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A section will be updated to our Provider Manual regarding ARS 8-272 (Psychiatric acute care services; outpatient and inpatient assessments) and 8-273 (Residential treatment services), which includes several important Provider requirements. As part of the requirements for obtaining inpatient assessment and/or treatment and residential treatment for children in DCS Custody, Providers must provide DCS staff specific written reports from a psychologist, psychiatric and mental health nurse practitioner, psychiatrist or physician, as appropriate and indicated in each specific report. This Provider Notice is to provide the updated forms and process requirements to complete the attached documents and the timelines in which policy and statute outlines. The forms are designed to ensure the Provider and DCS meet the statutory burden for the court to approve continued inpatient treatment for DCS youth (ARS 8-272 and 8-273).
The following forms (form links listed below) need to be completed and returned to the assigned DCS Specialist at key points in the process:
Psychiatric Inpatient Assessment
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Within 72 hours of Admission, a Statement from the Medical Director/ Designee of Inpatient Psychiatric Acute Care Hospital (CSO-1364B) must be provided by the medical provider stating that the facility’s services are appropriate to meet the child’s needs.
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Within 72 hours of Admission, the inpatient psychologist, psychiatric and mental health nurse practitioner, psychiatrist or physician must provide the Inpatient Assessment Report (CSO-1364A).
The Inpatient Assessment Report must thoroughly address:
- The reason why inpatient psychiatric acute care services are in the child's best interests;
- The reason inpatient psychiatric acute care services are the least restrictive available treatment;
- A diagnosis of the child's condition that requires inpatient psychiatric acute care services and list of medications; and
- The estimated length of time the child will require inpatient psychiatric acute care services (hospitalization).
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If the child is expected to remain hospitalized for 60 days or longer, the medical provider must complete the 60 Day Review of Residential/ Psychiatric Treatment Services (CSO-1361A) addressing the child’s continuing need for inpatient psychiatric acute care services. This form is filled out at least every 60 days after the date of the treatment order.
Placement or Transfer to BEHAVIORAL HEALTH INPATIENT FACILITY (BHIF)
If the inpatient assessment recommends Behavioral Health Inpatient Facility Services:
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Within 72 hours of Admission , the recommendation and assessments must be documented with either Inpatient Assessment Report (CSO-1364A), if recommendation made from inpatient setting or Outpatient Assessment Report (CSO-1363A), if recommendation made from outpatient setting.
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Within 72 hours of Admission , the Statement from Medical Director/Designee of Residential Treatment Center (BHIF-RTC) (CSO-1364C) must be provided by the medical provider stating that the facility’s services are appropriate to meet the child’s mental health needs.
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If the child remains in a BHIF for at least 60 days or longer, the medical provider must complete 60 Day Review of Residential/Psychiatric Treatment Services (CSO-1361A); and the BHIF must submit provide a written progress report.
*All reports must be filled out thoroughly and have the appropriate boxes checked and areas filled out. If a report does not meet the Court's satisfaction, the Court may subpoena the medical provider to appear in court and review the information verbally.
Please don't hesitate to contact your Mercy Care Network Management Representative with any questions or comments. You can find this Notice and all other provider notices on our Mercy Care website.
Thanks for all you do!
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