The 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) CFP--Certified Family Partner. A person who meets
the credentialing requirements in §353.1415(d) of this subchapter
(relating to Staff Member Credentialing).
(3) CFR--Code of Federal Regulations.
(4) Child or youth--An individual who is under age
21.
(5) Clinical supervision--An LPHA's or QMHP-CS's oversight
of a staff member who delivers mental health targeted case management
and mental health rehabilitative services to ensure that services
are clinically appropriate and in compliance with this subchapter.
(6) Community data--Additional information gathered
during the uniform assessment.
(7) 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 25 TAC §412.303 (relating to Definitions).
(8) 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 Chapter 354, Subchapter M of this title (relating to
Mental Health Targeted Case Management and Mental Health Rehabilitation),
with the exception of §354.2715 of this title (relating to Day
Programs for Acute Needs).
(9) Credentialing--A process by which the comprehensive
provider agency reviews and approves a staff member's educational
background, work experience, and licensure status (as applicable)
to ensure that the staff member meets requirements for staff member
credentialing as outlined in §353.1415. The process includes
primary source verification of credentials, establishing and applying
specific criteria and prerequisites to determine the staff member's
initial and ongoing competency, and assessing and validating the staff
member's qualifications to deliver care.
(10) HHSC--The Texas Health and Human Services Commission,
or its designee.
(11) Individual--A person seeking or receiving mental
health targeted case management, mental health rehabilitative services,
or both under this subchapter.
(12) 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.
(13) 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.
(14) 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.
(15) Life domains--Areas of life, including safety,
health, emotional, psychological, social, educational, cultural, and
legal.
(16) LPHA--Licensed Practitioner of the Healing Arts.
A staff member who is:
(A) a physician;
(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.
(17) Management information system--An information
system designed to plan, organize, staff, direct, and control the
operations and clinical decision-making of a managed care organization
or comprehensive provider agency.
(18) Medication training and support services--Medication
training and support services consist of education and guidance about
medications and their possible side effects.
(19) 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.
(20) 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.
(21) Peer provider--Staff with lived experience with
a mental health condition who meet the credentialing requirements
in §353.1415(c) of this subchapter.
(22) Pharmacological management--In-depth management
of psychopharmacological agents to treat an individual's mental health
symptoms.
(23) 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.
(24) Psychiatric diagnostic evaluation--An integrated
biopsychosocial assessment, including history, mental status, and
recommendations.
(25) QMHP-CS--Qualified Mental Health Professional-Community
Services. Staff who meet the credentialing requirements in §353.1415(a)
of this subchapter.
(26) Re-credentialing--The periodic process of reevaluating
a staff member's competency and qualifications.
(27) 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.
(28) 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) is 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.
(29) Referral and linkage--Activities that help link
an individual with medical, social, educational, and other providers
that are capable of providing needed services.
(30) Staff member--Comprehensive provider agency personnel,
including a full-time or part-time employee, contractor, or intern,
but excluding a volunteer.
(31) 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.
(32) 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.
(33) 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.
(34) 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.
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