Ohio Administrative Code › Title 5122 - Department of Mental Health and Addiction Services › Chapter 5122-24 - Certification Definitions › Section 5122-24-01 - Certification definitions

Current through all regulations passed and filed through July 1, 2024
(A) Purpose
The purpose of this rule is to provide definitions for key
				words and phrases used in the department certification standards.
(B) Applicability
The following definitions apply to Chapters 5122-24 to 5122-29
				of the Administrative Code:
(1)
			 "Abuse" means any act or absence of action inconsistent with human rights which
			 results or could result in physical injury to a person served, unless the act
			 is done in self defense or occurs by accident; any act which constitutes sexual
			 activity, as defined under Chapter 2907. of the Revised Code, where such
			 activity would constitute an offense against a person served under that
			 chapter; insulting or coarse language or gestures directed toward a person
			 served which subjects the person served to humiliation or degradation; or
			 depriving a person served of real or personal property by fraudulent or illegal
			 means. For children, the definition of abuse is the same as in sections
			 2919.22 and
			 2151.031 of
			 the Revised Code.
(2)
			 "Acceptability" means the way in which the provider ensures that its services
			 and activities are sensitive to the individual needs of people, and that the
			 provider addresses issues of freedom of choice, and of ethnic, racial, gender
			 and cultural characteristics. Acceptability includes seeking out the advice of
			 people being served, or of populations who may not be receiving sufficient
			 services as reflected by a comparison of community demographics and the
			 demographics of persons served by the provider, in order to understand how
			 acceptability varies within the general population.
(3) "Accessibility" means the ability for
			 persons served to enter, approach, communicate with, or make use of the
			 services of a provider, including but not limited to the need for bilingual
			 staff, minority-specific programming, staffing patterns that reflect community
			 demographics and adequacy of hours of operation.
(4) "Activity" means an action performed by a
			 provider that does not constitute a mental health or addiction service as
			 defined in paragraph (B)(66) of this rule, and therefore does not have a cost
			 per unit, but that is reimbursable by the department, either as an activity,
			 e.g., research, or as a portion of the unit cost of services, e.g.,
			 administrative.
(5) "Administer"
			 means the direct application of a single drug to the body of a client either by
			 injection, inhalation, ingestion or any other means. The complete act of
			 administration entails the following:
(a)
			 Removal of an individual dose from a previously dispensed, properly labeled
			 container;
(b) Verification of drug
			 dose with the practitioner's order;
(c) Properly identifying the client before
			 giving the individual dose; and
(d)
			 Properly recording the time, date, and dose given in the client's integrated
			 clinical record.
(6)
			 "Administrative supervision" means to monitor the administrative aspects of a
			 service or group of services within a provider.
(7) "Admission" means a provider's decision
			 to offer direct services to a person, and includes opening an individual client
			 record for the person at the time of the first admission to the
			 provider.
(8) "Appropriateness"
			 means actions, treatment or service that promote empowerment, dignity, and
			 self-worth as defined by the person served in consultation with the individuals
			 providing the service.
(9) "Board
			 of alcohol, drug addiction, and mental health services" or "board" means the
			 body constituted according to section
			 340.02
			 of the Revised Code, or a community mental health board or an alcohol and drug
			 addiction services board as described in section
			 340.021
			 of the Revised Code; which have the same duties as described in section
			 340.03
			 of the Revised Code,
(10)
			 "Certificate" means the official document containing the department's written
			 authorization to the provider to operate specific services or activities. These
			 services and activities are those which are included in the provider's contract
			 or sub-contract with the board of alcohol, drug addiction, and mental health
			 services or for which a non-contract provider has voluntarily applied to
			 operate.
(11) "Certification" means
			 the written authorization from the department for a provider to operate
			 specific services and provide activities according to Chapters 5122-24 to
			 5122-29 of the Administrative Code. These services and activities are those
			 which are included in the provider's contract or sub-contract with the board of
			 alcohol, drug addiction, and mental health services or for which a non-contract
			 provider has voluntarily applied to operate.
(12) "Certification standards" means the
			 requirements as stated in Chapters 5122-24 to 5122-29 of the Administrative
			 Code with which a provider must comply in order to receive certification by the
			 department to provide mental health or addiction services and activities listed
			 in section
			 340.09
			 of the Revised Code. These services and activities are those which are included
			 in the provider's contract with the Ohio department of medicaid, contract or
			 sub-contract with the board of alcohol, drug addiction, and mental health
			 services or for which a non-contract provider has voluntarily applied to
			 operate.
(13) "Client" means a
			 person admitted by a provider for mental health or addiction services or who
			 receives mental health or addiction services from a provider. "Persons,"
			 "Persons Receiving Services," "Persons Being Served," "Persons Served", or
			 "Consumer" has the same meaning as client. The terms include all categories of
			 persons of all ages, unless specified.
(14) "Community support system" means an
			 array of services and activities that provides treatment, support, and
			 rehabilitation services according to division (A)(2) of section
			 340.011
			 of the Revised Code.
(a) Location of persons
			 in need of mental health or addiction services to inform them of available
			 services and benefits mechanisms;
(b) Assistance for clients to obtain services
			 necessary to meet basic human needs for food, clothing, shelter, medical care,
			 personal safety, and income;
(c)
			 Mental health or addiction care, including, but not limited to outpatient, day
			 treatment, and, where appropriate, inpatient care;
(d) Emergency services and crisis
			 intervention;
(e) Assistance for
			 clients to obtain vocational services and opportunities for jobs;
(f) Provision of services designed to develop
			 social, community, and personal living skills;
(g) Access to a wide range of housing and the
			 provision of residential treatment and support;
(h) Support, assistance, consultation, and
			 education for families, friends, consumers of mental health and addiction
			 services, and others;
(i)
			 Recognition and encouragement of families, friends, neighborhood networks,
			 especially networks that include racial and ethnic minorities, churches,
			 community organizations, and meaningful employment as natural supports for
			 consumers of mental health or addiction services;
(j) Grievance procedures and protection of
			 the rights of consumers of mental health and addiction services; and
(k) Case management, which includes continual
			 individualized assistance and advocacy to ensure that needed services are
			 offered and procured.
(15) "Consent" means agreement to participate
			 in a research or treatment procedure on the basis of the subject's
			 understanding of its nature and possible risks and benefits.
(16) "Crisis" means a situation with a high
			 stress level, for either an individual or a system, and where usual coping
			 methods do not succeed in resolving the issues presented by the precipitating
			 event. A crisis is usually short in duration, lasting less than eight to twelve
			 weeks.
(17) "Culturological
			 assessment" means the systematic appraisal or examination of individuals,
			 groups and communities as to their cultural beliefs, values and practices to
			 determine explicit needs and intervention practices within the cultural context
			 of the people being evaluated, and includes the following domains:
(a) Patterns of life style;
(b) Specific cultural values/norms;
(c) Cultural taboos/myths;
(d) Worldview and ethnocentric
			 tendencies;
(e) General features
			 that client perceives similar to other cultures;
(f) Health and life care rituals and rites of
			 passage to maintain health;
(g)
			 Folk and professional health/illness systems utilized;
(h) Degree of cultural change and
			 acculturation noted;
(i) Caring
			 behaviors;
(j) Cultural
			 restrictions;
(k) Spiritual needs;
			 and
(l) Family.
(18) "Department" means the Ohio
			 department of mental health and addiction services.
(19) "Destruction" means the act of making a
			 drug unusable.
(20) "Director"
			 means the chief executive and administrative officer of the Ohio department of
			 mental health and addiction services.
(21) "Dispense" has the same meaning as
			 defined in paragraph (B) of rule
			 4729-5-01
			 of the Administrative Code. Only those individuals authorized by the Ohio board
			 of pharmacy may dispense medications.
(22) "Distribute" means the general system of
			 moving drugs from a supplier to final destination, whether administered to a
			 person served, stored, returned to supplier or destroyed.
(23) "Emergency" means a situation that is a
			 matter of life or death or of extreme drastic loss of a person's ability to
			 manage a potentially dangerous situation where the goal is avoidance of loss
			 and minimization of risks.
(24)
			 "Executive director" means the individual responsible for the day-to-day
			 operation of a provider. The executive director, as defined by this paragraph,
			 may be referred to by other titles, such as "chief executive
			 officer."
(25) "Grievance" means a
			 formal request for further review of any unresolved written complaint or a
			 complaint containing allegations of the denial, exercise or violation of the
			 rights of persons served. A grievance may be initiated either verbally or in
			 writing by a person served, client, ex-client, or any other person or provider
			 acting on behalf of a person served.
(26) "Hazardous materials" means any
			 substance considered to be potentially harmful to humans, including, but not
			 limited to, toxic chemicals or flammable substances.
(27) "ICR" means individual client record as
			 described in Chapter 5122-27 of the Administrative Code.
(28) "Intervention" means a procedure that is
			 intended to produce a change in behavior, cognition, and/or physiological or
			 biochemical process.
(29) "ITP"
			 means individualized treatment plan as described in rule
			 5122-27-03 of
			 the Administrative Code.
(30)
			 "Misconduct" means any act that may affect, interrupt or interfere with the
			 performance of official duties and that is illegal or a wrongful performance or
			 omission of a legal duty.
(31)
			 "Neglect" means a purposeful or negligent disregard of duty by an employee or
			 staff member. Such duty is one that is imposed on an employee or staff member
			 by statute, rule, or professional standards and which is owed to the person
			 served by that employee or staff member.
(32) "Orientation" means a process designed
			 to improve or enhance an employee's knowledge about his or her job
			 responsibilities and physical environment to increase awareness of the
			 expectations, choices, resources, and constraints that affect job performance
			 and adjustment.
(33) "Outcomes"
			 means the impact on the system or person served.
(34) "Parent" means the parent(s) having
			 legal custody or the custodian for a minor.
(35) "Person with serious emotional
			 disturbance" means a person less 
									who is under twenty-one years
			 of age who meets criteria that is a combination of duration of impairment,
			 intensity of impairment and diagnosis.
(a)
			 Criteria:
(i) Under
			 twenty-one years of age;
(ii) Marked to severe emotional/behavioral
			 impairment;
(iii) Impairment that
			 seriously disrupts family or interpersonal relationships; and
(iv) May require the services of other
			 youth-serving systems (e.g., education, human services, juvenile court, health,
			 intellectual disabilities, youth services, and
			 others).
(b)
			 Marked-to-severe behavioral impairment is defined as impairment that is at or
			 greater than the level implied by any of the following criteria in most social
			 areas of functioning:
(i) Inability or
			 unwillingness to cooperate or participate in self-care activities;
(ii) Suicidal preoccupation or rumination
			 with or without lethal intent;
(iii) School refusal and other anxieties or
			 more severe withdrawal and isolation;
(iv) Obsessive rituals, frequent anxiety
			 attacks, or major conversion symptoms;
(v) Frequent episodes of aggressive or other
			 antisocial behavior, either mild with some preservation in social relationships
			 or more severe requiring considerable constant supervision; and
(vi) Impairment so severe as to preclude
			 observation of social functioning or assessment of symptoms related to anxiety
			 (e.g., severe depression or psychosis).
(c) An impairment that seriously disrupts
			 family or interpersonal relationships is defined as one:
(i) Requiring assistance or intervention by
			 police, courts, educational system, mental health system, social service, human
			 services, and/ or children's services;
(ii) Preventing participation in
			 age-appropriate activities;
(iii)
			 In which community (home, school, peers) is unable to tolerate behavior;
			 or
(iv) In which behavior is
			 life-threatening (e.g., suicidal, homicidal, or otherwise potentially able to
			 cause serious injury to self or others).
(36) "Person with severe mental disability"
			 or "person with serious mental illness" means a person, age eighteen and over,
			 who currently, or at any time during the past year, has had a diagnosable
			 mental, behavioral, or emotional disorder of sufficient duration to meet
			 diagnostic criteria, that has resulted in functional impairment which
			 substantially interferes with or limits one or more major life activities.
			 Major life activities include activities of daily living such as eating,
			 bathing, or dressing; instrumental activities of daily living, such as maintain
			 a household, managing money, getting around the community, or taking prescribed
			 medications; or function in social, family or vocational/ educational
			 contexts."
(37) "Physician" (DO or
			 MD) means the same as "medical doctor" and "doctor of osteopathic
			 medicine."
(38) "Plan" means a
			 written document related to a service or activity that describes goals and
			 objectives, assigns responsibility for implementation, establishes outcome
			 measures, and assigns responsibility for monitoring and reporting
			 results.
(39) "Policy" means a
			 written statement developed by a provider that gives specific direction
			 regarding how the provider intends to operate, either administratively or
			 programmatically. Policies are developed to ensure that provider staff perform
			 their duties in a consistent manner and that the public can expect that all
			 services and activities will be conducted according to the policy
			 statement.
(40) "Practitioner"
			 means a person eligible to provide a service in accordance with Chapter 5122-29
			 of the Administrative Code.
(41)
			 "Prescribe" means the professional judgment of selecting a specific drug,
			 dosage and schedule of administration appropriate to the therapeutic needs of a
			 person served.
(42) "Principal"
			 means a person who has controlling authority or is in a leading position,
			 (e.g., executive director, chief financial officer, or chief clinical officer);
			 a principal may also be an owner, partner, or member of the governing body of
			 the provider.
(43) "PRN order" (pro
			 re nata order) means a written practitioner's order for a medication,
			 treatment, or procedure which is only carried out when a person served
			 manifests a specific, previously defined clinical or behavioral
			 characteristic.
(44) "Procedure"
			 means a written set of instructions describing the step-by-step actions to be
			 taken by provider staff in implementing the policies of the provider.
(45) Provider means:
(a) Any community addiction services provider
			 or community mental health services provider certified by the department to
			 provide services pursuant to section
			 5119.36
			 of the Revised Code.
(b) Any board
			 of alcohol, drug addiction, and mental health services approved by the
			 department in accordance with section
			 340.037
			 of the Revised Code to provide any of the mental health or addiction services
			 listed in section
			 340.09
			 of the Revised Code, or any board of alcohol, drug addiction, and mental health
			 services determined by the department to be providing a service subject to
			 department approval; or,
(c) Any
			 residential facility licensed according to section
			 5119.34
			 of the Revised Code that provides any of the mental health services listed in
			 Chapter 5122-29 of the Administrative Code.
(46) "Psychiatrist" (DO or MD) means an
			 individual who holds a current valid license to practice medicine according to
			 Chapter 4731. of the Revised Code, issued by the state medical board, who has
			 satisfactorily completed a residency training program in psychiatry as approved
			 by the residency review committee of the accreditation council for graduate
			 medical education of the American medical association, the committee on
			 postgraduate education of the American osteopathic association, or the American
			 osteopathic board of neurology and psychiatry, or who has been recognized as of
			 July 1, 1989, as a psychiatrist by the Ohio medical association or Ohio
			 osteopathic association, on the basis of formal training and five or more years
			 of medical practice limited to psychiatry, or who is a licensed physician
			 working under a temporary license and completing a residency in
			 psychiatry.
(47) "Recovery" means
			 the personal process of change in which Ohio residents strive to improve their
			 health and wellness, resiliency, and reach their full potential through
			 self-directed actions.
(48)
			 "Referral" means a recommendation to seek or request services and/or evaluation
			 between agencies in order to assess or meet the needs of persons served.
			 Referral, as used in "information and referral service", means the act of
			 assisting an individual gain access to services of a community
			 provider.
(49) "Resiliency" means a
			 dynamic process which takes into account the interaction of risk and protective
			 factors, contextual conditions, as well as the individual's traits and
			 abilities.
(50)
			 "Self-administration" means a person taking medication independently.
(51) "Service" means any action named and
			 defined in Chapter 5122-29 of the Administrative Code as a mental health or
			 addiction service provided for persons served by the provider and their
			 families and significant others, community organizations, and the general
			 public for the purpose of treating or preventing mental illness, emotional
			 disturbance, or substance abuse.
(52) "Significant others" means individuals
			 who are significant and important to the well-being of a person served, as
			 identified by the person served.
(53) "Standard" means a stated level of
			 performance for a service or activity expressed as an accepted and adhered-to
			 practice in the mental health or addiction service system.
(54) "Stock supply" means a volume of
			 medications that are not dispensed, or not labeled with the specific name of a
			 person served, and has the same meaning as "limited stock supply."
(55) "Student" means an individual enrolled
			 in an educational program that is approved, certified or accredited, and who
			 may provide mental health or addiction services as part of his/her practicum,
			 internship, or field placement, and with appropriate supervision according to
			 the requirements of the educational institution, applicable licensing board
			 standards, and in coordination with applicable provider policies and
			 procedures.
(56) "Supervise" means
			 to monitor, instruct and be accountable for provider staff in their performance
			 of clinical services to persons served according to the policies of the
			 provider, and has the same meaning as "clinical supervision."
(57) "Termination" means the decision to no
			 longer provide services to a person served by the provider.
(58) "Transfer" means a provider's
			 recommendation to discontinue providing one or more services to a person and to
			 begin providing another service(s) in the same provider.
(59) "Variance" means written permission
			 granted by the department to a provider to meet a modified requirement of a
			 rule of the Administrative Code.
(60) "Waiver" means written permission
			 granted by the department to a provider to be exempted from a rule or specific
			 provision of a rule of the Administrative Code.