APPENDIX A: DEFINITIONS

APPENDIX A: DEFINITIONS

"Abuse" means the inflicting of mental or physical pain or injury by other than accidental means, or unreasonable confinement, or the deprivation by an employee of services, which are necessary to the mental or physical health of the client. Temporary discomfort that is part of unapproved and documented treatment plan or use of a documented emergency procedure shall not be considered abuse.

"Accident" means an unexpected, unnatural or irregular event contributing to a client's death and includes, but is not limited to, medication errors, falls, fractures, chocking, elopement (escape, run away from or abscond), exposure, poisoning, drowning burns or thermal injury, electrocution, misuse of equipment, motor vehicle accidents, and natural disasters.

"Accreditation" means the authorization granted to an area program by DMH/DD/SAS, as a result of demonstrated compliance with the standards established in these Rules, to provide specific services.

"Administering medication" means direct application of a drug to the body of a client by injection, inhalation, ingestion, or any other means.

"Adolescent" means a minor from 13 though 17 years of age.

"Adult" means a person 18 years of age or older or a person under 18 years of age who has been married or who has been emancipated by a court of competent jurisdiction or is a member of the armed forces.

"Agency" means a home care agency as defined in GS 131E-136(2).

"Agency Director" means the person having the administrative responsibility for the operation of the agency.

"Alcohol abuse" means psychoactive substance abuse which is a residual category for noting maladaptive patterns of psychoactive substance use that have never met the criteria for dependence use that have met the criteria for dependence for that particular substance and which continues despite adverse consequences. The criteria for alcohol abuse delineated in the DSM IV is incorporated by reference.

"Alcohol dependence" means psychoactive substance dependence that is a cluster of cognitive behavioral and physiologic symptoms that indicate that a person has impaired control of psychoactive substance use of the substance despite adverse consequences. The criteria for alcohol dependence delineated in the DSM is incorporated by reference.

"Allied Health personnel," means licensed practical nurses or other health professional as defined in occupational licensure laws that are subject to supervision by health professional.

"Appropriate professional" means a licensed health care professional or a person with a baccalaureate degree in social work/psychology or meets the job specifications established for social worker by the office of state personnel. 

"Area Program" means a legally constituted public agency providing mental health, developmental disabilities 

and substance abuse services for a catchments area designated by the Commission. For purposes of these Rules, 

the term

"Area program" means the same as "area authority" as defined in G.S. 122C-3.

"Assessment" means a procedure for determining the nature and extent of the need for which the individual is seeking service.

"Basic necessity" means an essential item or substance needed to support life and health which includes, but it not limited to, a nutritionally sound balanced diet consisting of three meals per day, access to water and bathroom agencies at frequent intervals, seasonable clothing, medications prescribed by a physician, time for sleeping and frequent access to social contacts.

"Child" means a minor from birth through 12 years of age.

"Client" means an individual who receives home care.

"Client record" means a documented account of all services provided to a client.

"Commission" means the same as defined in G.S. 122C-3.

"Consent" means acceptance or agreement by a client or legally responsible person following receipt of sufficient information from the qualified professional who will administer the proposed treatment or procedure. Consent implies that the client or legally responsible person was provided with sufficient information, in a manner that the client of legally responsible person can understand, concerning proposed treatment, including both benefits and risks, in order to make a decision with regard to such treatment.

"Contract agency" means a legally constituted entity that the area program contracts for an individually identified client.

"Day/night agency" means a agency wherein a service is provided on a regular basis, in a structured environment, and is offered to the same individual for a period of three or more hours within a 24-hour period.

"Detoxification" means the physiological withdrawal of an individual from alcohol or other drugs in order that the individual can participate in rehabilitation activities.

"Department" means the Department of Health and Human Services.

"DFS" means the Division of Facility Services, 701 Barbour Drive, Raleigh, N.C. 27603.

"Paraprofessional Staff" means an individual who provides active paraprofessional, treatment, rehabilitation or habilitation services to clients.

"Director of Clinical Services" means Medical Director, Director of Medical Services, or other qualified professional designated by the governing body as the Director of Clinical Services.

"Division Director" means the Director of DMH/DD/SAS.

"DMH/DD/SAS" means the Division of Mental Health, Developmental Disabilities and Substance Abuse Services, 325 N. Salisbury Street, Raleigh, N.C. 27603.

"Documentation" means provision of written or electronic, dated and authenticated evidence of the delivery of client services or compliance with statutes or rules, e.g. entries in the client record, policies and procedures, minutes of meetings, memoranda, reports, schedules notices and announcements.

"Drug abuse" means psychoactive substance abuse which is a residual category for noting maladaptive patterns of psychoactive substance use that have never met the criteria for dependence for that particular class of substance which continues despite adverse consequences. The criteria for drug dependence delineated in the DSM IV is incorporated by reference.

"Drug dependence" means psychoactive substance dependence which is a cluster of cognitive behavioral and physiologic symptoms that indicate that a person has impaired control of psychoactive substance use and continues use of the substance despite adverse consequences. The criteria for drug dependence delineated in the DSM IV is incorporated by reference.

"DSM IV" means the publication of that title published by the American Psychiatric Association, 1400 K Street, N.W., Washington, D.C. 20005 at a cost of thirty-nine dollars and ninety-five cents ($39.95) for the soft cover edition and fifty-four dollars and ninety-five cents ($54.95) for the hardcover edition. When used in these definitions, incorporation by reference of DSM IV includes subsequent amendments and editions of the references material.

"DWI" means driving while impaired, as defined in G.S. 20-138.1.

"Emergency" means a situation in which a client is in imminent danger of causing abuse or injury to self or others or when substantial property damage is occurring as result of unexpected and severe forms of inappropriate behavior and rapid intervention by the staff is needed.

"Evaluation" means an assessment services that provide for an appraisal of client in order to determine the nature of the client's problem and his need for services. The services may include an assessment of the nature and extent of the client's problem through a systematic appraisal of any combination of mental, psychological, physical, behavioral, functional, social, economic, and intellectual resources for the purpose of diagnosis and determination of the disability of the client, the client's level of eligibility, and the most appropriate plan, if any, for services.

"Exploitation" means the illegal or unauthorized use of a client or a client's resources for another person's profit, business or advantage. 

"Agency" means the term as defined in G.S. 122C-3. For the purpose of these Rules, when more than one type 

of service is provided by the agency, each service shall be specifically addressed by required policy and procedures when applicable. 

"Follow-up care" means services provided to a licensed hospital's discharged client in their home by a hospital employee. 

"Governing Body," means, in the case of a corporation, the board of directors; the group having full legal authority for operation of the agency. "Governor's Advocacy Council for Persons with Disabilities (GACPD)" means the council legislatively mandated to provide protection and advocacy systems and promote employment for all persons with disabilities in North Carolina.

"Habilitation" means the same as defined in G.S. 122C-3.

"Hands on care," means any home care services, which involves touching the patient in order to implement client care plan.

"Hearing" means, unless otherwise specified, a contested case hearing under G.S. 150B, Article 3.

"Immediately" means at once, at or near the present time, without delay.

"Incident" means any happening which is not consistent with the routine operation of an agency or service or the routine care of a client and that is likely to lead adverse effects upon a client.

"Infant" means an individual from birth to one year of age.

"Individualized education program" means a written statement for a child with special needs is developed and implemented pursuant to 16 NCAC 2 E .1500 (Rules Governing Programs and Services for Children with Special Needs) available from the Department of Public Instruction.

"Inpatient Service" means a service provided in a hospital setting on s 24-hour basis under the direction of a physician. The service provides continuous, close supervision for individuals with moderate to serve mental or substance abuse problems.

"Intervention Advisory Committee" means a group established by the governing body in a agency that utilizes restrictive interventions as specified in Rule .0104 of Subchapter 14R. "Involuntary Client" means an individual who is admitted to a agency in accordance with G.S. 122C, Article 5, Parts 6 through 12. "Isolation time-out" means the removal of a client for a period of 30 minutes or more to a separate room from which exit is barred by staff, but not locked, and where there is continuous supervision by staff, for the purpose of modifying behavior.

"Legend drug" means a drug that cannot be dispensed without a prescription.

"License" means a permit to operate an agency which is issued by DFS under G.S. 122C, Article 2.

"Medication" means a substance recognized in the official "United States Pharmacopoeia" or 

"National Formulary" intended for use in the diagnosis, mitigation, treatment or prevention of disease.

"Minor" means a person less than 18 years of age who has not been married or who has not been emancipated by a decree issued by a court of competent jurisdiction or is not a member of the armed forces.

"Minor Client" means a person under 18 years of age who has neither been married nor been emancipated by a decree issued by a court of competent jurisdiction.

"Neglect" means the failure to provide care or services necessary to maintain the mental or physical health and well being of the client.

"Neuroleptic medication" means the category of psychotropic drugs, which is used to treat schizophrenia and related disorders. Examples of Neuroleptic medications are Chlorpromazine, Thioridazine and Haloperidol.

 "Normalization" means the utilization of culturally valued resources to establish or maintain personal behaviors, experiences and characteristics that are culturally normative or valued. 

"Operator" means the designated agent of the governing body who is responsible for the management of a licensable agency.

"Outpatient service" means the same as periodic services.

"Parent" means the legally responsible person unless otherwise clear from the context.

"Periodic service" means a service provided on an episodic basis, either regularly or intermittently, through short, recruiting visits for persons with mental illness, developmental disability or who are substance abusers.

"Physical Restraint" means the application or use of any manual method of restraint that restricts freedom of movement; or the application or use of any physical or mechanical device that restricts freedom of movement or normal access to one's body, including material or equipment attached or adjacent to the client's body that he or she cannot easily remove. Holding a client in a therapeutic hold or other manner that restricts his or her movement constitutes manual restraint for that client. 

Mechanical devices may restrain a client to a bed or chair, or may be used as ambulatory restraints. Examples of mechanical devices include cuffs, ankle straps, sheets or restraining shirts, arm splints, poesy mittens and helmets. Excluded from this definition of physical restraint are physical guidance, gentle physical prompting techniques, and escorting a client who is walking; soft ties used solely to prevent a medically ill client from removing intravenous tubes, indwelling catheters, cardiac monitor technology which are designed and used to increase client adaptive skills.

"Prevailing wage" means the wage rate paid to an experienced worker who is not disabled for the work to be preformed.

"Pre-school age child" means a child from three to five years old.

"Private agency" means a agency not operated by or under contract with an area program.

"Privileged" means authorization through governing body procedures for a agency employee to provide specific treatment or habilitation services to clients, based on the employee's education, training, experience, competence and judgment.

"Provider" means an individual, agency or organization that provides mental health, developmental disabilities or substance abuse services.

"Rehabilitation" means training, care and specialized therapies undertaken to assist a client to reacquire or maximize any or all lost skills or functional abilities.

"Residential service" unless otherwise provided in these Rules, means a service provided in a 24-hour living environment in a non-hospital setting where room, board and supervision are an integral part of the care treatment, habilitation provided to the individual.

"Responsible professional" means the term as defined in G.S. 122C-3 except the

"Responsible professional" shall also be a qualified professional as defined in G.S.122C3.

"School aged youth" means individuals from six through twenty-one years of age.

"Screening" means an assessment services that provides for an individual who is not a client in order to determine the nature of the individual's problem and his need for services. The service may include an assessment of the nature and extent of the Individual's problem through a systematic appraisal of any combination of mental, psychological, physical, and behavioral. Functional, social, economic and intellectual resources, for the purpose if diagnosis and determination of the disability of the individual, level of eligibility, if the individual will become a client, and the most appropriate plan, if any, for services.

"Secretary" means the Secretary of the Department of Human Resources or designee.

"Service" means as activity or interaction intended to benefit another, with, or on behalf of, an individual who is in need of assistance, care, habilitation, intervention, rehabilitation or treatment. "Service plan" means the same as treatment/habilitation plan defined in this Section.

"Staff member" means any individual who is employed by the agency.

"State agency” means the term as defined in G.S. 122C.

"Support services" means services provided to enhance an individual's progress in his primary treatment/habilitation 

program.

"System of care" means a spectrum of community based mental health and other necessary services which are organized into a coordinated network to meet the multiple and changing needs of emotionally disturbed children and adolescents.

"Toddler" means an individual from one through two years of age.

"Treatment" means the process of providing for the physical, emotional, psychological and social needs of a client through services. 

"Treatment/habilitation plan" means the term as defined in 10 NCAC 14V.0103 "Treatment or habilitation team" means an interdisciplinary group of qualified professionals sufficient in number and variety by discipline to assess and address the identified needs of a client and which is responsible for the formulation, implementation and periodic review of the client's treatment/habilitation plan.

"24-Hour service" means a service that is provided to a client on a 24-hour continuous basis.

"24-Hour Agency" means an agency wherein service is provided to the same client on a 24-hour continuous basis, and includes residential and hospital agencies. "Violence" means physical force exerted for the purpose of violating, damaging, abusing or injuring.

"Violence" means physical force exerted for the purpose of violating, damaging, abusing or injuring.

"Voluntary Client" means an individual who is admitted to an agency upon his own