Texas Administrative Code
Title 25 - HEALTH SERVICES
Part 1 - DEPARTMENT OF STATE HEALTH SERVICES
Chapter 419 - MENTAL HEALTH SERVICES - MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES
Subchapter J - INSTITUTIONS FOR MENTAL DISEASES
Section 419.373 - Definitions

Universal Citation: 25 TX Admin Code ยง 419.373

Current through Reg. 49, No. 38; September 20, 2024

The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

(1) Department--The Department of State Health Services or its designee.

(2) HHSC--The Health and Human Services Commission or its designee.

(3) Inpatient hospital services--Services provided under the supervision of a physician in an IMD that meets the requirements for psychiatric hospitals in 42 CFR §482.60(b), (c), and (d) and meets utilization review requirements in 42 CFR §482.30(a), (b), (d), and (e) unless the utilization review requirements have been waived pursuant to §1903(i)(4) of the Social Security Act and 42 CFR Part 456, Subpart H.

(4) Institution for mental diseases (IMD)--A hospital of more than 16 beds that is primarily engaged in providing psychiatric diagnosis, treatment, and care of individuals with mental diseases, including medical care, nursing care, and related services.

(5) IMD provider--An IMD that has an agreement with the department to provide IMD services.

(6) IMD services--Inpatient hospital services provided by an IMD provider for the care and treatment (including room and board) of individuals with mental diseases including, but not limited to:

(A) initiation, titration, or change in medication;

(B) monitoring and assessing by qualified mental health professionals;

(C) suicide precautions;

(D) redirection of inappropriate behaviors and/or reinforcement of appropriate behaviors;

(E) group and individual therapies;

(F) structured skills training activities; and

(G) nursing services.

(7) Mental diseases--Diseases listed as mental disorders in the latest editions of the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders, with the exception of mental retardation and chemical dependency disorders.

(8) Qualified mental health professional--A person acting within the scope of his or her training and licensure or certification, who is a:

(A) licensed social worker, as defined by the Social Work Practice Act, Occupations Code, § 505.002(6);

(B) licensed professional counselor, as defined by the Licensed Professional Counselor Act, Occupations Code, § 503.002(4);

(C) physician, as defined by the Medical Practice Act, Occupations Code, § 151.002(12), or a person employed by any agency of the United States having a license to practice medicine in any state of the United States;

(D) licensed nurse as provided for and defined in the Nursing Practice Act, Occupations Code, Chapter 301; or

(E) psychologist, as defined by the Psychologists' Licensing Act, Occupations Code, § 501.002(5).

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