Haw. Code R. § 11-175-2

Current through September, 2024
Section 11-175-2 - Definitions

As used in this chapter:

"Abuse" means actual or threatened physical injury, psychological harm, or sexual violation of a consumer by another person.

"Adult mental health division" or "AMHD" means the division of the department that promotes and provides for the establishment and operation of a community-based mental health system pursuant to section 334-3, Hawaii Revised Statutes.

"Aftercare" means activities offered, in order to maintain gains received, to persons who formerly received treatment or rehabilitation services.

"Case management services" means those activities performed with consumer involvement by a single accountable individual to support the consumer and ensure that the consumer has maximal access to and receives all resources and services which can help the consumer reach and maintain an optimal level of community functioning and integration.

"Center" means the identifiable administrative unit which shall be the focal point for the development, delivery coordination of services in each service area.

"Certified substance abuse counselor" means a person who is certified as a substance abuse counselor by the Department of Health.

"Clinical record" means an individualized written transcript which documents a consumer's treatment plans, the treatment provided, response to treatment, and justification for any deviation from the treatment plan and any individual limitation of rights.

"Community based mental health and substance abuse system" means a publicly accountable and integrated array of accessible mental health and substance abuse services.

"Comprehensive treatment plan" means an individualized written design for service based on all available information and which contains goals related to identified problems, measurable objectives related to the goals methods for achieving objectives, expected achievement dates, frequency of treatment procedures, names of staff assigned, and date(s) the plan is reviewed and revised.

"Consultation services" means providing advice or assistance on matters relating to mental health or substance abuse to other service providers in their provision of services.

"Consumer" means a person who is receiving or has received mental health or substance abuse services or identifies oneself as receiving or having received such services.

"Contract provider" means an individual or agency providing mental health or substance abuse services by contract with the Department of Health.

"Council" means the state council on mental health and substance abuse.

"Continuing support" means continuing services designed to provide safety-net supports. The population focus is on individuals with a qualifying severe and persistent mental illness with accompanying severe functional impairment who do not have access to other mental health services.

"Crisis services" means time-limited services that are intensive and focused services designed to assess, stabilize and provide linkage to treatment and other community supports, as appropriate. Crisis services are intended for individuals in mental health crisis or situational crisis and not already eligible for continuing support.

"Department" means the department of health, State of Hawaii.

"Director" means the director of health, State of Hawaii.

"Disaster" means an event of significant community impact that is outside the range of usual human experience and that would be markedly distressing to almost anyone, provoking, or expected to provoke intense helplessness, terror, or fear of serious threat to life of physical integrity, or sudden destruction of home or community infrastructure.

"Disaster services" means services that may include counseling, debriefing, or education intended to relieve or minimize the development of psychological distress or dysfunction in persons who have experienced stress from a disaster.

"Education services" means promotion, distribution and dissemination of relevant information on mental health and substance abuse.

"Emergency" means a circumstance or combination of circumstances which requires immediate response, the omission of which would seriously and immediately endanger the life or safety of a consumer or others. Bizarre or inappropriate behavior by a consumer without attendant dangerousness shall not constitute an emergency.

"Emergency treatment" means any treatment, the omission of which would seriously and immediately endanger the life or safety of a consumer or others.

"Evaluation services" means problem identification clinical diagnosis or diagnostic impression, assessment of the severity of each problem identified, identification of strengths and assets, and determination of treatment and rehabilitation services needed.

"Eligibility determination" or "eligibility assessment" means an assessment approved by AMHD, which is sufficient to establish as diagnosis of severe and persistent mental illness, persons in an acute, service mental health crisis, and those experiencing distress and trauma from a declared disaster, conducted in a standardized and timely manner for consumers who are applying for AMHD services to determine whether they are eligible for continuing support.

"Follow-up services" means contact with consumers who have been discharged or who have discontinued affiliation with a program..

"Global assessment of functioning" or "GAF" means a score assigned by the clinician, which is used as a criteria for psychological, social and occupational functioning on a numerical rating from 1-100 as described in the Diagnostic and Statistical Manual of Mental Disorders.

"Imminent harm" means that the staff of a psychiatric facility or residential treatment facility has reason to believe that without intervention by staff, a consumer would seriously and immediately endanger the life or safety of the consumer or others.

"Information services" means informing the public of available mental health, substance abuse and related services and how they may be obtained.

"Informed consent" means a voluntary, knowledgeable decision to allow any procedure, release of information, or other action, made by the patient or consumer, or the patient or consumer's attorney-in-fact, or guardian, based on a full disclosure and understanding of facts needed to make the decision and with appropriate documentation including the signature of the person who made the decision.

"Initial treatment plan" means an individualized written design for service used during the period from admission to completion of a comprehensive treatment plan.

"Intervention" means assisting individuals in using the system's services; and assuring that individuals and families receive immediate and appropriate services in a crisis, intervention shall include:

(1) "Crisis services" which means activities provided at any location where the needs of the individuals can best be met to assure that individuals and families receive immediate and appropriate attention in an emergency, maintaining to the greatest degree possible, the consumer's status as a functioning community person. Emergency services include but are not limited to around-the-clock telephone service, availability of on-call trained personnel, outreach, counseling of individuals and families, and short term admission to a crisis or psychiatric facility for stabilization, and short term planning to arrange linkages to needed services.

(2) "Non-crisis services" which means activities which assist consumers to enter or make use of the service delivery system in a nonemergency situation. "Least restrictive level of service" means treatment modalities and service settings which are the most therapeutic alternatives available for a consumer and which allow the consumer the greatest possible effective exercise of liberty.

"Long-term" care or long-term treatment" for the purpose of these rules, means care or treatment in a psychiatric facility exceeding 30 days or in a residential treatment facility exceeding 60 days. "Neglect" means actual or potential physical injury psychological harm, or sexual violation of a consumer as the result of omission by a person with a duty to act.

"Non-indigent" means that a person has been determined to have the financial ability to pay a portion or all of the fees for care and treatment. "Non-residential settings" means sites where consumers do not live and where mental health and substance abuse services are provided to those consumers.

"Outreach services" means actively seeking out persons at risk or in need of mental health or substance abuse services in non-treatment settings, alerting them and their families to the availability of resources, and motivating them to seek help.

"Paraprofessional" means a person working in a mental health or substance abuse program as part of a treatment team whose position does not require a professional degree or certification.

"Prevention" means activities which create conditions, opportunities and experiences designed to encourage and develop healthy self-sufficiency, increase personal competence, and reduce excessive stress, or assist in managing stress more effectively. Prevention occurs before a person loses the ability to function and before a person needs remedial services.

"Primary provider of service" means a staff member who is assigned primary responsibility for treatment of a consumer.

"Private provider" means an individual or agency providing mental health or substance abuse services which are not provided by or under contract with the department of health.

"Program" for the purpose of these rules, means the only or smallest distinct unit within a service setting offering treatment or care.

"Provider" of mental health, substance abuse, or other health services means:

(1) For the purpose of the state council and service area board membership, an individual whose training, purpose, or primary current activity, or identified affiliation is in the direct provision or administration of mental health, substance abuse, or other health services;

(2) Otherwise, it means an individual or agency providing mental health and substance abuse services.

"Qualified interpreter" means a person who has demonstrated competence in both English and the other language for which interpretation is to be provided and who has within the last 12 months participated successfully in a course approved by the department dealing with ethics, practices, and consumer rights related to mental health and substance abuse services.

"Qualifying diagnosis" means one of the following diagnoses listed in the Diagnostic and Statistical Manual of Mental Disorders - DMS-IV-TR (The numeral preceding each diagnosis reflects the corresponding number in the DMS-IV-TR.):

295. xx Schizophrenia

i. 295.10 Disorganized Type

ii. 295.20 Catatonic Type

iii. 295.30 Paranoid Type

iv. 295.60 Residual Type

v. 295.90 Undifferentiated Type

295.70 Schizoaffective Disorder

296.34 Major Depression, Recurrent Type, Severe with Psychotic Features

296. xx Bipolar Disorder

i. 296. Ox Single Manic Episode

ii. 296. 4x Most Recent Episode Manic

iii. 296. 5x Most Recent Episode Depressed

iv. 296. 6x Most Recent Episode Mixed

v. 296. 7 Most Recent Episode Unspecified

296. 89 Bipolar II Disorder

297. 1 Delusional Disorder.

"Referral services" means providing information about services not available through the service area center or its contract agencies or information to persons not eligible for available services, and linking individuals with needed services.

"Rehabilitation" means psychosocial services which assist individuals to develop daily and community living skills, to set goals for themselves, to learn problem solving to handle social relationships, and to utilize self-help' group experiences and prevocational services including educational and experiential activities, arrangements for linkages with vocational and volunteer programs and job placement services.

"Residential settings" means non-hospital sites where consumers live and where mental health or substance abuse services are provided to those consumers.

"Residential treatment facility" means a facility which provides a structured therapeutic residential program for two or more consumers identified as needing mental health or substance abuse services and which provides, in addition to room and board, treatment and rehabilitation/habilitation services within the context of a group living experience to each consumer based on an individual treatment plan.

"Screening services" means determining an individual's possible need for mental health and substance abuse services and eligibility for service area center services.

"Seclusion" means placing a consumer alone in a room or other enclosed space with the door locked or held closed.

"Service area" means a defined geographical area for which there is designated responsibility for the delivery of mental health and substance abuse services to persons residing, working or attending school within the area.

"Service area center" means the identifiable administrative unit which shall be the focal point for the development, delivery and coordination of mental health and substance abuse services in each service area.

"Severe and persistent mental illness" or 'SPMI" means that a person has been assessed with the presence of a qualifying diagnosis for the previous 12 months, or will be expected to demonstrate the presence of a qualifying diagnosis for the next 12 months, and that person demonstrates functional impairment that seriously limits the person's ability to function independently in an appropriate and effective manner, as evidenced by a score of 50 or lower on the GAF.

"Substance abuse" means a pattern of alcohol or drug use which impairs physical, social or occupational functioning and has a minimal duration of disturbance of at least one month.

"Target population" means a group of persons at risk or in need of mental health or substance abuse services.

"Training services" means increasing job-related knowledge and skills of administrative, professional and support personnel or others providing mental health and substance abuse services.

"Treatment" means activities intended to alleviate or reduce the duration and severity of mental illness and substance abuse problems.

"Work" means the performance of tasks in exchange for fair monetary compensation at the prevailing minimum wage in compliance with state and federal requirements or, if below the minimum wage in compliance with applicable requirements of the Fair Labor Standards Act, excluding, for the purpose of these rules, care of personal belongings, light tasks appropriate to group activities and to small group working and living arrangements designed as part of a treatment program, and unpaid work in recognized volunteer program.

Haw. Code R. § 11-175-2

[Eff 12/19/89, am and comp DEC 30 1988; comp [DEC 16 2010] (Auth: HRS §§ 334-9) (Imp: HRS §§ 334-2, 334-3)