The following words and terms, when used in this subchapter,
have the following meanings, unless the context clearly indicates
(1) Administrator--A person or entity that has authority
to represent a facility and is responsible for implementing and supervising
its administrative policies and procedures and for administratively
supervising the provision of services to individuals on a day-to-day
(2) Administrator's designee--A staff member designated
in a facility's written policies and procedures to act for a specified
purpose on behalf of the administrator.
(3) Admission--The acceptance of an individual for
crisis stabilization services based on a physician's order issued
in accordance with §306.55 (relating to Voluntary Admission Criteria
and Intake Process) and §306.57 (relating to Involuntary Admission
Criteria and Intake Process) of this subchapter.
(4) Admission examination--A psychiatric examination
and physical assessment conducted by a physician, to determine if
an individual requesting voluntary admission to an inpatient mental
health facility meets clinical criteria for admission, in accordance
with Texas Health and Safety Code §572.0025(f).
(5) Adolescent--An individual at least 13 years of
age, but younger than 18 years of age.
(6) Adult--An individual 18 years of age or older.
(7) Adult caregiver--An adult person whom a parent
has authorized to provide temporary care for a child, as defined in
Texas Family Code §34.0015(1).
(8) APRN--Advanced practice registered nurse. A registered
nurse licensed by the Texas Board of Nursing and as provided in Texas
Occupations Code §301.152.
(9) Assessment--The administrative process an inpatient
mental health facility uses to gather information from an individual
to determine if the admission is clinically justified, in accordance
with Texas Health and Safety Code §572.0025(h)(2), including
a medical history and the problem for which the individual is seeking
(10) Business day--Any day except a Saturday, Sunday,
or legal holiday listed in Texas Government Code §662.021.
(11) Child--An individual at least three years of age,
but younger than 13 years of age.
(12) Confidential information--Any communication or
record (whether oral, written, electronically stored or transmitted,
or in any other form) that consists of or includes any or all of the
information that must be protected from unauthorized use or disclosure
as required by applicable state or federal laws, and as defined in
1 TAC §390.1(5) (relating to Definitions).
(13) Crisis stabilization services--Short-term residential
treatment designed to reduce acute symptoms of a mental illness or
serious emotional disturbance of an individual and prevent admission
of the individual to an inpatient mental health facility.
(14) CSU--Crisis stabilization unit. A short-term residential
treatment unit designed to reduce an individual's acute symptoms of
mental illness or serious emotional disturbance instead of admission
to an inpatient mental health facility, licensed in accordance with
Chapter 510 of this title (relating to Private Psychiatric Hospitals
and Crisis Stabilization Units) and Texas Health and Safety Code Chapter
(15) Day--Calendar day, unless otherwise specified.
(16) DD--Developmental disability. As listed in Texas
Health and Safety Code §531.002(15), a severe, chronic disability
attributable to mental or physical impairment or a combination of
mental and physical impairments that:
(A) manifest before the individual reaches 22 years
(B) are likely to continue indefinitely;
(C) reflect the individual's need for a combination
and sequence of special, interdisciplinary, or generic services, individualized
supports, or other forms of assistance that are of a lifelong or extended
duration and are individually planned and coordinated; and
(D) result in substantial functional limitations in
three or more of the following categories of major life activity:
(ii) receptive and expressive language;
(vi) capacity for independent living; and
(vii) economic self-sufficiency.
(17) Discharge--The formal release of an individual
from the custody and care of an inpatient mental health facility in
accordance with Texas Health and Safety Code §572.004.
(18) Emergency medical condition--In accordance with
the Emergency Medical Treatment & Labor Act (42 U.S.C. §1395dd)
(Relating to examination and treatment for emergency medical conditions
and women in labor), a medical condition manifested by acute symptoms
of sufficient severity 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)
in serious jeopardy;
(B) serious impairment to bodily functions;
(C) serious dysfunction of any bodily organ or part;
(D) in the case of a pregnant woman having contractions:
(i) inadequate time to arrange a safe transfer to a
hospital before delivery; or
(ii) a transfer posing a threat to the health or safety
of the woman or the unborn child.
(19) General hospital--A hospital operated primarily
to diagnose, care for, and treat individuals who are physically ill
and licensed in accordance with Texas Health and Safety Code Chapter
(20) HHSC--Texas Health and Human Services Commission
or its designee.
(21) 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 originates during the developmental period.
(22) IDT--Interdisciplinary team. A group of licensed,
credentialed, and unlicensed staff members who possess the knowledge,
skills, and expertise to develop and implement an individual's treatment
or recovery plan and also includes:
(A) the individual's treating physician;
(B) the individual, and the individual's LAR or adult
caregiver, if applicable;
(C) the staff members identified in the treatment or
recovery plan as responsible for providing or ensuring the provision
of each treatment in accordance with §568.61(c)(1)(E)(iii) of
this title (relating to Inpatient Mental Health Treatment and Treatment
(D) any person identified by the individual, and the
individual's LAR or adult caregiver if applicable, unless clinically
(E) other staff members as clinically appropriate.
(23) Individual--A person seeking or receiving services
under this subchapter.
(24) Inpatient mental health facility--A mental health
facility that can provide 24-hour residential and psychiatric services
and that is:
(A) a facility operated by HHSC;
(B) a private mental hospital licensed by HHSC;
(C) a community center, facility operated by or under
contract with a community center or other entity HHSC designates to
provide mental health services;
(D) an identifiable part of a general hospital in which
diagnosis, treatment, and care for individuals with mental illness
is provided and that is licensed by HHSC; or
(E) a hospital operated by a federal agency.
(25) Intake--The administrative process for gathering
information about an individual and giving an individual information
about an inpatient mental health facility and the facility's treatment
and services, in accordance with Texas Health and Safety Code §572.0025(h)(3).
(26) Involuntarily-admitted individual--An individual
receiving inpatient mental health facility services based on an admission
made in accordance with:
(A) Texas Health and Safety Code Chapter 573 and described
in §306.57(a) of this subchapter; or
(B) Texas Health and Safety Code §574.021 and
described in §306.57(f) of this subchapter.
(27) LAR--Legally authorized representative. A person
authorized by law to act on behalf of an individual regarding a matter
described in this subchapter, and may include a parent, guardian,
or managing conservator of a minor, or the guardian of an adult.
(28) LBHA--Local behavioral health authority. An entity
designated as the local behavioral health authority by HHSC in accordance
with Texas Health and Safety Code §533.0356.
(29) Legal holiday--A holiday listed in the Texas Government
Code §662.021 and an officially designated county holiday applicable
to a court in which proceedings under the Texas Mental Health Code
(30) LIDDA--Local intellectual and developmental disability
authority. An entity designated as the local intellectual and developmental
disability authority by HHSC in accordance with Texas Health and Safety
(31) LMHA--Local mental health authority. An entity
designated as the local mental health authority by HHSC in accordance
with Texas Health and Safety Code §533.035(a).
(32) LPHA--Licensed practitioner of the healing arts.
A person who possesses any of the following state licenses is considered
an LPHA and is automatically certified as a qualified mental health
professional-community services (QMHP-CS):
(A) a physician;
(B) a physician assistant;
(C) an APRN;
(D) a licensed psychologist;
(E) a licensed professional counselor;
(F) a licensed clinical social worker; or
(G) a licensed marriage and family therapist.
(33) LVN--Licensed vocational nurse. A person licensed
as a vocational nurse by the Texas Board of Nursing in accordance
with Texas Occupations Code Chapter 301.
(34) Medical director--A physician who is board eligible
or certified in psychiatry by the American Board of Psychiatry and
Neurology or by the American Osteopathic Board of Neurology and Psychiatry
and who provides clinical and policy oversight for the CSU.
(35) Medical record--A compilation of systematic and
organized information relevant to the services provided to an individual.
(36) Medical services--Acts or services provided by
a physician acting as described in Texas Occupations Code Chapter
151, or as delegated by a physician, in accordance with Texas Occupations
Code Chapter 157.
(37) Mental illness--An illness, disease, or condition,
other than a sole diagnosis of epilepsy, dementia, substance use disorder,
ID, or DD that:
(A) substantially impairs an individual's thought,
perception of reality, emotional process, or judgment; or
(B) grossly impairs behavior as demonstrated by recent
(38) Monitoring--One or more staff members observing
an individual in person continuously or at pre-determined intervals;
as ordered by a physician or physician-delegated physician's assistant
(PA) or APRN; or by established protocol; and intervening when necessary
to protect the individual from harming self or others.
(39) Nursing facility--A Medicaid-certified facility
that is licensed in accordance with the Texas Health and Safety Code
(40) Nursing services--Acts or services provided by
a registered nurse (RN) acting within the RN's scope of practice and
assigned to an LVN, or delegated to an unlicensed person, in accordance
with Texas Occupations Code Chapter 301.
(41) Nursing staff--A person required to be licensed
in accordance with Texas Occupations Code Chapter 301 to engage in
professional or vocational nursing or the person delegated to perform
common nursing functions under the authority of an RN.
(42) 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
and 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.
(43) PA--Physician's assistant. A person licensed as
a physician assistant by the Texas State Board of Physician Assistant
Examiners in accordance with Texas Occupations Code Chapter 204.
(44) PASRR--Preadmission screening and resident review.
(45) PASRR Level I screening--The process of screening
an individual seeking admission to a nursing facility to identify
whether the individual is suspected of having a mental illness, ID,
(46) PASRR Level II evaluation--A face-to-face evaluation:
(A) of an individual seeking admission to a nursing
facility who is suspected of having a mental illness, ID, or DD; and