309-114-0005 Definitions As used in these rules: (1) "Authorized Representative" or "representative" means an individual who represents a party in a contested case hearing; the representative must be supervised by an attorney that is licensed by the Oregon State Bar. (2) "Chief Medical Officer" or “CMO” means the physician or physician’s designee appointed pursuant to ORS 426.020 who is responsible for the administration of medical treatment at each state institution and the supervision of physicians and practitioners who are employed by the hospital or are contracted to provide services at the hospital. (3) “Committed” or “Commitment” means an individual who is 18 years or older and is admitted for inpatient care and/or treatment at OSH under ORS 161.327, 161.328, 161.370, 179.473, 419C.396, 419C.529, 426.130, 427.215 or 426.220, 426.701, 426.702 when the individual's guardian or health care representative is unavailable or unable to consent. (4) “Dangerousness” means that more likely than not either: (a) Physical harm that may be inflicted by an individual upon their own body including: (A) Verbal or nonverbal threats that an individual will inflict physical harm on their body, attempts to die by suicide, or other acts that result in the infliction of physical harm on themselves; or (B) Historical patterns of behavior as that demonstrate that a patient is likely to engage in self-harm behaviors. This determination does not require an imminent risk of physical harm; or (b) Physical harm may be inflicted by an individual upon another individual, including: (A) Acts, behaviors or threats, including verbal threats, which have caused such harm, or which would place a reasonable individual in reasonable fear of sustaining such harm; or (B) Historical patterns of behavior demonstrating that a patient is likely to cause physical harm or would place a reasonable individual in reasonable fear of sustaining such harm. This determination does not require an imminent risk of physical harm. (5) "Division" means the Oregon State Hospitals Division of the Oregon Health Authority. (6) "Guardian" means a legal guardian who is an individual or entity appointed by a court of law to make decisions on behalf of another individual, including but not limited to a legally incapacitated individual. (7) “Health Care Representative” means an individual who has authority to make health care decisions for a patient. (8) “Independent Examining Practitioner” is a board-eligible psychiatrist or licensed psychiatric nurse practitioner, who must have been subjected to review by the medical staff executive committee as to qualifications to make such an examination, must have been provided with a copy of administration rules OAR 309-114-0000 through 309-114-0025 and must have participated in a training program regarding these rules, their meaning and application. The independent examining practitioner must not be directly involved in the patient’s current or past treatment or diagnosis, excluding time spent solely as an on-call provider. (9) "Legally Incapacitated" means having been found by a court of law under ORS 426.295 to be unable, without assistance, to properly manage or take care of one's personal affairs, or who is an individual under guardianship. (10) "Material Risk." A risk is material if it may have a substantial adverse effect on the patient's psychological or physical health, or both. Tardive dyskinesia is a material risk of neuroleptic medication. Other risks include, but are not limited to raised blood pressure, onset of diabetes and metabolic changes. (11) Oregon State Hospital” or “OSH” or “hospital” means any campus of the Oregon State Hospital system providing inpatient care and/or treatment to individual who are 18 years or older whether the program where the individual is receiving care and/or treatment is licensed at hospital level of care or other licensed level of care. (12) "Patient" means an individual who is 18 years or older and receiving inpatient care and/or treatment in a state institution, whether the program where the individual is receiving care and/or treatment is licensed at hospital level of care or other licensed level of care. (13) Patient with a “grave disability” means a patient who: (a) Is in danger of serious physical harm to their health or safety absent the proposed significant procedures; or (b) Manifests severe deterioration in routine functioning evidenced by loss of cognitive or volitional control over their actions which is likely to result in serious harm absent the proposed significant procedures. (14) "Individual Committed to the Division" or "Individual" means an individual who is 18 years or older and is admitted at OSH for inpatient care and/or treatment under ORS 161.327, 161.328, 161.370, 179.473, 419C.396, 419C.529, 426.130, 426.220, 426.701, 426.702 or 427.215. (15) "Psychiatric Nurse Practitioner," means a registered nurse with prescription authority who independently provides health care to clients with mental and emotional needs or disorders. (16) “Routine Medical Procedure” means a procedure customarily administered by facility medical staff under circumstances involving little or no risk of causing injury to a patient including, but not limited to physical examinations, blood draws, influenza vaccinations, tuberculosis (TB) testing, human immunodeficiency virus (HIV) testing and hygiene. (17) "Significant Procedure" means a diagnostic or treatment modality and all significant procedures of a similar class that pose a material risk of substantial pain or harm to the patient such as, but not limited to psychotropic medication and electro-convulsive therapy. Significant procedures do not include routine medical procedures. (18) “Significant Procedures of a Similar Class” means a diagnostic or treatment modality that presents substantially similar material risks as the significant procedure listed on the treating physician’s or psychiatric nurse practitioner's informed consent form and is generally considered in current clinical practice to be a substitute treatment or belong to the same class of medications as the listed significant procedure. (a) For purposes of these rules, medications listed in subsections 18 (a)(A) through 18(a)(F) of this rule must be considered the same or similar class of medication as other medications in the same subsection: (A) All medications used under current clinical practice as antipsychotic medications including typical and atypical antipsychotic medications; (B) All medications used under current clinical practice as mood stabilizing medications; (C) All medications used under current clinical practice as antidepressants; (D) All medications used under current clinical practice as anxiolytics; (E) All medications used under current clinical practice as psychostimulants; and (F) All medications used under current clinical practice as dementia cognitive enhancers. (b) Significant procedures of the same or similar class do not need to be specifically listed on the treating physician's or psychiatric nurse practitioner's form. (19) "State Institution" or "Institution" means any campus of the Oregon State Hospital system providing inpatient care and/or treatment to individuals who are 18 years or older. (20) "Superintendent" means the executive head of the Oregon State Hospital system, or the superintendent's designee. Statutory/Other Authority: ORS 179.040 & 413.042 Statutes/Other Implemented: ORS 179.321, 183.458, 426.070 & 426.385 History: BHS 13-2025, amend filed 05/06/2025, effective 05/11/2025 BHS 26-2024, temporary amend filed 11/13/2024, effective 11/13/2024 through 05/11/2025 BHS 20-2024, amend filed 07/23/2024, effective 07/23/2024 BHS 1-2021, amend filed 01/15/2021, effective 01/15/2021 BHS 9-2020, temporary amend filed 06/30/2020, effective 06/30/2020 through 12/26/2020 BHS 17-2018, amend filed 08/01/2018, effective 08/13/2018 MHS 5-2016, f. & cert. ef. 5-25-16 MHS 8-2015(Temp), f. & cert. ef. 11-24-15 thru 5-20-16 MHS 5-2015, f. & cert. ef. 8-28-15 MHS 2-2015(Temp), f. & cert. ef. 4-24-15 thru 10-20-15 MHS 15-2014(Temp), f. & cert. ef. 12-1-14 thru 5-29-15 MHS 4-2011, f. & cert. ef. 5-19-11 MHS 13-2010(Temp), f. & cert. ef. 11-19-10 thru 5-18-11 MHS 12-2010, f. & cert. ef. 9-9-10 MHS 5-2010(Temp), f. & cert. ef. 3-12-10 thru 9-8-10 MHS 6-2009, f. & cert. ef. 12-28-09 MHS 3-2009, f. & cert. ef. 6-26-09 MHS 2-2009(Temp), f. & cert. ef. 4-2-09 thru 7-22-09 MHS 1-2009(Temp), f. & cert. ef. 1-23-09 thru 7-22-09 MHS 6-2008, f. & cert. ef. 7-25-08 MHS 2-2008(Temp), f. & cert. ef. 4-7-08 thru 10-4-08 MHS 14-2007(Temp), f. 11-30-07, cert. ef. 12-1-07 thru 5-29-08 MHD 3-1988, f. 4-12-88, cert. cert. ef. 6-1-88 MHD 3-1983, f. 2-24-83, ef. 3-26-83