### §1665. Definitions

In this part:

#### (1) Alcohol-related neurodevelopmental disorders; ARND

The term "alcohol-related neurodevelopmental disorders" or "ARND" means, with a history of maternal alcohol consumption during pregnancy, central nervous system abnormalities, which may range from minor intellectual deficits and developmental delays to mental retardation. ARND children may have behavioral problems, learning disabilities, problems with executive functioning, and attention disorders. The neurological defects of ARND may be as severe as FAS, but facial anomalies and other physical characteristics are not present in ARND, thus making diagnosis difficult.

#### (2) Assessment

The term "assessment" means the systematic collection, analysis, and dissemination of information on health status, health needs, and health problems.

#### (3) Behavioral health aftercare

The term "behavioral health aftercare" includes those activities and resources used to support recovery following inpatient, residential, intensive substance abuse, or mental health outpatient or outpatient treatment. The purpose is to help prevent or deal with relapse by ensuring that by the time a client or patient is discharged from a level of care, such as outpatient treatment, an aftercare plan has been developed with the client. An aftercare plan may use such resources as a community-based therapeutic group, transitional living facilities, a 12-step sponsor, a local 12-step or other related support group, and other community-based providers.

#### (4) Dual diagnosis

The term "dual diagnosis" means coexisting substance abuse and mental illness conditions or diagnosis. Such clients are sometimes referred to as mentally ill chemical abusers (MICAs).

#### (5) Fetal alcohol spectrum disorders

#### (A) In general

The term "fetal alcohol spectrum disorders" includes a range of effects that can occur in an individual whose mother drank alcohol during pregnancy, including physical, mental, behavioral, and/or learning disabilities with possible lifelong implications.

#### (B) Inclusions

The term "fetal alcohol spectrum disorders" may include—

(i) fetal alcohol syndrome (FAS);

(ii) partial fetal alcohol syndrome (partial FAS);

(iii) alcohol-related birth defects (ARBD); and

(iv) alcohol-related neurodevelopmental disorders (ARND).

#### (6) FAS or fetal alcohol syndrome

The term "FAS" or "fetal alcohol syndrome" means a syndrome in which, with a history of maternal alcohol consumption during pregnancy, the following criteria are met:

(A) Central nervous system involvement, such as mental retardation, developmental delay, intellectual deficit, microencephaly, or neurological abnormalities.

(B) Craniofacial abnormalities with at least 2 of the following:

(i) Microophthalmia.

(ii) Short palpebral fissures.

(iii) Poorly developed philtrum.

(iv) Thin upper lip.

(v) Flat nasal bridge.

(vi) Short upturned nose.

(C) Prenatal or postnatal growth delay.

#### (7) Rehabilitation

The term "rehabilitation" means medical and health care services that—

(A) are recommended by a physician or licensed practitioner of the healing arts within the scope of their practice under applicable law;

(B) are furnished in a facility, home, or other setting in accordance with applicable standards; and

(C) have as their purpose any of the following:

(i) The maximum attainment of physical, mental, and developmental functioning.

(ii) Averting deterioration in physical or mental functional status.

(iii) The maintenance of physical or mental health functional status.

#### (8) Substance abuse

The term "substance abuse" includes inhalant abuse.

(Pub. L. 94–437, title VII, §701, as added Pub. L. 111–148, title X, §10221(a), Mar. 23, 2010, 124 Stat. 935.)

#### **Editorial Notes**

#### Codification

#### Codification

Section 701 of Pub. L. 94–437 is based on section 181 of title I of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148.

#### Prior Provisions

A prior section 1665, Pub. L. 94–437, title VII, §701, as added Pub. L. 102–573, title VII, §702(a), Oct. 29, 1992, 106 Stat. 4572, related to responsibilities of Indian Health Service for alcohol and substance abuse prevention and treatment, prior to the general amendment of this subchapter by Pub. L. 111–148.