Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM
Subchapter D - MENTAL HEALTH SERVICES-ADMISSION, CONTINUITY, AND DISCHARGE
Division 1 - GENERAL PROVISIONS
Section 306.153 - Definitions
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) Absence--When an individual, previously admitted to an SMHF and not discharged from the SMHF, is physically away from the SMHF for any reason, including hospitalization, home visit, special activity, unauthorized departure, or absence for trial placement.
(2) Admission--
(3) Adolescent--An individual at least 13 years of age, but younger than 18 years of age.
(4) Adult--An individual at least 18 years of age or older.
(5) Advance directive--As used in this subchapter, includes:
(6) Alternate provider--An entity that provides mental health services or substance use disorder treatment services in the community but not pursuant to a contract or memorandum of understanding with an LMHA or LBHA.
(7) APRN--Advanced practice registered nurse. A registered nurse licensed by the Texas Board of Nursing to practice as an advanced practice registered nurse as provided by Texas Occupations Code § 301.152.
(8) Assessment--The administrative process an SMHF or a facility with a CPB uses to gather information from a prospective patient, including a medical history and the problem for which the prospective patient is seeking treatment, to determine whether a prospective patient should be examined by a physician to determine if admission is clinically justified, as defined by Texas Health and Safety Code § 572.0025(h)(2).
(9) Assessment professional--In accordance with Texas Health and Safety Code § 572.0025(c)-(d), a staff member of an SMHF or facility with a CPB whose responsibilities include conducting the intake assessment described in § 306.175(g) and § 306.176(e) of this subchapter, and who is:
(10) ATP--Absence for trial placement. When an individual, currently admitted to an SMHF, is physically away from the SMHF for the SMHF to evaluate the individual's adjustment to a particular living arrangement before the individual's discharge and as a potential residence following discharge. An ATP is a type of furlough, as referenced in Texas Health and Safety Code, Chapter 574, Subchapter F.
(11) Business day--Any day except a Saturday, Sunday, or legal holiday listed in Texas Government Code § 662.021.
(12) Capacity--An individual's ability to understand and appreciate the nature and consequences of a decision regarding the individual's medical treatment, and the ability of the individual to reach an informed decision in the matter.
(13) Child--An individual at least three years of age, but younger than 13 years of age.
(14) Continuity of care--Activities designed to ensure an individual is provided uninterrupted services during a transition between inpatient and outpatient services and that assist the individual and the individual's LAR in identifying, accessing, and coordinating LMHA or LBHA services and other appropriate services and supports in the community needed by the individual, including:
(15) Continuity of care worker--An LMHA, LBHA, or LIDDA staff member responsible for providing continuity of care services. The staff member may collaborate with a peer specialist, recovery specialist, or family partner to provide continuity of services.
(16) COPSD--Co-occurring psychiatric and substance use disorder.
(17) COPSD model--An application of evidence-based practices for an individual diagnosed with co-occurring conditions of mental illness and substance use disorder.
(18) CPB--Contracted psychiatric bed. A state-funded contracted psychiatric bed that:
(19) CRCG--Community Resource Coordination Group. A local interagency group comprised of public and private providers who collaborate to develop individualized service plans for individuals whose needs may be met through interagency coordination and cooperation. CRCGs are established and operate in accordance with a Memorandum of Understanding on Services for Persons Needing Multiagency Services, required by Texas Government Code § 531.055.
(20) Crisis--A situation in which:
(21) Crisis treatment alternatives--Community-based facilities or units providing short-term, residential crisis treatment to ameliorate a behavioral health crisis in the least restrictive environment, including crisis stabilization units, extended observation units, crisis residential units, and crisis respite units. The intensity and scope of services varies by facility type and is available in a local service area based upon the local needs and characteristics of the community.
(22) Day--Calendar day.
(23) DD--Developmental disability. As listed in the Texas Health and Safety Code § 531.002, an individual with a severe, chronic disability attributable to a mental or physical impairment or a combination of mental and physical impairments that:
(24) Designated LMHA or LBHA--The LMHA or LBHA:
(25) Discharge--
(26) Discharged unexpectedly--A discharge from an SMHF or facility with a CPB:
(27) Emergency medical condition--A medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain, psychiatric disturbances, or symptoms of substance use disorder) such that the absence of immediate medical attention could reasonably result in:
(28) Face-to-face--A form of contact occurring in person or through the use of audiovisual or other telecommunications technology.
(29) Facility--A care facility including a state mental health facility, private psychiatric hospital, medical hospital, and community setting, but does not include a nursing facility or an assisted living facility.
(30) HHSC--Texas Health and Human Services Commission or its designee.
(31) ID--Intellectual disability. Consistent with Texas Health and Safety Code § 591.003, significantly sub-average general intellectual functioning existing concurrently with deficits in adaptive behavior and originating before age 18.
(32) Individual--A person seeking or receiving services under this subchapter.
(33) Individual involuntarily receiving treatment--An individual receiving inpatient services based on an admission to a state mental health facility or a facility with a CPB made in accordance with:
(34) Individual voluntarily receiving treatment--An individual receiving inpatient services based on an admission made in accordance with:
(35) Inpatient services--Residential psychiatric treatment provided to an individual in an SMHF, a facility with a CPB, a hospital licensed under the Texas Health and Safety Code, Chapter 241 or Chapter 577, or a CSU licensed under Chapter 510 of this title (relating to Private Psychiatric Hospitals and Crisis Stabilization Units).
(36) Intake assessment--The administrative process conducted by an assessment professional for gathering information about a prospective patient including the psychiatric and medical history, social history, symptomology and support system and giving a prospective patient information about the facility and the facility's treatment and services.
(37) LAR--Legally authorized representative. A person authorized by state law to act on behalf of an individual for the purposes of:
(38) LBHA--Local behavioral health authority. An entity designated as an LBHA by HHSC in accordance with Texas Health and Safety Code § 533.0356.
(39) LIDDA--Local intellectual and developmental disability authority. An entity designated by HHSC in accordance with Texas Health and Safety Code § 533A.035.
(40) LMHA--Local mental health authority. An entity designated as an LMHA by HHSC in accordance with Texas Health and Safety Code § 533.035(a).
(41) LMHA or LBHA network provider--An entity that provides mental health services in the community pursuant to a contract or memorandum of understanding with an LMHA or LBHA, including that part of an LMHA or LBHA directly providing mental health services.
(42) LMHA or LBHA services--Inpatient and outpatient mental health services provided by an LMHA or LBHA network provider to an individual in the individual's home community.
(43) Local service area--A geographic area composed of one or more Texas counties defining the population that may receive services from an LMHA or LBHA.
(44) MCO--Managed care organization. An entity governed by Chapter 843 of the Texas Insurance Code to operate as a health maintenance organization or to issue a private provider benefit plan.
(45) Mental illness--An illness, disease, or condition, other than a sole diagnosis of epilepsy, dementia, substance use disorder, ID, or DD that:
(46) MH priority population--Mental health priority population. As identified in state performance contracts with LMHAs or LBHAs, those groups of children, adolescents, and adults with mental illness or serious emotional disturbance assessed as most in need of mental health services.
(47) Minor--An individual younger than 18 years of age.
(48) Nursing facility--A long-term care facility licensed by HHSC as a nursing home, nursing facility, or skilled nursing facility as defined in Texas Health and Safety Code, Chapter 242.
(49) Offender with special needs--An individual who has a terminal or serious medical condition, a mental illness, an ID, a DD, or a physical disability, and is served by the Texas Correctional Office on Offenders with Medical or Mental Impairments as provided in Texas Health and Safety Code, Chapter 614.
(50) Ombudsman--The Ombudsman for Behavioral Health Access to Care established by Texas Government Code § 531.02251, which serves as a neutral party to help individuals, including individuals who are uninsured or have public or private health benefit coverage. The behavioral health care providers navigate and resolve issues related to the individual's access to behavioral health care, including care for mental health conditions and substance use disorders.
(51) PASRR--Preadmission screening and resident review in accordance with 40 TAC Chapter 19, Subchapter BB (relating to Nursing Facility Responsibilities Related to Preadmission Screening and Resident Review (PASRR)).
(52) PASRR Level I screening--The process of screening an individual to identify whether the individual is suspected of having a mental illness, ID, or DD.
(53) PASRR Level II evaluation--A face-to-face evaluation of an individual suspected of having a mental illness, ID, or DD performed by a LIDDA, LMHA, or LBHA to determine if the individual has a mental illness, ID, or DD, and if so, to:
(54) Peer specialist--A person who uses lived experience in addition to skills learned in formal training, to deliver strengths-based, person-centered services to promote an individual's recovery and resiliency in accordance with 1 TAC Chapter 354, Subchapter N.
(55) Permanent residence--The physical location where an individual lives, or if a minor, where the minor's parents or legal guardian lives. A post office box is not a permanent residence.
(56) Preliminary examination--An assessment for medical stability and a psychiatric examination in accordance with Texas Health and Safety Code § 573.022(a)(2).
(57) QMHP-CS--Qualified mental health professional-community services. A staff member who meets the requirements and performs the functions described in Chapter 301, Subchapter G of this title (relating to Mental Health Community Services Standards).
(58) Recovery--A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.
(59) Recovery or treatment plan--A written plan:
(60) Screening--Activities performed by a QMHP-CS to:
(61) SMHF--State mental health facility. A state hospital or a state center with an inpatient psychiatric component.
(62) SSLC--State supported living center. Consistent with Texas Health and Safety Code § 531.002, a residential facility operated by the State to provide individuals with an ID a variety of services, including medical treatment, specialized therapy, and training in the acquisition of personal, social, and vocational skills.
(63) Substance use disorder--The use of one or more drugs, including alcohol, which significantly and negatively impacts one or more major areas of life functioning and which meets the criteria for substance use as described in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association.
(64) TAC--Texas Administrative Code.
(65) TCOOMMI--Texas Correctional Office on Offenders with Medical or Mental Impairments or its designee.
(66) Transfer--To move from one facility to another facility.
(67) Treating physician--A physician who coordinates and oversees an individual's treatment.
(68) Treatment team--A group of treatment providers, an individual, the individual's LAR, if any, and the LMHA, LBHA, or LIDDA who work together in a coordinated manner to provide comprehensive mental health services to the individual.
(69) Uniform assessment--An assessment tool adopted by HHSC under § 301.353 of this title (relating to Provider Responsibilities for Treatment Planning and Service Authorization) used for recommending an individual's level of care.
