Compilation of Rules and Regulations of the State of Georgia
Department 82 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES
Chapter 82-4
Subject 82-4-1 - CHILD AND ADOLESCENT CRISIS STABILIZATION UNITS
Rule 82-4-1-.03 - Definitions

1.Abuse means any unjustifiable intentional or grossly negligent act, exploitation or series of acts, or omission of acts which causes physical or mental injury or endangers the safety of an individual, including but not limited to, verbal abuse, assault or battery, failure to provide treatment or care, or sexual harassment of the individual;

2.Adolescent means an individual between the ages of thirteen (13) and seventeen (17) and who is not emancipated;

3.Advanced Practice Nursing means practice under a "Nurse Protocol Agreement", which is a written document, mutually agreed upon and signed by an APRN and a physician, by which the physician delegates to that APRN the authority to perform certain medical acts pursuant to O.C.G.A. Sec. 43-34-25, which may include without being limited to, the ordering of drugs, medical devices, medical treatments, diagnostic studies, or in life-threatening situations radiographic imaging tests;

4.Advanced Practice Registered Nurse, (hereinafter referred to as APRN), means a registered professional nurse licensed under Title 43, Chapter 25 of the Official Code of Georgia Annotated, who is recognized by the Georgia Board of Nursing as having met the requirements established by the Georgia Board of Nursing to engage in advanced nursing practice and who holds a master's degree or other graduate degree approved by the Georgia Board of Nursing and national board certification in his or her area of specialty, or a person who is recognized as an advanced practice registered nurse by the Georgia Board of Nursing on or before June 30, 2006;

5.Certificate of Need (CON) as defined in O.C.G.A. Sec. 31-6-2 means an official determination by the Department of Community Health (DCH), evidenced by certification issued pursuant to an application, that the action proposed in the application satisfies and complies with the CON criteria contained in the Georgia Code and rules promulgated by DCH;

6.Certified Addiction Counselor means an individual who is certified by one of the approved certifying bodies recognized by the state of Georgia, i.e. the Alcohol and Drug Abuse Certification Board of Georgia or the Georgia Addiction Counselor's Association;

7.Charge Nurse means a registered nurse who has the responsibility for coordination and supervision of nursing services during the period of a work shift;

8.Chemical Restraint means an over-the-counter or prescribed medication or drug that is administered to manage an individual's behavior in a way that reduces the safety risk to the individual or to others that has the effect of reducing the individual's freedom of movement and that is not a standard treatment for the individual's medical or psychiatric condition;

9.Chief Executive Officer (CEO) means the person, by whatever title used, whom the governing body has delegated the responsibility for the management and operation of the facility including the implementation of the rules and policies adopted by the governing body;

10.Child means an individual between the ages of five (5) and twelve (12) years old;

11.Commissioner means the commissioner of the Department of Behavioral Health and developmental Disabilities (DBHDD);

12.Contraband means any item or article of property that poses a threat to the security and safety of the C & A CSU, individuals, employees, visitors or public, or other items prohibited by C & A CSU policy or state law;

13.Crisis Bed means any bed operated by the Crisis Stabilization Unit;

14.Crisis Stabilization Unit (CSU) means a medically monitored short-term residential program that is licensed by the Department under these rules and designated by the Department as an emergency receiving and evaluating facility to provide emergency disability services that include providing psychiatric and behavioral stabilization and detoxification services twenty-four hours a day, seven days a week;

15.Department means the Department of Behavioral Health and Developmental Disabilities (DBHDD);

16.Emancipated minor means a person who is at least sixteen (16) but less than eighteen (18) years of age where the rights of the minor's parents to the custody, control, services, and earnings of the minor have been terminated by operation of state law or pursuant to a valid emancipation order issued by a court of competent jurisdiction;

17.Emergency Disability Services provided in a C & A CSU means services provided to individuals who meet criteria for admission to an emergency receiving and evaluating facility on voluntary or involuntary status;

18.Emergency Receiving Facility means a facility designated by the Department to receive individuals under emergency conditions as provided in Part 1 of Article 3 of Chapter 3 and Part 1 of Article 3 of Chapter 7 of Title 37 of the Official Code of Georgia Annotated;

19.Evaluating Facility means a facility designated by the Department to receive individuals for evaluations provided in Part 2 of Article 3 of Chapter 3 and Part 2 of Article 3 of Chapter 7 of Title 37 of the Official Code of Georgia Annotated;

20.Governing Body means the Board of Trustees, the partnership, the corporation, the association, the person, group of persons or other legal entity that is legally responsible for operation of the C & A CSU;

21.Individual means a child or adolescent receiving services in a C & A CSU;

22.Individualized Resiliency Plan (IRP) is the document that is initiated during an individual's admission to the C & A CSU and is continued, when the individual is discharged to the next level of care. The development of an IRP proceeds from a synthesis of (a) the reason for admission, (b) the individual/family's goals and choices,(c) treatment and support needs as identified by multidisciplinary assessments, (d) interventions, and (e) discharge criteria;

23.Involuntary Status means admission of an individual who has a mental illness or an addictive disease and who meets clinical criteria for admission, and whose guardian has not admitted the individual on a voluntary status pursuant to O.C.G.A. Secs. 37-3-41, 37-7-41;

24.Law Enforcement Hold means that an individual is in the custody or control of law enforcement and must be discharged only to the custody of law enforcement;

25.Legal Guardian means:

26.License means the official authorization granted by the Department pursuant to any of the provisions of O.C.G.A. Sec. 37-1-29 and the rules to operate a C & A CSU physically located in Georgia;

27.Licensed/Certified Clinician in a CSU setting means a person who is licensed or certified as a LCSW, LMSW, LPC, APC, LMFT, AMFT, PhD, Psychologist or a CACII;

28.Licensed Practical Nurse (LPN) means any person who holds a current license to practice nursing pursuant to O.C.G.A. Sec. 43-26-32et seq;

29.Licensing requirements means any provisions of law, rule, regulation, or formal order of the Department which apply to the C & A CSU with respect to initial or continued authority to operate;

30.Manual Hold (also known as Manual Restraint or Personal Hold) means the application of physical force, without the use of any device, for the purpose of restricting the free movement of an individual's body regardless of duration or timeframe;

31.Medical Director means the chief medical officer who is physician with overall responsibility for treatment of individuals receiving services within the C & A CSU or a physician appointed in writing as the designee of such chief medical officer;

32.Nursing Administrator means a full time employee of the C & A CSU who:

33.Nursing staff, as used in these rules, means the licensed and unlicensed assistive personnel providing direct care twenty-four hours a day, seven days a week. This includes the registered nurse in charge, other registered nurses on duty, licensed practical nurses, and unlicensed assistive personnel in the employ of the C & A CSU;

34.Physician means a person lawfully licensed in this state to practice medicine and surgery under the provisions of O.C.G.A. Sec. 43-34-20et seq. Physician, as it is used in these rules, means physician as well as those practitioners to whom the physician may delegate authority as defined in Physician Extender below;

35.Physician's Assistant means a skilled person who is licensed to a supervising physician and who is qualified by academic and practical training to provide patients' services not necessarily within the physical presence but under the personal direction or supervision of the supervising physician pursuant to O.C.G.A. Sec. 43-34-102et seq;

36.Physician Extender means an advanced practice registered nurse or a physician's assistant to whom the physician may delegate authority as defined in O.C.G.A. Secs. 43-34-23, 43-34-25;

37.Plan of Correction means a plan for correcting deficiencies in meeting rules and regulations of the Department;

38.Psychiatric Residential Treatment Facility (PRTF) means a facility that provides comprehensive mental health and substance abuse treatment to children, adolescents and young adults twenty-one (21) years of age or younger who, due to severe emotional disturbance, are in need of quality active treatment that can only be provided in an inpatient treatment setting and for whom alternative, less restrictive forms of treatment have been tried and found unsuccessful or are not medically indicated;

39.Psychiatrist means any physician certified as a diplomat in psychiatry by the American Board of Psychiatry and Neurology, or who has completed three (3) years of an approved residency training program in psychiatry and has had at least two (2) years of full-time practice in this specialty;

40.Registered Professional Nurse (RN) means any person who holds a current license to practice nursing under O.C.G.A. Sec 43-26-3et seq;

41.Restraint means any method, device, material or equipment attached or adjacent to the individual's body that the individual cannot easily remove and that restricts freedom of movement or normal access to one's body. This includes use of a manual restraint; manual hold or personal hold, a physical device, a mechanical device, use of material that is any physical matter including cloth or fabric, or use of equipment;

42.Risk Mitigation Plan is a document which addresses safety management for CSUs for which the architectural structure and/or environment of care is not consistent with the applicable provision;

43.Seclusion means the involuntary confinement of an individual alone in a room or area of a room from which the individual is physically prevented from leaving;

44.Treatment means care, diagnostic and therapeutic services, including the administration of medication, and any other service for an individual as defined in O.C.G.A. Sec. 37-3-1;

45.Treatment Facility means a facility designated by the Department to receive individuals for involuntary commitment for treatment provided in Part 3 of Article 3 of Chapter 3 and Part 3 of Article 3 of Chapter 7 of Title 37 of the Official Code of Georgia Annotated;

46.Treatment Team means physician, RN, licensed clinician, and related professionals such as certified peer specialists, certified addiction counselors, etc;

47.Unlicensed Assistive Personnel, as used in these rules, means individuals in the employ of the C & A CSU who provide direct care and oversight to individuals served in the C & A CSU, including, but not limited to, vital signs, activities of daily living, safety observations, and other duties as assigned. Unlicensed assistive personnel may be referred to as psychiatric assistants, certified nursing assistants, mental health assistants, healthcare technicians, or other recognized industry terms;

48.Voluntary Status means admission of an individual who has a mental illness or an addictive disease who meets clinical criteria for admission, and who is able to understand and exercise the rights and powers of an individual on voluntary status as defined in O.C.G.A. Secs. 37-3-20, 37-7-20.