Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 56 - Behavioral Health Service Providers › Subchapter A - General Provisions › Section I-5603 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
Abuse
-the infliction of physical or
						mental injury or the causing of the deterioration of an individual by means
						including, but not limited to, sexual
abuse
, or exploitation
						of funds or other things of value to such an extent that his health or mental
						or emotional well-being is endangered. Injury may include, but is not limited
						to: physical injury, mental disorientation, or emotional harm, whether it is
						caused by physical action or verbal statement or any other act or omission
						classified as abuse by Louisiana law, including, but not limited to, the
Louisiana Childrens Code
.
Accredited
-the process of review and
						acceptance by an accreditation body.
Active Client
-a client that is being
						treated for addictive disorders at least every 90 days or a client that is
						being treated for mental health disorders at least every 180 days.
Addictionologist
-a licensed physician
						who is either of the following:
1.
					 certified by the American Board of Psychiatry and Neurology with a subspecialty
					 in addiction psychiatry; or
2.
					 certified by the American Board of Addiction Medicine.
Addiction Counselor
-any person who is
						licensed, certified, or registered in accordance with state statute and
						procedures established by the Addictive Disorder Regulatory Authority and who,
						by means of his special knowledge acquired through formal education or
						practical experience, is qualified to provide addiction counseling services to
						those individuals afflicted with or suffering from an addictive disorder or
						certain co-occurring disorders.
Addictive Disorder
-the repeated
						pathological use of substances including but not limited to alcohol, drugs, or
						tobacco, or repeated pathological compulsive behaviors including but limited to
						gambling, which cause physical, psychological, emotional, economic, legal,
						social, or other harms to the individual afflicted with the addiction or to
						others affected by the individual's affliction. Addiction disorder includes
						instances where withdrawal from or tolerance to the substance or behaviors are
						present, and also instances involving use and abuse of substances.
Addiction Outpatient Treatment Services (ASAM
						Level 1)
-an outpatient program that offers comprehensive, coordinated,
						professionally directed and defined addiction treatment services that may vary
						in level of intensity and may be delivered in a wide variety of settings.
						Services are provided in regularly scheduled sessions of fewer than nine
						contact hours a week.
Administrative Procedure Act (APA
						)
-R.S.
						49:950 et seq.
Admission
-the formal acceptance of an
						individual for assessment and/or therapeutic services provided by the BHS
						provider.
Adolescent
-an individual 13 through 17
						years of age.
ADRA
-Addictive Disorder Regulatory
						Authority.
Adult
-an individual 18 years of age or
						older.
Advanced Practice Registered Nurse
						(APRN)
-a licensed health care practitioner who is acting within the
						scope of practice of his/her respective licensing boards(s) and/or
						certifications.
Ambulatory Detoxification with Extended on-site
						Monitoring (ASAM Level II-D)
-an organized outpatient addiction
						treatment service that may be delivered in an office setting or health care or
						behavioral health services provider by trained clinicians who provide medically
						supervised evaluation, detoxification and referral services. The services are
						designed to treat the clients level of clinical severity to achieve safe and
						comfortable withdrawal from mood-altering chemicals and to effectively
						facilitate the clients entry into ongoing treatment and recovery. The services
						are provided in conjunction with intensive outpatient treatment services (level
						II.1).
Alternate Service Delivery Area
-an area
						that is not contiguous to the geographic service area of the licensed BHS
						parent location and/or is in an LDH region where a BHS provider may be allowed
						to provide Homebuilders services when the provider has less than three staff
						providing such services in that region.
Ambulatory Withdrawal Management with Extended
						on
site Monitoring (ASAM Level 2-WM)-an organized outpatient addiction
						treatment service that may be delivered in an office setting or health care or
						behavioral health services provider by trained clinicians who provide medically
						supervised evaluation, withdrawal management and referral services. The
						services are designed to treat the client's level of clinical severity to
						achieve safe and comfortable withdrawal from mood-altering chemicals and to
						effectively facilitate the client's entry into ongoing treatment and recovery.
						The services are provided in conjunction with intensive outpatient treatment
						services (level 2.1).
ASAM
-American Society of Addiction
						Medicine.
Authorized Licensed Prescriber
-a
						physician, PA, nurse practitioner, or medical psychologist (MP) licensed in the
						state of Louisiana and with full prescriptive authority who is authorized by
						the BHS provider to prescribe treatment to clients of the specific BHS provider
						at which he/she practices.
Behavioral Health Service (BHS) Provider
or
Provider
a facility, agency, institution, person, society,
						corporation, partnership, unincorporated association, group, or other legal
						entity that provides behavioral health services, presents itself to the public
						as a
provider
of behavioral health services.
Behavioral Health Services
-mental health
						services, substance use/addiction treatment services, or a combination of such
						services, for adults, adolescents and children. Such services may be provided
						in a residential setting, in a clinic setting on an outpatient basis, or in a
						home or community setting.
Building and Construction
						Guidelines
-structural and design requirements applicable to the BHS
						provider which does not include occupancy requirements.
Business Location
or
Primary
						Business Office Location
- the physical location/address that is
						designated by the provider as the main or primary business office location;
						there shall be only one designation of the main or primary business office
						location per provider; the main or primary business office location may be a
						licensed residential location, a licensed outpatient clinic, or other office
						location within the geographic service area authorized by the license.
Campus
-for purposes of this Chapter, a
						location where BHS services are provided that is within the geographic service
						area as the licensed BHS provider. A campus may have multiple
						buildings/multiple addresses as long as those buildings are contiguous and not
						separated by public streets, and are within the same geographic service area as
						the licensed BHS provider.
Case Management
-the coordination of
						services, agencies, resources, or people within a planned framework of action
						toward the achievement of goals established in the treatment plan that may
						involve liaison activities and collateral contracts with other
						providers.
Certified Addiction Counselor
						(CAC)
-pursuant to
						R.S.
						37:3387.1, any person who, by means of his
						specific knowledge acquired through formal education and practical experience,
						is qualified to provide addictive disorder counseling services and is certified
						by the ADRA as a CAC. The CAC shall not practice independently and shall not
						render a diagnostic impression.
Certified Clinical Supervisor-
any
						person holding the necessary credential of licensed, certified, or registered
						addiction counselor or any person who holds a specialty substance use
						credential in another professional discipline in a human services field at the
						master's level or higher; and who has satisfied the requirements established by
						the Addictive Disorder Regulatory Authority (ADRA) to provide clinical
						supervision.
Cessation of Business
-provider is
						non-operational and/or has stopped offering or providing services to the
						community.
Change of Ownership (CHOW)
-the
						addiction, substitution, or removal, whether by sale, transfer, lease, gift or
						otherwise, of a licensed health care provider subject to this rule by a person,
						corporation, or other entity, which results in a change of controlling interest
						of assets or other equity interests of the licensed entity may constitute a
						CHOW of the licensed entity. An example of an action that constitutes a CHOW
						includes, but is not limited to, the leasing of the licensed entity.
Child
-an individual under the age of
						13.
Client
-any person who seeks and receives
						treatment or services, including but not limited to rehabilitation services or
						addiction counseling services, furnished by a provider licensed pursuant to
						this Chapter.
Client Education
-information that is
						provided to clients and groups concerning alcoholism and other drug abuse,
						positive lifestyle changes, mental health promotion, suicide prevention and
						intervention, safety, recovery, relapse prevention, self-care, parenting, and
						the available services and resources. Educational group size is not restricted
						and may be offered as an outreach program.
Client Record
-a single complete record
						kept by the provider which documents all treatment provided to the client and
						actions taken by the provider on behalf of the client. The record may be
						electronic, paper, magnetic material, film or other media.
Clinical Services
-treatment services
						that include screening, assessment, treatment planning, counseling, crisis
						mitigation and education.
Clinically Managed High-Intensity Residential
						Treatment Services (ASAM Level 3.5)
-a residential program that offers
						continuous observation, monitoring, and treatment by clinical staff designed to
						treat clients experiencing substance-related disorders who have
						clinically-relevant social and psychological problems, such as criminal
						activity, impaired functioning and disaffiliation from mainstream values, with
						the goal of promoting abstinence from substance use and antisocial behavior and
						affecting a global change in clients' lifestyles, attitudes and values.
Clinically Managed Low Intensity Residential
						Treatment Services (ASAM Level 3.1)
-a residential program that offers
						at least five hours a week of a combination of low-intensity clinical and
						recovery-focused services for substance-related disorders. Services may include
						individual, group and family therapy, medication management and medication
						education, and treatment is directed toward applying recovery skills,
						preventing relapse, improving emotional functioning, promoting personal
						responsibility and reintegrating the client into the worlds of work, education
						and family life (e.g., halfway house).
Clinically Managed Population Specific
						High-Intensity Residential Treatment Services (ASAM Level 3.3)
-a
						residential program that offers at least 20 hours per week of a combination of
						medium-intensity clinical and recovery-focused services in a structured
						recovery environment to support recovery from substance-related disorders; is
						frequently referred to as extended or long term care.
Clinically Managed Residential Withdrawal
						Management (Social) (ASAM LEVEL 3.2-WM)
-an organized residential
						program utilizing 24 hour active programming and containment provided in a
						non-medical setting that provides relatively extended, sub-acute treatments,
						medication monitoring observation, and support in a supervised environment for
						a client experiencing non-life threatening withdrawal symptoms from the effects
						of alcohol/drugs and impaired functioning and who is able to participate in
						daily residential activities.
Co-Occurring Disorder
-a disorder in
						which an individual has at least one psychiatric disorder as well as an
						addictive disorder.
Community Psychiatric Support and Treatment
						(CPST)
- Centers for Medicare and Medicaid Services (CMS) approved
						Medicaid mental health rehabilitation services designed to reduce disability
						from mental illness, restore functional skills of daily living, build natural
						supports, and achieve identified person-centered goals or objectives through
						counseling, clinical psycho-education, and ongoing monitoring needs as set
						forth in an individualized treatment plan.
Compulsive Gambling
-persistent and
						recurrent maladaptive gambling behavior that disrupts personal, family,
						community, or vocational pursuits, and is so designated by a court, or
						diagnosed by a licensed physician or LMHP.
Controlled Dangerous Substance
-any
						substance defined, enumerated, or included in federal or state statute or
						regulations or any substance which may hereafter be designated as a
controlled dangerous substance
by amendment of supplementation
						of such regulations or statute. The term shall not include distilled spirits,
						wine, malt beverages, or tobacco.
Core Services
-the essential and
						necessary elements required of every BHS provider, when indicated, including
						assessment, orientation, client education, consultation with professionals,
						counseling services, referral, crisis mitigation, medication management,
						rehabilitation services, and treatment.
Counselor in Training (CIT)
-any person
						who has not yet met the qualification to become a licensed, certified, or
						registered counselor, but who has made application to the ADRA in accordance
						with state statute and procedures established by the ADRA. The CIT shall not
						practice independently and shall only work under the direct supervision of a
						licensed addiction counselor (LAC), CAC, or registered addiction counselor; or
						in the absence of a licensed, certified, or registered addiction counselor,
						under the direction of a qualified mental health professional.
Counselor in Training (CIT)
-a person
						currently registered with the Addictive Disorder Regulatory Authority (ADRA)
						and pursuing a course of training in substance abuse/addiction treatment
						counseling which includes educational hours, practicum hours, and direct,
						on-site supervision.
Crime of Violence
-an offense listed as a
crime of violence
in
						R.S.
						14:2.
Crisis Intervention
-face to face
						intervention provided to a client who is experiencing a psychiatric crisis. The
						services are designed to interrupt and/or ameliorate a crisis experience, via a
						preliminary assessment, immediate crisis resolution and de-escalation with
						referral and linkage to appropriate community services to avoid more
						restrictive levels of treatment.
Crisis Mitigation Services
-a BHS
						providers assistance to clients during a crisis that provides 24-hour on call
						telephone assistance to prevent relapse or harm to self or others, to provide
						referral to other services, and to provide support during related crises.
						Referral to 911 or a hospitals emergency department alone does not constitute
						crisis mitigation services.
Deemed Status
-following the issuance of
						an initial license, the departments acceptance of the BHS providers
						accreditation as compliance with this Chapter in lieu of on-site licensing
						surveys.
Department
-the LDH or any office or
						agency thereof designated by the secretary to administer the provisions of this
						Chapter.
Dependent Children
-any child/adolescent
						under the age of 18 that relies on the care of a parent or legal
						guardian.
DHH Authorized Accreditation
						Organization
-Repealed.
Diagnosis
-the act of identifying a
						disease or behavioral health disorder as defined by the current version of the
						Diagnostic and Statistical Manual (DSM). A
diagnosis
is
						determined by a qualified LMHP or physician based on comprehensive assessment
						of physical evidence (if related to diagnosis), signs and symptoms, clinical
						and psycho-social evidence, and individual/family history.
Direct Care Staff
-any member of the
						staff, including an employee, contractor or volunteer, that provides the
						services delineated in the comprehensive treatment plan. Food services,
						maintenance, and clerical staff are not considered as
direct care
						staff
.
Disaster
or
Emergency
-a
						local, community-wide, regional or statewide declared health crisis or
						event.
Dispense
or
Dispensing
-the interpretation, evaluation, and implementation
						of a prescription drug order, including the preparation and delivery of a drug
						or device to a patient or patient's agent in a suitable container appropriately
						labeled for subsequent administration to, or use by, a patient.
Dispense
necessarily includes a transfer of possession of a
						drug or device to the patient or the patient's agent.
Dispensing Physician
-any physician in
						the state of Louisiana who is registered as a dispensing physician with the
						Louisiana State Board of Medical Examiners (LSBME) and who dispenses to his/her
						patients any drug, chemical, or medication, except a bona fide medication
						sample.
Dispensing Physician
-any physician in
						the state of Louisiana who is registered as a
dispensing
						physician
with the Louisiana State Board of Medical Examiners and who
						dispenses to his/her patients any drug, chemical, or medication, except a bona
						fide medication sample.
Division of Administrative Law (DAL)
-the
						Louisiana Department of State Civil Service, Division of Administrative Law or
						its successor.
Exploitation
-act or process to use
						(either directly or indirectly) the labor or resources of an individual or
						organization for monetary or personal benefit, profit, or gain.
Facility Need Approval (FNA)
-the letter
						of approval from the Office of Behavioral Health (OBH) which is required for
						licensure applicants for opioid treatment programs prior to applying for a BHS
						provider license or the letter of approval from the Facility Need Review (FNR)
						Committee within the department which is required for licensure applicants for
						psychosocial rehabilitation (PSR) or CPST services prior to applying for a BHS
						provider license.
FDA
-the Food and Drug Administration of
						the United States Department of Health and Human Services.
Financial Viability
-the provider seeking
						licensure is able to provide verification and continuous maintenance of all of
						the following pursuant to
						R.S.
						40:2153:
1. a line of credit issued from a federally
					 insured, licensed lending institution in the amount of at least
					 $50,000;
2. proof of professional
					 liability insurance of at least $500,000 or proof of self-insurance of at least
					 $100,000, along with proof of enrollment as a qualified health care provider
					 with the Louisiana Patient's Compensation Fund (PCF):
a. if the BHS provider is self-insured and is
					 not enrolled in the PCF, professional liability limits shall be $1 million per
					 occurrence/$3 million per annual aggregate.