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RULE §910.3Definitions

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; www.hhs.texas.gov/services/disability/intellectual-or-developmental-disabilities/state-supported-living-centers-sslcs; 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 to 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.

Source Note: The provisions of this §910.3 adopted to be effective March 24, 2022, 47 TexReg 1457

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