441—24.1 (225C) Definitions.
“Accreditation” means the decision made by the commission that the organization has met the applicable standards.
“Advanced registered nurse practitioner” means a nurse who has current licensure as a registered nurse in Iowa, or licensure in another state that is recognized in Iowa pursuant to Iowa Code chapter 152E, and who is also registered as certified in psychiatric mental health specialties pursuant to board of nursing rules in 655—Chapter 7.
“Advisory board” means the board that reviews and makes recommendations to the organization on the program being accredited. The advisory board shall meet at least three times a year and shall have at least three members, at least 51 percent of whom are not providers. The advisory board shall include representatives who have disabilities or family members of persons with disabilities. The advisory board’s duties include review and recommendation of policies, development and review of the organizational plan for the program being accredited, review and recommendation of the budget for the program being accredited, and review and recommendation of the performance improvement program of the program being accredited.
“Anticipated discharge plan” means the statement of the condition or circumstances by which the individual using the service would no longer need each of the specific services accredited under this chapter.
“Appropriate” means the degree to which the services or supports or activities provided or undertaken by the organization are suitable and desirable for the needs, situation, or problems of the individual using the service.
“Assessment” means the review of the current functioning of the individual using the service in regard to the individual’s situation, needs, strengths, abilities, desires and goals.
“Benchmarks” means the processes of an organization that lead to implementation of the indicators.
“Chronic mental illness” means the condition present in people aged 18 and over who have a persistent mental or emotional disorder that seriously impairs their functioning relative to such primary aspects of daily living as personal relations, living arrangements, or employment. People with chronic mental illness typically meet at least one of the following criteria:
	      1. 	  They have undergone psychiatric treatment more intensive than outpatient care more than once in a lifetime (e.g., emergency services, alternative home care, partial hospitalization or inpatient hospitalization).
	      2. 	  They have experienced at least one episode of continuous, structured, supportive residential care other than hospitalization.
In addition, people with chronic mental illness typically meet at least two of the following criteria on a continuing or intermittent basis for at least two years:
	      1. 	  They are unemployed, employed in a sheltered setting, or have markedly limited skills and a poor work history.
	      2. 	  They require financial assistance for out-of-hospital maintenance and may be unable to procure this assistance without help.
	      3. 	  They show severe inability to establish or maintain a personal social support system.
	      4. 	  They require help in basic living skills.
	      5. 	  They exhibit inappropriate social behavior that results in demand for intervention by the mental health or judicial system.
In atypical instances, a person who varies from these criteria could still be considered to be a person with chronic mental illness.
“Commission” means the mental health and disability services commission (MH/DS commission) as established and defined in Iowa Code section 225C.5.
“Community” means a natural setting where people live, learn, work, and socialize.
“Community mental health center” means an organization providing mental health services that is established pursuant to Iowa Code chapters 225C and 230A.
“Crisis intervention plan” means a personalized, individualized plan developed with the individual using the service that identifies potential personal psychiatric, environmental, and medical emergencies. This plan shall also include those life situations identified as problematic and the identified strategies and natural supports developed with the individual using the service to enable the individual to self-manage, alleviate, or end the crisis. This plan shall also include how the individual can access emergency services that may be needed.
“Deemed status” means acceptance by the commission of accreditation or licensure of a program or service by another accrediting body in lieu of accreditation based on review and evaluation by the division.
“Department” means the Iowa department of human services.
“Developmental disability” means a severe, chronic disability that:
	      1. 	  Is attributable to a mental or physical impairment or combination of mental and physical impairments;
	      2. 	  Is manifested before the age of 22;
	      3. 	  Is likely to continue indefinitely;
	      4. 	  Results in substantial functional limitations in three or more of the following areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency; and
	      5. 	  Reflects the person’s need for a combination and sequence of special, interdisciplinary, or generic services, individualized supports, or other forms of assistance that are of lifelong or extended duration and are individually planned and coordinated.
A person from birth to the age of nine, inclusive, who has a substantial developmental delay or specific congenital or acquired condition may be considered to have a developmental disability without meeting three or more of the criteria described above if the person, without services and supports, has a high probability of meeting those criteria later in life.
“Direct services” means services providing therapy, habilitation, or rehabilitation activities or support services such as transportation.
“Division” means the division of behavioral, developmental, and protective services for families, adults, and children of the department of human services.
“Doctor of medicine or osteopathic medicine” means a person who is licensed in the state of Iowa under Iowa Code chapter 148 as a physician and surgeon or under Iowa Code chapter 150A as an osteopathic physician and surgeon.
“Functional assessment” means the analysis of daily living skills. The functional assessment also takes into consideration the strengths, stated needs, and level and kind of disability of the individual using the service.
“Goal achieving” means to gain the required skills and supports to obtain the goal of choice. For purposes of this chapter, the definition and explanation are taken from the Psychiatric Rehabilitation Practitioner Tools, as developed by the Boston Center for Psychiatric Rehabilitation.
“Goal keeping” means assisting the individual using the service in maintaining successful and satisfying role performance to prevent the emergence of symptoms associated with role deterioration. For purposes of this chapter, the definition and explanation are taken from the Psychiatric Rehabilitation Practitioner Tools, as developed by the Boston Center for Psychiatric Rehabilitation.
“Incident,” for the purposes of this chapter, means an occurrence involving the individual using the service that:
	      1. 	  Results in a physical injury to or by the individual that requires a physician’s treatment or admission to a hospital, or
	      2. 	  Results in someone’s death, or
	      3. 	  Requires emergency mental health treatment for the individual, or
	      4. 	  Requires the intervention of law enforcement, or
	      5. 	  Results from any prescription medication error, or
	      6. 	  Is reportable to protective services.
“Indicators” means conditions that will exist when the activity is done competently and benchmarks are achieved. Indicators also provide a means to assess the activity’s effect on outcomes of services.
“Informed consent” refers to time-limited, voluntary consent. The individual using the service or the individual’s legal guardian may withdraw consent at any time without risk of punitive action. “Informed consent” includes a description of the treatment and specific procedures to be followed, the intended outcome or anticipated benefits, the rationale for use, the risks of use and nonuse, and the less restrictive alternatives considered. The individual using the service or the legal guardian has the opportunity to ask questions and have them satisfactorily answered.
“Intensive psychiatric rehabilitation practitioner” means a person who has at least 60 contact hours of training in intensive psychiatric rehabilitation and either:
	      1. 	  Is certified as a psychiatric rehabilitation practitioner by the United States Psychiatric Rehabilitation Association; or
	      2. 	  Holds a bachelor’s degree with 30 semester hours or equivalent quarter hours in a human services field (including, but not limited to, psychology, social work, mental health counseling, marriage and family therapy, nursing, education, occupational therapy, and recreational therapy) and has at least one year of experience in the delivery of services to the population groups that the person is hired to serve.
“Leadership” means the governing board, the chief administrative officer or executive director, managers, supervisors, and clinical leaders who participate in developing and implementing organizational policies, plans and systems.
“Marital and family therapist” means a person who is licensed under Iowa Code chapter 154D in the application of counseling techniques in the assessment and resolution of emotional conditions. This includes the alteration and establishment of attitudes and patterns of interaction relative to marriage, family life, and interpersonal relationships.
“Mental health counselor” means a person who is licensed under Iowa Code chapter 154D in counseling services involving assessment, referral, consultation, and the application of counseling, human development principles, learning theory, group dynamics, and the etiology of maladjustment and dysfunctional behavior to individuals, families, and groups.
“Mental health professional” means a person who meets all of the following conditions:
	      1. 	  Holds at least a master’s degree in a mental health field including, but not limited to, psychology, counseling and guidance, psychiatric nursing and social work; or is a doctor of medicine or osteopathic medicine; and
	      2. 	  Holds a current Iowa license when required by the Iowa professional licensure laws (such as a psychiatrist, a psychologist, a marital and family therapist, a mental health counselor, an advanced registered nurse practitioner, a psychiatric nurse, or a social worker); and
	      3. 	  Has at least two years of postdegree experience supervised by a mental health professional in assessing mental health problems, mental illness, and service needs and in providing mental health services.
“Mental health service provider” means an organization whose services are established to specifically address mental health services to individuals or the administration of facilities in which these services are provided. Organizations included are:
	      1. 	  Those contracting with a county board of supervisors to provide mental health services in lieu of that county’s affiliation with a community mental health center (Iowa Code chapter 230A).
	      2. 	  Those that may contract with a county board of supervisors for special services to the general public or special segments of the general public and that are not accredited by any other accrediting body.
These standards do not apply to individual practitioners or partnerships of practitioners covered under Iowa’s professional licensure laws.
“Mental retardation” means a diagnosis of mental retardation under these rules which shall be made only when the onset of the person’s condition was before the age of 18 years and shall be based on an assessment of the person’s intellectual functioning and level of adaptive skills. A psychologist or psychiatrist who is professionally trained to administer the tests required to assess intellectual functioning and to evaluate a person’s adaptive skills shall make the diagnosis. A diagnosis of mental retardation shall be made in accordance with the criteria provided in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, published by the American Psychiatric Association.
“Natural supports” means those services and supports an individual using the service identifies as wanted or needed that are provided at no cost by family, friends, neighbors, and others in the community, or by organizations or entities that serve the general public.
“New organization” means an entity that has never been accredited under 441—Chapter 24 or an accredited entity under 441—Chapter 24 that makes a significant change in its ownership, structure, management, or service delivery.
“Organization” means:
	      1. 	  A governmental entity or an entity that meets Iowa Code requirements for a business organization as a for-profit or not-for-profit business. These entities include, but are not limited to, a business corporation under Iowa Code chapter 490 or a nonprofit corporation under Iowa Code chapter 504 that provides a service accredited pursuant to the rules in this chapter.
	      2. 	  A county, consortium of counties, or the department of human services that provides or subcontracts for the provision of case management.
	      3. 	  A division or unit of a larger entity, such as a unit within a hospital or parent organization.
“Organization” does not include: an individual for whom a license to engage in a profession is required under Iowa Code section 147.2, any person providing a service if the person is not organized as a corporation or other business entity recognized under the Iowa Code, or an entity that provides only financial, administrative, or employment services and that does not directly provide the services accredited under this chapter.
“Outcome” means the result of the performance or nonperformance of a function or process or activity.
“Policies” means the principles and statements of intent of the organization.
“Procedures” means the steps taken to implement the policies of the organization.
“Program” means a set of related resources and services directed to the accomplishment of a fixed set of goals for the population of a specified geographic area or for special target populations.
“Psychiatric crisis intervention plan” means a personalized, individualized plan developed with the individual using the service that identifies potential personal psychiatric emergencies. This plan shall also include those life situations identified as problematic and the identified strategies and natural supports developed with the individual using the service to enable the individual to self-manage, alleviate, or end the crisis. This plan shall also include how the individual can access emergency services that may be needed.
“Psychiatric nurse” means a person who meets the requirements of a certified psychiatric nurse, is eligible for certification by the American Nursing Association, and is licensed by the state of Iowa to practice nursing as defined in Iowa Code chapter 152.
“Psychiatrist” means a doctor of medicine or osteopathic medicine who is certified by the American Board of Psychiatry and Neurology or who is eligible for certification and who is fully licensed to practice medicine in the state of Iowa.
“Psychologist” means a person who:
	      1. 	  Is licensed to practice psychology in the state of Iowa or meets the requirements of eligibility for a license to practice psychology in the state of Iowa as defined in Iowa Code chapter 154B; or
	      2. 	  Is certified by the Iowa department of education as a school psychologist or is eligible for certification by the Iowa department of education.
“Qualified case managers and supervisors” means people who have the following qualifications:
	      1. 	  A bachelor’s degree with 30 semester hours or equivalent quarter hours in a human services field (including, but not limited to, psychology, social work, mental health counseling, marriage and family therapy, nursing, education, occupational therapy, and recreational therapy) and at least one year of experience in the delivery of services to the population groups that the person is hired as a case manager or case management supervisor to serve; or
	      2. 	  An Iowa license to practice as a registered nurse and at least three years of experience in the delivery of services to the population group the person is hired as a case manager or case management supervisor to serve.
People employed as case management supervisors on or before August 1, 1993, who do not meet these requirements shall be considered to meet these requirements as long as they are continuously employed by the same case management provider.
“Readiness assessment” means a process of involving the individual using the service in clarifying motivational readiness to participate in the recovery process. For purposes of this chapter, the definition and explanation are taken from the Psychiatric Rehabilitation Practitioner Tools, as developed by the Boston Center for Psychiatric Rehabilitation.
“Readiness development” means services designed to develop or increase an individual’s interest, motivation, and resolve to engage in the rehabilitation services process, as a means of enhancing independent functioning and quality of life. For purposes of this chapter, the definition and explanation are taken from the Psychiatric Rehabilitation Practitioner Tools, as developed by the Boston Center for Psychiatric Rehabilitation.
“Registered nurse” means a person who is licensed to practice nursing in the state of Iowa as defined in Iowa Code chapter 152.
“Rehabilitation services” means services designed to restore, improve, or maximize the individual’s optimal level of functioning, self-care, self-responsibility, independence and quality of life and to minimize impairments, disabilities and dysfunction caused by a serious and persistent mental or emotional disability.
“Rights restriction” means limitations not imposed on the general public in the areas of communication, mobility, finances, medical or mental health treatment, intimacy, privacy, type of work, religion, place of residence, and people with whom the individual using the service may share a residence.
“Serious emotional disturbance” means a diagnosable mental, behavioral, or emotional disorder that (1) is of sufficient duration to meet diagnostic criteria for the disorder specified by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR), published by the American Psychiatric Association; and (2) has resulted in a functional impairment that substantially interferes with or limits a consumer’s role or functioning in family, school, or community activities. “Serious emotional disturbance” shall not include developmental disorders, substance-related disorders, or conditions or problems classified in DSM-IV-TR as “other conditions that may be a focus of clinical attention” (V codes), unless those conditions co-occur with another diagnosable serious emotional disturbance.
“Service plan” means an individualized goal-oriented plan of services written in language understandable by the individual using the service and developed collaboratively by the individual and the organization.
“Staff” means people paid by the organization to perform duties and responsibilities defined in the organization’s policies and procedures.
[ARC 1660C, IAB 10/15/14, effective 12/1/14]