Current through Reg. 49, No. 38; September 20, 2024
(a)
Psychosocial rehabilitative services must include the following services, as
determined necessary for every individual:
(1)
independent living;
(2)
coordination;
(3) employment
related;
(4) housing related;
and
(5) medication
related.
(b) Independent
living services assist an individual in acquiring the most immediate,
fundamental functional skills needed to enable the individual to reside in the
community and avoid more restrictive levels of treatment, or assist an
individual in reducing behaviors or symptoms that prevent successful
functioning in the individual's environment of choice. Such services include
training in symptom management, personal hygiene, nutrition, food preparation,
exercise, money management, and community integration activities.
(c) Coordination services are training
activities that assist an individual in improving the ability to gain and
coordinate access to necessary care and services appropriate to the
individual's needs. Coordination services include instruction and guidance in
such areas as:
(1) assessment--identifying
strengths and areas of need across life domains;
(2) recovery/treatment planning--prioritizing
needs, establishing life and treatment goals, selecting interventions, and
developing and revising recovery/treatment plans that include wellness, relapse
prevention, and crisis plans;
(3)
access--identifying and initiating contact with potential service providers and
support systems across all life domains, including advocacy groups;
(4) coordination--setting appointments,
arranging transportation, and facilitating communication between providers;
and
(5) advocacy--
(A) asserting treatment needs, requesting
special accommodations, and evaluating provider effectiveness and compliance
with the agreed upon recovery/treatment plan; and
(B) requesting improvements and modifications
to ensure maximum benefit from the services and supports.
(d) Employment related services
provide supports and skills training that are not job-specific and focus on
developing skills to reduce or manage the symptoms of serious mental illness
that interfere with an individual's ability to make vocational choices or
obtain or retain employment. Such services consist of:
(1) instruction in dress, grooming, socially
and culturally appropriate behaviors, and etiquette necessary to obtain and
retain employment;
(2) training in
task focus, maintaining concentration, task completion, and planning and
managing activities to achieve outcomes;
(3) instruction in obtaining appropriate
clothing, arranging transportation, utilizing public transportation, accessing
and utilizing available resources related to obtaining employment, and
accessing employment-related programs and benefits;
(4) interventions or supports provided on or
off the job site to reduce behaviors or symptoms of serious mental illness that
interfere with job performance or that interfere with the development of skills
that would enable the individual to obtain or retain employment; and
(5) interventions designed to develop natural
supports on or off the job site to compensate for skill deficits that interfere
with job performance.
(e)
Housing related services develop an individual's strengths and abilities to
manage the symptoms of the individual's serious mental illness that interfere
with the individual's capacity to obtain or maintain independent, integrated
housing. Such services consist of:
(1) skills
training related to:
(A) home maintenance and
cleanliness;
(B) problem-solving
with the individual's landlord and neighbors, mortgage lender, or homeowner's
association; and
(C) maintaining
appropriate interpersonal boundaries; and
(2) supportive contacts with the individual
to reduce or manage the behaviors or symptoms related to the individual's
serious mental illness that interfere with maintaining independent, integrated
housing.
(f) Medication
related services provide training regarding an individual's medication
adherence. Such services consist of training in:
(1) the importance of the individual taking
the medications as prescribed;
(2)
the self-administration of the individual's medication;
(3) determining the effectiveness of the
individual's medications;
(4)
identifying side-effects of the individual's medications; and
(5) contraindications for medications
prescribed.
(g) The
requirements of this subsection apply for the delivery of psychosocial
rehabilitative services.
(1) Psychosocial
rehabilitative services:
(A) must be provided
in accordance with the requirements of the Texas Medicaid Provider Procedures
Manual (TMPPM), including all updates and revisions and all handbooks,
standards, and guidelines as determined by HHSC or a managed care organization
(MCO) with which they contract; and
(B) may be delivered as a telemedicine
medical service or a telehealth service, including via an audio-only platform,
in accordance with the requirements and limitations of Subchapter A, Division
33 of this chapter (relating to Advanced Telecommunications Services.
(2) Psychosocial rehabilitative
services may be provided:
(A) only to adults
who are not currently admitted to a CSU;
(B) individually or in a group; and
(C) only by a member of the individual's
therapeutic team.
(3) The
therapeutic team must be constituted and organized in a manner that ensures:
(A) the team includes a sufficient number of
staff to adequately address the rehabilitative needs of individuals assigned to
the team;
(B) team members are
appropriately credentialed to provide the full array of component
services;
(C) team members have
regularly scheduled team meetings; and
(D) every member of the team is knowledgeable
of the needs and services available to the specific individuals assigned to the
team.
(4) Independent
living services, coordination services, employment-related services, and
housing-related services must be provided by a:
(A) QMHP-CS;
(B) CSSP; or
(C) peer provider.
(5) Only licensed medical personnel acting
within the scope of their practice may provide medication-related
services.
(6) Crisis-related
services must be provided by a QMHP-CS.
(h) An individual receiving psychosocial
rehabilitative services is not eligible to simultaneously receive either skills
training and development or targeted case management services.
