1. (a)

   1. (1) Any facility in which psychiatric services are offered for a period of eight (8) to sixteen (16) hours a day and where, in the opinion of the attending psychiatrist, hospitalization as defined in the present licensure law is not necessary, is considered an outpatient psychiatric facility.
   2. (2) This definition does not include community mental health clinics and centers as they now exist.
   3. (3) Such facilities shall conform with applicable sections if those services are provided within the facility.
   4. (4) Such facilities shall conform with applicable sections of 20 CAR § 43-174, physical facilities — outpatient care facilities.

2. (b) General requirements.

   1. (1) Each psychiatric facility shall have a written plan describing the:

      1. (A) Organization of outpatient services; or
      2. (B) Arrangement for the provision of such services to meet patient needs.

   2. (2) The outpatient services shall include, but not be limited to:

      1. (A) Diagnostic evaluation;
      2. (B) Individual or group therapy;
      3. (C) Consultation; and
      4. (D) Rehabilitation.

   3. (3) The center shall be under the direction and management of a psychiatrist who is:

      1. (A) Qualified by training and experience requirements for examination by the American Board of Psychiatry and Neurology, Inc., or the American Osteopathic Board of Neurology and Psychiatry; and
      2. (B) Licensed in the State of Arkansas.
   4. (4) The program director of the outpatient center shall be an individual with at least two (2) years of administrative experience.

   5. (5) The center shall furnish, through the use of qualified personnel:

      1. (A) Psychological services;
      2. (B) Social work services;
      3. (C) Occupational therapy;
      4. (D) Recreational therapy; and
      5. (E) Psychiatric nursing.

   6. (6)

      1. (A) The center shall have a qualified director of nursing:

3. (i) With a master’s degree; or

   1. (ii) Qualified by education and experience in the care of individuals with mental illness.

      1. (B) If the director does not meet the qualifications, there shall be regular documented consultation by a qualified registered nurse.

   2. (7)

      1. (A) Staffing for the center shall ensure the presence in the center of a registered nurse during the hours the unit is open.
      2. (B) There shall be adequate numbers of registered nurses, licensed practical nurses, and mental health workers to provide the care necessary under each patient's active treatment program.
   3. (8) The center shall provide or have available psychological services to meet the needs of the patients.

   4. (9) There shall be a social service staff to provide services in accordance with:

      1. (A) Accepted standards of practice; and
      2. (B) Established policies and procedures.

   5. (10)

      1. (A) The center shall provide a therapeutic activities program.

      2. (B) The program shall be:

         1. (i) Appropriate to the needs and interests of the patients; and
         2. (ii) Directed toward restoring and maintaining optimal levels of physical and psychosocial functioning.
   6. (11) There shall be a procedure for referrals for needed services that are not provided directly by the facility.

   7. (12)

      1. (A) There shall be adequate space, equipment, and supplies for outpatient services to be provided effectively and efficiently in functional surroundings that are readily accessible and acceptable to the patients and community services.

      2. (B) All space, equipment, and facilities both within the psychiatric facility and those utilized outside the facility shall:

         1. (i) Be well maintained; and
         2. (ii) Meet applicable federal, state, and local requirements for:
4. (a) (a) Safety;

5. (b) (b) Fire;

   1. (c) (c) Health; and

      1. (d) (d) Sanitation.

   2. (13)

      1. (A) Policies and procedures shall have evidence of ongoing review and/or revision.

      2. (B) The first page of each manual shall have the:

         1. (i) Annual review date; and
         2. (ii) Signature of the department supervisor and/or person or persons conducting the review.

   3. (14)

      1. (A) Clinically relevant educational program shall be conducted on a regularly scheduled basis of not fewer than twelve (12) per year.

      2. (B) There shall be evidence of:

         1. (i) Program dates;
         2. (ii) Attendance; and
         3. (iii) Subject matter.

   4. (15)

      1. (A) Regular staff meetings shall be held at least monthly.
      2. (B) Dated minutes of each meeting shall be kept in writing.
   5. (16) There shall be an ongoing program for orientation of staff.

   6. (17) There shall be an ongoing QA/PI program.

      1. (c) Medical records shall include at least:
   7. (1) Identification data including patient's legal status;
   8. (2) Admitting psychiatric diagnosis as well as diagnoses of medical problems;
   9. (3) The reasons for the patient's admission to this level of care;

   10. (4) Social service records including:

       1. (A) Reports of interviews with patients, family members, and others; and
       2. (B) A social history and assessment;
   11. (5) Psychiatric evaluation (see 20 CAR § 43-136, specialized service — psychiatric services); and

   12. (6) Treatment plan (see 20 CAR § 43-136, specialized service — psychiatric services).

       1. (d) Medications. Outpatient services utilizing medications in therapeutic programs shall fulfill the requirements in 20 CAR § 43-115, pharmacy.
6. (e) Food and nutritional services. See 20 CAR § 43-116, food and nutrition services.
7. (f) Physical facilities. The outpatient psychiatric centers shall comply with 20 CAR § 43-174, physical facilities — outpatient care facilities.

Codification Notes: “QA/PI” means quality assurance/performance improvement.