North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 27 - MENTAL HEALTH, COMMUNITY FACILITIES AND SERVICES › Subchapter C - PROCEDURES AND GENERAL INFORMATION › Section .0100 - GENERAL POLICIES AND PROCEDURES › Section 27C .0102 - DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The definitions
				  contained in this Rule, and the terms defined in
				  G.S.
				  122C-3,
				  G.S.
				  122C-4 and
				  G.S.
				  122C-53(f) also apply to all
				  rules in Subchapters 27C, 27D, 27E and 27F.
(b) As used in these Rules, the following
				  terms have the meanings specified:
(1) "Abuse"
				  means the infliction of mental or physical pain or injury by other than
				  accidental means, or unreasonable confinement, or the deprivation by an
				  employee of services which are necessary to the mental or physical health of
				  the client. Temporary discomfort that is part of an approved and documented
				  treatment plan or use of a documented emergency procedure shall not be
				  considered abuse.
(2)
				  "Anti-psychotic medication" means the category of psychotropic drugs which is
				  used to treat schizophrenia and related disorders. Examples of neuroleptic
				  medications are Chlorpromazine, Thioridazine and Haloperidol.
(3) "Basic necessity" means an essential item
				  or substance needed to support life and health which includes, but is not
				  limited to, a nutritionally sound balanced diet consisting of three meals per
				  day, access to water and bathroom facilities at frequent intervals, seasonable
				  clothing, medications prescribed by a physician, time for sleeping and frequent
				  access to social contacts.
(4)
				  "Client advocate" means the term as defined in
				  G.S.
				  122C-3. For the purpose of these Rules, a
				  client advocate may be a facility employee who is not directly involved in the
				  treatment/habilitation of a specific client, but who is assigned, in addition
				  to other duties, to act as an advocate for that client.
(5) "Consent" means acceptance or agreement
				  by a client or legally responsible person following receipt of information from
				  the qualified professional who will administer the proposed treatment or
				  procedure. Consent implies that the client or legally responsible person was
				  provided with sufficient information, in a manner that the client or legally
				  responsible person can understand, concerning proposed treatment, including
				  both benefits and risks, in order to make a decision with regard to such
				  treatment.
(6) "Day/night facility"
				  means a facility wherein a service is provided on a regular basis, in a
				  structured environment, and is offered to the same individual for a period of
				  three or more hours within a 24-hour period.
(7) "Director of Clinical Services" means
				  Medical Director, Director of Medical Services, or other qualified professional
				  designated by the governing body as the Director of Clinical
				  Services.
(8) "Emergency" means a
				  situation in which a client is in imminent danger of causing abuse or injury to
				  self or others or when substantial property damage is occurring as a result of
				  unexpected and severe forms of inappropriate behavior and rapid intervention by
				  the staff is needed.
(9)
				  "Exploitation" means the use of a client's person or property for another's
				  profit or advantage or breech of a fiduciary relationship through improper use
				  of a client's person or property including situations where an individual
				  obtains money, property or services from a client from undue influence,
				  harassment, deception or fraud.
(10) "Facility" means the term as defined in
				  G.S.
				  122C-3. For the purpose of these Rules, when
				  more than one type of service is provided by the facility, each service shall
				  be specifically addressed by required policy and procedures when
				  applicable.
(11) "Governing body"
				  means, in the case of a corporation, the board of directors; in the case of an
				  area authority, the area board; and in all other cases, the owner of the
				  facility.
(12) "Governor's Advocacy
				  Council for Persons with Disabilities (GACPD)" means the council legislatively
				  mandated to provide protection and advocacy systems and promote employment for
				  all persons with disabilities in North Carolina.
(13) "Intervention Advisory Committee" means
				  a group established by the governing body in a facility that utilizes
				  restrictive interventions as specified in Rule .0104 of Subchapter
				  27E.
(14) "Involuntary client"
				  means an individual who is admitted to a facility in accordance with G.S. 122C,
				  Article 5, Parts 6 through 12.
(15)
				  "Isolation time-out" means the removal of a client for a period of 30 minutes
				  or more to a separate room from which exit is barred by staff, but not locked,
				  and where there is continuous supervision by staff, for the purpose of
				  modifying behavior.
(16) "Minor
				  client" means a person under 18 years of age who has neither been married nor
				  been emancipated by a decree issued by a court of competent
				  jurisdiction.
(17) "Neglect" means
				  the failure to provide care or services necessary to maintain the mental or
				  physical health and well-being of the client.
(18) "Normalization" means the utilization of
				  culturally valued resources to establish or maintain personal behaviors,
				  experiences and characteristics that are culturally normative or
				  valued.
(19) "Physical Restraint"
				  means the application or use of any manual method of restraint that restricts
				  freedom of movement; or the application or use of any physical or mechanical
				  device that restricts freedom of movement or normal access to one's body,
				  including material or equipment attached or adjacent to the client's body that
				  he or she cannot easily remove. Holding a client in a therapeutic hold or other
				  manner that restricts his or her movement constitutes manual restraint for that
				  client. Mechanical devices may restrain a client to a bed or chair, or may be
				  used as ambulatory restraints. Examples of mechanical devices include cuffs,
				  ankle straps, sheets or restraining shirts, arm splints, posey mittens, and
				  helmets. Excluded from this definition of physical restraint are physical
				  guidance, gentle physical prompting techniques, escorting a client who is
				  walking; soft ties used solely to prevent a medically ill client from removing
				  intravenous tubes, indwelling catheters, cardiac monitor electrodes, or similar
				  medical devices; and prosthetic devices or assistive technology which are
				  designed and used to increase client adaptive skills. Escorting means the
				  temporary touching or holding of the hand, wrist, arm, shoulder or back for the
				  purpose of inducing a client to walk to a safe location.
(20) "Protective device" means an
				  intervention that provides support for a medically fragile client or enhances
				  the safety of a self-injurious client. Such devices may include geri-chairs or
				  table top chairs to provide support and safety for a client with a physical
				  handicap; devices such as seizure helmets or helmets and mittens for
				  self-injurious behaviors; prosthetic devices or assistive technology which are
				  designed to increase client adaptive skills; or soft ties used to prevent a
				  medically ill client from removing intravenous tubes, indwelling catheters,
				  cardiac monitor electrodes, or similar medical devices. As provided in Rule
				  .0105(b) of Subchapter 27E, the use of a protective device for behavioral
				  control shall comply with the requirements specified in Rule .0104 in
				  Subchapter 14R.
(21) "Privileged"
				  means authorization through governing body procedures for a facility employee
				  to provide specific treatment or habilitation services to clients, based on the
				  employee's education, training, experience, competence and judgment.
(22) "Responsible professional" means the
				  term as defined in
				  G.S.
				  122C-3 except the "responsible professional"
				  shall also be a qualified professional as defined in Rule .0104 of Subchapter
				  27G.
(23) "Restrictive
				  intervention" means an intervention procedure which presents a risk of mental
				  or physical harm to the client and, therefore, requires additional safeguards.
				  Such interventions include the emergency or planned use of seclusion, physical
				  restraint (including the use of protective devices for the purpose or with the
				  intent of controlling unacceptable behavior), isolation time-out, and any
				  combination thereof.
(24)
				  "Seclusion" means isolating a client in a separate locked room for the purpose
				  of controlling a client's behavior.
(25) "Treatment" means the process of
				  providing for the physical, emotional, psychological and social needs of a
				  client through services.
(26)
				  "Treatment/habilitation plan" means the term as defined in
				  10A NCAC
				  27G .0103.
(27) "Treatment or habilitation team" means
				  an interdisciplinary group of qualified professionals sufficient in number and
				  variety by discipline to assess and address the identified needs of a client
				  and which is responsible for the formulation, implementation and periodic
				  review of the client's treatment/habilitation plan.
(28) "24-Hour Facility" means a facility
				  wherein service is provided to the same client on a 24-hour continuous basis,
				  and includes residential and hospital facilities.
(29) "Voluntary client" means an individual
				  who is admitted to a facility upon his own application or that of the legally
				  responsible person, in accordance with G.S. 122C, Article 5, Parts 2 through
				  5.