North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 26 - MENTAL HEALTH, GENERAL › Subchapter D - NORTH CAROLINA DEPARTMENT OF CORRECTION: STANDARDS FOR MENTAL HEALTH AND MENTAL RETARDATION › Section .0100 - SCOPE AND DEFINITIONS › Section 26D .0103 - DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
For the rules contained in this Subchapter, the following
					 definitions apply:
(1) "Administering
				  medication" means direct application of a medication whether by injection,
				  inhalation, ingestion, or any other means to the client.
(2) "Admission" means acceptance of an inmate
				  for mental health and mental retardation services in accordance with Department
				  procedures.
(3) "Area" means one of
				  the six geographic catchment areas designated by the Department for
				  administrative purposes.
(4) "Area
				  program" means a public agency providing mental health, developmental
				  disabilities and substance abuse services for a catchment area designated by
				  the Commission for Mental Health, Developmental Disabilities and Substance
				  Abuse Services.
(5) "Chief of
				  Mental Health Services" means the individual who is responsible for the
				  development, provision and monitoring of mental health and mental retardation
				  services in the Department's Division of Prisons. His duties include ensuring
				  compliance with statutory and professional standards for services.
(6) "Client" means an inmate who is admitted
				  to and is receiving mental health or mental retardation services.
(7) "Client care evaluation study" means
				  evaluation of the quality of services by measuring actual services against
				  specific criteria through collection of data, identification and justification
				  of variations from criteria, analysis of unjustified variations, corrective
				  action, and follow-up study.
(8)
				  "Client record" means a written account of all mental health and mental
				  retardation services provided to an inmate from the time of acceptance of the
				  inmate as the client until termination of services. This information is
				  documented on standard forms which are filed in a standard order in an
				  identifiable folder.
(9)
				  "Clinician" means a psychiatrist, physician, or psychologist.
(10) "Commission" means the Commission for
				  Mental Health, Developmental Disabilities and Substance Abuse Services,
				  established under Part 4 of Article 3 of G.S. 143B.
(11) "Contract agency" means an entity with
				  which the Department contracts for a service as defined in the standards
				  exclusive of intermittent purchase of service for an individually identified
				  client.
(12) "Department" means the
				  Department of Correction.
(13)
				  "DHR" means the Department of Health and Human Services.
(14) "DHR review team" means the staff
				  delegated by the Department of Health and Human Services to monitor the
				  implementation of standards in accordance with the provisions of
				  G.S.
				  148-19(d).
(15) "Direct care staff" means staff who
				  provide care, treatment, or habilitation services to the client on a continual
				  and regularly scheduled basis.
(16)
				  "Disability group" means two or more inmates who are either mentally ill or
				  mentally retarded.
(17) "Discharge"
				  means the termination of mental health or mental retardation services to the
				  client.
(18) "Dispensing
				  medication" means issuing for the client one or more unit doses of a medication
				  in a suitable container with appropriate labeling.
(19) "Documentation" means provision of
				  written, dated and authenticated evidence of the delivery of services to the
				  client or compliance with standards.
(20) "Emergency service" means a service
				  which is provided on a 24-hour, non-scheduled basis to inmates for immediate
				  screening and assessment of presenting problems. Crisis intervention and
				  referral to other services are provided as indicated.
(21) "Facility" means the physical area where
				  mental health or mental retardation services are provided, including both
				  buildings and grounds, under the auspices of the Department.
(22) "Habilitation" means education,
				  training, care and specialized therapies undertaken to assist a mentally
				  retarded client in achieving or maintaining progress in developmental
				  skills.
(23) "Habilitation plan"
				  means an individualized, written plan for the client who is mentally retarded
				  which includes measurable, time-specific objectives based on evaluations,
				  observations, and other assessment data. The plan is based on the strengths and
				  needs of the client and identifies specific staff responsibilities for
				  implementation of the plan.
(24)
				  "Health professional" means a staff member trained in the delivery of medical
				  or mental health services.
(25)
				  "Inmate" means an incarcerated individual who remains in the custody of the
				  Department.
(26) "Inpatient
				  service" means a service provided on a 24-hour basis. Client care is provided
				  under the clinical direction of a physician or doctoral level psychologist. The
				  service provides continuous, close supervision for the client with moderate to
				  severe mental health problems.
(27)
				  "Legend drug" means a drug that must be dispensed with a
				  prescription.
(28) Medication"
				  means a substance in the official "United States Pharmacopoeia" or "National
				  Formulary" intended for use in the diagnosis, cure, mitigation, treatment or
				  prevention of disease or intended to affect the structure or any function of
				  the body.
(29) "Mental health
				  program director" means the individual who is responsible for the operation of
				  mental health and mental retardation services for inmates.
(30) "Mental illness" means the term as
				  defined in
				  G.S.
				  122C-3.
(31) "Mental retardation" means the term as
				  defined in
				  G.S.
				  122C-3.
(32) "Nurse" means a person licensed to
				  practice in the State of North Carolina either as a registered nurse or as a
				  licensed practical nurse.
(33)
				  "Officer in charge" means the correctional officer who has designated
				  responsibility for the custody and safekeeping of inmates in the
				  facility.
(34) "Outpatient service"
				  means a service designed to meet the diagnostic and therapeutic needs of the
				  client residing with the regular inmate population. Individual counseling,
				  psychotherapy, extended testing and evaluation, and medication therapy are
				  provided as needed.
(35) "Peer
				  review" means the formal assessment by professional staff of the quality and
				  efficiency of services ordered or performed by other professional
				  staff.
(36) "Physician" means a
				  medical doctor who is licensed to practice medicine in the State of North
				  Carolina.
(37) "Prevention service"
				  means a service provided to the prison population. Service activities include
				  counseling, information, instruction, and technical assistance with the goals
				  of preventing dysfunction and promoting well being.
(38) "Privileging" means a process by which
				  each staff member's credentials, training and experience are examined and a
				  determination made as to which treatment or habilitation modalities the staff
				  member is qualified to provide.
(39) "Program evaluation" means the
				  systematic documented assessment of program objectives to determine the
				  effectiveness, efficiency, and scope of the system under investigation, to
				  define its strengths and weaknesses and thereby to provide a basis for informed
				  decision-making.
(40) "Protective
				  device" means an intervention that provides support for a medically fragile
				  client or enhances the safety of the client with self-injurious behavior. Such
				  device may include geri-chairs or table top chairs to provide support and
				  safety for the client with a major physical handicap; devices such as seizure
				  helmets or helmets and mittens for self-injurious behaviors; or a device such
				  as soft ties used to prevent a medically ill client from removing intravenous
				  tubes, indwelling catheters, cardiac monitor electrodes, or similar medical
				  devices.
(41) "Psychiatric nurse"
				  means an individual who is licensed to practice as a registered nurse in the
				  State of North Carolina by the North Carolina Board of Nursing and who is a
				  graduate of an accredited master's level program in psychiatric mental health
				  nursing with two years of nursing experience, or has a master's degree in
				  behavioral science with two years of supervised clinical experience, or has
				  four years of experience in psychiatric mental health nursing.
(42) "Psychiatrist" means a physician who is
				  licensed to practice medicine in the State of North Carolina and who has
				  completed an accredited training program in psychiatry.
(43) "Psychologist" means an individual who
				  is licensed as a practicing psychologist or a psychological associate in the
				  State of North Carolina or one exempt from licensure requirements who meets the
				  supervision requirements of the North Carolina Board of Examiners of Practicing
				  Psychologists as specified in
				  21 NCAC
				  54 .2000.
(44) "Psychotherapy" means a form of
				  treatment of mental illness or emotional disorder which is based primarily upon
				  verbal interaction with the client. Treatment is provided by a trained
				  professional for the purpose of removing or modifying existing symptoms, of
				  attenuating or reversing disturbed patterns of behavior, and of promoting
				  positive personality growth and development.
(45) "Psychotropic medication" means
				  medication given with the primary intention of treating mental illness. These
				  medications include, but are not limited to, antipsychotics, antidepressants,
				  minor tranquilizers and lithium.
(46) "Qualified mental health professional"
				  means any one of the following: psychiatrist; psychiatric nurse; psychologist;
				  psychiatric social worker; an individual with a master's degree in a related
				  human service field and two years of supervised clinical experience in mental
				  health services; or an individual with a baccalaureate degree in a related
				  human service field and four years of supervised clinical experience in mental
				  health services.
(47) "Qualified
				  mental retardation professional" means an individual who holds at least a
				  baccalaureate degree in a discipline related to developmental disabilities and
				  who has at least one year of experience in working with mentally retarded
				  clients.
(48) "Qualified
				  professional" means a qualified mental health professional or a qualified
				  mental retardation professional.
(49) "Qualified record manager" means an
				  individual who is a graduate of a curriculum accredited by the Committee on
				  Allied Health Education and Accreditation of the American Medical Association
				  and the Council on Education of the American Health Information Management
				  Association and who is currently registered or accredited by the American
				  Health Information Management Association.
(50) "Quality assurance" means a process for
				  objectively and systematically monitoring and evaluating the quality,
				  appropriateness, and effectiveness of mental health and mental retardation
				  services provided and the degree to which those services meet the identified
				  needs and intended goals for the client.
(51) "Release" means the completion of an
				  inmate's active sentence and return to the community.
(52) "Research" means inquiry involving a
				  trial or special observation made under conditions determined by the
				  investigator to confirm or disprove a hypothesis, or to explicate some
				  principle or effect.
(53)
				  "Residential service" means a service provided in a designated treatment
				  setting where 24-hour supervision is an integral part of the care, treatment,
				  habilitation or rehabilitation provided to the client.
(54) "Responsible clinician" means the
				  psychologist, psychiatrist, or physician designated as responsible for the
				  client's treatment. This may include a clinician designated as on-call for the
				  facility.
(55) "Restraint" means
				  limitation of the client's freedom of movement with the intent of controlling
				  behavior by mechanical devices which include, but are not limited to, cuffs,
				  ankle straps, or sheets. For purposes of these Rules, restraint is a
				  therapeutic modality and does not include protective devices used for medical
				  conditions or to assist a non-ambulatory client to maintain a normative body
				  position, or devices used for security purposes.
(56) "Seclusion" means isolating the client
				  in a separate locked room or a room from which he cannot exit for the purpose
				  of controlling the client's behavior. For purposes of these Rules, seclusion is
				  a therapeutic modality and does not include segregation for administrative
				  purposes.
(57) "Service" means an
				  activity or interaction intended to benefit an individual who is in need of
				  assistance, care, habilitation, intervention, rehabilitation or
				  treatment.
(58) "Service delivery
				  site" means any area, correctional institution, residential unit, or inpatient
				  unit operated by the Department where mental health and mental retardation
				  services are provided.
(59) "Social
				  worker" means an individual who holds a master's degree in social work from an
				  accredited school of social work and has two years of clinical social work
				  experience in a mental health setting or who is a clinical social worker
				  certified by the North Carolina Certification Board for Social Work.
(60) "Standards" means minimum standards for
				  the delivery of mental health and mental retardation services to clients,
				  prescribed by the Commission for Mental Health, Developmental Disabilities and
				  Substance Abuse Services and codified in
				  10A NCAC
				  26D .0100 through
				  26D .1600.
(61) "State facility" means a facility
				  operated by the Division of Mental Health, Developmental Disabilities and
				  Substance Abuse Services and which provides mental health, mental retardation
				  or substance abuse services.
(62)
				  "Support service" means a service provided to enhance the client's progress in
				  his primary treatment or habilitation program.
(63) "Testing services" means the
				  administration and interpretation of the results of standardized instruments
				  for the assessment, diagnosis or evaluation of psychological or developmental
				  disorders.
(64) "Treatment" means
				  the process of providing for the physical, emotional, psychological, and social
				  needs of the client through services.
(65) "Treatment plan" means an
				  individualized, written plan of treatment for a mentally ill client. The plan
				  contains time-specific goals and strategies for implementing the goals, and
				  identifies direct care staff responsible for the provision of treatment
				  services to the client.
(66)
				  "Waiver" means a situation in which the Commission determines that a specific
				  prison site is not required to comply with a specific standard. A waiver is
				  granted according to the provisions of
				  10A NCAC
				  27G .0800.
Authority
					 G.S.
					 148-19(d);
Eff.
					 January 4, 1994;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. June 20,
					 2015.