Fillable Mental Health Licensure Policies and (North Carolina)

Fill Online, Printable, Fillable, Blank Mental Health Licensure Policies and (North Carolina) Form

Use Fill to complete blank online NORTH CAROLINA pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Mental Health Licensure Policies and (North Carolina)

On average this form takes 74 minutes to complete

The Mental Health Licensure Policies and (North Carolina) form is 32 pages long and contains:

0 signatures
250 check-boxes
179 other fields

Country of origin: US
File type: PDF

BROWSE NORTH CAROLINA FORMS

Related forms

North Carolina Department of Health and Human Services (North Carolina)
Mental Health Licensure Policies and (North Carolina)
LIST OF REQUIRED MATERIALS FOR INITIAL AND CHANGE (North Carolina)
Application for a Copy of a North Carolina (North Carolina)
Application for North Carolina Death, Marriage or Divorce (North Carolina)
Request to Amend a Record (North Carolina)
Report of Fetal Death and/or Certicate of Birth (North Carolina)
Application for a Copy of a North Carolina (North Carolina)
ADULT CARE HOME PERSONAL CARE PHYSICIAN AUTHORIZATION AND (North Carolina)
Medreleaseform Medication Release Form (North Carolina)
This is to certify that Name of Employee (North Carolina)
PRIOR APPROVAL UTILIZATION REVIEW ON-SITE REVIEW (North Carolina)
ADULT CARE HOME PERSONAL CARE PHYSICIAN AUTHORIZATION AND (North Carolina)
DHB 2043 9-2019 (North Carolina)
CONFIDENTIAL MEDICAID/NC HEALTH CHOICE BENEFICIARY PROFILE REQUEST (North Carolina)
NOTICE OF CHANGE IN OVERPAYMENT FOR MEDICAL ASSISTANCE (North Carolina)
Consent/Authorization Form for Child Medical & Child/Family Evaluations (North Carolina)
North Carolina Department of Health and Human Services (North Carolina)
DMA -5006 (Rev. 10/91) STATE OF NORTH CAROLINA (North Carolina)
TRIBAL AND INDIAN HEALTH SERVICES T he individual (North Carolina)

Fill has a huge library of thousands of forms all set up to be filled in easily and signed.

Fill in your chosen form

Sign the form using our drawing tool

Send to someone else to fill in and sign.

find another form

Redo

Arial Font

Arial
Calibri
Roboto
Open Sans

AFont color

AB
A.B
A..B
A...B
A....B

Remove Field

ADD FIELDS

Mental Health Licensure and Certification Section

Polic

y and Procedure list 10/14/2021

Mental Health Licensure Policies and

Procedures Worksheets

Use of form:

Mental Health Licensure requires the licensee to develop written policies and procedures. Therefore, policies and procedures must

be submitted to the Licensure and Training Consultant at the first review.

Instructions:

1. Use the policy worksheet to identify the page number you address each point for ease in reference and review.

2. Policy and procedure manuals must include a table of contents with page numbers

3. This worksheet must be completed and submitted with Policies and Procedures

Policies should be dated and the pages numbered. This worksheet is not a substitution for the rules. The licensee is responsible for

complying with all applicable rules and statutes. Therefore, the information below is only a snapshot of the actual rules and is not a

substitute for obtaining a licensure rule book.

Fillable Form

Mental Health Licensure and Certification Section

licy and Procedure list 10/14/2021

Name – Facility

__________________________

Address – Facility (Street, City, State, Zip Code)

Date

______________

Name of LTC

Program Code

Policy / Procedure Checklist

SUBCHAPTER G. RULES FOR MENTAL HEALTH, DEVELOPMENTAL DISABILITIES, AND SUBSTANCE ABUSE FACILITIES AND SERVICES

Policy Page Number

Must be Entered

10A NCAC 27G .201 Governing Body

Yes

Comments

1. Delegation of Management Authority (Chain of command).

2. Admission Criteria for admission into facility.

3. Admission Assessments including:

• who will perform the assessment; and

• time frames for completing an assessment.

4. Criteria for discharging a client from the facility

5. Client record management, including:

• persons authorized to document;

• how to transport records;

• safeguard of records

• record accessibility to authorized users and

• assurance of confidentiality of records.

Fillable Form

Mental Health Licensure and Certification Section

Polic

y and Procedure list 10/14/2021

Policy Page Number

Must be Entered

Rule

Yes

Comments

6. Screenings and assessments, which shall include:

• Individuals presenting problem or need;

• will provide services to address the needs of the

individual;

•

disposition of clients.

7. Quality assurance and Quality improvement activities, including:

• QUALITY IMPROVEMENT and QUALITY ASSURANCE

committee;

• QUALITY IMPROVEMENT and QUALITY ASSURANCE

improvement plan;

• methods for monitoring client care

• qualified supervision for all staff

• strategies for improving client care;

• staff credentialing/privileging

• review of all fatalities

•

adoption of standards practice.

8. Incident Reporting

9. Voluntary Non-Compensated client work

10. Fee assessment and collection

11. Medical Emergency Plan

12. Authorization for and follow-up of lab tests.

Fillable Form

Mental Health Licensure and Certification Section

licy and Procedure list 10/14/2021

Policy Page

Number Must be

Entered

Rule

Yes

Comments

13. Transportation including the accessibility of emergency

information for a client when transporting.

14. Safety precautions and requirements for facility areas, including

special client activity areas; (one area is your Fire/Disaster Plan:

What you plan to do if there is a fire or disaster and how you will

execute the plan).

15. Volunteers: services of volunteers, including supervision and

requirements for maintaining client confidentiality.

16. Areas in which staff, including nonprofessional staff, receive

training and continuing education.

17. Client grievance policy and procedures for review of client

grievances

18. Minutes of the governing body shall be permanently maintained.

19. Policies and procedures for;

• identifying,

• reporting,

• investigating and,

• controlling infectious and communicable diseases of staff

and client.

Fillable Form

Mental Health Licensure and Certification Section

licy and Procedure list 10/14/2021

Policy Page Number

Must be Entered

10A NCAC 27G .0203 Competencies of Qualified and Associate

Professionals

Yes

Comments

1. Policy on implementing and creating the individualized

supervision plan upon hiring each associate professional

Policy Page Number

Must be Entered

10A NCAC 27G .0204 COMPETENCIES AND SUPERVISION OF

PARAPROFESSIONALS

Yes

Comments

2. Policy on implementing and creating of the individualized

supervision upon hire of each paraprofessional.

Policy Page Number

Must be Entered

10A NCAC 27G .0205. ASSESSMENT AND TREATMENT/HABILITATION OR

SERVICE PLAN

Yes

Comments

3. The plan shall be developed based on the assessment, and in

partnership with the client or legally responsible person or both,

within 30 days of admission for clients who are expected to

receive services beyond 30 days.

4. The plan shall include:

• client outcome(s) that are anticipated to be achieved by

the provision of the service and a projected date of

achievement;

• strategies;

• staff responsible;

• a schedule for review of the plan at least annually in

consultation with the client or legally responsible person

or both;

• the basis for evaluation or assessment of outcome

achievement; and

• written consent or agreement by the client or

responsible party, or a written statement by the provider

stating why such consent could not be obtained.

Fillable Form

Mental Health Licensure and Certification Section

olicy and Procedure list 10/14/2021

Page Number Must be

Entered

Medication Dispensing

10A NCAC 27G .0209. MEDICATION REQUIREMENTS

Yes

Comments

1. Medications dispensed only by written M.D. order.

2. Dispensing of medications only by Licensed person.

3. How take-home Methadone is given to the client by R.N. only.

4. Policy on how Facilities shall not keep prescription drugs for

dispensing without a Pharmacist, except for emergency use.

Medication packaging and labeling

Comments

5. Policy on Non-Prescribed drug containers not dispensed by a

Pharmacist must have an original label with expiration dates

visible.

6. Policy on Prescription medications must be dispensed in tamper-

resistant packaging.

7. Policy on the label of prescription meds must include:

• Client name;

• M.D. name;

• dispensed date;

• administration directions; clear directions for self-admin

• name, strength, quantity & expiration date of the drug;

• name & address of pharmacy; the name of Pharmacist.

Medication administration

Comments

8. How prescription or non-prescription drugs shall be administered.

9. How medications authorized for self-administered medications

10. A Medication Administration Record (MAR) of all drugs

administered to each client must be kept current. Medications

administered shall be recorded immediately after administration.

The MAR is to include the following:

• client's name;

• name, strength, and quantity of the drug;

• instructions for administering the drug;

• date and time the drug is administered; and

•

name or initials of the person administering the drug.

Mental Health Licensure and Certification Section

licy and Procedure list 10/14/2021

Policy Page Number Must be

Entered

Rule

Yes

Comments

11. Medications, including injections, shall be administered only by

licensed persons or by unlicensed persons trained by a registered

nurse, Pharmacist or other legally qualified person and privileged

to prepare and administer medications.

12. Client requests for medication changes or checks shall be recorded

and kept with the MAR file followed by an appointment or

consultation with a physician.

Medication Disposal

Comments

13. Upon discharge of a patient or resident, the remainder of their

drug supply shall be disposed of promptly unless it is reasonably

expected that the patient or resident shall return to the facility. In

such a case, the remaining drug supply shall not be held for more

than 30 calendar days after the date of discharge.

Medication Storage

Comments

14. Medications shall be stored:

• in a securely locked cabinet in a clean, well-lighted,

ventilated room between 59º and 86º F.;

• in a refrigerator, if required, between 36º and 46º F. If the

refrigerator is used for food items, medications shall be

kept in a separate, locked compartment or container;

• separately for each client;

• separately for external and internal use;

• securely if approved by a physician for a client to self-

medicate.

Medication review

Comments

1. A 6-month drug review by a Psychiatrist or Pharmacist is required

if taking Psychotropic medications

2. Findings from drug review recorded in client record with a

corrective action plan.

3. Staff is responsible for informing M.D. of review results if medical

intervention is indicated.

Mental Health Licensure and Certification Section

olicy and Procedure list 10/14/2021

Policy Page Number

Must be Entered

Medication Errors

YES

Comments

4. Policy on significant adverse drug reactions and how it is reported

immediately to a physician or Pharmacist.

SUBCHAPTER D. GENERAL RIGHTS

Policy Page Number

Must be Entered

10A NCAC 27D .0101. POLICY ON RIGHTS RESTRICTIONS AND

INTERVENTIONS

YES

Comments

If a facility uses Seclusion, Restraints and Isolation Time Out this section MUST be in the facility's policy and procedure manual

1. How ALL instances of alleged or suspected abuse, neglect or

exploitation of clients are reported to the County Department of

Social Services.

2. What safeguards are used when medications are known to present

a serious risk.

3. Identify restrictive intervention (R.I.) that is prohibited from use

within the facility.

4. If a 24-hour facility, the circumstances under which staff are

prohibited from restricting a client's rights.

5. Identify allowed restrictive intervention(s) in your facility.

6. Staff (position) responsible for informing the client of restrictive

interventions.

7. Due process procedure for a client who refuses the use of restrictive

interventions.

8. Identify staff person (position) responsible for giving written

permission for giving written permission for 24hr restrictive

interventions.

9. Identify staff person (position) who is responsible for review client

of restrictive interventions.

10. Process for appeal for the resolution of any disagreement over the

planned use of a restrictive intervention.

Fillable Form

Mental Health Licensure and Certification Section

olicy and Procedure list 10/14/2021

Policy Page Number Must

be Entered

Rule Continued

Yes

Comments

11. Following the use of restrictive intervention, the staff shall conduct a

debriefing and planning with the client and legally responsible person.

This process should be conducted based on the cognitive functioning of

the client.

Policy Page Number Must

be Entered

10A NCAC 27D .0102. SUSPENSION AND EXPULSION POLICY

Comments

12. Policy documenting each client shall be free from threat or fear of

unwarranted suspension or expulsion from the facility.

13. The policy shall address the criteria to be used for suspension,

expulsion or other discharge not mutually agreed upon and shall

establish documentation requirements that include:

• Timeframe for resuming services after suspension.

• the specific time and conditions for resuming services

following suspension;

• efforts by the staff of the facility to identify an alternative

ervice to meet the client's needs and designation of suc

ervice; and

•

the discharge plan, if any.

Policy Page Number Must

be Entered

10A NCAC 27D .0103. SEARCH AND SEIZURE POLICY

Comments

14. A policy that specifies the conditions under which searches of the client

or their living area may occur, and if permitted, the procedures for

seizure of the client's belongings or property in possession of the client.

15. Each client is free from unwarranted invasion of privacy.

16. Specifications on the conditions under which searches of the client or

person's area may occur.

17. Where and how to document a search and seizure.

(A) scope of search;

(B) reason for search;

(D) a description of any property seized; and

(E) an account of the disposition of seized property.

Mental Health Licensure and Certification Section

licy and Procedure list 10/14/2021

Policy Page Number

Must be Entered

10A NCAC 27D .0104. PERIODIC INTERNAL REVIEW

YES

Comments

18. Procedure on conducting a review at least every 3 years to check

for compliance with applicable laws.

19. The governing body will keep and maintain the three most recent

written reports of the findings of reviews.

Policy Page Number

Must be Entered

10A NCAC 27D .0201. INFORMING CLIENTS

Comments

20. Written client rights shall be made available to each client and or

legal representative.

21. Each client shall be informed of their right to contact the Disability

Rights of North Carolina.

22. Documentation is kept in the client record that client rights have

been explained.

23. Within 72 hours or three visits, the client will be informed of rules

and violation penalties; disclosure rules for confidential info;

procedure for obtaining a copy of treatment plan; grievance

procedure (including contact person); suspension/expulsion and

search and seizure.

24. In facilities using Restrictive Interventions: timeframe client will

be informed of the purpose, goal & reinforcement structure of a

behavior management system; potential restrictions; notification

provisions regarding use; notice that the legally responsible person

after use of restrictive interventions; a competent adult may

designate an individual to receive information after restrictive

interventions and notification provisions regarding restriction of

rights.

Policy Page Number

Must be Entered

10A NCAC 27D .0202. INFORMING STAFF

Comments

25. Policy on informing staff of client rights.

26. Documentation of receipt of information by each staff

Mental Health Licensure and Certification Section

olicy and Procedure list 10/14/2021

Policy Page Number

Must be Entered

10A NCAC 27D .0301. SOCIAL INTEGRATION

YES

Comments

27. Each client in a day/night or 24-hour facility is encouraged to

participate in appropriate and generally acceptable social

interactions and activities with other clients and non

‑

client

members of the community.

28. Clients shall not be prohibited from appropriate and generally

acceptable social interactions and activities with other clients and

non

‑

client members of the community.

Policy Page Number

Must be Entered

10A NCAC 27D .0302. CLIENT SELF‑GOVERNANCE

Comments

29. A day/night or 24

‑

hour facility allows client input into facility

governance and the development of client self

‑

governance groups

Policy Page Number

Must be Entered

10A NCAC 27D .0303. INFORMED CONSENT

Comments

30. Clients will be informed about the alleged benefits, potential risks

and alternative treatments.

31. Clients will be about the length of time the consent is valid and

what the procedure is to withdraw consent:

• The timeframe of consents (no more than six months)

• written consents for;

 Planned interventions

 Antabuse and Depo-Provera

32. Clients have a right to refuse treatment and not be threatened

with termination.

Fillable Form

Mental Health Licensure and Certification Section

Polic

y and Procedure list 10/14/2021

Policy Page Number

Must be Entered

10A NCAC 27D .0304. PROTECTION FROM HARM, ABUSE,

NEGLECT OR EXPLOITATION

YES

Comments

33. Staff shall protect clients from harm, abuse, neglect and

exploitation in accordance with G.S. 122C-66.

34. Staff shall not subject a client to any sort of abuse or neglect.

35. Goods or services shall not be sold to or purchased from a client.

36. Staff shall use only that degree of force necessary to repel or

secure a violent and aggressive client and

• ensure if force necessary written the degree of force that is

necessary depends upon the individual characteristics of the

client (such as age, size and physical and mental health) and

the degree of aggressiveness displayed by the client.

37. Any violation by a staff of this rule is grounds for dismissal.

SUBCHAPTER E. TREATMENT OR HABILITATION RIGHTS

SECTION 10A NCAC 27E. PROTECTIONS REGARDING

INTERVENTIONS PROCEDURES

If the facility uses Seclusion, Restraints and Isolation Time Out below 10A,

NCAC 27E Treatment of Habilitation Rights must be reflected in the

facility's policy and procedure manual.

Policy Page Number Must

be Entered

10A NCAC 27E .0101. LEAST RESTRICTIVE ALTERNATIVE

1. Facilities shall provide services using the least restrictive, most

appropriate while ensuring a safe and respectful environment.

2. The use of restrictive interventions shall be accompanied by

actions to ensure dignity and respect during and after the

intervention. Including using the intervention as a last resort; and

employing the intervention by people trained in its use.

Yes

Comments

Mental Health Licensure and Certification Section

olicy and Procedure list 10/14/2021

Policy Page Number Must

be Entered

10A NCAC 27E .0102. PROHIBITED PROCEDURES

YES

Comments

3. The following procedures are prohibited: corporal punishment;

painful body contact; substances which create painful bodily

eactions; electric shock; insulin shock; unpleasant-tastin

oodstuffs; application of noxious substances (noise, bad smells,

splashing with water); physically painful procedures to reduce

behavior

4. The governing body may determine to prohibit the use of any

interventions deemed unacceptable.

Policy Page Number Must

be Entered

10A NCAC 27E .0103. GENERAL POLICIES REGARDING INTERVENTION

PROCEDURES

Comments

5. Procedures are only employed when clinically or medically

indicated as a method of therapeutic treatment.

6. The determination that a procedure is clinically/medically

indicated and the authorization for the use of such treatment for a

specific client can only be made by a physician or a licensed Ph.D.

who has been formally trained and privileged in the use of a

procedure.

Policy Page Number Must

be Entered

10A NCAC 27E .0104. SECLUSION, PHYSICAL RESTRAINT AND ISOLATION TIME-OUT

AND PROTECTIVE DEVICES USED FOR BEHAVIORAL CONTROL

Comments

7. Written policy delineates the use of restrictive interventions.

8. The use of restrictive interventions shall be limited to:

• emergency situations, in order to terminate a behavior or

action in which a client is in imminent danger of abuse or

injury to self or other persons or when property damage is

occurring that poses an imminent risk of danger of injury or

harm to self or others; or

• as a planned measure of therapeutic treatment (NOTE: NO

PRTF shall NOT have planned restrictive intervention's

483.356 - Protection of residents.)

Mental Health Licensure and Certification Section

olicy and Procedure list 10/14/2021

Policy Page Number Must

be Entered

Rule Continued

Yes

Comments

9. Restrictive interventions are considered a planned intervention and must

be included in the client's treatment/habilitation plan whenever it is used:

• More than four times or

• More than 40 hours in a calendar month

• in a single episode in which the original order is renewed for up to a total

of 24 hours in accordance with the limit specified in Item in your policy

• as a measure of therapeutic treatment designed to reduce dangerous,

aggressive, self-injurious or undesirable behaviors to a level that will allow

the use of less restrictive treatment or habilitation procedures.

10. The planned intervention has consent or approval and shall be considered

valid for no more than six months and that the decision to continue the

specific intervention shall be based on clear and recent behavioral

evidence that the intervention is having a positive impact and continues

to be needed

11. How restrictive interventions will not be used as coercion, punishment or

retaliation by staff or for the convenience of staff or due to inadequacy of

staffing.

12. Restrictive interventions will not be used in a manner that causes harm or

abuse.

13. Define and outline the permissible use of restrictive interventions within a

facility.

14. The facility shall collect and analyze data on the use of seclusion and

physical restraint. The data collected and analyzed shall reflect for each

incident:

• the type of procedure used, and the length of time employed;

• alternatives considered or employed; and

•

the effectiveness of the procedure or alternative employed.

15. The facility shall analyze the data on at least a quarterly basis to monitor

effectiveness, determine trends and take corrective action where

necessary. In addition, the facility shall make the data available to the

Secretary upon request.

Mental Health Licensure and Certification Section

Policy and Procedure list 10/14/2021

Policy Page Number

Must be Entered

Rule Continued

Yes

Comments

16. Identifying, training, assessing the competence of facility

employees who may authorize and implement restrictive

interventions.

17. The duties and responsibilities of responsible professionals

regarding the use of restrictive interventions.

18. The person responsible (position) for documentation when

restrictive interventions are used.

19. The person responsible (position) for the notification of others

when restrictive interventions are used.

20. The person responsible (position) for checking the client's physical

and psychological well-being and assessing the possible

consequences of using a restrictive intervention.

21. Procedures with the use of Restrictive Interventions:

• documentation physical disabilities

• a room used for seclusion

• if using Isolation: criteria

• whenever a restrictive intervention is utilized, documentation

shall be made in the client record to include

• how emergency use of restrictive interventions shall be

limited.

22. Precautions and actions are employed when a client is in seclusion

or physical restraint.

23. Discontinuing immediately at any indication of risk to the client's

health or safety.

24. Standing orders or PRN orders shall not be used to authorize the

use of seclusion, physical restraint or isolation time-out.

Mental Health Licensure and Certification Section

olicy and Procedure list 10/14/2021

Policy Page Number

Must be Entered

Rule Continued

Yes

Comments

25. When any restrictive intervention is utilized for a client, who,

when and how others will be notified.

26. How the facility will conduct reviews and reports on all use of

restrictive interventions.

Policy Page Number

Must be Entered

10A NCAC 27E .0105. PROTECTIVE DEVICES

Comments

27. Procedure ensuring when a protective device is utilized for a client

• The necessity for the protective device

• Facility employee using device has been trained and demonstrate

ompetence in the use for a device

• Observation and interventions documented in a client record

•

Protocol on maintenance and cleaning of the devices

28. Procedure documenting if a facility is operated by or under

contract with an area program, the utilization of protective devices

in the treatment/habilitation plan shall be subject to review by the

Client Rights Committee.

10A NCAC 27E .0106. INTERVENTION ADVISORY COMMITTEES

Comments

29. Intervention Advisory Committee shall be established to provide

additional safeguards in a facility that utilizes restrictive

interventions as planned interventions

30. Document who is required in the membership of your

Intervention Advisory Committee.

31. A procedure governs the Intervention Advisory Committee and

details how client information is disseminated and reasoning for

disseminating.

32. A procedure regarding the Intervention Advisory Committee will

document the specific training and orientation given to the

Committee.

Mental Health Licensure and Certification Section

licy and Procedure list 10/14/2021

Treatment Rights in 24-hour Facilities

Policy Page Number Must be

Entered

NCGS 122C-61: Treatment rights in 24-hour facilities

YES

Comments

1. The client will have the right to receive necessary

treatment for and prevention of physical ailments based

upon the client's condition and projected length of stay.

2. Clients have the right during treatment or habilitation

(no later than the time of discharge) to an individualized

written discharge plan containing recommendations for

further services designed to enable the client to live as

normally as possible.

Policy Page Number Must be

Entered

NCGS 122C-62: Additional rights in 24-hour facilities

Comments

3. Adult Clients have the right to:

• Make and receive confidential phone calls

• Receive visitors between 8:00 am and 9:00 pm for at

least 6 hours daily; 2 hours shall be after 6:00 pm.

Visiting shall not take precedence over therapies.

• Communicate & meet under appropriate

supervision with individuals of their own choice.

• Make visits outside of the facility unless issues are

related to commitment proceedings or court orders.

• Be out of doors daily and have access to facilities &

equipment for physical exercise several times a

week.

• Keep and use personal clothing and possessions.

• Participate in religious worship.

• Retain a driver's license unless otherwise prohibited.

• Have access to individual storage space for private

use.

Mental Health Licensure and Certification Section

Policy and Procedure list 10/14/2021

Policy Page Number Must be

Entered

Rule Continued

Yes

Comments

4. Minor Clients have the right to:

• Make and receive phone calls.

• Under appropriate supervision, receive visitor's

b/n 8:00 am and 9:00 pm for at least 6 hours

daily; 2 hours shall be after 6:00 pm. Visiting

shall not take precedence over therapies.

• Send and receive mail and have access to

writing materials, postage, staff assistance.

• Receive special education and vocational

training.

• Be out of doors daily and participate in play,

recreation, and physical exercise regularly in

accordance with client needs.

• Keep and use personal clothing and possessions

under appropriate supervision.

• Participate in religious worship.

• Have access to individual storage space for

personal belongings.

• Have access to and spend a reasonable sum of

own money.

• Retain a driver's license unless otherwise

prohibited.

Mental Health Licensure and Certification Section

Policy and Procedure list 10/14/2021

Subchapter 27F Specific Rules for 24-Hour Facilities

SUBCHAPTER 27F - 24-HOUR FACILITIES

Policy Page Number

Must be Entered

10A NCAC 27F .0101 Scope

Yes

Comments

1. Article 3, Chapter 122C of the General Statutes provides

specific rights for each client who receives mental

health, developmental disability or substance abuse

service. This subchapter delineates the rules regarding

those rights for clients in a 24-hour facility.

Policy Page Number

Must be Entered

10A NCAC 27F .0102. LIVING ENVIRONMENT

Yes

Comments

2. Efforts to make a quiet atmosphere for uninterrupted

sleep, privacy areas.

3. The client may suitably decorate the room when

appropriate.

Policy Page Number

Must be Entered

10A NCAC 27F .0103 Health, Hygiene and Grooming

Yes

Comments

4. Clients will have the right to dignity, privacy and humane

care in healthy hygiene

and grooming.

5. The client will have access to shower/tub daily or more

often as needed, access to a barber or beautician, access

to linens and towels and other toiletries.

6. Adequate toilets, lavatory and bath facilities equipped

for a client with mobility impairment will be available.

7. Ct bathtubs, showers and toilets will be private.

Mental Health Licensure and Certification Section

Policy and Procedure list 10/14/2021

Policy Page Number

Must be Entered

10A NCAC 27F .0104 Storage and Protection of Clothing

and Possessions

Yes

Comments

8. Staff will make every effort to protect clients' personal

clothing and possessions from loss or damage.

Policy Page Number

Must be Entered

10A NCAC 27F .0105 Client's Personal Funds

Yes

Comments

9. Each client will be encouraged to maintain funds in a

personal account.

10. Funds managed by staff will: assure client right to

deposit and withdraw money; regulate the receipt and

distribution, and deposits of funds; provide adequate

financial records on all transactions; assure client funds

are kept separate; allow a deduction from accounts for

payment of treatment/habilitation services when

authorized; issue receipts for deposits and withdrawals

provide quarterly client statements.

11. Authorization by the client is required before a

deduction can be made from an account for any amount

owed for damages done by the client to the facility, to

an employee of the facility, a visitor or another Client.

SUBCHAPTER 13O – HEALTHCARE PERSONNEL REGISTRY

Policy Page Number Must

be Entered

10A NCAC 13O .0102 Investigating and Reporting Health Care

Personnel Registry

Yes

Comments

1. The reporting by health care facilities to the

Department of all allegations against health care

personnel as defined in G.S. 131E-256 (a)(1),

including injuries of unknown source, shall be done

within 24 hours of the health care facility becoming

aware of the allegation. The results of the health

care facility's investigation shall be submitted to the

Department in accordance with G.S. 131E-256(g).

Sign the document

DRAW TYPE UPLOAD

Choose file

Sending Options

Clear

Adding Fields

Fields are being added to your document to make it really easy to fill, send and sign this PDF. Once finished you can manually add any additional fields and signatures to the document by dragging them from the toolbar.

For larger documents this process may take up to one minute to complete

Finish

Download
Save PDF to desktop

Email
Email completed PDF

Send for Signing
Email for others to sign

Print
Print document

Send for signing

Email for others to sign

Choose a Field
Click on a field and
select the person that should complete it

Want to add a signature?
You can add a signature field
and assign it to someone else
to sign

Send for signing

Email for others to sign

Choose a Field
Click on a field and
select the person that should complete it

Send for signing

Email for others to sign

Someone else

NAME

Email completed PDF

Template

Convert to a reusable Template

Complete document

Mental Health Licensure Policies and (North Carolina)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 4 January 2022

Message

View Audit Log
Print With Audit Log
Duplicate Document

You're on your way to completing your first doc!

already registered?

First 20 documents completely FREE!

No credit card required

Digitally sign with 1 click

Request signatures from others

Secure storage for sensitive data

Upload your own forms

Simple PDF editing

Huge library of 1000's of forms