(b) A center's professional staff shall

1. (1) be accountable to the governing body;
2. (2) be responsible for the quality of clinical care provided each patient;
3. (3) adhere to ethical conduct standards and professional practices;
4. (4) comply with policies and procedures approved by the governing body; and
5. (5) maintain an organizational chart that identifies staff names and titles and hierarchy of oversight.

(c) A center's direct care staff shall

1. (1) have the appropriate qualifications to provide the services required by each patient's treatment plan;
2. (2) practice only within the scope of the staff member's license, certification, or training; and
3. (3) have current certification in cardiopulmonary resuscitation.

(d) A center's staff shall include

1. (1) a center administrator who

   1. (A) meets one of the following qualifications:

      1. (i) holds a master's degree in a human services or healthcare field and has at least one year of qualifying experience in the behavioral health field;
      2. (ii) holds a bachelor's degree in a human services or healthcare field and has at least two years of qualifying experience in the behavioral health field;
   2. (B) is a full-time employee;

   3. (C) is responsible for

      1. (i) supervising and managing the center's daily operations;
      2. (ii) reviewing each accident and incident report and identifying hazards to the clinical director;
      3. (iii) participating in the development of new programs and modifications; and
      4. (iv) working collaboratively with the clinical director regarding clinical decisions;
   4. (D) may function as the sole administrator for a center that operates as a collocated center; and
   5. (E) may not have other job responsibilities that would impede the ability to administer and operate the center;

2. (2) a clinical director who

   1. (A) has expertise in managing medical and psychiatric conditions and who is a physician or physician assistant who holds an active license under AS 08.64 or an advanced practice registered nurse who is licensed under AS 08.68;
   2. (B) is responsible for developing and implementing policies and procedures and overseeing clinical services and treatment;
   3. (C) may function as the sole clinical director for a center that operates as a collocated center; and
   4. (D) may function as the licensed prescriber, if all requirements of (3) of this subsection are met;

3. (3) a licensed prescriber who

   1. (A) is responsible for managing the psychiatric and medical care of each patient;

   2. (B) is licensed

      1. (i) under AS 08.64 as a physician or physician assistant; or
      2. (ii) under AS 08.68 as an advanced practice registered nurse and has an unrestricted license and prescriptive authority;
   3. (C) has expertise in managing medical and psychiatric conditions; and
   4. (D) may function as the sole licensed prescriber for a collocated center;

4. (4) a sufficient number of registered nurses to meet the needs of each patient, and who

   1. (A) shall be on duty during the center's hours of operation; a facility that operates as a collocated center shall have at least

      1. (i) one registered nurse on duty if the combined census is 16 patients or fewer; or
      2. (ii) two registered nurses on duty, one for each center, if the combined census is more than 16 patients;
   2. (B) are currently licensed under AS 08.68;
   3. (C) have at least one year of qualifying experience providing direct care to patients with a behavioral health or medical diagnosis; and
   4. (D) are responsible for providing nursing services in accordance with accepted standards of practice, the center's policies, and individual patient treatment plans;

5. (5) a sufficient number of mental health professionals to meet the needs of each patient, and who

   1. (A) have at least one year of qualifying experience in providing direct care to patients with behavioral health diagnoses;

   2. (B) are responsible for

      1. (i) providing direct care to each patient and may serve as primary counselor to a specified caseload;
      2. (ii) serving as resource persons for other professionals and unlicensed staff; and
      3. (iii) attending and participating in individual treatment planning and discharge planning; and
   3. (C) are responsible for participating in the development of plans of care; and

6. (6) a sufficient number of non-licensed or non-certified staff to meet the needs of each patient, and who

   1. (A) are at least 18 years old;
   2. (B) have a high school diploma or general educational development (GED);
   3. (C) provide services in accordance with center policies, documented education, training and experience, and the patient plans of care; and
   4. (D) shall be supervised by nursing or mental health professional staff.

(e) During a center's hours of operation,

1. (1) the center's administrator or qualified designee shall be on site or on call;
2. (2) the center's clinical director or qualified designee shall be on site or on call;
3. (3) the facility shall assign a registered nurse to assume responsibility for oversight of nursing staff and nursing services;
4. (4) a licensed prescriber shall be on site or on call;
5. (5) qualified direct care staff members shall be on site and available to ensure each patient's health, safety, and well-being; and

6. (6) staff coverage shall be maintained to ensure each patient's continual safety, protection, direct care, and supervision in consideration of

   1. (A) patient acuity;
   2. (B) patient ages and needs;
   3. (C) the time of day; and
   4. (D) the center's size, location, and physical environment.

(g) A center shall develop an orientation and annual in-service training program that includes the following requirements:

1. (1) for all center staff,

   1. (A) an orientation that includes job-specific training, before the staff member may work in the center;
   2. (B) in-service training, based on the center's and patients' needs;

   3. (C) as part of both orientation and in-service training, information about

      1. (i) confidentiality;
      2. (ii) patient rights;
      3. (iii) the grievance process;
      4. (iv) fire and disaster plans;
      5. (v) basic emergency care for accidents and emergencies;
      6. (vi) the center's mission, vision, and core values;
      7. (vii) personnel policies and procedures;
      8. (viii) abuse, neglect, and misappropriation prevention, identification, and reporting;
      9. (ix) duties and responsibilities of each employee;
      10. (x) standards of conduct required by the center, including professional boundaries;
      11. (xi) maintaining a clean, healthy, and a safe environment, and safe and therapeutic milieu; and
      12. (xii) infectious diseases and universal precautions; and
   4. (D) orientation and in-service training that is provided by individuals who are qualified by education, training, and experience;

2. (2) for all direct care staff, crisis services and intervention training upon hire and at least annually that includes

   1. (A) an overview of mental health and substance abuse, including an overview of behavioral health settings and levels of care;
   2. (B) detecting signs of illness or dysfunction that warrant medical or nursing intervention;
   3. (C) side effects and adverse reactions commonly caused by psychotropic medications;
   4. (D) basic skills required to meet the health needs and challenges of each patient;
   5. (E) components of a crisis cycle;
   6. (F) recognizing the signs of anxiety and escalating behavior;

   7. (G) crisis intervention and the use of non-physical intervention skills, including

      1. (i) de-escalation;
      2. (ii) mediation conflict resolution;
      3. (iii) active listening; and
      4. (iv) verbal and observational methods to ensure patient safety;
   8. (H) therapeutic communication;
   9. (I) the disease process and signs and symptoms of mental or emotional disorders;
   10. (J) levels of observation;
   11. (K) regulations, standards, and policies related to seclusion and restraint, including the safe application of physical and mechanical restraints and physical assessment of the restrained patient; and
   12. (L) exercises for direct care staff to demonstrate techniques to manage the delivery of patient care services; each direct care staff member shall demonstrate competency in patient care techniques before the staff member may provide services to patients; and
3. (3) for all nursing staff, in-service training that focuses on psychopharmacology and psychotropic medications, including side effects and possible adverse reactions.

(i) A center shall maintain a personnel file for each staff member. A personnel file must contain

1. (1) the employee's employment application and resume, including contact information and employment history;
2. (2) reference letters from former employers or personal references or written documentation based on telephone contact with references;
3. (3) evidence of current professional credentials, licenses, or certifications, as applicable;
4. (4) annual performance evaluations, including evidence of competency in performing assigned tasks;
5. (5) personnel actions, other appropriate materials, reports, and notes relating to the individual's employment;
6. (6) the employee's start and termination dates;
7. (7) proof of required orientation and in-service training completion;
8. (8) results of criminal background checks, if required;
9. (9) job description and performance expectations; and
10. (10) a written confidentiality agreement, signed by the employee.