Definitions

(1) “Advanced Practice Nurse” (APN) means a licensed registered nurse certified as an advanced practice nurse by the Tennessee Board of Nursing under Title 63, Chapter 7, T.C.A. who has been issued a certificate of fitness to write and sign prescriptions. (2) “Clinical Professional” means a staff member who is a qualified mental health professional, a registered nurse, a pharmacist, or a member of the RMHI Medical Staff. (3) “Conservator” means a person or an entity appointed by a court under Title 34, Chapter 3 or Chapter 5, T.C.A. with authority to make health care decisions for an adult who lacks capacity to make informed decisions. (4) “Declaration for Mental Health Treatment” means a document authorized by Title 33, Chapter 6, Part 10, T.C.A. that allows a person to say how they want to be treated or not be treated when they are unable to make informed decisions about their mental health treatment. (5) “The Department” means the Tennessee Department of Mental Health and Substance Abuse Services. (6) “Emergency” means circumstances in which there exists: (a) An immediate threat of serious physical harm to the patient or to others caused by the violent behavior of the patient; (b) Actual violent behavior by the patient causing substantial property damage; and/or (c) An immediate threat to the patient of deteriorating physical well-being with risk to life or long-term health caused by the effects of mental illness and/or a physical illness or condition. (7) “Informed Consent” means voluntary consent or authorization, when applicable, given in writing after sufficient explanation and disclosure of the subject matter involved to enable the person whose consent is sought to make a knowing and willful decision without any element of force, fraud, deceit, duress, or other form of constraint or coercion. (8) “Involuntary Patient” means a patient who has been admitted pursuant to Title 33, Chapter 6, Part 4 or 5, T.C.A. §§ 33-3-401, 33-3-402, 33-3-403, 33-3-412, 33-3-607, 33-7-301, 33-7- 303, or 37-1-128. (9) “Lacks Capacity” means that the patient is unable to understand the following: (a) A proposed psychotropic medication, physical treatment, and/or release of information; (b) The risks and benefits of such psychotropic medication, physical treatment, and/or release of information; (c) The risks and benefits of any available alternative(s) to the psychotropic medication, physical treatment, and/or release of information; and/or (d) The risks and benefits of not receiving the psychotropic medication, physical treatment, and/or release of information, then (e) That patient cannot give informed consent for psychotropic medication, physical treatment, and/or release of information unless a conservator or other legal representative has been granted that authority. PROCEDURES FOR PRESCRIPTION AND ADMINISTRATION OF CHAPTER 0940-01-02 PSYCHOTROPIC MEDICATIONS AT MENTAL HEALTH INSTITUTES (10) “Legally Incompetent Patient” means a patient from whom a court, pursuant to T.C.A. Title 34, has removed the power to make decisions as to treatment and for whom it has appointed a conservator to make such decisions. (11) “Legal Representative” means an individual who has been granted legal authority to act on behalf of another individual. (12) “Licensed Physician” means a graduate of an accredited medical school authorized to confer the degree of Doctor of Medicine (M.D.) who is duly licensed in the state, or an osteopathic physician who is a graduate of a recognized osteopathic college authorized to confer the degree of Doctor of Osteopathy (D.O.) and who is licensed to practice osteopathic medicine in the state. (13) “Medical Record” means written documents, computerized electronic information, radiology film and scans, laboratory reports and pathology slides, videos, audio recordings, and other forms of information regarding the condition of a patient. The medical record includes both electronic and paper medical record systems. (14) “Medication” means prescriptive medication, including psychotropic medication, that is administered to patients to treat or prevent disease or other abnormal conditions. (a) “Prescriptive Medication” means a drug which requires authorization by a physician, advanced practice nurse, physician assistant, pharmacist, or other professional authorized by law to prescribe medication and which cannot be obtained on an over- the-counter basis in the community. This includes drugs prescribed to treat physical illnesses or conditions and psychotropic medication prescribed to treat mental illness. (b) “Psychotropic Medication” means a drug which exercises a direct effect upon the central nervous system and which is capable of influencing and modifying behavior. Psychotropic medications include but are not limited to anti-psychotics, anti- depressants, agents for control of mania and depression, anti-anxiety agents, psychomotor stimulants, and hypnotics. (15) “Patient Rights Advocate” (PRA) means a person designated by the RMHI Chief Executive Officer or designee to have the responsibilities imposed by these rules. (16) “Physical Treatment” means a medical procedure or medication prescribed to treat a physical condition or illness, with the exception of routine first aid, performing examinations, giving injections, or obtaining laboratory samples. (17) “Physician Assistant” (PA) means a person licensed as a physician assistant under Title 63, Chapter 13, T.C.A. (18) “Privileged” means authorization has been granted by the RMHI Governing Body to a physician, advanced practice nurse, physician assistant, or other licensed practitioner to render specific services, based upon the individual’s professional license and certification, as well as experience, competence, ability, and judgment. (19) “Qualified Mental Health Professional” means a person who is licensed in the state, if required for the profession, and who is a psychiatrist; physician with expertise in psychiatry as determined by training, education, or experience; psychologist with health service provider designation; psychological examiner or senior psychological examiner; licensed master’s social worker with two (2) years of mental health experience or licensed clinical social worker; marital and family therapist; nurse with a master’s degree in nursing who functions as a PROCEDURES FOR PRESCRIPTION AND ADMINISTRATION OF CHAPTER 0940-01-02 PSYCHOTROPIC MEDICATIONS AT MENTAL HEALTH INSTITUTES psychiatric nurse; professional counselor; or, if the person is providing service to patients who are children, any of the above educational credentials plus mental health experience with children. (20) “Regional Mental Health Institute” (RMHI) means a mental health hospital or psychiatric inpatient unit operated by the Department. (21) “Regular Working Day” means 8:00 a.m. until 4:30 p.m., Monday through Friday, excluding legal state holidays. (22) “Release of Information” means authorization, in accordance with applicable state and federal statutes and regulations, for a healthcare provider or organization to request or provide information that identifies an individual as a patient or former patient and information regarding their diagnosis and treatment to a specified person or organization. (23) “Release of Information Form” means the Authorization to Release Confidential Information Form approved by the Department to be utilized to authorize release of information. (24) “Revocation of Authorization to Release Confidential Information Form” means the form approved by the Department to be utilized to document revocation of a release of information. (25) “RMHI Medical Staff” means a self-governing entity accountable to the RMHI Governing Body that is comprised of licensed physicians, advanced practice nurses, physician assistants, and, in accordance with the RMHI Medical Staff Bylaws, other licensed practitioners. Members of the RMHI Medical Staff are privileged by the RMHI Governing Body to provide specific patient care functions, such as ordering medications and providing medical treatment. For purposes of these rules, physicians in an approved residency program at an RMHI shall be considered to be members of the RMHI Medical Staff. (26) “Staff Member” means an individual employed by or performing duties at the RMHI, including contract employees, students, residents, and volunteers. (27) “Treatment Review Committee” (TRC) means a committee constituted under T.C.A. § 33-6- 107 and these rules to make decisions for patients. (28) “Treatment Team” means RMHI staff members directly involved in developing, implementing, and monitoring a patient’s treatment plan, including but not limited to the attending physician or assigned advanced practice nurse or physician assistant, a registered nurse, and a social services staff member. (29) “Voluntary Patient” means a patient who has been admitted pursuant to Title 33, Chapter 6, Part 2 or Part 3, T.C.A.