<<Prev Rule

Texas Administrative Code

Next Rule>>
TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 306BEHAVIORAL HEALTH DELIVERY SYSTEM
SUBCHAPTER BSTANDARDS OF CARE IN CRISIS STABILIZATION UNITS
DIVISION 1GENERAL REQUIREMENTS
RULE §306.45Definitions

The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

  (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 basis.

  (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 treatment.

  (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 577.

  (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 of age;

    (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:

      (i) self-care;

      (ii) receptive and expressive language;

      (iii) learning;

      (iv) mobility;

      (v) self-direction;

      (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; or

    (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 241.

  (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 Planning);

    (D) any person identified by the individual, and the individual's LAR or adult caregiver if applicable, unless clinically contraindicated; and

    (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 are held.

  (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 Code §533A.035.

  (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 disturbed behavior.

  (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 Chapter 242.

  (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, or DD.

  (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

Cont'd...

Next Page

Link to Texas Secretary of State Home Page | link to Texas Register home page | link to Texas Administrative Code home page | link to Open Meetings home page