§2120.33. Definitions

            As used in this Part, the following terms have the meaning ascribed in this Section unless the context clearly indicates otherwise:

            (1) "Acquired brain injury" means an injury to the brain that has occurred after birth and is not hereditary, congenital, or degenerative. The injury commonly results in a change in neuronal activity, which affects the physical integrity, the metabolic activity, or the functional ability of the cell. It can also result in the disturbance of behavioral or emotional functioning. These impairments may be either temporary or permanent and cause partial or total functional disability or psychosocial maladjustment. The term does not refer to brain injuries induced by birth trauma.

            (2) "Adult" means an individual eighteen years of age or older.

            (3) "Adult brain injury facility" means any of the following:

            (a) A facility publicly or privately owned providing a rehabilitative treatment environment which serves four or more adults who suffer from brain injury and are not related to the operator. Services shall include personal assistance or supervision for a period of twenty-four hours continuously per day preparing them for community integration.

            (b) A home or apartment publicly or privately owned providing a rehabilitative treatment environment which serves one to six adults who suffer from brain injury and are not related to the operator in a home or apartment setting preparing them for community integration.

            (c) A facility publicly or privately owned providing an outpatient rehabilitative treatment environment which serves adults who suffer from brain injury and are not related to the operator in an outpatient day treatment setting in order to advance the individual's independence for higher level of community or transition to a greater level of independence in community or vocational function.

            (4) "Behavioral services" means services that identify maladaptive behaviors which interfere with the persons safe integration into the community and the formulation of an inclusive behavior management program to decrease identified maladaptive behaviors.

            (5) "Brain injury" means an acquired or traumatic injury to the brain. Such term does not include brain dysfunction caused by congenital disorders, degenerative disorders, or birth trauma but may include brain injuries caused by anoxia due to trauma.

            (6) "Client" means an individual receiving care from an adult brain injury facility and shall include only individuals who are medically stable and do not require an IV, feeding tube, or other artificial or mechanical supports for life sustaining processes.

            (7) "Cognitive rehabilitation" means a systematic, functionally oriented service of therapeutic cognitive activities based on an assessment and an understanding of the behavior of a client. Services are directed to achieve functional improvement by any of the following methods:

            (a) Reinforcing, strengthening, or re-establishing previously learned patterns of behavior.

            (b) Establishing new patterns of cognitive activity or mechanisms to compensate for impaired neurological systems.

            (8) "Community integration" means the participation in the mainstream of community life and maintaining social relationships with family members, peers, and others in the community who do not have brain injuries. Integration also means that clients have equal access to and full participation in community resources and activities available to the general public at the maximum amount of safety and independence as possible.

            (9) "Department" means the Louisiana Department of Health.

            (10) "Functional limitations" means actual behaviors or mental or physical disabilities exhibited by adults with brain injuries or conditions presented by their environments, or both, that shall be modified or minimized in order for clients to fulfill their potential or maximize their functioning.

            (11) "Head injury" means a traumatic or acquired brain injury.

            (12) "Impairment" means any loss or abnormality of psychological, cognitive, physiological, or anatomical structure or functioning.

            (13) "Medication management program" means a systematic, functionally oriented program formulated in consultation with the client's primary provider, and implemented by staff trained by a nursing director. The program shall be based upon an assessment and understanding of the behaviors of the client and recognition of the unique medical and pharmacological needs of the client. It shall also mean an incorporation of the most appropriate level of assistance necessary to advance towards independence.

            (14) "Nursing director" means a person who meets the legal requirement of a registered nurse in Louisiana. The goals of a nursing director are to advance community integration through:

            (a) Overseeing the medication management program, including staff training to implement the program.

            (b) Assisting the client in the restoration and maintenance of maximal health.

            (c) Consulting the primary provider to advance the client with their medication management program.

            (d) Advancing understanding of their unique medical and pharmacological needs.

            (e) Improving the client's quality of life.

            (15) "Personal care" means services and supports including but not limited to:

            (a) Bathing, hair care, skin care, shaving, nail care, oral hygiene, overall hygiene, and activities of daily living.

            (b) Interventions to assist one with eating and bowel and bladder management.

            (c) Positioning.

            (d) Care of adaptive personal care devices.

            (e) An appropriate level of supervision.

            (16) "Primary provider" means a provider board certified in his specialty who currently holds a valid license in Louisiana. The primary provider is responsible for overseeing the decision making process for admission and continued stay of clients.

            (17) "Rehabilitation" means the process of providing those comprehensive services deemed appropriate to the needs of a client in a coordinated manner in a program designed to achieve functional objectives of improved health, welfare, maximum physical, cognitive, social, psychological, and community functioning.

            (18) "Rehabilitative treatment environment" means a rehabilitation setting that provides for all of the following:

            (a) A provision of a range of choices, with personal preference, self-determination, and dignity of risk receiving full respect and consideration.

            (b) A variety of social interactions that promote community integration.

            (c) An environment of peer support and mentorship.

            (d) Professional team involvement.

            (e) A physical environment conducive to enhancing the functional abilities of the client.

            (f) Necessary therapeutic services. These therapeutic services may include social work, behavioral services, speech therapy, physical therapy, occupational therapy, vocational services, and therapeutic recreational services. All therapeutic providers must be licensed under state and, if applicable, national boards.

            (g) A medication management program.

            (h) Cognitive rehabilitation activities.

            (i) The identification of functional limitations.

            (19) "Support" means activities, materials, equipment, or other services designed and implemented to assist the client with a brain injury. Examples include but are not limited to instruction, training, assistive technology, or removal of architectural barriers.

            (20) "Therapeutic recreational services" means services that identify leisure activities and assistance in modifying and adapting identified leisure activities to allow safe participation by the client as a means to improve quality of life and aid in integration into the community.

            (21) "Traumatic brain injury" means an insult to the brain, not of a degenerative or congenital nature, caused by an external physical force that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive abilities or physical functioning. It can also result in the disturbance of behavioral or emotional functioning. These impairments may be either temporary or permanent and cause partial or total functional disability or psychosocial maladjustment.

            (22) "Vocational services" means services provided directly or through cooperating agencies to a client in accordance with his individualized plan and designed to improve or enhance skills and behaviors necessary for successful placement in a volunteer or work setting.

            Acts 2005, No. 245, §1, eff. June 29, 2005; Acts 2006, No. 105, §1; Acts 2008, No. 165, §1, eff. June 12, 2008; Acts 2022, No. 271, §4.