Or. Admin. R. 309-033-0210

Current through Register Vol. 63, No. 5, May 1, 2024

Section 309-033-0210 - [Effective 5/28/2024] Definitions

(1) "Administrator" means the director or chief executive over behavioral health services in a community hospital or the person in charge of treatment and rehabilitation programs at nonhospital facilities. Whenever "administrator" appears it means the administrator or designee.

(2) "Assignment" means "placement" as defined in OAR 309-033-0210.

(3) "Authority" or "OHA" means the Oregon Health Authority.

(4) "Caregiver" means the person who is appointed by the court under ORS 426.125 to be allowed to care for a person who has a mental illness on conditional release.

(5) "Certificate" means the document or documents issued by the Division, which identifies and declares certification of a provider pursuant to OAR 309-008-0100 to 309-008-1600. A letter accompanying issuance of the certificate will detail the scope and approved service delivery locations of the certificate.

(6) "Clinical record" means the record required by OAR 309-014-0035 documenting the mental health services delivered to clients by a CMHP or subcontractor.

(7) "Community Mental Health Program (CMHP)" means the entity responsible for organization of various services for persons with a mental health diagnosis or addictive disorders, operated by, or contractually affiliated with, a local mental health authority and operated in a specific geographic area of the state under an agreement with the Division pursuant to OAR 309-014-0000.

(8) "Community hospital" means any hospital that is not Oregon State Hospital.

(9) "Council" means a regional acute care psychiatric facility organization with a mission statement and bylaws, comprised of facility representatives, consumers, and family members. The council is advisory to the facility.

(10) "County governing body" means the county court or the board of county commissioners of one or more counties who operate a CMHP, or in the case of a Native American Reservation, the Tribal Council, or if the county declines to operate or contract for all or part of a CMHP, the board of directors of a public or private corporation selected by the county.

(11) "County of commitment" means the county in which the person was initially placed under civil commitment, or the county to which the county of commitment was transferred as appropriate.

(12) "County of placement" means the county in which the person under civil commitment is residing for the purpose of treatment, care, and custody.

(13) "County of residence" means the county where the person currently maintains a mailing address or, if the person has no current mailing address within the state, the county where the person was taken into custody or the county in which a person under civil commitment has been conditionally released as defined by ORS 426.241 to 426.255.

(14) "Court" means the circuit court acting pursuant to ORS Chapter 426.

(15) "Custody" means the prehearing physical retaining of a person taken into custody by:

(a) A peace officer pursuant to ORS 426.070, 426.228, 426.233;

(b) A peace officer at the direction of the director pursuant to ORS 426.233;

(c) A health care facility licensed under ORS Chapter 441, and approved by the Division, pursuant to ORS 426.231;

(d) A state hospital pursuant to ORS 426.232;

(e) A community hospital pursuant to ORS 426.070 or 426.232;

(f) A nonhospital facility pursuant to ORS 426.070 or 426.233; or

(g) A regional acute care psychiatric facility or nonhospital facility pursuant to ORS 426.072 or 426.233.

(16) "Director" means the director of the community mental health program and includes the director's designee, who must be a QMHP, or peace officer authorized by the director to act on their behalf for purposes of this rule.

(17) "Director of the county of commitment" means the director for the county where the person is under civil commitment.

(18) "Director of the county of placement" means the director for the county where the person under civil commitment is to be placed.

(19) "Director of the county of residence" means the director for the county of residence.

(20) "Diversion" means the certified 14-day period of intensive treatment extending the prehearing period of detention pursuant to the provision of ORS 426.237(1)(b).

(21) "Division" means the Health Systems Division of the Oregon Health Authority.

(22) "Emergency" means, in the opinion of the treating licensed independent practitioner, immediate action is required to preserve the life or physical health of a person, or because the behaviors of that person creates a substantial likelihood of immediate physical harm to self, or to others in the facility. The fact that a person is in custody under the provisions or ORS 426.072, 426.232 or 426.233 must not be the sole justification that an emergency exists.

(23) "Fresh air" means the inflow of air from outside the facility where the person under civil commitment is receiving services. "Fresh air" may be accessed through an open window or similar method as well as through access to the outdoors.

(24) "Healthcare supervisor" means the appointed licensed independent practitioner, master's level registered nurse or registered nurse certified by the American Nursing Association who reviews and approves policies and procedures related to reporting medical concerns to a LIP and staff training on the administrative rules in OAR Chapter 33, Division 207.

(25) "Hospital" or "facility" means the community hospital, regional acute care psychiatric facility, or nonhospital facility eligible for, or presently certified for, the use of seclusion or restraints to committed persons and persons in custody or on diversion.

(26) "Hospital hold" means the taking of a person into custody by order of a licensed independent practitioner pursuant to ORS 426.232.

(27) "Legally incapacitated person" means a person who has been found by the court to be unable to give informed consent to medical treatment and the court has appointed a guardian to make such decisions on the person's behalf pursuant to ORS 126.127.

(28) "Licensed Independent Practitioner (LIP)" means a physician, nurse practitioner, or naturopathic physician as defined in ORS 426.005.

(29) "Material risk" means the risk may have a substantial adverse effect on the patient's psychological and/or physical health.

(30) "Mechanical restraint" means any device or equipment used to restrict a person's freedom of movement.

(31) "Notice of Mental Illness (NMI)" is the notification required, pursuant to ORS 426.070, to be submitted to the director by any two persons, a county health officer, or a magistrate, and thereafter submitted by the director to the court or, pursuant to ORS 426.234, to be submitted by the LIP or the director to the court. Pursuant to ORS 426.070 and 426.234, the court commences proceedings pursuant to ORS 426.070 to 426.130 upon receipt of the NMI.

(32) "Nonhospital facility" means any facility, other than a hospital, that is certified by the Authority to provide adequate security, psychiatric, nursing, and other services to persons under ORS 426.232 or 426.233.

(33) "Nonhospital hold" means the taking of a person into custody by order of a director pursuant to the provisions of ORS 426.233. A director's hold and a trial visit hold are variations of a nonhospital hold.

(34) "Nurse" means a registered nurse, or a psychiatric nurse practitioner licensed by the Oregon Board of Nursing, but does not include a licensed practical nurse or a certified nurse assistant.

(35) "Outdoors" means an area with fresh air that is not completely enclosed overhead. "Outdoors" may include a courtyard or similar area.

(36) "Pro re nata" (P.R.N) means that a medication or medical treatment has been ordered to be given as needed.

(37) "Patient Day" means the day of admission plus each additional day of stay, but not the day of discharge, unless it is also the day of admission.

(38) "Peace officer" means a sheriff, constable, marshal, municipal police officer, member of the Oregon State Police or investigator of the Criminal Justice Division of the Department of Justice and such other persons as may be designated by law.

(39) "Person with mental illness" means a person who has been found to have a mental disorder and, due to this mental disorder, is a danger to self or others; unable to provide for basic personal needs that are necessary to avoid serious physical harm in the near future, and is not receiving such care as is necessary to avoid such harm; or is a person who otherwise meets criteria pursuant to ORS 426.005.

(40) "Physician" means a person who holds a degree of Doctor of Medicine, Doctor of Osteopathy, or Doctor of Podiatric Medicine, if the context in which the term "physician" is used does not authorize or require the person to practice outside the scope of a license issued under ORS 677.805 ("Ankle" defined for ORS 677.805 to 677.840) through 677.840 (Fees).

(41) "Physician Assistant" means a person who is licensed as such in accordance with ORS 677.265 (Powers of board generally), 677.495 (Definitions for ORS 677.495 to 677.535), 677.505 (Application of provisions governing physician assistants to other health professions), 677.510 (Board approval of using services of physician assistant), 677.515 (Medical services provided by physician assistant), 677.520 (Performance of medical services by unlicensed physician assistant prohibited), and 677.525 (Fees).

(42) "Placement" means the facility, program, or provider the person under civil commitment is sent to receive care, custody and treatment, including the transfer of a person under civil commitment from one location where the person was in care, custody, and treatment to another location for the same purpose.

(43) "Psychiatrist" means a physician licensed as provided pursuant to ORS 677.010 to 677.450 by the Board of Medical Examiners for the State of Oregon and who has completed an approved residency training program in psychiatry.

(44) "Psychologist" means a clinical psychologist licensed by the Oregon Board of Psychologist Examiners.

(45) "Qualified Mental Health Professional (QMHP)" means a qualified mental health professional as defined in OAR 309-019-0125.

(46) "Recertification" means the certification of continued civil commitment provided for under ORS 426.301.

(47) "Regional Acute Care Psychiatric Facility" means a facility certified by the Division to provide services for adults as described in OAR 309-033-0850 through 309-033-0890 and is operated in cooperation with a regional or local council. A regional acute care psychiatric facility must include 24 hour per day psychiatric, multi-disciplinary, inpatient or residential stabilization, care and treatment, for adults aged 18 or older with severe psychiatric disabilities in a designated region of the state. For the purpose of these rules, a state hospital is not a regional acute care psychiatric service. The goal of a regional acute care service is the stabilization, control and/or amelioration of acute dysfunctional symptoms or behaviors that result in the earliest possible return of the person to a less restrictive environment.

(48) "Restraint" means any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely. Restraint may be used only for the management of violent or self-destructive behavior that jeopardizes the immediate physical safety of the patient, a staff member, or others.

(49) "Seclusion" is the involuntary confinement of a patient alone in a room or area, from which the person is physically prevented from leaving. Seclusion may be used only for the management of violent or self-destructive behavior that jeopardizes the immediate physical safety of the person, patients, a staff member, or others.

(50) "Secure Transportation" of minors has the meaning given that term in OAR 419-400-0005(57).

(51) "Secure Transportation Services" for minors has the meaning given that term in OAR 419-400-0005(60).

(52) "Secure transport provider" means a secure transport provider approved according to OAR 309-033-0432.

(53) "Significant procedure" means a diagnostic or treatment modality which poses a material risk of substantial pain or harm to the patient or resident such as, but not limited to, electro-convulsive therapy.

(54) "State hospital" means any campus of the Oregon State Hospital system.

(55) "Superintendent" means the chief executive officer of the Oregon State Hospital or their designee.

Or. Admin. R. 309-033-0210

MHD 6-1998, f. 6-26-98, cert. ef. 7-1-98, Renumbered from 309-200-0010; MHD 2-2000(Temp), f. & cert. ef. 1-25-00 thru 7-22-00; MHD 9-2000, f. & cert. ef. 7-21-00; MHS 28-2016, f. & cert. ef. 12/29/2016; BHS 17-2022, temporary amend filed 10/14/2022, effective 10/14/2022 through 4/11/2023; BHS 9-2023, amend filed 04/04/2023, effective 4/7/2023; BHS 7-2024, amend filed 04/30/2024, effective 5/28/2024

Statutory/Other Authority: ORS 413.042, 426.005, 426.060, 426.110(2), 426.232 & 426.236

Statutes/Other Implemented: ORS 426.005 - 426.395