (4) include the availability of telephonic or in-person consultation with a physician, a physician assistant, an advanced practice registered nurse, or the emergency medical staff of a general acute care hospital 24 hours a day, seven days per week; (5) be provided with the appropriate medical, psychiatric, and psychological services on-site or closely coordinated off-site as determined by the severity and urgency of the recipient's condition; (6) be provided directly to a recipient by any of the following individuals, working within the scope of the individual's practice: (A) a substance use disorder counselor; (B) a behavioral health clinical associate; (C) a mental health professional clinician; (D) an individual with an active license under AS 08 to practice as (i) a physician; (ii) a physician assistant; (iii) an advanced practice registered nurse; (iv) a registered nurse supervised by a physician or advanced practice registered nurse; or (v) a licensed practical nurse supervised by a physician or advanced practice registered nurse; and (7) include access to nursing care and observation of the recipient as needed. (g) Clinically managed medium-intensity residential substance use disorder treatment services must (1) be delivered as a residential service on the premises of a community behavioral health services provider; (2) include 20 or more hours of clinical and therapeutic rehabilitative services per week; (3) include the availability of consultation with a physician, a physician assistant, an advanced practice registered nurse, or the emergency medical staff of a general acute care hospital 24 hours a day, seven days per week, including (A) telephonic consultation available no later than eight hours after the provider's request for consultation; (B) in-person consultation available no later than 24 hours after the provider's request for consultation; (4) be provided with the appropriate medical, psychiatric, and psychological services on-site or closely coordinated off-site as determined by the severity and urgency of the recipient's condition; (5) be available 24 hours per day, must be provided on-site, and must be provided directly to a recipient by any of the following individuals, working within the scope of the individual's practice: (A) a substance use disorder counselor; (B) a behavioral health clinical associate; (C) a mental health professional clinician; (D) an individual with an active license under AS 08 to practice as (i) a physician; (ii) a physician assistant; (iii) an advanced practice registered nurse; (iv) a registered nurse supervised by a physician or advanced practice registered nurse; or (v) a licensed practical nurse supervised by a physician or advanced practice registered nurse; and (6) include access to nursing care and observation of the recipient as needed. (h) Clinically managed high-intensity residential substance use disorder treatment services must (1) be delivered as a long-term residential inpatient service on the premises of a community behavioral health services provider; (2) include 20 or more hours of clinical and therapeutic rehabilitative services per week; (3) include the availability of consultation with a physician, a physician assistant, an advanced practice registered nurse, or the emergency medical staff of a general acute care hospital 24 hours a day, seven days per week, including (A) telephonic consultation available no later than eight hours after the provider's request for consultation; (B) in-person consultation available no later than 24 hours after the provider's request for consultation; (4) be provided with the appropriate medical, psychiatric, and psychological services on-site or closely coordinated off-site as determined by the severity and urgency of the recipient's condition; (5) be available 24 hours per day, must be provided on-site, and must be provided directly to a recipient by any of the following individuals, working within the scope of the individual's practice: (A) a substance use disorder counselor; (B) a behavioral health clinical associate; (C) a mental health professional clinician; (D) an individual with an active license under AS 08 to practice as (i) a physician; (ii) a physician assistant; (iii) an advanced practice registered nurse; (iv) a registered nurse supervised by a physician or advanced practice registered nurse; or (v) a licensed practical nurse supervised by a physician or advanced practice registered nurse; and (6) include access to nursing care and observation of the recipient as needed. (i) In this section, "telephonic" means two-way vocal communication by telephone or voice over internet protocol technologies. 7 AAC 70.125. Additional requirements for providing opioid use disorder treatment services. (a) To be approved by the department to provide opioid use disorder treatment services, a community behavioral health services provider described in 7 AAC 70.010 (a)(1) or a substance use disorder treatment provider described in 7 AAC 70.010 (a)(2) must (1) comply with each requirement of 42 C.F.R. Part 8, adopted by reference in 7 AAC 70.910 ; (2) be accredited or working toward accreditation in accordance with 7 AAC 70.150 ; (3) be certified under 42 C.F.R. Part 8 by the United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA); (4) be registered with the federal Drug Enforcement Administration; (5) have a valid drug room license from the Board of Pharmacy under 12 AAC 52.800 (a); (6) provide a comprehensive range of medical and behavioral health clinic and rehabilitative services that address addiction and addictive behavior; (7) cooperate with the Department of Corrections to assist with opiate withdrawal or maintenance treatment of a recipient in custody; (8) cooperate with the attending physician and hospital staff to continue opioid treatment services upon hospitalization of a recipient; and (9) adhere to the Federal Guidelines for Opioid Treatment Programs, adopted by reference in 7 AAC 70.910 . (b) All opioid use disorder treatment services, including behavioral health clinic and rehabilitation services, must be medically necessary and clinically appropriate in accordance with the (1) ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, adopted by reference in 7 AAC 70.910 ; (2) Diagnostic and Statistical Manual of Mental Disorders, adopted by reference in 7 AAC 70.910 ; and (3) International Classification of Diseases - 10th Revision, Clinical Modification (ICD-10-CM), adopted by reference in 7 AAC 70.910 . (c) Unless a recipient voluntarily terminates participation in the opioid use disorder treatment program, the provider may not withdraw opioid use disorder treatment services earlier than 21 days after beginning treatment. However, the medical director may impose a withdrawal of services after fewer than 21 days, and without the recipient's voluntary termination of participation, if withdrawal of services is medically necessary for the safety and well-being of the recipient. The provider shall have written withdrawal procedures for withdrawing services from a recipient without the recipient's voluntary termination of participation. The provider shall explain those procedures to the recipient before imposing them. (d) Services must be available to assure the reasonable continuity of care of each recipient. Hours of operation must reasonably consider and accommodate recipient schedules, including schedules for transportation, school, homemaking, employment, and child care, and in reasonable consideration of the provider's operational costs. In order to meet the requirements under this subsection, a provider shall ensure that (1) services are made available at least six days a week, 52 weeks a year, with the exception of closures on state and federal holidays; a provider shall inform the department of the provider's published hours of operation, including holidays and other scheduled closures; (2) the provider offers medication dispensing Monday through Friday during a regular 9:00 a.m. - 5:00 p.m. business day; and (3) medication dispensing is scheduled for hours needed to reasonably accommodate recipient needs, including on Saturdays, on Sundays, and after the business day under (2) of this subsection if indicated by recipient needs. (e) For an emergency leading to temporary closure of an opioid use disorder treatment program, an up-to-date plan for emergency administration of medications must be maintained. The plan must (1) provide for the capability to respond to emergencies on a 24-hour basis; and (2) identify an alternative dosing location that (A) is secured in advance; and (B) complies with registration requirements of the federal Drug Enforcement Administration. (f) In this section, "medical director" has the meaning given in 42 C.F.R. 8.2, adopted by reference in 7 AAC 70.910 . 7 AAC 70.130. Qualifications of a community behavioral health services provider not receiving money from the department. To be approved by the department, a community behavioral health services provider described in 7 AAC 70.010 (a)(1) that does not receive money from the department must (1) meet the requirements of this section and the additional requirements of 7 AAC 70.030 (a) for the services that the provider has been approved to provide; (2) collect and report the statistical and service data requested by the department under AS 47.37.140 ; if providing any substance use disorder treatment service listed in 7 AAC 70.030 (a)(4) - (7); (3) have a documented formal agreement with a physician to provide general direction and direct clinical services as needed, if the provider is providing behavioral health clinic services; (4) maintain a clinical record for each recipient in accordance with 7 AAC 135.130 ; (5) ensure that all recipients have given informed consent; (6) report to the department any recipient who is missing or deceased; (7) comply with the requirements of AS 47.05.300 - 47.05.390 and 7 AAC 10.900 - 7 AAC 10.990 as applicable for each individual described in 7 AAC 10.900 (b) and associated with a provider; (8) submit to the department a record of a criminal history background check for each member of the provider's staff upon request; (9) maintain liability and malpractice insurance in accordance with professional and industry standards; and (10) comply with the following requirements regarding provider records, including recipient clinical records if the provider closes as a service provider under this chapter: (A) notify the department in writing not later than 48 hours after the decision to close as a service provider; (B) notify the department whether the provider will (i) retain and store the provider records; (ii) transfer its records to the department; or (iii) transfer its records to another organization; (C) maintain a formal plan for the transfer of records that ensures access to records and include a description of how and when the provider will notify each recipient of service of where the files will be transferred, and how the recipient can get a copy of that recipient's records; the plan for notice under this subparagraph must include a list of those recipients for whom the provider has on file a signed release allowing the recipient's files to be transferred, and a list of those for whom a signed release has not been obtained; (D) before transfer, ensure that records of minors are separated from records of adults. 7 AAC 70.140. Qualifications of a Department of Corrections substance use disorder treatment program. To be approved by the department, a substance use disorder treatment program operated for the Department of Corrections under AS 33.30 must collect and report the statistical and service data requested by the department under a memorandum of agreement, or similar device, with the Department of Corrections. 7 AAC 70.145. Additional requirements to accept referrals from the alcohol safety action program or other court-ordered treatment referrals. A provider that renders behavioral health services to a recipient referred by the alcohol safety action program, as defined in AS 28.35.039 , or that accepts other court-ordered treatment referrals must (1) agree to receive paperwork or referral authorization before screening, assessing, or rendering behavioral health services for the purpose of satisfying court-ordered treatment; (2) immediately notify in writing the referring entity if a recipient has been discharged for not complying with the treatment program; (3) seek approval from the referring entity before a recipient can be readmitted to services to satisfy the recipient's court-ordered treatment if that recipient has been discharged for noncompliance; (4) agree to admit recipients to receive behavioral health services not later than 30 calendar days after the referral unless the provider contacts the referring entity to make other arrangements for the recipient's care; and (5) report to the department or referring entity any information related to the recipient's care as requested. 7 AAC 70.150. Behavioral health services provider accreditation. (a) Except as provided in (b) of this section, to receive a department approval under 7 AAC 70.030 , a behavioral health services provider must (1) be accredited to provide behavioral health services by (A) The Joint Commission; (B) the Commission on Accreditation of Rehabilitation Facilities (CARF); or (C) the Council on Accreditation (COA); (2) be accredited by an alternative accreditation agency approved by the department under 7 AAC 70.160 ; or (3) meet the interim standards for operation under 7 AAC 70.200 - 7 AAC 70.265 . (b) After June 30, 2015, a behavioral health services provider must (1) be accredited to provide behavioral health services by (A) The Joint Commission; (B) the Commission on Accreditation of Rehabilitation Facilities (CARF); (C) the Council on Accreditation (COA); or (D) an alternative accreditation agency approved by the department under 7 AAC 70.160 ; or (2) be issued a provisional department approval under 7 AAC 70.030 (d). (c) A community behavioral health services provider must obtain accreditation for each location reported to the department under 7 AAC 70.030 (b)(3) that is applicable to the services for which the provider is seeking department approval. (d) A behavioral health services provider must submit to the department a copy of the complete accreditation agency site review report no later than 30 days after receipt from the accreditation agency. (e) Upon receipt of a written request by the department, a behavioral health services provider that is not already accredited to provide behavioral health services must submit to the department a report on the provider's progress toward receiving accreditation. 7 AAC 70.160. Alternative accreditation approval. (a) To request approval of an alternative accreditation under 7 AAC 70.150 (a)(2) or (b)(1)(D), a behavioral health services provider must submit a written request to the department that includes the documentation necessary for the department to evaluate the alternative accreditation agency and that agency's accreditation process. (b) At a minimum, an alternative accreditation agency (1) must evaluate the behavioral health services provider's policies and procedures in areas of (A) provider ethics; (B) admissions; (C) client rights; (D) service delivery; (E) medication management; (F) infection control; (G) performance measures and quality improvement; (H) leadership and organizational structure; (I) physical environment; (J) human resources; and (K) information systems management; (2) must use standardized evaluation tools to evaluate the provider; (3) must demonstrate a business practice that updates the accreditation agency's standards on a continuous basis to meet changes in industry standards; (4) must assist the provider with maintaining or improving quality of care through a variety of technical assistance tools; (5) must be capable of evaluating the provider's ability to safely and effectively provide behavioral health clinic services, behavioral health rehabilitation services, withdrawal management services, or residential substance use disorder services; (6) must use independent evaluation of providers; and (7) may not be affiliated directly or indirectly with a provider. (c) The department will approve an alternative accreditation if (1) the minimum standards in (b) of this section are met; (2) the accreditation is appropriate for the behavioral health services provider's scope of practice; and (3) the accreditation agency's accreditation standards meet or exceed the interim standards of operation under 7 AAC 70.200 - 7 AAC 70.260 . (d) The department will notify a behavioral health services provider in writing of its decision. A provider may appeal the department's decision under this section in accordance with AS 44.62.330 - 44.62.630. 7 AAC 70.200. Interim standards for operation. Before July 1, 2015, a behavioral health services provider may meet the requirements of 7 AAC 70.150 by meeting the interim behavioral health services provider standards of 7 AAC 70.200 - 7 AAC 70.260 . 7 AAC 70.205. Provider ethics. A behavioral health services provider must demonstrate the provider's commitment to ethical behavior in all aspects of operation by establishing a written ethical code of conduct to which all employees must adhere. 7 AAC 70.220. Standards of service. A behavioral health services provider must (1) use appropriate and comprehensive standardized assessments to evaluate the needs of each recipient entering and receiving ongoing treatment by the provider; (2) develop written comprehensive treatment plans based upon the assessed needs of the recipient; (3) document new recipient orientation to services and all recipient participation in the development and implementation of treatment plans; (4) render only those services that are documented in the treatment plan as medically necessary, clinically appropriate, and based on the assessed needs of the recipient; (5) document all clinical services in a timely manner; (6) provide services in a way that is culturally sensitive to the state's diverse population; and (7) make appropriate referrals, provide appropriate information, and coordinate services with other service providers to ensure continuity of care when a recipient transfers to another provider or is discharged from services. 7 AAC 70.225. Internal service structure. For each category of service provided by a behavioral health services provider, that provider must (1) have in writing (A) a service description; (B) a service philosophy; and (C) service goals; (2) establish procedures for crisis intervention, including screening recipients for risk to self or others; (3) provide clinical supervision to all personnel providing clinical or direct services to a recipient; and (4) conduct regular quality assurance reviews that (A) monitor the quality of the service; (B) monitor the appropriateness of service; and (C) are used to identify training needs and improve the quality of the service. 7 AAC 70.230. Medication management. A behavioral health services provider must (1) have comprehensive written policies and procedures that cover all aspects of medication management; and (2) conduct a periodic review and evaluation of the provider's compliance with its own medication management policies and procedures. 7 AAC 70.235. Infection control. A behavioral health services provider must implement an infection control program that reduces a staff member's or recipient's risk of infection. The provider must periodically evaluate the infection control program for effectiveness and make any changes that are needed. 7 AAC 70.240. Performance measures and quality improvement. A behavioral health services provider must (1) promote a culture within its own organization that promotes excellence and continual quality improvement; (2) establish policies and procedures for identifying and analyzing critical incidents and sentinel events; (3) collect data for the purpose of monitoring performance, managing risk, and improving service delivery; and (4) be able to show how the data collected under this section is used to implement changes that increase quality of care, manage risk, and decrease the number of critical incidents or sentinel events. 7 AAC 70.245. Leadership. A behavioral health services provider must (1) establish policies and procedures for organizational governance and responsibility; (2) have an active governing body empowered to guide, plan, and support the provider in achieving its mission and goals; (3) have a written description of the provider's leadership structure, including a description of the roles and responsibilities of each level of leadership; (4) demonstrate effective leadership within all areas of the provider's organization by having leaders who (A) engage in both short- and long-term strategic planning; (B) communicate effectively with staff and recipients; (C) develop and implement policies and procedures that guide the business and clinical operations of the provider; (D) establish the mission and direction of the organization; (E) are responsible for ongoing performance improvement and achievement of established outcomes; and (F) solicit and value feedback from recipients, personnel, and other stakeholders to create services that meet or exceed the expectations of recipients; (5) comply with all federal, state, and local laws; and (6) be financially solvent and adhere to established accounting practices. 7 AAC 70.250. Physical environment. A behavioral health services provider must (1) maintain a safe, healthy, and therapeutic physical environment for providing services; (2) monitor the provider's environment and make any necessary changes; (3) develop and implement an emergency management plan, including the conduct of practice drills; and (4) develop and implement a risk management plan designed to reduce the risk of harm to a person, property, or the ability of the provider to meet the requirements of this chapter. 7 AAC 70.255. Human resources. A behavioral health services provider must (1) have a sufficient number of qualified staff to meet recipient needs and the performance expectations of the provider; (2) hire only those individuals who are qualified to perform the duties assigned; (3) provide initial orientation to new staff members; (4) establish minimum qualifications for each job classification; (5) perform and document an annual evaluation for each staff member; (6) require personal accountability from each staff member for that staff member's work performance; and (7) implement a system for managing staff caseloads to support high quality care. 7 AAC 70.260. Information system management. A behavioral health services provider must (1) ensure that the provider's management information system is secure and protects the privacy and confidentiality rights of the recipients; and (2) maintain a complete and accurate clinical record system. 7 AAC 70.900. Voluntary surrender; disciplinary actions. (a) If the department determines that a behavioral health services provider is not in compliance with this chapter or the provider's action or inaction is placing the health, safety, or well-being of a recipient in jeopardy, the department may (1) request voluntary surrender of an approval; (2) impose a temporary or permanent special condition on the provider's approval; (3) impose a specific probationary period during which the provider must correct the deficiencies that the department has identified; (4) suspend the provider's approval for a specific period of time; (5) revoke the provider's approval. (b) The department will suspend or revoke a provider's approval if, during a probationary period imposed under (a)(3) of this section, a provider fails to correct the deficiencies that the department has identified. (c) The department will notify a provider of its intention to impose a special condition, impose a probationary period, suspend an approval, or revoke an approval under (a)(2) - (5) of this section in accordance with AS 44.62.330 - 44.62.630, including a provider's right to appeal that action. 7 AAC 70.910. Requirements adopted by reference. The following documents referenced in this chapter are adopted by reference: (1) American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, June 2013 (DSM-5), as amended from time to time; (2) American Society of Addiction Medicine, ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, Third Edition, 2013; (3) the Revised Clinical Institute Withdrawal Assessment for Alcohol Scale ( CIWA-Ar), originally published in the British Journal of Addiction (1989), Volume 84; (4) the Clinical Opiate Withdrawal Scale ( COWS), originally published in the Journal of Psychoactive Drugs, Volume 35, Number 2, April-June 2003; (5) International Classification of Diseases - 10th Revision, Clinical Modification (ICD-10-CM), 2016 revision, as amended from time to time; (6) Zero to Three: National Center for Infants, Toddlers, and Families, Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-3R), revised as of 2005; (7) 42 C.F.R. Part 8 (certification of opioid treatment programs), revised as of October 1, 2015; (8) United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Federal Guidelines for Opioid Treatment Programs, HHS Publication No. (SMA) PEP15-FEDGUIDEOTP, dated March 2015. 7 AAC 70.920. Adult experiencing a serious mental illness. (a) An adult experiencing a serious mental illness is an individual 21 years of age or older who currently has or at any time during the past year has had a diagnosable mental, emotional, or behavioral disorder of sufficient duration to meet diagnostic criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, adopted by reference in 7 AAC 70.910 , or the International Classification of Diseases, adopted by reference in 7 AAC 70.910 , and that (1) has consistently resulted in (A) impaired thinking and judgment that may include the presence of delusions or hallucinations; (B) socially disruptive behavior that may include an emotional response that is inappropriate to the situation; or (C) conduct that is illegal or outside socially accepted rules and mores; (2) has resulted in serious functional impairment that interferes with the individual's ability to participate in two or more of the following life domains within a culturally appropriate context: (A) the ability to fulfill social responsibilities, including the ability to engage in work, school, parenting, maintaining a household, or other meaningful, productive activity; (B) the ability to meaningfully interact with others, including the ability to actively communicate with others, maintain a supportive social network, avoid isolation, and control disruptive behaviors; (C) the capacity for self-care of the individual's physical health, personal hygiene and grooming, and nutritional needs; (D) the capacity to maintain mental health, including the ability to problem-solve issues, to maintain the individual's independence and personal safety, and to use available community resources for those purposes; or (3) has resulted in current hospitalization or the imminent risk of hospitalization. (b) In addition to the impairments described in (a)(1) and (2) of this section, for individuals with cognitive impairments or organic brain syndrome, there must be documented evidence showing the ability of the individual to benefit from rehabilitative services that would enable the individual to self-regulate behavior, modulate emotional reactivity, and improve functioning in major life domains. 7 AAC 70.930. Child experiencing a severe emotional disturbance. (a) A child experiencing a severe emotional disturbance is an individual under 21 years of age who currently has or at any time during the past year has had a diagnosable mental, emotional, or behavioral disorder of sufficient duration to meet diagnostic criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, adopted by reference in 7 AAC 70.910 , the International Classification of Diseases, adopted by reference in 7 AAC 70.910 , or the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-3R), adopted by reference in 7 AAC 70.910 , and that (1) has resulted in a severe functional impairment that significantly interferes with the child's ability to participate in one or more life domains at a developmentally appropriate level and within a culturally appropriate context; or (2) has resulted in the individual exhibiting one or more of the following: (A) persistent symptoms of distress or diminished affect that do not readily respond to encouragement, reassurance, or instructional control; (B) impeded development or inappropriate attachment as a result of exposure to traumatic life events or impaired relationships; (C) pervasive behavior that is disruptive, aggressive, or risk-taking and that places the individual at serious risk of physical harm to self or to another person or results in serious property damage; (D) consistent inability to participate appropriately in a community setting, including family, school, work, or child care; (E) imminent risk for out-of-home placement; (F) imminent risk for being placed in the custody of the department under AS 47.12.120 or as a result of exposure to maltreatment under AS 47.10.011 ; (G) current hospitalization or the imminent risk of hospitalization. (b) In addition to the impairments described in (a)(1) and (2) of this section, for individuals with cognitive impairments or organic brain syndrome, there must be documented evidence showing that the individual has the ability to benefit from rehabilitative services that would enable the individual to self-regulate behavior, modulate emotional reactivity, and improve developmentally appropriate functioning in major life domains. 7 AAC 70.990. Definitions. In this chapter, unless the context requires otherwise, (1) "active treatment" means that the individual who renders the services actively engages the recipient and provides pre-planned specific interventions, supports, or other actions that assist the recipient in achieving the goals written in the behavioral health treatment plan; (2) "adult experiencing a serious mental illness" means an individual described in 7 AAC 70.920 ; (3) "behavioral health clinical associate" means an individual (A) who may have less than a master's degree in psychology, social work, counseling, or a related field with specialization or experience in providing rehabilitation services to recipients with severe behavioral health conditions; (B) whose responsibilities may include provision of psychosocial evaluation, education related to a recipient's behavioral health condition, encouraging and coaching, counseling, and teaching of needed life skills; and (C) who works within the scope of the individual's training, experience, and education; (4) "behavioral health clinic services" means the services provided to a recipient under 7 AAC 135.010 (b); (5) "behavioral health rehabilitation services" means the services provided to a recipient under 7 AAC 135.010 (c); (6) "behavioral health services" means the outpatient evaluation or treatment of an individual's mental health or substance use; (7) "behavioral health services provider" means (A) a community behavioral health services provider; (B) a substance use disorder treatment provider that, as described in 7 AAC 70.010 (a)(2), is not receiving money from the department; (8) "breathalyzer" means a device for estimating blood alcohol content from a breath sample; (9) "case management" means assistance to the recipient and the recipient's family in accessing and coordinating high-quality needed services, including (A) medical, psychiatric, and mental health services; (B) substance use disorder treatment; (C) educational, vocational, and social supports; and (D) community-based services, related assessments, and post-discharge follow-up activities; (10) "child experiencing a severe emotional disturbance" means an individual described in 7 AAC 70.930 (11) "community behavioral health services provider" means a provider listed in 7 AAC 70.010 (a)(1) that has obtained a department approval under 7 AAC 70.030 to provide identified behavioral health services and meets the requirements set out in 7 AAC 70.100 or 7 AAC 70.130 ; (12) repealed 6/30/2021; (13) "co-occurring disorders" means a diagnosable substance use disorder and a diagnosable mental health disorder that the recipient experiences at the same time; (14) "counseling" means an exchange of information, opinions, and ideas between the recipient and the recipient's provider about the recipient's life choices and behaviors for the purposes of assisting the recipient to make positive changes in the recipient's behavior; (15) "crisis or relapse prevention planning" means service activities designed to support the recovery of the individual in order to reduce and prevent recurrence of harmful use of alcohol or other drugs; (16) "department" means the Department of Health; (17) repealed 4/24/2020; (18) repealed 4/24/2020; (19) "discharge or transfer planning" means the planning necessary for a recipient to make a smooth transition away from active involvement with treatment services or from one level of care to another level of care; (20) "dual diagnosis capable program" means a program (A) that addresses co-occurring disorders in its policies and procedures, assessment, treatment planning, program content, and discharge planning; (B) in which the program staff is able to address the interaction between substance use and mental health disorders; and (C) that is not required to operate under the direction of a physician and does not provide behavioral health clinic services; (21) "dual diagnosis enhanced program" means a program that (A) has a higher level of integration of substance use and mental health treatment services than a dual diagnosis capable program and is able to provide unified treatment of the symptoms of the recipient's substance use and mental health disorders, in addition to addressing the interactions between the co-occurring disorders; and (B) provides behavioral health clinic services under the direction of a physician with individual services supervised by a mental health professional clinician; (22) "functional impairment" (A) means a disorder that substantially interferes with or prevents a recipient from achieving or maintaining one or more developmentally appropriate social, behavioral, cognitive, communicative, or adaptive skills; (B) includes disorders of episodic, recurrent, or continuous duration; (C) does not include temporary, expected responses to stressful events in the recipient's environment; (23) "general acute care hospital" has the meaning given in 7 AAC 12.990 ; (24) "general direction" means, in a community behavioral health services provider, a physician provides general program and clinical consultative services when needed; (25) "management of a recipient's chronic disease" means using a community-wide, systematic, and structured multidisciplinary approach to interventions designed to prevent or manage one or more chronic conditions; (26) "medication administration services" means the administration, by medical personnel, of injectable or oral medications to a recipient, documentation of medication compliance, assessment and documentation of side effects, and evaluation and documentation regarding the effectiveness of the medication; in this paragraph, "medical personnel" means (A) a physician; (B) a physician assistant; (C) an advanced practice registered nurse; (D) a registered nurse supervised by a physician or advanced practice registered nurse; (E) a licensed practical nurse supervised by a physician or advanced practice registered nurse; (27) "mental, emotional, or behavioral disorder" means a disorder identified by a provider listed in 7 AAC 135.030 and in accordance with the (A) Diagnostic and Statistical Manual of Mental Disorders, adopted by reference in 7 AAC 70.910 ; (B) International Classification of Diseases, adopted by reference in 7 AAC 70.910 ; or (C) Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-3R), adopted by reference in 7 AAC 70.910 ; (28) "mental health professional clinician" means (A) an individual who (i) is working for a community behavioral health services provider; (ii) is performing limited behavioral health services that are within that individual's field of expertise; (iii) is not working in a capacity that requires the individual to be licensed under AS 08 ; and (iv) has a master's degree or more advanced degree in psychology, counseling, child guidance, community mental health, marriage and family therapy, social work, or nursing; (B) a nurse who (i) has a master's degree in nursing; (ii) has received special training or experience in mental health; (iii) has an active license to practice nursing under AS 08.68 ; and (iv) is working in the individual's field of expertise; (C) a marital and family therapist who (i) has an active license to practice marital and family therapy under AS 08.63 ; and (ii) is working in the individual's field of expertise; (D) a professional counselor who (i) has an active license to practice as a professional counselor under AS 08.29 ; and (ii) is working in the individual's field of expertise; (E) a social worker who (i) has a master's degree in social work; (ii) has an active license to practice as a social worker under AS 08.95 ; and (iii) is working in the individual's field of expertise; or (F) a psychologist or psychological associate who (i) has an active license to practice as a psychologist or psychological associate under AS 08.86 ; and (ii) is working in the individual's field of expertise; (29) "service area" means the geographic area described by an applicant and affirmed by the department as the area for which services will be provided by a provider authorized under this chapter; (30) "short-term crisis" means an acute episode of a mental, emotional, behavioral, or psychiatric disorder; (31) "substance use disorder" means a disorder that is identified by a diagnostic code found in the Diagnostic and Statistical Manual of Mental Disorders, adopted by reference in 7 AAC 70.910 , or the International Classification of Diseases, adopted by reference in 7 AAC 70.910 , and that is related to (A) alcohol, amphetamine, or similar acting sympathomimetics; (B) cannabis, cocaine, hallucinogens, inhalants, nicotine, or opioids; (C) analogs of phencyclidine (PCP) or similar arylcyclohexylamines; or (D) sedatives, hypnotics, or anxiolytics; (32) "substance use disorder counselor" means an individual who (A) has completed a course of study, training, or education, or who has documented evidence of experience, that has resulted in demonstrated competency to assist with or to independently conduct screening, assessment, treatment planning, case management, and provision of rehabilitative services for the treatment of substance use disorders; and who (i) works within the scope of the individual's education, training, and experience; (ii) adheres to a code of professional ethics; and (iii) participates in continuing education to enhance relevant knowledge, skills, abilities, and professional characteristics; or (B) holds any current, valid certificate from the National Association for Alcoholism and Drug Abuse Counselors, the International Certification and Reciprocity Consortium, the Alaska Commission for Behavioral Health Certification, or the Alaska Native Tribal Health Consortium Behavioral Health Aide Program; (33) "substance use disorder treatment provider" means a provider that is subject to the requirements of AS 47.30.475 , 47.30.520 - 47.30.620, or AS 47.37 and that operates an opioid disorder treatment program, alcohol and drug withdrawal management services, residential substance use disorder treatment facility, or outpatient substance use disorder treatment services to provide treatment to recipients with substance use disorders; (34) "urinalysis" means laboratory testing of a recipient's urine performed by a laboratory accredited under 42 C.F.R. Part 493. (35) "opioid use disorder treatment program" means an individual or entity that (A) administers or dispenses a narcotic drug to a narcotic addict for withdrawal or maintenance treatment; (B) provides to individuals when appropriate or necessary a comprehensive range of medical and behavioral health clinical and rehabilitative services; and (C) is approved under this chapter. (36) "autism services" (A) means the (i) design, implementation, and evaluation of instructional and environmental modifications to produce socially significant improvements in human behavior; (ii) empirical identification of functional relations between behavior and environmental factors, and the utilization of contextual factors, motivating operations, antecedent stimuli, positive reinforcement, and other consequences to help people develop new behaviors, increase or decrease existing behaviors, and engage in behaviors under specific environmental conditions; and (iii) application of adaptive behavior treatment by protocol, group adaptive behavior treatment by protocol, adaptive behavior treatment by protocol modification, or family adaptive treatment guidance; (B) does not include (i) psychological testing; (ii) diagnosis of a mental or behavioral disorder; or (iii) the practice of neuropsychology, psychotherapy, cognitive therapy, sex therapy, psychoanalysis, hypnotherapy, or long-term counseling; (37) "missing," with respect to (A) a child, means absent for more than 10 hours without approval from a residential child care facility as defined in AS 47.32.900 ; (B) an adult recipient who currently receives services from a behavioral health services provider, means absent for more than 72 hours with approval from a residential treatment facility, a housing facility owned or operated by the provider, or an assisted living home where services are delivered to the recipient by the provider; or (C) an individual described in (A) or (B) of this paragraph, means the subject of a missing person report that the provider receives from a member of law enforcement or a family member; (38) "withdrawal management" means the process to safely and effectively provide the immediate physiological stabilization and treatment of a recipient who is intoxicated, incapacitated, or experiencing withdrawal from a specific psychoactive substance; (39) "withdrawal management services" means treatment in accordance with the ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, adopted by reference in 7 AAC 70.910 , for the following levels of care: (A) level 1 withdrawal management: ambulatory withdrawal management services without extended on-site monitoring; (B) level 2 withdrawal management: ambulatory withdrawal management services with extended on-site monitoring provided under 7 AAC 70.110 ; (C) level 3.2 withdrawal management: clinically managed residential withdrawal management services provided under 7 AAC 70.110 ; (D) level 3.7 withdrawal management: medically monitored inpatient withdrawal management services provided under 7 AAC 70.110 . Chapter 71 Community Mental Health Services Article 1 Scope 7 AAC 71.010. Applicability. Repealed. Article 2 Contracts for Services 7 AAC 71.020. Application process. Repealed. 7 AAC 71.025. Geographic planning areas. Repealed. 7 AAC 71.030. Governing boards and advisory boards. Repealed. 7 AAC 71.035. Execution of contract. Repealed. 7 AAC 71.040. Coordination and non-duplication of services. Repealed. 7 AAC 71.045. Capital expenditures. Repealed. Article 3 Standards for Operation of a Community Mental Health Center 7 AAC 71.100. Organization and administration. Repealed. 7 AAC 71.105. Policy and procedures manual. Repealed. 7 AAC 71.110. Fiscal administration. Repealed. 7 AAC 71.115. Personnel administration. Repealed. 7 AAC 71.120. Program evaluation. Repealed. 7 AAC 71.125. Quality assurance. Repealed. 7 AAC 71.130. Plan of services. Repealed. 7 AAC 71.135. Types of services and populations to be served. Repealed. 7 AAC 71.140. Availability and accessibility of services. Repealed. 7 AAC 71.145. Coordination and continuity of services. Repealed. 7 AAC 71.150. Center facility. Repealed. 7 AAC 71.155. Client records. Repealed. 7 AAC 71.160. Records retention. Repealed. 7 AAC 71.162. Closure of center; records. Repealed. 7 AAC 71.165. Waiver of requirements. Repealed. Article 4 Client Rights 7 AAC 71.200. Legal rights. Repealed. 7 AAC 71.205. Informed consent. Repealed. 7 AAC 71.210. Bill of client rights. Repealed. 7 AAC 71.215. Confidentiality. Repealed. 7 AAC 71.220. Grievance procedures. Repealed. 7 AAC 71.300. Definitions. Repealed. Article 5 Management Information System for Mental Health Programs 7 AAC 71.400. Management Information System for mental health programs; required submission of data. Repealed. 7 AAC 71.405. Submission of data by providers. Repealed. 7 AAC 71.410. Obligation to submit accurate and complete data. Repealed. 7 AAC 71.415. Transmission of data. Repealed. 7 AAC 71.420. Confidential information. Repealed. 7 AAC 71.425. Use and disclosure of data and information. Repealed. 7 AAC 71.430. Access to system computer records. Repealed. 7 AAC 71.435. System record retention. Repealed. 7 AAC 71.440. Security of data. Repealed. 7 AAC 71.449. Definitions for 7 AAC 71.400 - 7 AAC 71.449. Repealed. Article 6 General Provisions 7 AAC 71.990. Definitions. Repealed. Chapter 72 Civil Commitment Article 1 Scope and Applicability 7 AAC 72.010. Scope of chapter. Repealed. Article 2 Designation of Facilities 7 AAC 72.012. Adoption by reference. Repealed. 7 AAC 72.015. Facilities eligible for designation; exemption from designation. (a) The department will only approve the following facilities under this chapter and AS 47.30.660 - 47.30.915 to operate as a designated treatment facility: (1) a hospital that is licensed under AS 47.32.010 and 7 AAC 12.610 ; or (2) a facility that (A) is exempt from state licensure but is accredited by a nationally recognized accreditation organization; and (B) is operated under 25 U.S.C. 5301 - 5423 (Indian Self-Determination and Education Assistance Act), as amended. (b) For the purposes of this chapter, a facility designated as a treatment facility is also a designated evaluation facility. (c) The department will approve the following facilities under this chapter and AS 47.30.660 - 47.30.915 to operate as a designated evaluation facility: (1) a hospital that is licensed under AS 47.32.010 and 7 AAC 12.610 ; (2) a crisis residential center licensed under AS 47.32.010 as a subacute mental health facility; and (3) a facility that (A) is exempt from state licensure; (B) is operated under 25 U.S.C. 5301 - 5423 (Indian Self-Determination and Education Assistance Act), as amended; and (C) complies with the requirements for an evaluation facility under AS 47.30.660 - 47.30.915. (d) An evaluation facility or treatment facility that is operated by the department is exempt from the facility designation requirements of this chapter. 7 AAC 72.017. Function of a designated facility. Repealed. 7 AAC 72.020. Application for facility designation. (a) The administrator of a facility described in 7 AAC 72.015 may apply for designation as an evaluation facility or treatment facility by submitting an application to the department on a form and in a manner prescribed by the department that includes: (1) a copy of the facility's current license; if the facility is a hospital is operating under a provisional license issued under 7 AAC 12.610 , the administrator shall also submit a written report that describes each violation and the facility's efforts to achieve compliance; (2) certification, on a form provided by the department, that the facility is in compliance with AS 47.30.660 - 47.30.915 and this chapter; (3) a copy of the table of contents for the facility's policies and procedures, prepared as described in (b) of this section; the complete policies and procedures must be available for department review, and a copy of any specific procedure must be provided if requested by the department; and (4) for an accredited facility described in 7 AAC 72.015 (a)(2), a copy of the facility's current accreditation; if the report describes a deficiency, the administrator shall submit a written report that describes each deficiency and the facility's efforts to achieve compliance. (b) The administrator of a designated facility shall develop, and amend as necessary, written policies and procedures that cover (1) personnel administration; (2) fiscal administration; (3) patient records; (4) patient rights under AS 47.30.817 - 47.30.865; (5) language and cultural relevance of services; (6) coordination and continuity of services; (7) services for patients with physical disabilities; (8) management of pharmaceuticals; (9) quality assurance procedures; (10) program evaluation procedures; (11) ongoing inservice training; and (12) interdisciplinary services for patients with an alcohol or drug problem or a developmental disability, including planning for treatment before and after discharge. (c) Repealed 4/25/2025. (d) Repealed 4/25/2025. (e) Repealed 4/25/2025. 7 AAC 72.030. Waiver of requirements. (a) Upon request by a facility administrator, the commissioner or the commissioner's designee will waive a provision of this chapter if the administrator (1) provides an alternative method that reasonably assures, to the satisfaction of the commissioner or the commissioner's designee, the same level of protection and treatment that the provision sought to be waived affords the patient; and (2) demonstrates, to the satisfaction of the commissioner or the commissioner's designee, that the waiver does not result in a violation of a requirement of AS 47.30.660 - 47.30.915 or 7 AAC 12 . (b) A request for a waiver from a provision of this chapter must be in writing and must (1) identify the provision for which a waiver is sought; (2) explain the reasons why the facility cannot comply with the provision; (3) describe the alternative method proposed to satisfy the requirement in (a)(1) of this section; and (4) describe the facility's plan for complying with the provision, including a time schedule for compliance. (c) The department will rescind a waiver granted under this section if the department determines that the facility in not in compliance with (a)(1) and (2) of this section. 7 AAC 72.040. Decision on application for designation. (a) Within 60 days after receipt of a written application for designation under 7 AAC 72.020 (a), after review of any additional information requested under (b) of this section, and based on the department's determination as to whether the facility complies with 7 AAC 72.015 (a) or 7 AAC 72.015 (c), as applicable, the department will, in writing, either (1) approve the application, with modifications or conditions as necessary, make a decision on any request for a waiver submitted under 7 AAC 72.030 , and designate the facility as an evaluation facility or as a treatment facility; or (2) deny the application and specify the reasons for denial. (b) If the department requires additional information to make a decision under this section, the department will request that information in writing and advise the applicant that the 60-day review period will be suspended until the information is received. (c) If the department denies an application under this section, the administrator may request reconsideration of that decision under 7 AAC 72.060 . 7 AAC 72.050. Annual report regarding facility designation. (a) On or before June 30 of each year, the administrator of a designated facility shall submit to the department, on a form supplied by the department, the following: (1) for a hospital described in 7 AAC 72.015 (a)(1), (A) a copy of the facility's current license; if the facility is operating under a provisional license issued under 7 AAC 12.610 , the administrator shall also submit a written report that describes each violation and the facility's efforts to achieve compliance; (B) certification, on a form supplied by the department, that the facility is in compliance with AS 47.30.660 - 47.30.915 and this chapter; if a waiver has been granted under 7 AAC 72.030 , the administrator shall also submit a report setting out the status of the facility's compliance plan and schedule; (C) a list of policies and procedures described in 7 AAC 72.020 (b) that have been updated during the previous year and a copy of the current table of contents for the policies and procedures; and (D) a copy of each written agreement prepared under 7 AAC 72.110 , or a certification attesting that each written agreement already submitted to the department is still in effect; (2) for a facility described in 7 AAC 72.015 (a)(2), (A) a copy of the facility's current accreditation; (B) certification, on a form supplied by the department, that the facility is in compliance with AS 47.30.660 - 47.30.915 and this chapter; if a waiver has been granted under 7 AAC 72.030 , the administrator shall also submit a report setting out the status of the facility's compliance plan and schedule; (C) a copy of the facility's most recent accreditation report; if the report describes a deficiency, the administrator shall provide a written report of the nature of each deficiency and of the efforts to achieve compliance; (D) a list of policies and procedures described in 7 AAC 72.020 (b) that have been updated during the previous year and a copy of the current table of contents for the policies and procedures; and (E) a copy of each written agreement prepared under 7 AAC 72.110 , or a certification attesting that each written agreement already submitted to the department is still in effect. (b) The department will review the information submitted under this section and will advise the administrator in writing that the department finds the facility to be in compliance with this chapter, unless the department finds that the facility no longer meets the requirements for designation set out in 7 AAC 72.015 (a) or 7 AAC 72.015 (c), as applicable. If the department finds that the facility no longer (1) meets the requirements for designation, the department will notify the administrator in writing under 7 AAC 72.070 ; or (2) complies with the conditions of any waiver issued under 7 AAC 72.030 , the department will rescind the waiver under 7 AAC 72.030 (c). 7 AAC 72.060. Reconsideration. The administrator may, within 30 days after receiving the department's decision under 7 AAC 72.040 , request reconsideration of the decision. In the request for reconsideration, the administrator may include any additional materials and information that support facility designation and that are relevant to the department's decision. Within 30 days after receipt of a request for reconsideration, after review of any additional material and information submitted, and based on the department's determination as to whether the facility complies with 7 AAC 72.015 , the department will (1) approve the application, with modifications or conditions as necessary; or (2) reaffirm the decision made under 7 AAC 72.040 . 7 AAC 72.070. Revocation of designation. (a) Based on the department's review of a facility's performance under this chapter, including a review of information provided by the facility or by an interested person under (e) of this section, the department will revoke the facility's designation if the department determines that the facility does not substantially comply with (1) the applicable requirements of AS 47.30.660 - 47.30.915; or (2) the applicable requirements of this chapter. (b) Except as provided in (c) of this section, and at least 30 days before the effective date of the revocation, the department will notify the administrator of the department's determination and of the department's intent to revoke the facility's designation. (c) If the department determines that immediate revocation of a facility's designation is necessary to protect the public from a substantial and immediate threat to health or safety, the department will notify the administrator of the department's determination and that the facility's designation has been immediately revoked. (d) The department will issue a notice under this section in writing, will specify the basis for revocation in the notice, and will state in the notice that the administrator may appeal the decision under 7 AAC 72.410 - 7 AAC 72.440 . The department will hand-deliver the notice to an authorized agent of the facility or will mail the notice to the last known address of the facility's authorized agent. For the purpose of starting the 30-day period in (b) of this section, or triggering immediate revocation under (c) of this section, notice is effective upon personal delivery of the notice or on the third day after the department mails the notice, whichever occurs first. For the purposes of this subsection, the department mails a notice if the department sends that notice through the United States mail, a courier-type delivery service, a facsimile, or a telegram. (e) An interested person may submit a request to the department, asking that the department revoke a facility's designation, and clearly stating how the facility has failed to comply with an applicable provision of AS 47.30.660 - 47.30.915 or this chapter. Within 14 days after receiving a request under this subsection, the department will send the interested person and the administrator of the facility written notification as to whether the department will perform a review under (a) of this section. Article 3 Requirements for Designated Facilities 7 AAC 72.080. General requirements for a designated facility. The administrator of a designated evaluation facility or designated treatment facility shall ensure that (1) staff members receive training to develop appropriate interactions with patients; (2) properly trained and qualified staff handle the protection, security, and observation of patients; (3) children under 18 years of age do not share a room with adults; (4) discharge plans are initiated early in the evaluation or treatment process and that the facility provides stabilization, establishes diagnoses, and initiates care with the goal of permitting the patient's early return to the community for followup care; discharge planning at an evaluation facility includes determining whether a patient should be released or transferred to a treatment facility, and whether the patient needs medication; (5) treatment is individualized; as necessary, the administrator shall hire or contract with staff to deliver necessary specialized care; and (6) subject to the disclosure restrictions of 42 C.F.R. Part 2, for a patient who is also receiving treatment for alcohol or drug abuse at a facility that receives federal financial assistance as described in 42 C.F.R. Part 2, the local community mental health center or other after-care agency is notified within 48 hours if a client from that center or agency, or an unassigned patient, is admitted for care, after obtaining a release for this notification from the patient. 7 AAC 72.085. Determination regarding declarations for mental health treatment. The staff at a designated facility shall make a reasonable effort to determine whether a patient committed under AS 47.30 has made a declaration of preferences or instructions regarding mental health treatment under AS 47.30.950 - 47.30.980 by consulting the patient, the patient's health care provider, the patient's spouse or parent, a person in the patient's household, or a person designated by the patient. 7 AAC 72.090. Qualified personnel. Repealed. 7 AAC 72.100. Personnel administration. Repealed. 7 AAC 72.110. Written agreements. (a) The administrator shall enter into a written agreement with each community mental health center served by the facility to provide for coordination and continuity of services related to the admission and discharge of patients receiving inpatient psychiatric care. (b) An agreement under (a) of this section must state that the center, after being notified by the facility of a patient's discharge from the facility, will schedule an appointment at the center with the patient for (1) clinical services within one week after a patient's discharge from the facility; and (2) medication management services before depletion of any psychotropic medication dispensed or prescribed for a patient upon discharge, and that, whenever possible, medication management services are to include a psychiatric evaluation. (c) If a single-point-of-entry psychiatric emergency facility is located in the area served by a designated facility, the designated facility shall, at a minimum, have in place with that other facility a memorandum of understanding that includes terms identical to those required under (b) of this section. 7 AAC 72.120. Availability of services. Repealed. 7 AAC 72.130. Environment. Repealed. 7 AAC 72.140. Patient rights. Repealed. 7 AAC 72.150. Patient records. (a) For each patient, a facility shall maintain a clinical record with forms that document the facility's use of the emergency examination or the evaluation procedure set out in 7 AAC 72.220 - 7 AAC 72.260 . (b) The facility shall safeguard patient records, including electronic records, against loss, defacement, tampering, and use by unauthorized persons. Information from patient records, including electronic records, may be released only in accordance with AS 47.30.845 and (c) of this section. (c) For a patient being treated for alcohol or drug abuse in a facility that receives federal assistance as described in 42 C.F.R. 2.12(b), the facility may disclose information from that patient's records only as allowed under 42 C.F.R. Part 2, including use of the consent form required under 42 C.F.R. 2.31. (d) Patient records that are required to be submitted to the department are subject to the applicable requirements of 7 AAC 85 . 7 AAC 72.155. Quarterly report of patient information. Within 60 days after the end of each calendar quarter, the administrator shall submit to the department, on a form supplied by the department, the following information regarding patients admitted to the facility during the previous quarter who were found to be suffering from a mental illness and who posed a danger to self or others, or who were gravely disabled, as determined by each patient's treating physician or psychiatrist: (1) the number of patients admitted voluntarily; (2) the number of patients admitted involuntarily; (3) the number of patients admitted who had insurance or self-pay coverage that was billed; (4) the average length of stay for all patients admitted during the quarter, whether voluntary or involuntary; (5) the number of patients who were readmitted during the quarter. 7 AAC 72.160. Quality assurance plan. Repealed. 7 AAC 72.165. Transfer of patients between designated facilities. An already committed patient may not be transferred from a designated evaluation or treatment facility to another designated facility or to a state-operated hospital, unless (1) a mental health professional (A) determines that the transfer is in the best treatment interests of the patient; (B) obtains, before the transfer, certification from the patient's attending physician that the patient is medically stable; and (C) contacts authorized admitting personnel at the receiving facility or hospital, and explains why the patient's mental condition or behavior necessitates transfer to another facility or hospital; and (2) the administrator of the facility proposing the transfer obtains, before the transfer, permission from the administrator at the receiving facility or hospital to transfer the patient. 7 AAC 72.170. Evaluation. Repealed. 7 AAC 72.180. Reports. Repealed. 7 AAC 72.190. Standards for treatment facility. Repealed. 7 AAC 72.200. Handicapped, cultural, and testing services. Repealed. 7 AAC 72.210. Clinical services and treatment plan.