North Dakota Administrative Code
Title 75 - Department of Human Services
Article 75-03 - Community Services
Chapter 75-03-17 - Psychiatric Residential Treatment Facilities for Children
Section 75-03-17-01 - Definitions

Universal Citation: ND Admin Code ยง 75-03-17-01

Current through Supplement No. 394, October, 2024

1. "Accredited" means to be accredited and in good standing by an independent, not-for-profit accreditation organization approved by the United States department of health and human services and the department, including the commission on accreditation of rehabilitation facilities, the joint commission, and the council on accreditation.

2. "Active treatment" means a strength based, culturally competent, and medically appropriate treatment designed to meet immediate needs with specific outcome and return to the family or another less restrictive community setting as soon as clinically possible and when treatment in a facility is no longer medically necessary.

3. "Aftercare" means followup support and services provided to a resident and family after discharge from a facility.

4. "Applicant" means the entity requesting licensure as a psychiatric residential treatment facility for children under this chapter.

5. "Child", "children", or "resident" means an individual or individuals under the age of twenty-one.

6. "Clinical supervision" means the oversight responsibility for individual treatment plans and individual service delivery.

7. "Condition" means a violation of the requirements of any applicable law or regulation.

8. "Department" means the department of health and human services.

9. "Diagnostic assessment" means a written summary of the history, diagnosis, and individual treatment needs of an individual with a mental illness using diagnostic, interview, and other relevant assessment techniques.

10. "Discharge planning" means the multidisciplinary process that begins at the time of admission that identifies the child's and family's needed services and supports upon discharge.

11. "Employee" means an individual compensated by the facility to work, including contracted service providers who conduct onsite training, treatment groups, individual therapy, or other facility services.

12. "Family-driven" means the family has a primary decisionmaking role in the care of its own children.

13. "Individual person-centered treatment plan" means a youth-guided and family-driven written plan of intervention, treatment, and services that is developed under clinical supervision on the basis of a diagnostic assessment.

14. "Individual with a mental illness" means an individual with an organic, mental, or emotional disorder that substantially impairs the capacity to use self-control, judgment, and discretion in the conduct of personal affairs and social relations. "Individual with a mental illness" does not include an individual with intellectual disabilities of significantly subaverage general intellectual functioning which originate during the developmental period and is associated with impairment in adaptive behavior, although an individual who has intellectual disabilities may also be an individual who has a mental illness. A substance use disorder does not per se constitute mental illness, although an individual who has a substance use disorder may also be an individual who has a mental illness.

15. "Initial license" means a license for a new facility that is in effect for one year.

16. "Nonemployee" means an individual, including a volunteer or student intern, who is not compensated by the facility.

17. "Psychiatric residential treatment facility for children" or "facility" means a facility or a distinct part of a facility that provides to children and adolescents a total, twenty-four-hour, therapeutic environment integrating group living, educational services, and a clinical program based upon a comprehensive, interdisciplinary clinical assessment and an individualized treatment plan that meets the needs of the child and family. The services are available to children in need of and able to respond to active psychotherapeutic intervention and who cannot be effectively treated in their own family, in another home, or in a less restrictive setting. The facility must be in compliance with requirements for psychiatric residential treatment facilities under 42 U.S.C. 1396d [Pub. L. 89-97; 79 Stat. 351] and title 42, Code of Federal Regulations, subpart D, part 441 and subpart G, part 483.

18. "Residential treatment" means a twenty-four-hour a day program under clinical supervision in a community residential setting other than an acute care hospital, for the active treatment of individuals with mental illness.

19. "Sentinel event" means any serious injury or trauma to a resident, death of a resident, or inappropriate sexual contact.

20. "Serious injury" means any significant impairment of the physical condition of the child as determined by qualified medical personnel. This includes burns, lacerations, bone fractures, substantial hematoma, and injuries to internal organs, whether self-inflicted or inflicted by someone else.

21. "Serious risk of harm" means a substantial likelihood of:

a. Suicide, as manifested by current suicidal threats, attempts, or significant depression creating immediate risk of suicide;

b. Killing or inflicting serious bodily harm to self or another individual, as manifested by current act; or

c. Substantial deterioration in physical health or substantial injury, disease, or death based on current poor self-control or judgment.

22. "Special treatment procedures" are defined as follows:

a. "Drug used as a restraint" means any drug that:
(1) Is administered to manage a resident's behavior in a way that reduces the safety risk to the resident or others;

(2) Has a temporary effect of restricting the resident's freedom of movement; and

(3) Is not a standard treatment for the resident's medical or psychiatric condition.

b. "Emergency safety interventions" means the use of restraint or seclusion as an immediate response to an emergency safety situation.

c. "Emergency safety situation" means unanticipated resident behavior that places the resident or others at serious threat of violence or injury if no intervention occurs and that calls for an emergency safety intervention.

d. "Mechanical restraint" means any device attached or adjacent to the resident's body that the resident cannot easily remove that restricts freedom of movement or normal access to the resident's body.

e. "Personal restraint" means the application of physical force without the use of any device, for the purposes of restraining the free movement of a resident's body. The term personal restraint does not include briefly holding without undue force a resident in order to calm or comfort the resident, or holding a resident's hand to safely escort a resident from one area to another.

f. "Physical escort" means the temporary touching or holding of the hand, wrist, arm, shoulder, or back for the purpose of inducing a resident who is acting out to walk to a safe location.

g. "Restraint" means a personal restraint, mechanical restraint, or drug used as a restraint.

h. "Seclusion" means the confinement of a resident alone in a room or an area from which the resident is physically prevented from leaving.

i. "Timeout" means the voluntary option of a resident to move to a designated area from which the resident is not physically prevented from leaving, for the purpose of providing the resident an opportunity to regain self-control.

23. "Tier 1 mental health professional" means a licensed psychiatrist, licensed psychologist, licensed physician or a physical assistant, or an advanced practice registered nurse.

24. "Trauma-informed" means an understanding of the prevalence of traumatic experiences in a child who receives mental health services and of the profound neurological, biological, psychological, and social effect of trauma and violence on the child being treated.

25. "Youth-guided" means a child has the right to be empowered, educated, and given a decisionmaking role in the care of the child's own life.

General Authority: NDCC 25-03.2-10

Law Implemented: NDCC 25-03.2-01, 25-03.2-03

Disclaimer: These regulations may not be the most recent version. North Dakota may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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