Amends Section 10.69A(a)(7) of SL 2009-451, as previously amended by Section 5A of SL 2009-575 and Section 10.35 of SL 2010-31, to: (1) provide that before a child can be admitted to Level III or Level IV placement in Medicaid child mental health, development disabilities, and substance abuse residential services an assessment must be completed to determine the appropriateness of placement; (2) increase the maximum length of stay to 180 days (was 120 days); (3) require any exceptions to the maximum length of stay for non-CABHAs (Critical Access Behavioral Health Agency) require an independent psychological or psychiatric assessment, and for CABHAs, a psychological or psychiatric assessment that may be completed by the CABHA; (4) eliminate requirement that the Department of Health and Human Services study the effectiveness of the length of stay limitation; and (5) specify that authorization approval is not conditional upon all signatures on a discharge plan. Authorizes the local management entity (LME) to designate appropriate individuals to sign the discharge plan within 24 hours of receipt.