A. In addition to
the license application requirements in A.R.S. §
36-422
and R9-10-105, an applicant for a license as a behavioral health residential
facility shall include on the application:
1.
Whether the applicant is planning to provide:
a. Behavioral health services to individuals
under 18 years of age, including the licensed capacity requested;
b. Behavioral health services to individuals
18 years of age and older, including the licensed capacity requested;
or
c. Respite services;
2. Whether the applicant is
requesting authorization to provide an outdoor behavioral health care program,
including:
a. The requested licensed capacity
for providing the outdoor behavioral health care program to individuals 12 to
17 years of age, and
b. The
requested licensed capacity for providing the outdoor behavioral health care
program to individuals 18 to 24 years of age;
3. Whether the applicant is requesting
authorization to provide:
a. Court-ordered
evaluation,
b. Court-ordered
treatment,
a.c. Behavioral health
services to individuals 18 years of age or older whose behavioral health issue
limits the individuals' ability to function independently, or
b.d.
Personal care services;
4. Whether the applicant is requesting
authorization to provide recidivism reduction services as an adult residential
care institution, including the requested licensed capacity for providing
recidivism reduction services;
5.
For a behavioral health residential facility requesting authorization to
provide respite services, the requested number of individuals the behavioral
health residential facility plans to admit for respite services who:
a. Are included in the requested licensed
capacities in subsections (A)(1)(a) and (b),
b. Are under 18 years of age and who do not
stay overnight in the behavioral health residential facility, and
c. Are 18 years of age and older and who do
not stay overnight in the behavioral health residential facility; and
6. For an outdoor behavioral
health care program, a copy of the outdoor behavioral health care program's
current accreditation report.