Section 354.2603 - DefinitionsThe following words and terms, when used in this subchapter, have the following meanings unless the context clearly indicates otherwise.
(1) Adult--An individual who is age 21 or older.(2) Appeal--A mechanism for an independent review of an adverse determination or a request for a review of an action or failure to act that may result in a fair hearing.(3) Audio-only--Has the meaning assigned by § 354.1430(1) of this chapter (relating to Definitions).(4) Behavioral health emergency--A situation involving an individual who is behaving in a violent or self-destructive manner and in which preventive, de-escalation, or verbal techniques have been determined to be ineffective and it is immediately necessary to restrain or seclude the individual to prevent:(A) imminent probable death or substantial bodily harm to the individual because the individual is attempting to commit suicide or inflict serious bodily harm; or(B) imminent physical harm to others because of acts the individual commits.(5) Case manager--A staff member of the comprehensive provider agency who provides mental health targeted case management services.(6) CFP--Certified Family Partner. A person who meets the credentialing requirements in § 353.1415(d) of this title (relating to Staff Member Credentialing).(7) CFR--Code of Federal Regulations.(8) Child or youth--An individual who is under age 21.(9) Community-based--Mental health targeted case management services that are provided at a location other than the comprehensive provider agency's office.(10) Community data--Additional information gathered during the uniform assessment.(11) CSSP--Community services specialist. A staff member of a local mental health authority who has documented full-time experience in the provision of mental health targeted case management and mental health rehabilitative services prior to August 31, 2004. See definition in Title 26 Texas Administrative Code (TAC) §301.303 (relating to Definitions).(12) Comprehensive provider agency--An entity that provides or subcontracts for the delivery of the full array of mental health targeted case management and mental health rehabilitative services set forth in this subchapter, with the exception of § 354.2715 of this subchapter (relating to Day Programs for Acute Needs).(13) Crisis plan--A plan developed in advance of a crisis and in collaboration with the individual, legally authorized representative (LAR), caregiver, or family of the individual receiving services that identifies circumstances that determine a crisis that would jeopardize the individual's ability to remain in the community and the actions preferred and necessary to avert removal from the community.(14) CSU--Crisis stabilization unit. A crisis stabilization unit licensed under Chapter 577 of the Texas Health and Safety Code and 26 TAC Chapter 510 (relating to Private Psychiatric Hospitals and Crisis Stabilization Units).(15) Family Psychotherapy--Therapy that focuses on the dynamics of the family unit where the goal is to strengthen the family's problem solving and communication skills.(16) Group Psychotherapy--Therapy that involves one or more therapists working with several clients at the same time.(17) HHSC--The Texas Health and Human Services Commission, or its designee.(18) IMD--Institution for mental diseases. Based on 42 CFR § 435.1009, a hospital, nursing facility, or other institution of more than 16 beds that is primarily engaged in providing psychiatric diagnosis, treatment, or care of individuals with mental illness, including medical attention, nursing care, and related services.(19) Independent Living--A service within psychosocial rehabilitative services that assists 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 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.(20) Individual--A person seeking or receiving mental health targeted case management, mental health rehabilitative services, or both under this subchapter.(21) Individual Psychotherapy--Therapy that focuses on a single client.(22) Intensive case management--A level of mental health targeted case management that includes a focused effort to coordinate community resources, uses evidence-based wraparound process planning to address a child's or youth's unmet needs across life domains, and assists a child or youth in gaining access to necessary care and services appropriate to the child's or youth's needs.(23) Intensive case management plan--A written document that is part of the medical record for a child or youth receiving intensive case management and is developed by a case manager, in collaboration with the child or youth and the child's or youth's LAR or primary caregiver, that identifies services needed by the child or youth and sets forth a plan for how the child or youth may gain access to the identified services.(24) LAR--Legally authorized representative. A person authorized by law to act on behalf of an individual with regard to a matter described in this subchapter, including a parent, guardian, or managing conservator of a minor, or the guardian of an adult.(25) Licensed medical personnel--A staff member who is:(B) a physician assistant;(C) an advanced practice registered nurse;(E) a licensed vocational nurse; or(26) Life domains--Areas of life, including safety, health, emotional, psychological, social, educational, cultural, and legal.(27) LPHA--Licensed Practitioner of the Healing Arts. A staff member who is:(B) a licensed professional counselor;(C) a licensed clinical social worker;(D) a licensed psychologist;(E) an advanced practice registered nurse;(F) a physician assistant; or(G) a licensed marriage and family therapist.(28) Medication training and support services--Medication training and support services consist of education and guidance about medications and their possible side effects.(29) Mental health rehabilitative services--Services that are individualized, age-appropriate, and provide training and instructional guidance that restore an individual's functional deficits due to serious mental illness or serious emotional disturbance. The services are designed to improve or maintain the individual's ability to remain in the community as a fully integrated and functioning member of that community.(30) Mental health targeted case management--Services furnished to assist individuals with severe mental illness and functional impairments or serious emotional disorders and functional impairments to gain access to needed medical, social, educational, and other services.(31) On-site--Services that are provided at a location operated by a comprehensive provider agency.(32) Peer provider--Staff with lived experience with a mental health condition who meet the credentialing requirements in § 353.1415(c) of this title.(33) Pharmacological management--In-depth management of psychopharmacological agents to treat an individual's mental health symptoms.(34) Platform--Has the meaning assigned by Texas Government Code § 531.001 (4-d).(35) Primary caregiver--A person 18 years of age or older who has:(A) actual care, control, and possession of a child or youth; or(B) assumed responsibility for providing shelter and care for an adult.(36) Psychiatric diagnostic evaluation--An integrated biopsychosocial assessment, including history, mental status, and recommendations.(37) Psychosocial rehabilitative services--Social, behavioral, and cognitive interventions provided by members of an adult's therapeutic team that build on strengths and focus on restoring the adult's ability to develop and maintain social relationships, occupational or educational achievements, and other independent living skills that are affected by a serious mental illness in adults. Psychosocial rehabilitative services may also address the impact of co-occurring disorders upon the adult's ability to reduce symptomology and increase daily functioning.(38) QMHP-CS--Qualified Mental Health Professional-Community Services. Staff who meet the credentialing requirements in § 353.1415(a) of this title.(39) 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.(40) Recovery or treatment plan (recovery/treatment plan)--A written plan that: (A) is developed with the individual, the LAR if required, other persons whose inclusion is requested by the individual or LAR and who agree to participate, and a QMHP-CS or LPHA;(B) is completed in conjunction with the uniform assessment;(C) amended at any time based on an individual's needs;(D) guides the recovery process and fosters resiliency;(E) identifies the individual's changing strengths, capacities, goals, preferences, needs, and desired outcomes; and(F) identifies services and supports to meet the individual's goals, preferences, needs and desired outcomes.(41) Recovery or treatment planning (recovery/treatment planning)--A systematic process for engaging the individual, LAR, and the primary caregiver and others to develop goals and identify a course of action to respond to the individual's clinically assessed needs, including medical, social, educational, and other services needed by the individual.(42) Referral and linkage--Activities that help link an individual with medical, social, educational, and other providers that are capable of providing needed services.(43) Routine care services--Mental health services provided to an individual who is not in crisis.(44) Service provider--An entity separate from the comprehensive provider agency which may also provide services to an individual outside of the services performed under this subchapter.(45) Staff member--Comprehensive provider agency personnel, including a full-time or part-time employee, contractor, or intern, but excluding a volunteer.(46) Strengths-based--The concept used in service delivery that identifies, builds on, and enhances the capabilities, knowledge, skills, and assets of the individual, LAR, or primary caregiver, and family, their community, and other team members. The focus is on increasing functional strengths and assets rather than on the elimination of deficits.(47) Telehealth service--Has the meaning assigned by Texas Occupations Code § 111.001(3).(48) Telemedicine medical service--Has the meaning assigned by Texas Occupations Code § 111.001(4).(49) Therapeutic team--A group of staff members who work together in a coordinated manner for the purpose of providing comprehensive mental health services to an individual.(50) UA--Uniform assessment. A required assessment that assists in determining the medical necessity of services. For adults, the UA includes the Adult Needs and Strengths Assessment (ANSA), community data, relevant rating scales, diagnostic information, and any other state-required assessment tools and procedures. For children or youth, the UA includes the Child and Adolescent Needs and Strengths (CANS) assessment, community data, relevant rating scales, diagnostic information, and any other state-required assessment tools and processes.(51) Utilization management guidelines--Guidelines developed by HHSC that establish the type, amount, and duration of mental health targeted case management services and mental health rehabilitative services for each individual.(52) Wraparound Process Planning--A strengths-based approach used in intensive case management to develop an intensive case management plan that addresses the child's or youth's unmet needs across life domains.1 Tex. Admin. Code § 354.2603
Adopted by Texas Register, Volume 43, Number 41, October 12, 2018, TexReg 6821, eff. 10/17/2018; Amended by Texas Register, Volume 48, Number 03, January 20, 2023, TexReg 0211, eff. 1/23/2023