Kentucky Administrative Regulations › Title 908 - CABINET FOR HEALTH AND FAMILY SERVICES - DEPARTMENT FOR DEVELOPMENTAL HEALTH, DEVELOPMENTAL AND INTELLECTUAL DISABILITIES › Chapter 3 - Institutional Care › Section 908 KAR 3:010 - Patient's rights

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO: KRS Chapters 202A, 202B
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				202A.191 and
				202B.060
				require the Secretary for the Cabinet for Health and Family Services to
				promulgate administrative regulations that insure proper administration and
				enforcement of KRS Chapter 202A and KRS Chapter 202B. This administrative
				regulation establishes requirements relating to the rights of an individual
				patient with mental illness, developmental or intellectual disabilities and
				requirements relating to the use of seclusion, restraint, and treatment under
				emergency situations concerning these patients.
Section 1. Definitions.
(1) "Authorized representative" means the
			 patient's attorney, guardian of a disabled adult, parent or guardian of a
			 juvenile, or an individual authorized in writing by the patient to act in the
			 patient's behalf.
(2) "Emergency
			 situation" means the presence of a situation in which a patient's behavior in
			 the present environment presents an immediate and substantial danger, or threat
			 of immediate or substantial danger, to that person or to others, such as:
(a) Verbal threats or abuse toward other
			 patients that creates a substantial risk that other patients may react in a
			 manner that poses an immediate substantial danger, or threat of immediate
			 substantial danger, to themselves or others, or that interferes in a
			 substantial manner with the realistic opportunity of other patients to improve
			 their own level of functioning through care and treatments in a hospital or
			 residential treatment center; and
(b) Substantial deviation from an individual
			 treatment plan that has been formulated with the mutual consent of the staff
			 and the patient or approved pursuant to a court hearing, or the overt or
			 repetitious violation of rules and procedures of the hospital or residential
			 treatment center by the patient that presents an immediate and substantial
			 danger to that person or to others if the patient has previously been fully
			 informed as to the content of the patient's individual treatment plan and as to
			 the rules and procedures which may be applicable to the patient's
			 behavior.
(3)
			 "Individual treatment plan" means a written document that is a part of each
			 patient's medical record and that contains information, such as:
(a) A statement of the diagnosis of the
			 patient;
(b) The short and
			 long-range objectives of care and treatment;
(c) The methods of treatment to be employed;
			 and
(d) The names of persons
			 responsible for preparing and implementing the plan.
(4) "Restraint" means the application of any
			 physical device, the application of physical body pressure by another to
			 control or limit physical activity, or the intravenous, intramuscular, or
			 subcutaneous administration of any pharmacologic or chemical agent to an
			 individual with mental illness, developmental or intellectual disabilities
			 resident with the sole or primary purpose of controlling or limiting the
			 physical activities of the patient or resident.
(5) "Seclusion" means the confinement of an
			 individual with mental illness, developmental or intellectual disabilities
			 patient alone in a locked room.
(6)
			 "Substantive changes" means those changes that reflect distinct changes in
			 goals of treatment, methods to be employed, and the names of persons primarily
			 responsible for overall review or implementation of the individual treatment
			 plan, except for:
(a) Changes in the amount,
			 frequency of administration, or specific type of medication, unless the changes
			 involve introduction of new classes of medication, including antipsychotic or
			 anticonvulsant drugs; and
(b)
			 Changes in the frequency, duration, place, or supervision of daily activities,
			 unless the changes exclude participation in the activities previously
			 identified in the treatment plan or initiation of new activities that could not
			 be reasonably anticipated on the basis of short and long-term treatment
			 goals.