1. (a) If, as a result of the progress evaluation required by 7 AAC 50.845(a) if the residential psychiatric treatment center recommends that the child not remain in treatment in the facility, the facility shall document in its medical records that the

   1. (1) child's condition can no longer be safely, appropriately, or effectively treated in the facility's treatment program, but that the child could be safely, appropriately, or effectively treated in the treatment program of another residential psychiatric treatment center;
   2. (2) child's condition can no longer be safely, appropriately, or effectively treated in the facility's treatment program, and that persistent clinical indications exist that the child needs a more intensive psychiatric treatment of the level of a psychiatric hospital; however, the residential psychiatric treatment center may not make a finding under this paragraph merely because the child suffers a short-term or episodic worsening of the child's condition or behavior, unless the facility documents that it has repeatedly but unsuccessfully attempted intervention using all of its services and those of special consultants as appropriate to arrest or reverse the worsening of the child's condition or behavior;
   3. (3) child's medical condition requires transfer to a medical setting; or

   4. (4) child no longer requires the intensity of service and treatment of a residential psychiatric treatment center based on documentation

      1. (A) of demonstrably sustainable gains in the areas described in 7 AAC 50.845(b)(1)(B) that the child can sustain without requiring cueing or control by the program staff of a residential psychiatric treatment center;
      2. (B) that the child can be safely and effectively treated in a less restrictive setting; and
      3. (C) of a final plan as required under (b) of this section for transition, discharge, and care after discharge for the child.

2. (b) A final plan for transition, discharge, and care after discharge for the child must

   1. (1) ensure that the residential psychiatric treatment center meets the needs of the child and the child's family through the arrangement of after-care services, and that the treatment team assembled under 7 AAC 50.840 and the facility's clinical staff will consult and be available for intervention for at least the longer of

      1. (A) one month for every two months that the child received care in the facility; or
      2. (B) three months;
   2. (2) require that the residential psychiatric treatment center, during the time set out in (1) of this subsection, contact at least once a month the treatment team assembled under 7 AAC 50.840, so that the facility can ensure an appropriate transition of the child to community placement and treatment; and

   3. (3) include the following documentation:

      1. (A) where and with whom the child will live;
      2. (B) specified medical and mental health providers to provide ongoing care to the child;
      3. (C) identification of a school for the child to attend, with an IEP in place for the child;
      4. (D) specific supports and services from persons or programs including the case manager, the department or child placement agency, community residential or treatment facilities or programs, and the child's family;
      5. (E) the involvement, if applicable, of religious, cultural, recreational or other community agencies that will be providing support or services to the child, the child's family, or the provider of full time care to the child;
      6. (F) documentation of the substantial agreement of the treatment team assembled under 7 AAC 50.840; and
      7. (G) the consent of the child's parent, Indian custodian, or guardian, and the consent of the child if the child is age sixteen or older and is capable of understanding the consequences, risks, and benefits of the decision.

3. (c) In addition to the requirements of this section, a residential psychiatric treatment center

   1. (1) shall meet the requirements regarding discharge specified in 7 AAC 50.340; and
   2. (2) may not follow the procedures for discharge in 7 AAC 50.425( l) unless the signs of danger to self or others exhibited by the child are so severe that the resident cannot be managed in the facility and requires immediate hospitalization.

(Eff. 6/21/2001, Register 158)