(a)

1. (1) New behavioral health agency applicants must complete:

   1. (A) Department of Human Services Behavioral Health Agency Certification Form 100;
   2. (B) Department of Human Services Behavioral Health Agency Form 200; and
   3. (C) Department of Human Services Behavioral Health Agency Form 210.
2. (2) Department of Human Services Behavioral Health Agency Certification Form 100, Department of Human Services Behavioral Health Agency Form 200, and Department of Human Services Behavioral Health Agency Form 210 can be found at the following website: Provider Services & Quality Assurance - Arkansas Department of Human Services.

(c) Each applicant must be an outpatient behavioral healthcare agency:

1. (1) Whose primary purpose is the delivery of a continuum of outpatient behavioral health services in a free-standing independent clinic; and
2. (2) That is independent of any Department of Human Services certified behavioral health agency.

(h)

1. (1)

   1. (A) Applicants must:

(i) Maintain and document accreditation; and

1. (ii) Prominently display certification of accreditation issued by the accrediting organization in a public area at each site.

   1. (B) Accreditation must recognize and include all the applicant’s behavioral health agency programs, services, and sites.

2. (2)

   1. (A) Initial accreditation must include an on-site survey for each service site for which provider certification is requested.
   2. (B) Accreditation documentation submitted to the department must list all sites recognized and approved by the accrediting organization as the applicant’s service sites.

3. (3) Accreditation documentation must include the applicant’s governance standards for operation and sufficiently define and describe all services or types of care (customer service units or service standards) the applicant intends to provide including, without limitation:

   1. (A) Crisis intervention/stabilization;
   2. (B) In-home family counseling;
   3. (C) Outpatient treatment;
   4. (D) Day treatment;
   5. (E) Therapeutic foster care;
   6. (F) Intensive outpatient; or
   7. (G) Medication management/pharmacotherapy.
4. (4) Any outpatient behavioral health program associated with a hospital must have a free-standing behavioral health outpatient program national accreditation.
5. (5) The applicant must attach the entity’s family involvement policy to each application.