The following words and terms, when used in this chapter, have
the following meanings, unless the context clearly indicates otherwise.
(1) Administrative Law Judge (ALJ)--An independent
hearing examiner assigned by the Texas Health and Human Services Commission
(HHSC) who presides over a hearing for an appeal of a fee with the
power to administer oaths, receive evidence, take testimony, and make
findings of fact or law.
(2) Adult--A person who is not a minor.
(3) Appellant--The individual or their legally authorized
representative (LAR) appealing a fee.
(4) Charges--The total amount of all fees.
(5) Current maximum rate--The rate, established by
HHSC, that reflects the average daily cost of support, maintenance,
and treatment (SMT) per individual for each facility. A copy of the
current maximum rates for all facilities may be obtained at www.hhs.texas.gov/services/mental-health-substance-use/state-hospitals;
or by contacting HHSC Health and Specialty Care System, Reimbursement
Management, P.O. Box 12668, Mail Code E-619, Austin, Texas 78701-2668.
(6) Facility--Any state hospital, state supported living
center, and the intermediate care facility for individuals with an
intellectual disability (ICF/IID) component of the Rio Grande State
Center operated by HHSC.
(7) Fee--A specific amount of money assessed, based
on at least one source of funds, that is owed monthly to a facility
for an individual's SMT.
(8) Full day--A 24-hour period extending from midnight
(9) HHSC--Texas Health and Human Services Commission.
(10) Individual--Any person who is admitted to a facility
and who is provided SMT as an inpatient or resident (i.e., a person
to whom a bed is assigned by the facility).
(11) Legally authorized representative (LAR)--A person
authorized by law to act on behalf of an individual, including a parent,
guardian, or managing conservator of a minor individual, or a guardian
of an adult individual.
(12) Minor--A person under 18 years of age who is not
and has not been married or who has not had the disabilities of minority
removed for general purposes.
(13) Party--The appellant or HHSC.
(14) Reimbursement office--The HHSC facility reimbursement
office that manages the assessment and notification of charges and
the appeal process.
(15) SMT--Support, maintenance, and treatment.