Hawaii Administrative Rules › Title 11 - DEPARTMENT OF HEALTH › Subtitle 1 - GENERAL DEPARTMENTAL PROVISIONS › Chapter 175 - MENTAL HEALTH AND SUBSTANCE ABUSE SYSTEMS › Subchapter 1 - PURPOSE AND DEFINITIONS › Section 11-175-2 - Definitions

Current through June, 2024
As used in this chapter:
"Abuse" means actual or threatened physical injury,
					 psychological harm, or sexual violation of a consumer by another person.
"Adult mental health division" or "AMHD" means the division
					 of the department that promotes and provides for the establishment and
					 operation of a community-based mental health system pursuant to section
					 334-3,
					 Hawaii Revised Statutes.
"Aftercare" means activities offered, in order to maintain
					 gains received, to persons who formerly received treatment or rehabilitation
					 services.
"Case management services" means those activities
					 performed with consumer involvement by a single accountable individual to
					 support the consumer and ensure that the consumer has maximal access to and
					 receives all resources and services which can help the consumer reach and
					 maintain an optimal level of community functioning and integration.
"Center" means the identifiable administrative unit which
					 shall be the focal point for the development, delivery coordination of services
					 in each service area.
"Certified substance abuse counselor" means a person who
					 is certified as a substance abuse counselor by the Department of Health.
"Clinical record" means an individualized written
					 transcript which documents a consumer's treatment plans, the treatment
					 provided, response to treatment, and justification for any deviation from the
					 treatment plan and any individual limitation of rights.
"Community based mental health and substance abuse system"
					 means a publicly accountable and integrated array of accessible mental health
					 and substance abuse services.
"Comprehensive treatment plan" means an individualized
					 written design for service based on all available information and which
					 contains goals related to identified problems, measurable objectives related to
					 the goals methods for achieving objectives, expected achievement dates,
					 frequency of treatment procedures, names of staff assigned, and date(s) the
					 plan is reviewed and revised.
"Consultation services" means providing advice or
					 assistance on matters relating to mental health or substance abuse to other
					 service providers in their provision of services.
"Consumer" means a person who is receiving or has received
					 mental health or substance abuse services or identifies oneself as receiving or
					 having received such services.
"Contract provider" means an individual or agency
					 providing mental health or substance abuse services by contract with the
					 Department of Health.
"Council" means the state council on mental health and
					 substance abuse.
"Continuing support" means continuing services designed to
					 provide safety-net supports. The population focus is on individuals with a
					 qualifying severe and persistent mental illness with accompanying severe
					 functional impairment who do not have access to other mental health
					 services.
"Crisis services" means time-limited services that are
					 intensive and focused services designed to assess, stabilize and provide
					 linkage to treatment and other community supports, as appropriate. Crisis
					 services are intended for individuals in mental health crisis or situational
					 crisis and not already eligible for continuing support.
"Department" means the department of health, State of
					 Hawaii.
"Director" means the director of health, State of
					 Hawaii.
"Disaster" means an event of significant community impact
					 that is outside the range of usual human experience and that would be markedly
					 distressing to almost anyone, provoking, or expected to provoke intense
					 helplessness, terror, or fear of serious threat to life of physical integrity,
					 or sudden destruction of home or community infrastructure.
"Disaster services" means services that may include
					 counseling, debriefing, or education intended to relieve or minimize the
					 development of psychological distress or dysfunction in persons who have
					 experienced stress from a disaster.
"Education services" means promotion, distribution and
					 dissemination of relevant information on mental health and substance
					 abuse.
"Emergency" means a circumstance or combination of
					 circumstances which requires immediate response, the omission of which would
					 seriously and immediately endanger the life or safety of a consumer or others.
					 Bizarre or inappropriate behavior by a consumer without attendant dangerousness
					 shall not constitute an emergency.
"Emergency treatment" means any treatment, the omission of
					 which would seriously and immediately endanger the life or safety of a consumer
					 or others.
"Evaluation services" means problem identification
					 clinical diagnosis or diagnostic impression, assessment of the severity of each
					 problem identified, identification of strengths and assets, and determination
					 of treatment and rehabilitation services needed.
"Eligibility determination" or "eligibility assessment"
					 means an assessment approved by AMHD, which is sufficient to establish as
					 diagnosis of severe and persistent mental illness, persons in an acute, service
					 mental health crisis, and those experiencing distress and trauma from a
					 declared disaster, conducted in a standardized and timely manner for consumers
					 who are applying for AMHD services to determine whether they are eligible for
					 continuing support.
"Follow-up services" means contact with consumers who have
					 been discharged or who have discontinued affiliation with a program..
"Global assessment of functioning" or "GAF" means a score
					 assigned by the clinician, which is used as a criteria for psychological,
					 social and occupational functioning on a numerical rating from 1-100 as
					 described in the Diagnostic and Statistical Manual of Mental Disorders.
"Imminent harm" means that the staff of a psychiatric
					 facility or residential treatment facility has reason to believe that without
					 intervention by staff, a consumer would seriously and immediately endanger the
					 life or safety of the consumer or others.
"Information services" means informing the public of
					 available mental health, substance abuse and related services and how they may
					 be obtained.
"Informed consent" means a voluntary, knowledgeable
					 decision to allow any procedure, release of information, or other action, made
					 by the patient or consumer, or the patient or consumer's attorney-in-fact, or
					 guardian, based on a full disclosure and understanding of facts needed to make
					 the decision and with appropriate documentation including the signature of the
					 person who made the decision.
"Initial treatment plan" means an individualized written
					 design for service used during the period from admission to completion of a
					 comprehensive treatment plan.
"Intervention" means assisting individuals in using the
					 system's services; and assuring that individuals and families receive immediate
					 and appropriate services in a crisis, intervention shall include:
(1) "Crisis services" which means activities provided at
					 any location where the needs of the individuals can best be met to assure that
					 individuals and families receive immediate and appropriate attention in an
					 emergency, maintaining to the greatest degree possible, the consumer's status
					 as a functioning community person. Emergency services include but are not
					 limited to around-the-clock telephone service, availability of on-call trained
					 personnel, outreach, counseling of individuals and families, and short term
					 admission to a crisis or psychiatric facility for stabilization, and short term
					 planning to arrange linkages to needed services.
(2) "Non-crisis services" which means activities which
					 assist consumers to enter or make use of the service delivery system in a
					 nonemergency situation. "Least restrictive level of service" means treatment
					 modalities and service settings which are the most therapeutic alternatives
					 available for a consumer and which allow the consumer the greatest possible
					 effective exercise of liberty.
"Long-term" care or long-term treatment" for the purpose
					 of these rules, means care or treatment in a psychiatric facility exceeding 30
					 days or in a residential treatment facility exceeding 60 days. "Neglect" means
					 actual or potential physical injury psychological harm, or sexual violation of
					 a consumer as the result of omission by a person with a duty to act.
"Non-indigent" means that a person has been determined to
					 have the financial ability to pay a portion or all of the fees for care and
					 treatment. "Non-residential settings" means sites where consumers do not live
					 and where mental health and substance abuse services are provided to those
					 consumers.
"Outreach services" means actively seeking out persons at
					 risk or in need of mental health or substance abuse services in non-treatment
					 settings, alerting them and their families to the availability of resources,
					 and motivating them to seek help.
"Paraprofessional" means a person working in a mental
					 health or substance abuse program as part of a treatment team whose position
					 does not require a professional degree or certification.
"Prevention" means activities which create conditions,
					 opportunities and experiences designed to encourage and develop healthy
					 self-sufficiency, increase personal competence, and reduce excessive stress, or
					 assist in managing stress more effectively. Prevention occurs before a person
					 loses the ability to function and before a person needs remedial
					 services.
"Primary provider of service" means a staff member who is
					 assigned primary responsibility for treatment of a consumer.
"Private provider" means an individual or agency providing
					 mental health or substance abuse services which are not provided by or under
					 contract with the department of health.
"Program" for the purpose of these rules, means the only
					 or smallest distinct unit within a service setting offering treatment or
					 care.
"Provider" of mental health, substance abuse, or other
					 health services means:
(1) For the purpose of the state council and service area
					 board membership, an individual whose training, purpose, or primary current
					 activity, or identified affiliation is in the direct provision or
					 administration of mental health, substance abuse, or other health
					 services;
(2) Otherwise, it means an individual or agency providing
					 mental health and substance abuse services.
"Qualified interpreter" means a person who has
					 demonstrated competence in both English and the other language for which
					 interpretation is to be provided and who has within the last 12 months
					 participated successfully in a course approved by the department dealing with
					 ethics, practices, and consumer rights related to mental health and substance
					 abuse services.
"Qualifying diagnosis" means one of the following diagnoses
					 listed in the Diagnostic and Statistical Manual of Mental Disorders - DMS-IV-TR
					 (The numeral preceding each diagnosis reflects the corresponding number in the
					 DMS-IV-TR.):
295. xx Schizophrenia
i. 295.10 Disorganized Type
ii. 295.20 Catatonic Type
iii. 295.30 Paranoid Type
iv. 295.60 Residual Type
v. 295.90 Undifferentiated Type
295.70 Schizoaffective Disorder
296.34 Major Depression, Recurrent Type, Severe with
					 Psychotic Features
296. xx Bipolar Disorder
i. 296. Ox Single Manic Episode
ii. 296. 4x Most Recent Episode Manic
iii. 296. 5x Most Recent Episode Depressed
iv. 296. 6x Most Recent Episode Mixed
v. 296. 7 Most Recent Episode Unspecified
296. 89 Bipolar II Disorder
297. 1 Delusional Disorder.
"Referral services" means providing information about
					 services not available through the service area center or its contract agencies
					 or information to persons not eligible for available services, and linking
					 individuals with needed services.
"Rehabilitation" means psychosocial services which assist
					 individuals to develop daily and community living skills, to set goals for
					 themselves, to learn problem solving to handle social relationships, and to
					 utilize self-help' group experiences and prevocational services including
					 educational and experiential activities, arrangements for linkages with
					 vocational and volunteer programs and job placement services.
"Residential settings" means non-hospital sites where
					 consumers live and where mental health or substance abuse services are provided
					 to those consumers.
"Residential treatment facility" means a facility which
					 provides a structured therapeutic residential program for two or more consumers
					 identified as needing mental health or substance abuse services and which
					 provides, in addition to room and board, treatment and
					 rehabilitation/habilitation services within the context of a group living
					 experience to each consumer based on an individual treatment plan.
"Screening services" means determining an individual's
					 possible need for mental health and substance abuse services and eligibility
					 for service area center services.
"Seclusion" means placing a consumer alone in a room or
					 other enclosed space with the door locked or held closed.
"Service area" means a defined geographical area for which
					 there is designated responsibility for the delivery of mental health and
					 substance abuse services to persons residing, working or attending school
					 within the area.
"Service area center" means the identifiable
					 administrative unit which shall be the focal point for the development,
					 delivery and coordination of mental health and substance abuse services in each
					 service area.
"Severe and persistent mental illness" or 'SPMI" means that
					 a person has been assessed with the presence of a qualifying diagnosis for the
					 previous 12 months, or will be expected to demonstrate the presence of a
					 qualifying diagnosis for the next 12 months, and that person demonstrates
					 functional impairment that seriously limits the person's ability to function
					 independently in an appropriate and effective manner, as evidenced by a score
					 of 50 or lower on the GAF.
"Substance abuse" means a pattern of alcohol or drug use
					 which impairs physical, social or occupational functioning and has a minimal
					 duration of disturbance of at least one month.
"Target population" means a group of persons at risk or in
					 need of mental health or substance abuse services.
"Training services" means increasing job-related knowledge
					 and skills of administrative, professional and support personnel or others
					 providing mental health and substance abuse services.
"Treatment" means activities intended to alleviate or
					 reduce the duration and severity of mental illness and substance abuse
					 problems.
"Work" means the performance of tasks in exchange for fair
					 monetary compensation at the prevailing minimum wage in compliance with state
					 and federal requirements or, if below the minimum wage in compliance with
					 applicable requirements of the Fair Labor Standards Act, excluding, for the
					 purpose of these rules, care of personal belongings, light tasks appropriate to
					 group activities and to small group working and living arrangements designed as
					 part of a treatment program, and unpaid work in recognized volunteer
					 program.