The following words and terms, when used in this chapter, have
the following meanings, unless the context clearly indicates otherwise.
(1) Administrator--The individual, appointed by a governing
body, who has authority to represent the hospital and, as delegated
by the governing body, has responsibility for operating the hospital
in accordance with the hospital's written policies and procedures.
(2) Administrator's designee--An individual designated
in a hospital's written policies and procedures to act for a specified
purpose on behalf of the administrator.
(3) Admission--The acceptance of an individual to a
hospital's custody and care for inpatient mental health treatment
based on:
(A) a physician's order issued in accordance with §568.22(f)(2)(B)
of this chapter (relating to Voluntary Admission);
(B) a physician's order issued in accordance with §568.23(c)(3)
of this chapter (relating to Emergency Detention);
(C) an order of protective custody issued in accordance
with Texas Health and Safety Code §574.022;
(D) an order for temporary inpatient mental health
services issued in accordance with Texas Health and Safety Code §574.034;
(E) an order for extended inpatient mental health services
issued in accordance with Texas Health and Safety Code §574.035;
(F) an order for commitment issued in accordance with
Texas Code of Criminal Procedure Chapters 46B or 46C; or
(G) an order for placement in accordance with Texas
Family Code Chapter 55.
(4) Adult--An individual 18 years of age.
(5) Business day--Any day except a Saturday, Sunday,
or legal holiday listed in Texas Government Code §662.021.
(6) CFR--The Code of Federal Regulations.
(7) Day--Calendar day.
(8) Discharge--The release by a hospital of a patient
from the custody and care of the hospital.
(9) DSM--The current edition of the Diagnostic Statistical Manual of Mental Disorders published
by the American Psychiatric Association.
(10) 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 be expected to result in:
(A) placing the health of the individual (or with respect
to a pregnant woman, the health of the woman or her unborn child)
or others in serious jeopardy;
(B) serious impairment to bodily functions;
(C) serious dysfunction of any bodily organ or part;
(D) serious disfigurement; or
(E) in the case of a pregnant woman who is having contractions:
(i) that there is inadequate time to effect a safe
transfer to another hospital before delivery; or
(ii) that transfer may pose a threat to the health
or safety of the woman or the unborn child.
(11) Governing body--The governing authority of a hospital
that is responsible for the hospital's organization, management, control
and operation, including appointment of the administrator.
(12) HHSC--The Texas Health and Human Services Commission.
(13) Hospital--
(A) A private psychiatric hospital licensed under Texas
Health and Safety Code Chapter 577 (relating to Private Mental Hospitals
and Other Mental Health Facilities) and Chapter 510 of this title
(relating to Private Psychiatric Hospitals and Crisis Stabilization
Units); or
(B) an identifiable inpatient mental health services
unit in a hospital licensed under Texas Health and Safety Code Chapter
241 (relating to Hospitals) and 25 TAC Chapter 133 (relating to Hospital
Licensing).
(14) Interdisciplinary treatment team (IDT)--A group
of individuals who possess the knowledge, skills and expertise to
develop and implement a patient's treatment plan and includes:
(A) the patient's treating physician;
(B) the patient and the patient's legally authorized
representative (LAR), if any;
(C) the staff members identified in the treatment plan
as responsible for providing or ensuring the provision of each treatment
in accordance with §568.61(c)(1)(E)(iii) of this chapter (relating
to Inpatient Mental Health Treatment and Treatment Planning);
(D) any individual identified by the patient or the
patient's LAR, unless clinically contraindicated; and
(E) other staff members as clinically appropriate.
(15) Inpatient mental health treatment--Residential
care provided in a hospital for a patient with a mental illness diagnosis,
which may include a co-occuring diagnosis of a substance use, neurodevelopmental
disorder, or both, which includes:
(A) medical services;
(B) nursing services;
(C) social services;
(D) therapeutic activities, if ordered by the treating
physician; and
(E) psychological services, if ordered by the treating
physician.
(16) Involuntary patient--A patient who is receiving
inpatient mental health treatment based on an admission made in accordance
with:
(A) §568.23 of this chapter (relating to Emergency
Detention); or
(B) §568.24 of this chapter (relating to Admission
of an Individual under an Order of Protective Custody, for Court-ordered
Inpatient Mental Health Services, or Under Order for Commitment or
Order for Placement).
(17) Legally authorized representative (LAR)-- A parent,
guardian, or managing conservator of a minor, or the guardian of an
adult authorized by law to act on behalf of an individual regarding
a matter described in this subchapter regarding:
(A) admission, treatment, transfer, or discharge, including:
(i) a parent, non-Department of Family and Protective
Services managing conservator or guardian of minor;
(ii) a Department of Family and Protective Service
managing conservator of a minor acting pursuant to Texas Health and
Safety Code §572.001(c-2)-(c-4); and
(iii) a person eligible to consent to treatment for
a minor under Texas Family Code §32.001(a)(1), (2), or (3), who
may request from a district court authorization under Texas Family
Code Chapter 35A for the temporary admission of a minor who has been
within their care for the past 6 months.
(B) consent on behalf of an individual with regard
to a matter described in this subchapter other than admission, treatment,
transfer, or discharge, including:
(i) persons described by subparagraph (A) of this paragraph;
and
(ii) an agent acting under a Medical Power of Attorney
under Texas Health and Safety Code Chapter 250 or a Declaration for
Mental Health Treatment under Texas Civil Practice and Remedies Code
Chapter 137.
(18) Legal holiday--A holiday listed in Texas Government
Code §662.021 and an officially designated county holiday applicable
to a court in which proceedings are held under the Texas Mental Health
Code.
(19) Licensed marriage and family therapist--An individual
who is licensed as a marriage and family therapist by the Texas Behavioral
Health Executive Council in accordance with Texas Occupations Code
Chapter 502.
(20) Licensed master social worker--An individual who
is licensed as a master social worker by the Texas Behavioral Health
Executive Council in accordance with Texas Occupations Code Chapter
505.
(21) Licensed professional counselor--An individual
who is licensed as a professional counselor by the Texas Behavioral
Health Executive Council in accordance with Texas Occupations Code
Chapter 503.
(22) Licensed psychologist--An individual who is licensed
as a psychologist by the Texas Behavioral Health Executive Council
in accordance with Texas Occupations Code Chapter 501.
(23) Licensed social worker--An individual who is licensed
as a social worker by the Texas Behavioral Health Executive Council
in accordance with Texas Occupations Code Chapter 505.
(24) Licensed vocational nurse (LVN)--An individual
who is licensed as a vocational nurse by the Texas Board of Nursing
in accordance with Texas Occupations Code Chapter 301.
(25) Mandatory overtime--The time, other than on-call
time, a nursing staff member is required to work at a hospital beyond
the hours or days that were scheduled for the staff member. Neither
the length of the shift (whether 4, 8, 12, or 16 hours) nor the number
of shifts scheduled to work per week (whether 4, 5, or 6 per week)
is the determinative factor in deciding whether time is mandatory
overtime.
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