reglab/statecodes huggingface dataset:
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 .0300 - RIGHT TO REFUSE TREATMENT › Section 28D .0301 - THERAPEUTIC AND DIAGNOSTIC PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) In
				  addition to the treatment procedures specified in
				  G.S.
				  122C-57(f), other intrusive
				  procedures which are not routine medical diagnostic or treatment procedures
				  shall require the express and informed written consent of the client or his
				  legally responsible person prior to their initiation except in medical
				  emergencies. Such procedures shall include but are not limited to the
				  following:
(1) procedures that introduce
				  radioactive dyes;
(2)
				  hyperalimentation;
(3)
				  endoscopy;
(4) lumbar
				  puncture;
(5) prescribing and
				  administration of the following drugs:
(A)
				  Antabuse;
(B) Clonodine when used
				  for non-FDA approved uses; and
(C)
				  Depo-Provera when used for non-FDA approved uses; and
(6) neuroleptic drug therapy following the
				  diagnosis of tardive dyskinesia or after the symptoms of tardive dyskinesia
				  have appeared as observed by using a standardized abnormal involuntary movement
				  rating scale.
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 .0300 - RIGHT TO REFUSE TREATMENT › Section 28D .0302 - INTRUSIVE INTERVENTIONS

Current through Register Vol. 39, No. 2, July 15, 2024
When a client or his legally responsible person refuses
					 treatment or habilitation utilizing interventions specified in Section .0200 of
					 this Subchapter in a non-emergency situation, the following process shall be
					 followed for both voluntary and involuntary clients:
(1) The responsible professional shall speak
				  to the client or legally responsible person, if applicable, and attempt to
				  explain his assessment of the client's condition, the reasons for recommending
				  the intervention, the benefits and risks, and the advantages and disadvantages
				  of alternative courses of action. If the client or his legally responsible
				  person still refuses to participate and the responsible professional still
				  believes that these interventions are a necessary part of the client's
				  treatment or habilitation plan:
(a) The
				  responsible professional shall tell the client and the legally responsible
				  person, if applicable, that the matter will be discussed at a meeting of the
				  client's treatment/habilitation team;
(b) If the client's condition permits, the
				  responsible professional shall invite the client and the legally responsible
				  person, if applicable, to attend the meeting of the treatment/habilitation
				  team; and
(c) The responsible
				  professional shall suggest that the client and the legally responsible person,
				  if applicable, discuss the matter with a person of his own choosing such as a
				  relative, friend, or internal client advocate.
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 .0400 - REFUSAL OF PSYCHOTROPIC MEDICATION › Section 28D .0401 - ADMINISTRATION OF MEDICATIONS IN AN EMERGENCY

Current through Register Vol. 39, No. 2, July 15, 2024
(a) For the
				  purposes of the rules in this Section, "emergency" means a situation in which a
				  client is in imminent danger of causing physical harm to self or other persons
				  unless there is rapid intervention by the state facility employee in the form
				  of the administration of psychotropic medication.
(b) When a client in a state facility refuses
				  psychotropic medication in a situation that constitutes an emergency, the
				  Director of Clinical Services may authorize administration of the psychotropic
				  medication upon written certification that psychotropic medication is essential
				  in order to prevent the client from causing imminent physical harm to self or
				  other persons.
(c) If it is
				  impossible to comply with the procedure in Paragraph (b) of this Rule without
				  jeopardizing the life of the client or other persons, the medication may be
				  administered upon a physician's written or verbal order.
(d) In any situation falling within Paragraph
				  (b) or (c) of this Rule, the physician authorizing the psychotropic medication
				  shall immediately document the authorization with such documentation including
				  a statement describing the circumstances making the medication necessary and
				  setting forth the reasons why lesser intrusive alternative measures would not
				  have been adequate.
(e) Within 24
				  hours, or when imminent danger has passed or upon expiration of the physician's
				  order, whichever comes first, the use of psychotropic medication shall be
				  re-evaluated by the physician. Continuation of the administration of
				  psychotropic medication in an emergency after the re-evaluation by the
				  physician shall be permitted for up to 48 hours after written approval by the
				  Clinical Director. If the emergency no longer exists then the procedures
				  specified in Rules .0403 and .0404 of this Section shall apply.
(f) The occurrence of three emergency
				  episodes within a 30-day period where psychotropic medications are administered
				  shall constitute the need for the treatment team to review the
				  treatment/habilitation plan. The treatment team shall develop a plan to respond
				  to future crisis situations.
Authority
					 G.S.
					 122C-51;
					 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 .0400 - REFUSAL OF PSYCHOTROPIC MEDICATION › Section 28D .0402 - BEST INTEREST TEST

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The responsible
				  professional shall document in the client record that the administration of
				  psychotropic medication against the client's will is in the best interest of
				  the client. "Psychotropic medication administration is in the best interest of
				  the client" means that:
(1) the client
				  presents an imminent physical threat to himself, other clients, or state
				  facility employee (Behavior constituting such threat shall be explicitly
				  documented in the client record);
(2) the client is incapable without
				  medication of participating in any treatment or habilitation plan available at
				  the state facility that will give him a realistic opportunity of improving his
				  condition; or
(3) although it is
				  possible to devise a treatment or habilitation plan without psychotropic
				  medication which will give the client a realistic opportunity of improving his
				  condition, there is a significant possibility that the client will harm himself
				  or others before improvement of his condition is realized if medication is not
				  administered.
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 .0400 - REFUSAL OF PSYCHOTROPIC MEDICATION › Section 28D .0403 - REFUSAL IN STATE FACILITIES OTHER THAN MR CENTERS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) This
				  Rule applies to all state facilities with the exception of mental retardation
				  centers. Mental retardation centers shall comply with Rule .0404 of this
				  Section.
(b) In the case of an
				  emergency, procedures specified in Rule .0401 of this Section shall
				  apply.
(c) In the case of a
				  client's refusal of psychotropic medication in a non-emergency, the best
				  interest test as specified in Rule .0402 of this Section shall apply. A court
				  order issued regarding the administration of medication for forensic patients
				  would take precedence over this Rule.
(d) Administration to Involuntary Clients.
(1) When an involuntary client or his legally
				  responsible person refuses psychotropic medication in a situation that is not
				  an emergency, the following procedures are required:
(A) The attending physician shall speak to
				  the client or legally responsible person, if applicable, and attempt to explain
				  his assessment of the client's condition, the reasons for prescribing the
				  medication, the benefits and risks of taking the medication, and the advantages
				  and disadvantages of alternative courses of action. If the client or his
				  legally responsible person still refuses and the physician still believes that
				  psychotropic medication administration is in the best interest of the client as
				  specified in Rule .0402 of this Section:
(i)
				  the physician shall tell the client and the legally responsible person, if
				  applicable, that the matter will be discussed at a meeting of the client's
				  treatment team;
(ii) if the
				  client's clinical condition permits, the physician shall invite the client and
				  the legally responsible person, if applicable, to attend the meeting of the
				  treatment team; and
(iii) the
				  physician shall suggest that the client and the legally responsible person, if
				  applicable, discuss the matter with a person of his own choosing, such as a
				  relative, friend, guardian or client advocate.
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 .0400 - REFUSAL OF PSYCHOTROPIC MEDICATION › Section 28D .0404 - REFUSAL IN REGIONAL MENTAL RETARDATION CENTERS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) This Rule
				  applies to mental retardation centers. All other state facilities shall comply
				  with Rule .0403 of this Section.
(b) In the case of an emergency, procedures
				  specified in Rule .0401 of this Section shall apply.
(c) In the case of a client's refusal of
				  psychotropic medication in a non-emergency, the best interest test as specified
				  in Rule .0402 of this Section shall apply.
(d) Medication Refusal Incident Defined.
(1) A medication refusal incident is defined
				  as any behavior on the part of the client, be it verbal or non-verbal, or
				  legally responsible person, which is judged to be an attempt to communicate an
				  unwillingness to have psychotropic medication administered to the
				  client.
(2) Given the
				  characteristics of the mentally retarded population, some very
				  common­place acts that may not necessarily constitute refusal should be
				  considered. These may include:
(A) passivity
				  or the lack of active participation in various activities which may require
				  physical prompting such as hand over hand manipulation in order to learn a
				  particular skill or complete a particular task;
(B) spitting out medication because of
				  objectionable texture or taste (Therefore, disguising the texture or taste of
				  psychotropic medica­tion with a pleasant tasting vehicle such as
				  applesauce or pudding may not necessarily be considered administration against
				  the client's will.); or
(C)
				  tantrums, self-injurious behavior, aggressive acts, etc. which would not
				  automatically be judged to represent a client's attempt to refuse medication.
				  However, it is recognized these behaviors in some cases may indeed be the only
				  form of communication a client may have with which to express his or her
				  refusal.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter E - ADVANCE CARE DIRECTIVES FOR CLIENTS › Section .0100 - RIGHT TO NATURAL DEATH › Section 28E .0101 - SCOPE

Current through Register Vol. 39, No. 2, July 15, 2024
These Rules set forth the right of an individual to control
					 decisions relating to his medical care, including the right to a peaceful and
					 natural death, as set forth in
					 G.S.
					 90-321. These Rules apply to the Division's
					 four psychiatric hospitals, the N.C. Special Care Center, the three Alcohol and
					 Drug Abuse Treatment Centers, and the five Mental Retardation Centers,
					 hereafter referred to as Division facilities.
Authority
					 G.S.
					 32A-15;
					 90-320;
					 143B-147;
Eff.
					 November 2, 1992;
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 E - ADVANCE CARE DIRECTIVES FOR CLIENTS › Section .0100 - RIGHT TO NATURAL DEATH › Section 28E .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.
				  90-321 shall apply to the rules in this
				  Subchapter.
(b) As used in these
				  Rules, the following terms have the meanings specified:
(1) "Advance care directive" means any
				  indication made in writing by a client in which the client makes provision or
				  directions as to who will make health care decisions should the client become
				  incapable of doing so; whether in such cases extraordinary means of sustaining
				  life should be employed; or both.
(2) "Capable client" means a client who has
				  the ability to make and communicate health care decisions, as confirmed by the
				  client's attending physician.
(3)
				  "Division" means the term as defined in
				  G.S.
				  122C-3.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter E - ADVANCE CARE DIRECTIVES FOR CLIENTS › Section .0100 - RIGHT TO NATURAL DEATH › Section 28E .0103 - ADVANCE CARE DIRECTIVES

Current through Register Vol. 39, No. 2, July 15, 2024
The Division shall honor advance care directives made by
					 clients prior to admission or made by capable clients after admission. Division
					 facilities shall decline to honor any advance care directive which does not
					 conform with the requirements set forth by
					 G.S.
					 32A-25 (for a health care power of attorney)
					 or G.S.
					 90-321 (for a living will).
Authority
					 G.S.
					 32A-15;
					 90-320;
					 90-321;
					 90-322;
					 143B-147;
Eff.
					 November 2, 1992;
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 E - ADVANCE CARE DIRECTIVES FOR CLIENTS › Section .0100 - RIGHT TO NATURAL DEATH › Section 28E .0104 - NATURAL DEATH IN ABSENCE OF DIRECTIVE

Current through Register Vol. 39, No. 2, July 15, 2024
Clients in division facilities retain the right to die with
					 dignity even where they have made no advance care directive, or have made a
					 directive which does not comply with statutory requirements. In the absence of
					 an advance care directive, the Division shall maintain strict compliance with
					 the procedure established by
					 G.S.
					 90-322 for determination of when, and under
					 what conditions, extraordinary means or artificial nutrition or hydration may
					 be withheld or withdrawn.
Authority
					 G.S.
					 90-320;
					 90-322;
					 143B-147;
Eff.
					 November 2, 1992;
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 F - ADMISSION AND DISCHARGE › Section .0100 - ADMISSIONS › Section 28F .0101 - REGIONS FOR DIVISION INSTITUTIONAL ADMISSIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Except
				  as otherwise provided in rules codified in this Chapter and Chapters 26 through
				  29 of this Title and except for State-wide programs and cross-regional
				  admissions approved by the Division Director based upon the clinical need of
				  the individual or for the purpose of accessing available beds or services, a
				  person seeking admission to a regional institution of the Division shall be
				  admitted only to the institution which serves the region of the state which
				  includes the person's "county of residence" as defined in
				  G.S.
				  122C-3.
(b) For state operated hospitals and
				  developmental centers, the regions of the state and the counties which
				  constitute the regions are as follows:
(1)
				  Western Region: Broughton Hospital, and J. Iverson Riddle Developmental Center
				  shall serve Alleghany, Alexander, Ashe, Avery, Buncombe, Burke, Cabarrus,
				  Caldwell, Catawba, Cherokee, Clay, Cleveland, Davidson, Gaston, Graham,
				  Haywood, Henderson, Iredell, Jackson, Lincoln, Macon, Madison, McDowell,
				  Mecklenburg, Mitchell, Polk, Rowan, Rutherford, Stanly, Surry, Swain,
				  Transylvania, Union, Watauga, Wilkes, Yadkin, and Yancey County;
(2) Central Region: Central Regional
				  Hospital, Murdoch Developmental Center, Whitaker Psychiatric Residential
				  Treatment Program (PRTF), and Wright School shall serve Alamance, Anson,
				  Caswell, Chatham, Davie, Durham, Forsyth, Franklin, Granville, Guilford,
				  Halifax, Harnett, Hoke, Lee, Montgomery, Moore, Orange, Person, Randolph,
				  Richmond, Rockingham, Stokes, Vance, Wake, and Warren County; and
(3) Eastern Region: Cherry Hospital and,
				  Caswell Developmental Center shall serve Beaufort, Bertie, Bladen, Brunswick,
				  Camden, Carteret, Chowan, Columbus, Craven, Cumberland, Currituck, Dare,
				  Duplin, Edgecombe, Gates, Greene, Hertford, Hyde, Johnston, Jones, Lenoir,
				  Martin, Nash, New Hanover, Northampton, Onslow, Pamlico, Pasquotank, Pender,
				  Perquimans, Pitt, Robeson, Sampson, Scotland, Tyrrell, Washington, Wayne, and
				  Wilson County.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0201 - SCOPE

Current through Register Vol. 39, No. 2, July 15, 2024
The rules in this Section apply to admissions, commitments
					 and discharges of all clients to and from the regional psychiatric hospitals of
					 the Division. The criteria and procedures shall be followed by staff of the
					 hospitals and by area program staff making referrals to the hospitals and
					 serving clients following discharge from the hospitals. Rule .0213 of this
					 Section contains provisions that relate only to minors from non-single portal
					 area programs. Until the effective date of the repeal of Rules .0128 and .0129,
					 Rules .0211 and .0212 shall supersede.
Authority
					 G.S.
					 122C-211;
					 122C-212;
					 143B-147;
Eff.
					 February 1, 1989;
Amended Eff. July 1, 1996;
Pursuant
					 to G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0202 - EXPLANATION OF TERMS

Current through Register Vol. 39, No. 2, July 15, 2024
For the purposes of the rules in this Section the following
					 terms shall have the meanings indicated:
(1) "Area program staff" means professionals
				  who are employees of the area authority or who contract with the area authority
				  or are employed by an agency which contracts with the area authority and who
				  are clinically privileged by the area authority.
(2) "Authorization" means the process whereby
				  area program staff approve of the hospitalization of a client currently
				  residing in their catchment area, and agree that the hospitalization shall be
				  included in their bed day utilization count.
(3) "Continuity of care" means the seamless
				  integration of both inpatient and outpatient services into a unified plan of
				  care for clients served by the area authority.
(4) "County of residence" has the meaning
				  specified in
				  G.S.
				  122C-3.
(5) "County where currently residing" means
				  the county where the client was living immediately prior to
				  hospitalization.
(6) "Division"
				  means the Division of Mental Health, Developmental Disabilities and Substance
				  Abuse Services.
(7) "Eligible
				  Psychologist" means a licensed practicing psychologist who has at least two
				  years' clinical experience.
(8)
				  "Facility" has the meaning specified in
				  G.S.
				  122C-3.
(9) "Hospital" means one of the regional
				  psychiatric hospitals of the Division.
(10) "Mental illness" has the meaning
				  specified in
				  G.S.
				  122C-3.
Authority
					 G.S.
					 122C-3;
					 143B-147;
Eff.
					 February 1, 1989;
Amended Eff. July 1, 1996;
Pursuant
					 to G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0203 - AUTHORIZATION OF HOSPITALIZATION BY AREA PROGRAM

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				  Designated area program staff shall authorize all hospitalizations for
				  individuals residing in an area program's catchment area.
(b) This authorization shall be done when the
				  individual is evaluated by the area program for referral to the hospital for
				  admission and shall be reviewed in accordance with area program
				  policy.
(c) When such authorization
				  is for an individual residing in a facility within the catchment area but whose
				  county of residence is outside the catchment area, the authorizing area program
				  shall notify the area program serving the individual's county of residence
				  within 24 hours.
(d) Authorization
				  for continuing hospitalization is the responsibility of the area program
				  serving the individual's county of residence.
Authority
					 G.S.
					 122C-211(e);
					 122C-261(f);
					 122C-262;
					 143B-147;
Eff.
					 February 1, 1989;
Amended Eff. July 1, 1996;
Pursuant
					 to G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0204 - AUTHORIZATION OF HOSPITALIZATION WHEN INDIVIDUAL ARRIVES DIRECTLY AT HOSPITAL

Current through Register Vol. 39, No. 2, July 15, 2024
(a) When an individual from an area program
				  arrives at the hospital for admission without area program authorization, the
				  hospital shall contact designated personnel of the individual's county of
				  residence area program, before admission is approved.
(b) If the area program does not respond
				  within one hour, the hospital is deemed to have been authorized to admit, and
				  shall contact the area program on the next working day to obtain authorization
				  for continuation of the hospitalization.
Authority
					 G.S.
					 122C-3;
					 122C-211;
					 143B-147;
Eff.
					 February 1, 1989;
Amended Eff. July 1, 1996;
Pursuant
					 to G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0205 - WRITTEN EVALUATION BY AREA PROGRAM

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Area
				  program staff shall evaluate each individual prior to authorization and
				  referral to the hospital unless
				  G.S.
				  122C-262 applies.
(b) The evaluation shall be in writing and
				  shall include the following:
(1) identifying
				  information, e.g., client's full name (including maiden name), address,
				  birthdate, race;
(2) referral
				  source;
(3) presenting
				  problem;
(4) if available,
				  medications and pertinent medical and psychiatric information, including the
				  DSM-IV diagnoses, history of treatment, side effects, allergies, last injection
				  date, recent laboratory work;
(5)
				  name, address and phone number of legally responsible person and next of kin,
				  if applicable;
(6) legal charges
				  pending, if applicable; and
(7)
				  name and telephone number of the area program staff members to contact for
				  further information including staff to call after regular working
				  hours.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0206 - ADDITIONAL INFORMATION FOR TREATMENT

Current through Register Vol. 39, No. 2, July 15, 2024
The following client information, if available, shall be
					 sent with the evaluation which accompanies the individual to the hospital. If
					 not immediately available, it shall be sent, together with any information
					 required by Rule .0205 of this Section but not provided in the evaluation, by
					 the authorizing area program to the appropriate hospital admissions office
					 within one working day of the client's admission to the hospital. This
					 information, which shall be used by hospital staff in developing the client's
					 treatment plan, shall include but need not be limited to the following:
(1) name of client's mental health center
				  therapist and psychiatrist and case manager, if applicable;
(2) county of residence;
(3) name, address and telephone number of the
				  individuals in the client's family and social support network who may provide
				  information for use in plan development;
(4) previous admissions to any state
				  facility, i.e., psychiatric, substance abuse, developmental
				  disabilities;
(5) current
				  psychiatric and other medications, including compliance with medications and
				  aftercare instructions;
(6)
				  alternatives attempted or considered prior to referral to the
				  hospital;
(7) goal of
				  hospitalization specifying the treatment objectives that the hospital should
				  address;
(8) specific suggestions
				  for programming and other treatment planning recommendations; and
(9) release plans, which include information
				  relevant to placement and other special considerations of the client upon
				  discharge from the hospital.
Authority
					 G.S.
					 122C-261;
					 122C-262;
					 122C-263;
					 122C-264;
					 122C-265;
					 122C-266;
					 122C-267;
					 122C-268;
					 122C-268.1;
					 122C-269;
					 122C-270;
					 122C-271;
					 122C-272;
					 122C-273;
					 122C-274;
					 122C-275;
					 122C-276;
					 122C-277;
					 143B-147;
Eff.
					 February 1, 1989;
Amended Eff. July 1, 1996; March 1,
					 1990;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0207 - COMMUNICATION TO AREA PROGRAM REGARDING ADMISSION/DENIAL

Current through Register Vol. 39, No. 2, July 15, 2024
(a) In
				  all instances where area program staff have evaluated, authorized, and referred
				  the individual to a hospital with a recommendation for admission, the area
				  program staff shall call the hospital admission office to inform it of the
				  authorization and referral, and advise it as to the name and phone number of an
				  area program contact person.
(b) If
				  the opinion of the examiner at the hospital is that the individual does not
				  meet inpatient criteria, the examiner shall contact designated area program
				  staff to discuss the individual's condition prior to releasing the individual.
				  Unreasonable delay shall not occur as a result of the foregoing and in no event
				  shall the individual be detained by the hospital for more than 24
				  hours.
(c) If the opinion of the
				  examiner is that the individual does meet inpatient criteria, the hospital
				  shall contact designated area program staff within 24 hours to notify them of
				  the admission.
(d) When the
				  hospital staff does not accept a client for admission, the hospital staff,
				  client, area program staff, and if applicable, family or legally responsible
				  person, shall discuss where in the community the client shall be returned and
				  shall discuss with the client options for receiving services.
Authority
					 G.S.
					 122C-132;
					 122C-221;
					 122C-261;
					 122C-262;
					 122C-263;
					 122C-264;
					 122C-265;
					 122C-266;
					 122C-267;
					 122C-268;
					 122C-268.1;
					 122C-269;
					 122C-270;
					 122C-271;
					 122C-272;
					 122C-273;
					 122C-274;
					 122C-275;
					 122C-276;
					 122C-277;
					 122C-261;
					 143B-147;
Eff.
					 February 1, 1989;
Amended Eff. July 1, 1996;
Pursuant
					 to G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0208 - GENERAL CRITERIA FOR ADMISSION

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				  Admission staff shall evaluate the individual to determine that:
(1) there is the presence of mental
				  illness;
(2) the individual is in
				  need of treatment or further evaluation at the facility; and
(3) admitting the individual to the hospital
				  is an appropriate treatment modality.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0209 - COORDINATION AND CONTINUITY OF CLIENT CARE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Each
				  hospital in conjunction with each area program shall develop a process to
				  assure ongoing communication between the hospital and area program regarding
				  clients in treatment at the hospital. This process shall include provisions for
				  case collaboration, particularly around treatment issues and issues related to
				  discharge planning and community care. For minor clients and for adult clients
				  adjudicated incompetent, such collaboration shall include the legally
				  responsible person. The process shall include but is not limited to the
				  following:
(1) specifically designated staff
				  at both the hospital and area program to facilitate communication;
(2) routinely scheduled case management
				  contact at hospital site;
(3)
				  hospital staff visitation to area programs;
(4) telephone conferences; and
(5) a discharge plan developed in
				  collaboration among hospital and area program staff and client.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0210 - NOTIFICATION OF CLIENT HEARING AND/OR DISCHARGE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  hospital shall give the authorizing area program 72 hours notice of planned
				  discharge of all clients except those clients for whom unplanned discharge
				  precludes 72 hours notice. In those cases notice shall be given within 24
				  hours. If there is a disagreement between the hospital and area program
				  regarding the planned discharge of a voluntary client, the disagreement shall
				  be resolved by the procedures specified in Rule .0212 of this
				  Section.
(b) The hospital shall
				  provide 24 hours notice to the authorizing area program prior to a court
				  hearing, of the recommendations to be made at the hearing. At the time of this
				  notification, a collaborative discharge contingency plan shall be developed in
				  case the judge does not order commitment.
(c) The Post-Institutional Plan, together
				  with the items specified in Rule .0211 of this Section, shall be sent to the
				  authorizing area program within 24 hours of discharge.
(d) A discharge summary shall be sent to the
				  authorizing area program prior to the first scheduled appointment and in any
				  case no later than 15 days after discharge.
Authority
					 G.S.
					 122C-112;
					 143B-147;
Eff.
					 February 1, 1989;
Amended Eff. July 1, 1996;
Pursuant
					 to G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0211 - PLACEMENT OF CLIENTS OUTSIDE THEIR COUNTY OF RESIDENCE

Current through Register Vol. 39, No. 2, July 15, 2024
Note:
Until the effective date of the repeal
					 of Rule .0128 of this Section, this Rule shall supersede.
(a) If a discharge plan proposes that a
				  client live in a facility outside his county of residence, hospital staff shall
				  notify the authorizing area program so that the area program can begin making
				  such a living arrangement. Hospital staff shall provide the authorizing area
				  program with information which shall include:
(1) the client's status, diagnosis and
				  needs;
(2) information regarding
				  the facility being considered; and
(3) information regarding the facility's
				  ability to serve the client being considered to live there.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0212 - RESOLUTION OF DIFFERENCES OF OPINION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Differences
				  of opinion between area authority/county program staff and hospital staff
				  regarding admission, treatment or discharge issues shall be resolved through
				  negotiation involving hospital and area authority/county program staff,
				  clients, legally responsible persons, and with client consent, family
				  members.
(b) If resolution of
				  issues regarding authorization, admission or discharge is not reached by the
				  Directors of the two organizations, the dispute shall be resolved following the
				  procedures as set forth in
				  10A NCAC
				  26A .0200;
				  10A NCAC
				  27G .0810 through
				  27G .0812 continuing to the final
				  level of appeal, if necessary, with procedures in G.S. 150B, Article 3
				  Administrative Hearings.
(c) During
				  the resolution of differences of opinion between area authority/county program
				  and hospital staff, the client shall be provided with the more conservative and
				  secure treatment option.
Authority
					 G.S.
					 143B-147;
Eff. February 1,
					 1989;
Amended Eff. November 1, 2005; July 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0200 - VOLUNTARY ADMISIONS, INVOLUNTARY COMMITEMENTS AND DISCHARGES OF ADULTS FROM REGIONAL PSYCHIATRIC HOSPITALS › Section 28F .0213 - REFERRALS OF MINORS FROM A NON-SINGLE PORTAL AREA

Current through Register Vol. 39, No. 2, July 15, 2024
(a) In a
				  non-single portal area, in addition to area program staff, a licensed physician
				  or eligible psychologist may refer a minor directly to a hospital. This person
				  shall be known as the "referring agent."
(b) As part of the referring process, the
				  referring agent shall provide the evaluation and other information specified in
				  Rules .0205 and .0206 of this Section.
(c) To assure appropriate planning for
				  treatment, discharge, and aftercare, when a licensed physician or eligible
				  psychologist makes a referral pursuant to this Rule, he or she shall be asked
				  by the hospital to agree in writing to:
(1)
				  continued involvement with the child and family during hospital
				  treatment;
(2) participation in
				  identification and coordination of community services that are essential to
				  discharge planning; and
(3)
				  provision of aftercare, as needed.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0300 - MEDICAL STAFF BYLAWS OF NORTH CAROLINA REGIONAL MENTAL HOSPITALS › Section 28F .0301 - ORGANIZATION OF STAFFS

Current through Register Vol. 39, No. 2, July 15, 2024
The medical and dental staffs of the four psychiatric
					 hospitals shall organize themselves in conformity with the model bylaws and
					 rules set forth in Rule .0308 of this Section. Rule .0308 of this Section shall
					 be the model bylaws and rules used by each such association in drafting of
					 bylaws and rules for itself and each such association shall have bylaws and
					 rules in substantial conformity to those in Rule .0308 of this
					 Section.
Authority
					 G.S.
					 143B-147;
Eff. February 1,
					 1976;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0300 - MEDICAL STAFF BYLAWS OF NORTH CAROLINA REGIONAL MENTAL HOSPITALS › Section 28F .0302 - APPLICANTS FOR MEMBERSHIP

Current through Register Vol. 39, No. 2, July 15, 2024
Applicants for membership on the medical staffs shall be
					 duly licensed or authorized to practice medicine or dentistry in the State of
					 North Carolina according to those standards set forth by the North Carolina
					 State Board of Medical Examiners or the North Carolina State Board of Dental
					 Examiners. No applicant shall be denied staff membership on the basis of sex,
					 race, creed, color, or national origin. Staff members shall indicate their
					 acceptance of membership on the medical staff by signed agreement that they
					 will abide by the medical staff bylaws, rules, and regulations and by the
					 bylaws of the governing body.
Authority
					 G.S.
					 143B-147;
Eff. February 1,
					 1976;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0300 - MEDICAL STAFF BYLAWS OF NORTH CAROLINA REGIONAL MENTAL HOSPITALS › Section 28F .0303 - MEDICAL DIRECTOR OF HOSPITAL

Current through Register Vol. 39, No. 2, July 15, 2024
The medical director of a hospital shall be a member of the
					 hospital medical staff and shall be a medical doctor duly licensed to practice
					 medicine in the State of North Carolina with approved training and experience
					 in the practice of psychiatry.
Authority
					 G.S.
					 143B-147;
Eff. February 1,
					 1976;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0300 - MEDICAL STAFF BYLAWS OF NORTH CAROLINA REGIONAL MENTAL HOSPITALS › Section 28F .0304 - APPLICATION PROCESS

Current through Register Vol. 39, No. 2, July 15, 2024
Applicants for the medical staff may be appointed or
					 reappointed by the Director of the hospital with concurrence of the Director of
					 Clinical Services and after consultation with the credentials committee.
					 Appointment to the medical staff shall confer upon the appointee only such
					 privileges as may hereinafter be provided. Determination of privileges will be
					 made by the Director and Director of Clinical Services after recommendation of
					 the executive committee of the medical staff. Such determination is based on
					 applicant's training, experience, demonstrated competence, and conducted
					 satisfactory performance of duties.
Authority
					 G.S.
					 143B-147;
Eff. February 1,
					 1976;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0300 - MEDICAL STAFF BYLAWS OF NORTH CAROLINA REGIONAL MENTAL HOSPITALS › Section 28F .0305 - RESTRICTION OR TERMINATION OF STAFF PRIVILEGES

Current through Register Vol. 39, No. 2, July 15, 2024
Should the superior of any physician or dentist recommend
					 restriction or termination of the employment of any physician or dentist of the
					 medical staffs for personal conduct or performance of duties issues as
					 specified in the State Personnel Manual, such recommendation will be forwarded
					 in writing to the Director and Director of Clinical Services who in turn may,
					 within a period of five days, refer said recommendation to the executive
					 committee of the medical staff for review. The result of this review will be
					 forwarded to the Director within five days. If the Director and Director of
					 Clinical Services accept the recommendation of the executive committee of the
					 medical staff, said recommendation will be made known to the physician or
					 dentist in question. Further appeal may be made in accordance with the standard
					 grievance procedure established by the State Personnel Act. Any physician or
					 dentist may be suspended by the Director and Director of Clinical Services for
					 flagrant misconduct pending the appeal mechanism as state
					 above.
Authority
					 G.S.
					 143B-147;
Eff. February 1,
					 1976;
Amended Eff. March 1, 1990;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0300 - MEDICAL STAFF BYLAWS OF NORTH CAROLINA REGIONAL MENTAL HOSPITALS › Section 28F .0306 - EMERGENCY AND TEMPORARY PRIVILEGES

Current through Register Vol. 39, No. 2, July 15, 2024
The Director and Director of Clinical Services shall have
					 the authority to grant emergency and temporary privileges to a qualified
					 physician who is not a member of the medical staff for a period of time not to
					 exceed 30 days.
Authority
					 G.S.
					 143B-147;
Eff. February 1,
					 1976;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 28 - MENTAL HEALTH, STATE OPERATED FACILITIES AND SERVICES › Subchapter F - ADMISSION AND DISCHARGE › Section .0300 - MEDICAL STAFF BYLAWS OF NORTH CAROLINA REGIONAL MENTAL HOSPITALS › Section 28F .0307 - DIVISIONS OF STAFF

Current through Register Vol. 39, No. 2, July 15, 2024
The medical staff shall be divided into honorary, visiting,
					 active, and resident staffs. Officers, standing and special committees shall be
					 elected and appointed with duties assigned, including meeting schedules and
					 attendance requirements, in accordance with the model bylaws.
Authority
					 G.S.
					 143B-147;
Eff. February 1,
					 1976;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. August 24,
					 2019.