RS 28:2

§2. Definitions Whenever used in this Title, the masculine shall include the feminine, the singular shall include the plural, and the following definitions apply: (1)(a) "Addictive disorder" is a primary, chronic neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. An addictive disorder is characterized by behaviors that include one or more of the following: (i) Impaired control over drug use. (ii) Compulsive use. (iii) Continued use despite harm. (iv) Cravings. (b) Addictive disorders include mood-altering behaviors or activities or process addictions. Examples of process addictions include, without limitation, gambling, spending, shopping, eating, and sexual activity. (2) "Behavioral health" is a term used to refer to both mental health and substance use. (3) "Client" refers to a recipient of services who has been charged with or convicted of a crime and who requires special protection and restraint in a forensic treatment facility. (4) "Conditional discharge" means the physical release of a judicially committed person from a treatment facility by the director or administrator or by the court. The patient may be required to report for outpatient treatment as a condition of his release. The judicial commitment of such persons shall remain in effect for a period of up to one hundred twenty days and during this time the person may be hospitalized involuntarily for appropriate medical reasons upon court order. (5) "Court" means any duly constituted district court or court having family or juvenile jurisdiction. "Court" does not include a city court, which shall have no jurisdiction to commit persons to mental health treatment facilities in civil or criminal proceedings, except when exercising juvenile jurisdiction. (6) "Dangerous to others" means the condition of a person whose behavior or significant threats support a reasonable expectation that there is a substantial risk that he will inflict physical harm upon another person in the near future. (7) "Dangerous to self" means the condition of a person whose behavior, significant threats or inaction supports a reasonable expectation that there is a substantial risk that he will inflict physical or sever emotional harm upon his own person. (8) "Department" means the Louisiana Department of Health. (9) "Diagnosis" means the art and science of determining the presence of disease in an individual and distinguishing one disease from another. (10) "Director" or "administrator" means a person in charge of a treatment facility or his deputy. (11) "Discharge" means the full or conditional release from a treatment facility of any person admitted or otherwise detained under this Chapter. (12) "Formal voluntary admission" means the admission of a person suffering from mental illness or a substance-related or addictive disorder desiring admission to a treatment facility for diagnosis or treatment of such condition who may be formally admitted upon his written request. Such persons may be detained following a request for discharge pursuant to R.S. 28:52.2. (13) "Gravely disabled" means the condition of a person who is unable to provide for his own basic physical needs, such as essential food, clothing, medical care, or shelter, as a result of serious mental illness or a substance-related or addictive disorder and is unable to survive safely in freedom or protect himself from serious physical harm or significant psychiatric deterioration. The term also includes incapacitation by alcohol, which means the condition of a person who, as a result of the use of alcohol, is unconscious or whose judgment is otherwise so impaired that he is incapable of realizing and making a rational decision with respect to his need for treatment. (14) "Legal guardian" means a person judicially or statutorily designated with the duty and authority to make decisions in matters having a permanent effect on the life and development of the individual on whose behalf the guardianship is established. (15) "Local governing entity" means an integrated human services delivery system with local accountability and management and which provides behavioral health and developmental disabilities services through local human services districts and authorities. (16) "Major surgical procedure" means an invasive procedure of a serious nature with incision upon the body or parts thereof under general, local, or spinal anesthesia, utilizing surgical instruments, for the purpose of diagnosis or treatment of a medical condition. Diagnostic procedures, including but not limited to the following, shall not be considered as major surgical procedures: (a) Endoscopy through natural body openings, such as the mouth, anus, or urethra, to view the trachea, bronchi, esophagus, stomach, pancreas, small or large intestine, urethra, urinary bladder, or ureters, and to obtain from such organs specimens of fluids or tissues for chemical or microscopic analysis. (b) Sub-cutaneous percutaneous liver biopsy. (c) Punch biopsy of skeletal muscles. (d) Bone marrow biopsy. (e) Lumbar puncture. (f) Myelogram. (g) Thoracocentesis. (h) Abdominocentesis. (i) Conization of the uterine cervix. (j) Renal angiography. (k) Femoral angiography. (l) Carotid angiography. (m) Vertebral angiography. (17) "Medical psychologist" means a psychologist who has undergone specialized training in clinical psychopharmacology and has passed a national proficiency examination in psychopharmacology approved by the Louisiana State Board of Medical Examiners and who holds a current and valid license from the Louisiana State Board of Medical Examiners. For the purposes of this Chapter a medical psychologist shall have at least three years training, primary experience, or both, in diagnosis and treatment of mental illness. (18) "Mental health advocacy service" means a service established by the state of Louisiana for the purpose of providing legal counsel and representation for persons with mental illness or substance-related or addictive disorders and for ensuring that the legal rights of those persons are protected. (19) "Minor" means a person under eighteen years of age. (20) "Parent" means a person who is the biological mother or father of an individual or the legally adoptive mother or father of an individual. (21) "Patient" means any person detained and taken care of as a person who has a mental illness or person who is suffering from a substance-related or addictive disorder. (22) "Peace officer" means any sheriff, police officer, or other person deputized by proper authority to serve as a peace officer. (23) "Person of legal age" means any person eighteen years of age or older. (24) "Person who has a mental illness" means any person with a psychiatric disorder which has substantial adverse effects on his ability to function and who requires care and treatment. It does not refer to a person with, solely, an intellectual disability; or who suffers solely from epilepsy or a substance-related or addictive disorder. (25) "Petition" means a written civil complaint filed by a person of legal age alleging that a person has a mental illness or is suffering from a substance-related or addictive disorder and requires judicial commitment to a treatment facility. (26) "Physician" means an individual licensed to practice medicine by the Louisiana State Board of Medical Examiners in active practice or an individual in a post-graduate medical training program of an accredited medical school in Louisiana or a medical officer similarly qualified by the government of the United States while in the state in the performance of his official duties. (27) "Primary care provider" means the principal, treating health care professional, excluding a physician, or psychiatrist, rendering mental health care services to a person including a psychologist, medical psychologist, or psychiatric mental health nurse practitioner. (28) "Psychiatric deterioration" means a decline in mental functioning, which diminishes the person's capacity to reason or exercise judgment. (29) "Psychiatric mental health nurse practitioner" means an advanced practice registered nurse licensed to practice as a nurse practitioner or clinical nurse specialist by the Louisiana State Board of Nursing, in accordance with the provisions of R.S. 37:911 et seq., who focuses clinical practice on individuals, families, or populations across the life span at risk for developing or having a diagnosis of psychiatric disorders, mental health problems, or both. A psychiatric mental health nurse practitioner means a specialist who provides primary mental health care to patients seeking mental health services in a wide range of settings. Primary mental health care provided by a psychiatric mental health nurse practitioner involves the continuous and comprehensive services necessary for the promotion of optimal mental health, prevention and treatment of psychiatric disorders, and health maintenance. Such primary health care includes the assessment, diagnosis, and management of mental health problems and psychiatric disorders. A psychiatric mental health nurse practitioner means a provider of direct mental health care services who synthesizes theoretical, scientific, and clinical knowledge for the assessment and management of both health and illness states and who is licensed to practice as a nurse practitioner in Louisiana in accordance with R.S. 37:911 et seq. For purposes of this Chapter, a psychiatric mental health nurse practitioner shall have at least two years of training, primary experience, or both in diagnosis and treatment of mental illness. For purposes of this Chapter, a psychiatric mental health nurse practitioner shall also have authority from the Louisiana State Board of Nursing to prescribe legend and certain controlled drugs in accordance with the provisions of R.S. 37:913(3)(b), (8), and (9). (30) "Psychiatrist" means a physician who has at least three years of formal training or primary experience in the diagnosis and treatment of mental illness. (31) "Psychologist" means an individual licensed to practice psychology in Louisiana in accordance with R.S. 37:2351 et seq., or licensed to practice medical psychology in Louisiana in accordance with R.S. 37:1360.51 et seq., and who has been engaged in the practice of a clinical specialty for not less than three years. (32) "Respondent" means a person alleged to have a mental illness or be suffering from a substance-related or addictive disorder and for whom an application for commitment to a treatment facility has been filed. (33) "Restraint" means the partial or total immobilization of any or all of the extremities or the torso by mechanical means for psychiatric indications. Restraint does not include the use of mechanisms usually and customarily used during medical or surgical procedures, including but not limited to body immobilization during surgery and arm immobilization during intravenous administration. Restraint does not include orthopedic appliances used to posturally support the patient, such as posies. (34) "Seclusion" means the involuntary confinement of a patient alone in a room where the patient is physically prevented from leaving for any period of time, except that seclusion does not include the placement of a patient alone in a room or other area for no more than thirty minutes at a time and no more than three hours in any twenty-four-hour period pursuant to behavior-shaping techniques, such as "time-out". (35) "State psychiatric hospital" means a public, state-owned and operated inpatient facility for the treatment of mental illness and substance-related and addictive disorders. (36) "Substance-related disorders" encompass disorders relating to the use of drugs in any of the following classes, which are not fully distinct: (a) Alcohol. (b) Caffeine. (c) Cannabis. (d) Hallucinogens, with separate categories for phencyclidine or similarly acting arylcyclohexylamines and for other hallucinogens. (e) Inhalants. (f) Opioids. (g) Sedatives, hypnotics, and anxiolytics. (h) Stimulants, including amphetamine-type substances and cocaine. (i) Tobacco. (j) Other or unknown substances. (37) "Substance use disorder" refers to a pattern of symptoms resulting from use of a substance which the individual continues to take, despite experiencing problems as a result. Substance use disorders occur when the recurrent use of alcohol, drugs, or both causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Substance use disorder is based on evidence of impaired control, social impairment, risky use, and pharmacological criteria. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, allows clinicians to specify how severe the substance use disorder is, depending on how many symptoms are identified. Based on a set of eleven criteria, two or three symptoms indicate a mild substance use disorder, four or five symptoms indicate a moderate substance use disorder, and six or more symptoms indicate a severe substance use disorder. (38) "Transfer" means the removal of a patient from one mental institution to another without any procedure for admission other than is prescribed by the department. (39) "Treatment" means an active effort to accomplish an improvement in the mental condition or behavior of a patient or to prevent deterioration in his condition or behavior. Treatment includes but is not limited to hospitalization, partial hospitalization, outpatient services, examination, diagnosis, training, the use of pharmaceuticals, and other services provided for patients by a treatment facility. (40)(a) "Treatment facility" means any public or private hospital, retreat, institution, mental health center, or facility licensed by the state in which any person who has a mental illness or person who is suffering from a substance-related or addictive disorder is received or detained as a patient or client. The term includes Veterans Administration and public health hospitals and forensic facilities. "Treatment facility" includes but is not limited to the following, and shall be selected with consideration of first, medical suitability; second, least restriction of the person's liberty; third, nearness to the patient's usual residence; fourth, financial or other status of the patient; and fifth, patient's expressed preference, except that such considerations shall not apply to forensic facilities: (i) Public and private behavioral health services providers licensed pursuant to R.S. 40:2151 et seq. (ii) Licensed residential treatment facilities. (iii) Public or private nursing homes. (iv) Public or private general hospitals. (v) Public or private psychiatric hospitals. (vi) Forensic facilities. (b) Clients in custody of the Department of Public Safety and Corrections may be admitted to forensic facilities by emergency certificate provided that judicial commitment proceedings are initiated during the period of treatment at the forensic facility authorized by emergency certificate. Judicial commitments, however, may be made to any of the facilities listed in Subparagraph (a) of this Paragraph except forensic facilities. However, in the case of any involuntary hospitalization as a result of such emergency certificate for a substance-related or addictive disorder or in the case of any judicial commitment as the result of a substance-related or addictive disorder, such commitment or hospitalization may be made to any of the facilities listed in Subparagraph (a) of this Paragraph, except forensic facilities, provided that such facility has a substance-related or addictive disorder inpatient operation maintained separate and apart from any mental health inpatient operation at such facility. (c) "Treatment facility" shall not include a jail or prison of any kind, or any facility under the control or supervision of the Department of Public Safety and Corrections unless the facility has been designated by the Louisiana Department of Health and the Department of Public Safety and Corrections as a treatment facility pursuant to R.S. 15:830.1(B); however, a jail or prison shall not be construed as a forensic facility. Only adult inmates sentenced to the Department of Public Safety and Corrections may be admitted to a treatment facility designated pursuant to R.S. 15:830.1(B). Amended by Acts 1972, No. 154, §2; Acts 1974, No. 294, §1; Acts 1976, No. 614, §2, eff. Aug. 4, 1976; Acts 1977, No. 714, §1; Acts 1978, No. 680, §1; Acts 1978, No. 782, §1, eff. July 17, 1978; Acts 1978, No. 786, §33, eff. July 17, 1978; Acts 1979, No. 767, §1; Acts 1982, No. 308, §1; Acts 1982, No. 501, §1; Acts 1983, No. 448, §1; Acts 1985, No. 197, §1., eff. July 6, 1985; Acts 1987, No. 96, §2; Acts 1992, No. 120, §1; Acts 1995, No. 1287, §1, eff. June 29, 1995; Acts 1997, No. 985, §1; Acts 2006, No. 271, §3; Acts 2006, No. 664, §1; Acts 2009, No. 251, §7, eff. Jan. 1, 2010; Acts 2012, No. 418, §1; Acts 2013, No. 220, §10, eff. June 11, 2013; Acts 2014, No. 811, §14, eff. June 23, 2014; Acts 2017, No. 369, §§2, 7; Acts 2018, No. 206, §1; Acts 2021, No. 238, §2; Acts 2021, No. 372, §1; Acts 2022, No. 271, §1; Acts 2022, No. 382, §1.