reglab/statecodes huggingface dataset:
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0100 - SAFE ENVIRONMENT › Section 28C .0106 - REPORTING CLIENT INJURIES

Current through Register Vol. 39, No. 2, July 15, 2024
Whenever a minor or incompetent adult client experiences a
					 major physical injury, the legally responsible person shall be immediately
					 notified. Whenever a competent adult experiences a major physical injury, the
					 client's designated next of kin may be notified of the injury when such
					 notification is in accordance with
					 G.S.
					 122C-53(a).
Authority
					 G.S.
					 122C-51;
					 122C-53;
					 131E-67;
					 143B-147;
Eff. July
					 1, 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. March 6,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0200 - ESTHETIC AND HUMANE ENVIRONMENT › Section 28C .0201 - STATE FACILITY ENVIRONMENT

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  State Facility Director shall assure the provision of an esthetic and humane
				  environment that enhances the positive self-image of the client and preserves
				  human dignity. This includes:
(1) providing
				  warm and cheerful furnishings;
(2)
				  providing flexible and humane schedules; and
(3) directing state facility employees to
				  address clients in a respectful manner.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0200 - ESTHETIC AND HUMANE ENVIRONMENT › Section 28C .0202 - ACTIVITIES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Each state
				  facility shall provide space, supervision and equipment for client activities
				  and exercise in accordance with
				  G.S.
				  122C-62(b)(5) and
				  G.S.
				  122C-62(d)(5).
(b) The State Facility Director shall assure
				  that clients have reasonable access to entertainment equipment in working order
				  such as a television, radio, phonograph, and appropriate recreational
				  equipment.
(c) Any imposed
				  limitation on the client's freedom to exercise his rights in Paragraph (a) of
				  this Rule by the responsible professional shall be documented in accordance
				  with G.S.
				  122C-62(e).
Authority
					 G.S.
					 122C-62;
					 131E-67;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. April 1, 1990; July 1,
					 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. March 6,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0200 - ESTHETIC AND HUMANE ENVIRONMENT › Section 28C .0203 - PERSONAL LIVING SPACE

Current through Register Vol. 39, No. 2, July 15, 2024
Each client in a state facility may suitably decorate his
					 room, or portion of a multi-resident room, with respect to the client's choice,
					 normalization principles, and with respect for the physical structure. The
					 State Facility Director may establish written policies and justifications which
					 limit this right for special admissions such as medical, surgical, forensic, or
					 short-term admissions where admission is for less than 30
					 days.
Authority
					 G.S.
					 122C-51;
					 131E-67;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. April 1, 1990; July 1,
					 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. March 6,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0200 - ESTHETIC AND HUMANE ENVIRONMENT › Section 28C .0204 - HEALTH, HYGIENE AND GROOMING

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The State
				  Facility Director shall assure each client the right to dignity, privacy and
				  humane care in the provision of personal health, hygiene and grooming care
				  including, but not limited to:
(1)
				  individualized bathing schedules to promote privacy;
(2) an opportunity for a shower or tub bath
				  daily, or more often as needed;
(3)
				  the opportunity to shave every day;
(4) access to the services of a barber or a
				  beautician on a regular basis; and
(5) provision of linens and towels, toilet
				  paper and soap for all clients and other individual personal hygiene articles
				  for indigent clients. Such other articles include but are not limited to
				  toothpaste, toothbrush, sanitary napkins, tampons, shaving cream and shaving
				  utensil.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0300 - PRIVACY AND PERSONAL FREEDOM › Section 28C .0301 - COMMUNICATION RIGHTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) In order to
				  ensure the protection of client rights specified in
				  G.S.
				  122C-62(a)(1) and
				  G.S.
				  122C-62(d)(2), each state
				  facility shall post the state facility schedule for the collection and
				  distribution of mail and packages in areas accessible to clients. Limited
				  postage shall be made available to indigent clients. State facility employees
				  shall provide assistance to clients as needed in sending and receiving
				  correspondence. Such physical assistance may include writing letters, wrapping
				  packages or reading letters to clients upon their request.
(b) Adult clients in state facilities shall
				  have access to telephones in private areas in order to ensure the protection of
				  the client right specified in
				  G.S.
				  122C-62(b)(1). Access to
				  telephones by minor clients in state facilities shall be in accordance with
				  G.S.
				  122C-62(d)(1). State
				  facility employees shall assist adult and minor clients in placing calls upon
				  request of the client.
(c) In order
				  to ensure the protection of client rights specified in
				  G.S.
				  122C-62(b)(2) and
				  G.S.
				  122C-62(d)(3), each state
				  facility shall post visiting hours in areas accessible to clients. The State
				  Facility Director may establish the same visiting hours for the entire state
				  facility or different visiting hours for different client living areas within
				  the state facility. Suitable areas indoors shall be made available for adult
				  clients and visitors to visit in private, and minor clients and visitors to
				  visit as free as possible from disturbance by other clients. The areas where
				  clients may receive visitors may be specified by the State Facility
				  Director.
(d) Clients being held at
				  a state facility to determine capacity to proceed to trial pursuant to
				  G.S.
				  15A-1002 may receive visitors as specified in
				  G.S.
				  122C-62(b)(2) and
				  G.S.
				  122C-62(d)(3). The following
				  limitations shall be imposed in accordance with
				  G.S.
				  122C-62(g); however, no
				  limitations shall be imposed on visitations by those persons specified in
				  G.S.
				  122C-62(a)(2), (a)(3), (c)(1), (c)(2), and
				  (c)(3):
(1)
				  Each state forensic facility may establish a policy limiting visitations by:
(A) precluding visits for up to the first
				  three days;
(B) imposing a visit
				  duration limit; and
(C) limiting
				  the number of visitors, as long as criteria are established making such
				  limitations on an individual basis in order to promote the health, safety and
				  welfare of the clients.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0300 - PRIVACY AND PERSONAL FREEDOM › Section 28C .0302 - PERSONAL CLOTHING

Current through Register Vol. 39, No. 2, July 15, 2024
(a) All clients
				  have the right to retain and wear their own clothes as specified in
				  G.S.
				  122C-62(b)(6) and
				  G.S.
				  122C-62(d)(6) except when
				  such clothes are determined to be inappropriate to the treatment regimen by the
				  responsible professional, and the reason for that determination is documented
				  in accordance with
				  G.S.
				  122C-62(e).
(b) The State Facility Director has an
				  obligation to supply an adequate allowance of clothing to clients whom the
				  state facility deems indigent and who cannot provide their own clothing. Such
				  clothing shall be seasonable, of proper size, of the character worn by the
				  client's peers in the community, and in good condition.
(c) Personal clothing left by discharged
				  clients shall be held for a 30-day period, during which time efforts shall be
				  made to contact the client. If the clothing is not claimed by the client within
				  30 days, it shall be handled in accordance with state facility
				  policy.
(d) Clothing provided by
				  the state facility may be kept by the client upon discharge from the state
				  facility, at the State Facility Director's discretion.
(e) The State Facility Director shall make
				  provision for the laundering of client clothing.
Authority
					 G.S.
					 122C-62;
					 131E-67;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. July 1, 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. March 6,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0300 - PRIVACY AND PERSONAL FREEDOM › Section 28C .0303 - PERSONAL POSSESSIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Client access
				  to personal possessions shall be in accordance with
				  G.S.
				  122C-62(b)(6) and
				  G.S.
				  122C-62(d)(6) except when
				  the possessions are determined to be potentially dangerous articles or
				  otherwise inappropriate to the treatment regimen by the responsible
				  professional and the reason for the determination is documented in accordance
				  with G.S.
				  122C-62(e). Each state
				  facility may develop a policy which restricts any of the following potentially
				  dangerous articles to ensure the safety of clients: scissors, cigarette
				  lighters, matches, razors, mirrors, pocket knives, switch blades, or products
				  which contain potentially abusive substances.
(b) Personal possessions deposited with the
				  state facility for safe-keeping shall be made available to the client upon
				  request at reasonable intervals, unless the client is an incompetent adult or a
				  minor, in which case these items shall be made available to the incompetent
				  adult client or minor or legally responsible person upon request by the legally
				  responsible person. These items shall be returned to the client or legally
				  responsible person upon discharge of the client from the state facility, except
				  as specified in Rules .0307, .0308, or .0309 of this Section.
Authority
					 G.S.
					 122C-62;
					 131E-67;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. July 1, 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. March 6,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0300 - PRIVACY AND PERSONAL FREEDOM › Section 28C .0304 - STORAGE AND PROTECTION OF CLOTHING AND POSSESSIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  state facility shall make a concerted effort to protect the client's personal
				  clothing and possessions from theft, damage, destruction, loss, and
				  misplacement. This includes but is not limited to the following:
(1) advising the client, upon admission, to
				  deposit jewelry and other valuable articles with the state facility for
				  safe-keeping;
(2) providing
				  individual locked storage space for the client's own use in accordance with
				  G.S.
				  122C-62(b)(10) and
				  G.S.
				  122C-62(d)(8) which will
				  hold a reasonable amount of clothing and other personal possessions. Staff
				  assistance shall be available if the client is unable due to physical or mental
				  inability to manipulate the locking mechanism, except when such storage space
				  is determined to be inappropriate to the treatment regimen by the responsible
				  professional and the reason for that determina­tion is documented in
				  accordance with
				  G.S.
				  122C-62(e);
(3) developing an inventory of each client's
				  clothing and personal possessions upon admission and reviewing and updating it
				  annually; and
(4) discretely
				  marking personal clothing items and, for clients being provided long term care,
				  discretely marking clothing items provided by the state facility with the
				  client's name. Clients who elect to launder their own clothing shall not be
				  required to have clothing marked but shall be informed that they thereby assume
				  the risk of possible loss.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0300 - PRIVACY AND PERSONAL FREEDOM › Section 28C .0305 - SOCIAL INTERACTION

Current through Register Vol. 39, No. 2, July 15, 2024
The state facility shall establish policies to assure the
					 provision of suitable opportunities for the client's social interaction with
					 members of the same and opposite sex and to actively seek, unless specifically
					 contraindicated, interaction with non-handicapped persons other than
					 staff.
Authority
					 G.S.
					 122C-51;
					 122C-62;
					 131E-67;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. July 1, 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. March 6,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0300 - PRIVACY AND PERSONAL FREEDOM › Section 28C .0306 - CONFIDENTIALITY

Current through Register Vol. 39, No. 2, July 15, 2024
State facility employees shall comply with
					 G.S.
					 122C-52 through
					 G.S.
					 122C-56 and the confidentiality rules
					 codified in
					 10A NCAC
					 26B and available in "Confidentiality Rules"
					 division publication APSM 45-1. This document is available for inspection in
					 each state facility or in the Publications Office of the
					 Division.
Authority
					 G.S.
					 122C-52 through
					 122C-56;
					 131E-67;
					 143B-10;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. July 1, 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. March 6,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0300 - PRIVACY AND PERSONAL FREEDOM › Section 28C .0308 - SEARCH OF UNIT/WARD

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The entire
				  unit, ward or parts of the unit, ward and building may be searched by state
				  facility employees if there is good, substantial and reliable cause to believe
				  that a threatening situation exists that may be dangerous to the client or
				  state facility employee. At the forensic unit at Dorothea Dix Hospital, routine
				  searches may be conducted periodically in accordance with the provisions of
				  Paragraphs (b) through (f) of this Rule.
(b) The appropriate unit or ward director or
				  designated supervisory staff on duty shall give written authorization (based on
				  facts of justification and what they expect to find from the search) for a
				  search to be conducted. Written authorization will include scope of
				  search.
(c) Clients affected by a
				  proposed search shall be notified at the time of search and shall be given the
				  opportunity to be present during the search of the immediate area, unless this
				  is not practical due to the dangerousness of the situation or because the
				  client is not on the state facility premises. Individual locked storage spaces
				  shall only be searched when the client is present unless there is an immediate
				  danger of personal injury. Clients not present when a search is conducted shall
				  be informed that a search took place when they return to their unit or
				  ward.
(d) The search must be
				  conducted by no less than two state facility employees. Reasonable efforts
				  shall be made to notify an internal client advocate prior to the search unless
				  there exists an imminent danger which does not permit time for such
				  notification. In all cases, an internal client advocate shall be notified of
				  the search.
(e) When confiscated
				  items can be attributed to a particular client, written justification and
				  authorization for the search shall be entered in an incident report filed with
				  the State Facility Director's office. The search and findings shall be
				  documented in the client record.
(f) An inventory of confiscated items shall
				  be made and kept on file with a copy of the inventory given to the client or
				  his legally responsible person if ownership is determined.
Authority
					 G.S.
					 122C-58;
					 122C-62;
					 131E-67;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. April 1, 1990; July 1,
					 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. March 6,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0300 - PRIVACY AND PERSONAL FREEDOM › Section 28C .0309 - ISSUANCE OF A SEARCH WARRANT

Current through Register Vol. 39, No. 2, July 15, 2024
If there is probable cause to believe that a client is in
					 possession of the following items and if criminal prosecution of the client is
					 anticipated, such information shall be conveyed by proper affidavit to a
					 magistrate or other official authorized to determine whether a search warrant
					 should be issued:
(1) contraband or
				  otherwise unlawfully possessed items including, but not limited to, illegal
				  drugs, weapons, or stolen items;
(2) an item which constitutes evidence of a
				  criminal offense; or
(3) an item
				  which constitutes evidence of the identity of a person participating in a
				  criminal offense.
Authority
					 G.S.
					 15A-241 through
					 15A-245;
					 131E-67;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. April 1, 1990;
Pursuant
					 to G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. March 6,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter C - DIGNITY AND RESPECT › Section .0300 - PRIVACY AND PERSONAL FREEDOM › Section 28C .0310 - CLIENT'S PERSONAL FUNDS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Where the state
				  facility has been designated as representative payee or when the client is a
				  Medicaid recipient, provisions in Paragraphs (b) through (g) of this Rule shall
				  be interpreted in accordance with any requirements of the funding
				  source.
(b) In accordance with
				  G.S.
				  122C-62(b)(8) and
				  G.S.
				  122C-62(d)(9), the maximum
				  amount of money clients will be allowed to have and spend will be determined by
				  the treatment/habilitation team or will be determined by each unit in a state
				  facility based upon the needs and abilities of the client population. Client
				  requests to retain money above the maximum allowable amount shall be reviewed
				  by the client treatment/habilitation team and the decision shall be documented
				  in the client record. Any imposed limitation or restriction by the responsible
				  professional on the client's right to have and spend the sum of money
				  determined to be reasonable shall be documented in accordance with
				  G.S.
				  122C-62(e).
(c) The state facility shall develop written
				  policies and procedures which:
(1) allow the
				  client to deposit and withdraw money from a personal fund account;
(2) regulate the receipt and distribution of
				  funds in personal fund accounts;
(3) provide for the receipt of deposits in
				  personal fund accounts from friends, relatives or others and withdrawal by the
				  client;
(4) provide for the keeping
				  of adequate financial records on all transactions affecting funds on deposit in
				  personal fund accounts;
(5) provide
				  for the issuance of receipts to persons depositing or withdrawing funds;
				  and
(6) provide for a periodic
				  accounting of personal fund accounts.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0100 - RIGHT TO TREATMENT OR HABILITATION › Section 28D .0101 - APPROPRIATE EVALUATION AND TREATMENT OR HABILITATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Each
				  client except day clients shall receive a prompt and comprehensive physical and
				  brief mental status examination, including laboratory evaluation where
				  appropriate, within 24 hours after admission to the state facility.
				  Comprehensive psychological or developmental evaluations shall be performed
				  when needed, as determined by the treatment/habilitation team. The type and
				  dates of all examinations shall be documented in the client record. There must
				  be a physical examination of the client before ordering medication except in an
				  emergency.
(b) In addition to the
				  treatment rights specified in
				  G.S.
				  122C-57(a), all handicapped
				  clients have a right to habilitation and rehabilitation as specified in
				  G.S.
				  168-8.
(c) Each client shall receive evaluation and
				  treatment/habilitation in accordance with
				  G.S.
				  122C-57(b),
				  G.S.
				  122C-60 and
				  G.S.
				  122C-61. Evaluation and
				  treatment/habilitation shall be provided in the least restrictive
				  environment.
Authority
					 G.S.
					 122C-51;
					 122C-57;
					 122C-60;
					 122C-61;
					 122C-211;
					 122C-221;
					 122C-231;
					 122C-241;
					 122C-266;
					 122C-285;
					 131E-67;
					 143B-147;
					 168-8;
Eff. October
					 1, 1984;
Amended Eff. April 1, 1990; July 1, 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0100 - RIGHT TO TREATMENT OR HABILITATION › Section 28D .0102 - MEDICAL AND DENTAL CARE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The State
				  Facility Director shall assure access to prompt, adequate and necessary medical
				  and dental care and treatment to the client for physical and mental ailments
				  and injuries and for the prevention of illness or disability as specified in
				  G.S.
				  122C-61(1). "Necessary" may
				  be determined in light of the client's length of stay and condition. Short term
				  clients shall be apprised of other medical and dental conditions and informed
				  of appropriate medical and dental care.
(b) All medical and dental care and treatment
				  shall be consistent with accepted standards of medical and dental practice. The
				  medical care shall be performed under appropriate supervision of licensed
				  physicians and the dental care shall be performed under appropriate supervision
				  of licensed dentists.
(c) Each
				  client shall receive physical and dental examinations at least
				  annually.
(d) In cases of medical
				  emergency or necessity:
(1) if the necessary
				  equipment or expertise is not available at the state facility, the attending
				  physician shall arrange treatment at an appropriate medical facility;
(2) if the client is at an unreasonable
				  distance from his home facility, he shall be taken to a nearer appropriate
				  hospital or clinic; and
(3) if the
				  events in Subparagraphs (d)(1) or (2) of this Rule occur, the State Facility
				  Director shall assure that those persons specified in
				  G.S.
				  122C-206(e) are
				  notified.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0100 - RIGHT TO TREATMENT OR HABILITATION › Section 28D .0103 - INDIVIDUALIZED TREATMENT OR HABILITATION PLAN

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				  The state facility shall provide qualified professionals to formulate and
				  supervise implementation of the treatment/habilitation plan in accordance with
				  G.S.
				  122C-57(a).
(b) Each client shall be encouraged and
				  helped to attend the treatment/habilitation team meeting and to actively and
				  meaningfully participate in the formulation of his treatment or habilitation
				  plan. The legally responsible person of a minor or incompetent adult client
				  shall also be encouraged to attend. The amount of participation by the client
				  or legally responsible person shall be documented in the client record. The
				  internal client advocate shall be allowed to attend the treatment/habilitation
				  team meeting in accordance with
				  G.S.
				  122C-53(g).
(c) Each client may, upon request, have an
				  in-house review of his individual treatment or habilitation plan or request the
				  opinion of another person at no cost to the state.
(d) The client's treatment or habilitation
				  plan shall be reviewed at least quarterly by the treatment/habilitation
				  team.
(e) A discharge plan shall be
				  formulated in accordance with Rule .0105 of this Section.
(f) Upon request, a copy of the client's
				  treatment or habilitation plan or an interpretive letter shall be furnished to
				  the legally responsible person of an incompetent adult client or legally
				  responsible person of a minor client except for minor clients in alcohol or
				  drug rehabilitation programs as specified in 42 C.F.R. Part 2 or when minors
				  are receiving treatment upon their own consent in accordance with
				  G.S.
				  90-21.5.
(g) The treatment/habilitation team shall
				  inform the client of the availability of his treatment/habilitation plan and
				  shall provide the client with a copy of his treatment/habilitation plan upon
				  request by the client when filed in accordance with
				  G.S.
				  122C-53(c).
Authority
					 G.S.
					 90-21.5;
					 122C-51;
					 122C-53;
					 122C-57;
					 122C-61;
					 122C-62;
					 131E-67;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. April 1, 1990; July 1,
					 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0100 - RIGHT TO TREATMENT OR HABILITATION › Section 28D .0104 - TRANSFER

Current through Register Vol. 39, No. 2, July 15, 2024
When transferring clients, the State Facility Director
					 shall follow the procedures specified in
					 G.S.
					 122C-206 and division publication "Transfer
					 of Clients Between State Facilities, APSM 45-1", adopted pursuant to
					 G.S.
					 150B-14(c). The Division
					 publication is available for inspection in each state facility or in the
					 Publications Office of the Division.
Authority
					 G.S.
					 122C-206;
					 131E-67;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. April 1, 1990; July 1,
					 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0100 - RIGHT TO TREATMENT OR HABILITATION › Section 28D .0105 - DISCHARGE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) When a state
				  facility discharges a client, each client shall have a discharge plan as
				  specified in
				  G.S.
				  122C-61(2) unless the
				  client:
(1) is receiving respite
				  services;
(2) escapes or breaches
				  the conditions of a conditional release;
(3) is unanticipatedly discharged by the
				  court following district court hearing; or
(4) is immediately discharged upon request of
				  the client or legally responsible person.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0100 - RIGHT TO TREATMENT OR HABILITATION › Section 28D .0106 - CONSENT

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Consents
				  required in Sections .0200, .0300 and .0400 in this Subchapter shall be
				  obtained in writing or verbally over the telephone.
(b) Written consent of the client or his
				  legally responsible person shall be obtained whenever possible. Information
				  which is necessary to adequately inform the client shall be documented in the
				  client record and shall include the following:
(1) name of the procedure or treatment and
				  its purpose expressed in laymen's terms;
(2) evidence that the benefits, risks,
				  possible complications and possible alternative methods of treatment have been
				  explained to the client or his legally responsible person;
(3) notification that the consent may be
				  withdrawn at any time without reprisal;
(4) specific length of time for which consent
				  is valid;
(5) when anesthesia is
				  indicated, permission to administer a specified type of anesthesia;
(6) permission to perform the procedure or
				  treatment;
(7) when applicable,
				  authorization for the examination and disposal of any tissue or body parts that
				  may be removed; and
(8) signature
				  of the client or his legally responsible person on written
				  authorizations.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0200 - PROTECTIONS REGARDING CERTAIN PROCEDURES › Section 28D .0201 - LEAST RESTRICTIVE ALTERNATIVE AND PROHIBITED PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Each facility shall provide
				  services/supports that promote a safe and respectful environment. These
				  include:
(1) using the least restrictive and
				  most appropriate settings and methods;
(2) promoting coping and engagements skills
				  that are alternatives to injurious behavior towards self or others;
(3) providing choices of activities
				  meaningful to the clients serviced/supported; and
(4) sharing of control over decisions with
				  the client/legally responsible person and staff.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0200 - PROTECTIONS REGARDING CERTAIN PROCEDURES › Section 28D .0202 - ELECTROCONVULSIVE THERAPY

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  treatment/habilitation team may recommend the use of electroconvulsive
				  therapy.
(b) Before
				  electroconvulsive therapy can be utilized two licensed physicians, one of whom
				  shall be clinically privileged to perform electroconvulsive therapy, shall
				  approve a written plan, which includes indication of need, specific goals to be
				  achieved, methods for measuring treatment efficacy, and indications for
				  discontinuation of treatment. In addition, electroconvulsive therapy shall not
				  be administered to any client under age 18 unless, prior to the treatment, two
				  independent psychiatric consultants with training or experience in the
				  treatment of adolescents have examined the client, consulted with the
				  responsible state facility psychiatrist and have written and signed reports
				  which document concurrence with the use of such treatment. For clients under
				  the age of 13, such reviews shall be conducted by child
				  psychiatrists.
(c) The internal
				  client advocate shall be informed at the time of the decision to utilize
				  electroconvulsive therapy whenever the legally competent client requests such
				  notification or when proposed for use with minor clients or adults adjudicated
				  incompetent.
(d) Electroconvulsive
				  therapy shall not be initiated without prior consent in accordance with
				  G.S.
				  122C-57(f).
(e) If the adult client is determined to be
				  de facto incompetent by the treatment/habilitation team and is determined to
				  need electroconvulsive therapy, legal guardianship procedures shall be
				  initiated and consent requirements of Paragraph (d) of this Rule shall be
				  met.
(f) All electroconvulsive
				  therapy shall be administered in accordance with generally accepted medical
				  practice and shall be documented in the client record.
(g) The State Facility Director shall
				  maintain a statistical record of the use of electroconvulsive therapy which
				  shall include, but not be limited to, the number of treatments by client, unit
				  or like grouping, responsible physician, and client characteristics. The
				  statistical record shall be made available to the Division Director on a
				  monthly basis.
Authority
					 G.S.
					 122C-51;
					 122C-56;
					 122C-57;
					 131E-67;
					 143B-147;
Eff.
					 October 1, 1984;
Amended Eff. July 1, 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0200 - PROTECTIONS REGARDING CERTAIN PROCEDURES › Section 28D .0203 - GENERAL POLICIES REGARDING INTERVENTIVE PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) This
				  Rule governs the policies and requirements regarding the use of the following
				  interventions:
(1) seclusion;
(2) physical restraint including:
(A) mechanical restraint; or
(B) manual restraint;
(3) isolation time-out;
(4) exclusionary time-out for more than 15
				  minutes;
(5) time-out for more than
				  one hour;
(6) protective devices
				  when used for behavioral control;
(7) contingent withdrawal or delay of access
				  to personal possessions or goods to which the client would ordinarily be
				  entitled;
(8) consistent
				  deprivation of items or cessation of an activity which the client is scheduled
				  to receive (other than basic necessities); and
(9) overcorrection which the client
				  resists.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0200 - PROTECTIONS REGARDING CERTAIN PROCEDURES › Section 28D .0204 - INDICATIONS FOR USE OF SECLUSION AND ISOLATION TIME-OUT

Current through Register Vol. 39, No. 2, July 15, 2024
Seclusion and isolation time-out shall be used only:
(1) in those situations specified in
				  G.S.
				  122C-60;
(2) after less restrictive measures have been
				  attempted and have proven ineffective. Less restrictive measures that shall be
				  considered include:
(a) counseling;
(b) environmental changes;
(c) education techniques; and
(d) interruptive or re-direction techniques;
				  and
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0200 - PROTECTIONS REGARDING CERTAIN PROCEDURES › Section 28D .0205 - INDICATIONS FOR USE OF PHYSICAL RESTRAINTS

Current through Register Vol. 39, No. 2, July 15, 2024
Physical restraints shall be used only:
(1) in those situations specified in
				  G.S.
				  122C-60;
(2) after consideration of the client's
				  physical and psychological well-being as specified in Rule .0203(b) of this
				  Section; and
(3) after a less
				  restrictive alternative has been attempted or has been determined and
				  documented to be clinically inappropriate or inadequate to avoid injury. Less
				  restrictive alternatives that shall be considered include but are not limited
				  to:
(a) counseling;
(b) environmental changes;
(c) education techniques; and
(d) interruptive or re-direction
				  techniques.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0200 - PROTECTIONS REGARDING CERTAIN PROCEDURES › Section 28D .0207 - PROTECTIVE DEVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Whenever
				  protective devices that cannot be removed at will by the client are utilized,
				  the state facility shall:
(1) assure that the
				  protective device shall be used only to promote the client's physical
				  safety;
(2) assure that the factors
				  putting the client's physical safety at risk are fully explored and addressed
				  in treatment planning with the participation of the client and legally
				  responsible person if applicable;
(3) document the utilization of protective
				  device in the client's nursing care plan, when applicable, and
				  treatment/habilitation plan;
(4)
				  document what positive alternatives and less restrictive alternatives were
				  considered, whether those alternatives were tried, and why those alternatives
				  were unsuccessful;
(5) assure that
				  the protective device is used only upon the written order of a qualified
				  professional that specifies the type of protective device and the duration and
				  circumstances under which the protective device is used;
(6) assure and document that the staff
				  applying the protective device is trained and has demonstrated competence to do
				  so;
(7) inspect to ensure that the
				  devices are in good repair and free of tears and protrusions;
(8) determine, at the time of application of
				  the protective device, the degree of observation needed to assure the safety of
				  those placed in restraints. The type of protective device used, the individual
				  patient situation, and the existence of any specific manufacturer's warning
				  concerning the safe use of a particular product shall all be considered in
				  determining the degree of observation needed. Observation shall include direct
				  line of sight or the use of video surveillance. In no instance shall
				  observation be less frequent than at 30-minute intervals.
(9) assure that whenever the client is
				  restrained and subject to injury by another client, a state facility employee
				  shall remain present with the client continuously.
(10) assure that the person is released as
				  needed, but at least every two hours;
(11) re-evaluate need for and impact on
				  client of protective device at least every 30 days; and
(12) assure that observations and
				  interventions shall be documented in the client record.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0200 - PROTECTIONS REGARDING CERTAIN PROCEDURES › Section 28D .0208 - INTERVENTIONS REQUIRING ADDITIONAL SAFEGUARDS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  interventions specified in this Rule present a significant risk to the client
				  and therefore require additional safeguards. These procedures shall be followed
				  in addition to the procedures specified in Rule .0203 of this
				  Section.
(b) The following
				  interventions are designed for the primary purpose of reducing the incidence of
				  aggressive, dangerous or self-injurious behavior to a level which will allow
				  the use of less intrusive treatment/habilitation procedures. Such interventions
				  include the use of:
(1) seclusion, physical
				  restraint or isolation time-out employed as a measure of therapeutic
				  treatment;
(2) seclusion, physical
				  restraint or isolation time-out used on an emergency basis more than 40 hours
				  in a calendar month or one episode in which the original order is renewed for
				  up to a total of 24 hours in accordance with the limits specified in
				  Subparagraph (l)(8) of Rule .0206 of this Section;
(3) unpleasant tasting substances;
(4) planned non-attention to specific
				  undesirable behaviors when the target behavior is health threatening;
(5) contingent deprivation of any basic
				  necessity;
(6) contingent
				  application of any noxious substances which include but are not limited to
				  noise, bad smells or splashing with water; and
(7) any potentially physically painful
				  procedure or stimulus which is administered to the client for the purpose of
				  reducing the frequency or intensity of a behavior.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0200 - PROTECTIONS REGARDING CERTAIN PROCEDURES › Section 28D .0209 - TRAINING: EMPHASIS ON ALTERNATIVES TO RESTRICTIVE INTERVENTIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Facilities shall implement policies and
				  practices that emphasize the use of alternatives to seclusion, physical
				  restraint and isolation time-out.
(b) Prior to providing services to people
				  with disabilities, staff including service providers, employees, students or
				  volunteers, shall demonstrate competence by successfully completing training in
				  communication skills and other strategies for creating an environment in which
				  the likelihood of imminent danger of abuse or injury to a person with
				  disabilities or others, or to property is prevented.
(c) Provider agencies shall establish
				  training based on state competencies, monitor for internal compliance and
				  demonstrate they acted on data gathered.
(d) The training shall be competency based,
				  include measurable learning objectives, measurable testing (written and by
				  observation of behavior) on those objectives and measurable methods to
				  determine passing or failing the course.
(e) Formal refresher training shall be
				  completed at least annually by each service provider.
(f) Content of the training that the service
				  provider plans to use shall be approved by the Division of MH/DD/SAS pursuant
				  to Paragraph (g) of this Rule.
(g)
				  Staff shall demonstrate competence in the following core areas:
(1) knowledge and understanding of the people
				  being served;
(2) recognizing and
				  interpreting human behavior;
(3)
				  recognizing the effect of internal and external stressors that may affect
				  people with disabilities;
(4)
				  strategies for building positive relationships with people with
				  disabilities;
(5) recognizing
				  cultural, environmental and organizational factors that may affect people with
				  disabilities;
(6) recognizing the
				  importance, and assisting people with disabilities in making decisions about
				  their life;
(7) skills in assessing
				  individual risk for escalating behavior;
(8) communication strategies for defusing and
				  de-escalating potentially dangerous behavior; and
(9) positive behavioral supports (providing
				  means for people with disabilities to choose activities which directly oppose
				  or replace behaviors which are unsafe).
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter D - TREATMENT OR HABILITATION RIGHTS › Section .0200 - PROTECTIONS REGARDING CERTAIN PROCEDURES › Section 28D .0210 - TRAINING IN SECLUSION, PHYSICAL RESTRAINT AND ISOLATION TIME-OUT

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Seclusion, physical restraint and
				  isolation time-out may be employed only by staff who have been trained and have
				  demonstrated competence in the proper use of and alternatives to these
				  procedures. Facilities shall ensure that staff authorized to employ and
				  terminate these procedures are retrained at least annually and have
				  demonstrated competence.
(b) Prior
				  to providing direct care to people with disabilities whose
				  treatment/habilitation plan includes restrictive interventions, staff including
				  service providers, employees, students or volunteers, shall complete training
				  in the use of seclusion, physical restraint and isolation time-out and shall
				  not use these interventions until the training is completed and competence is
				  demonstrated.
(c) A prerequisite
				  for taking this training is demonstrating competence by completion of training
				  in preventing, reducing and eliminating the need for seclusion, physical
				  restraint and isolation time-out.
(d) The training shall be competency-based,
				  include measurable learning objectives, measurable testing (written and by
				  observation of behavior) on those objectives and measurable methods to
				  determine passing or failing the course.
(e) Formal refresher training shall be
				  completed by each service provider periodically (minimum annually).
(f) Content of the training that the service
				  provider plans to employ shall be approved by the Division of MH/DD/SAS
				  pursuant to Paragraph (g) of this Rule.
(g) Acceptable training programs shall
				  include, but not be limited to, presentation of:
(1) refresher information on alternatives to
				  the use of seclusion, physical restraint and isolation time-out;
(2) guidelines on when to intervene
				  (understanding imminent danger to self and others);
(3) emphasis on safety and respect for the
				  rights and dignity of all persons involved (using concepts of least restrictive
				  interventions and incremental steps in an intervention);
(4) strategies for the safe implementation of
				  seclusion, physical restraint and isolation time-out;
(5) the use of emergency safety interventions
				  which include continuous assessment and monitoring of the physical and
				  psychological well-being of the client and the safe use of restraint throughout
				  the duration of the restrictive intervention;
(6) prohibited procedures;
(7) debriefing strategies, including
				  importance and purpose; and
(8)
				  documentation methods and procedures.