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RULE §306.45Definitions

    (B) performed by a LIDDA, LHMA, or LBHA to determine if the individual has a mental illness, ID, or DD and, if so, to:

      (i) assess the individual's need for care in a nursing facility;

      (ii) assess the individual's need for specialized services; and

      (iii) identify alternate placement options.

  (47) Peer specialist--A person who uses lived experience, in addition to skills learned in formal training, to deliver strengths-based, person-centered services to promote an individual's recovery and resiliency, in accordance with 1 TAC Chapter 354, Subchapter N (relating to Peer Specialist Services).

  (48) Physician--A staff member:

    (A) licensed as a physician by the Texas Medical Board in accordance with Texas Occupations Code Chapter 155; or

    (B) authorized to perform medical acts under an institutional permit at a Texas postgraduate training program approved by the Accreditation Council on Graduate Medical Education, the American Osteopathic Association, or the Texas Medical Board.

  (49) Pre-admission screening--The clinical process used by a QMHP-CS or LPHA to gather information from an individual, including a medical history, any history of substance use, trauma, and the problem for which the individual is seeking treatment to determine if a physician should conduct an admission examination.

  (50) Preliminary examination--The psychiatric examination and assessment for medical stability performed and documented by a physician in accordance with Texas Health and Safety Code §573.022 to determine if emergency detention in an inpatient mental health facility is clinically justified for an individual for whom:

    (A) an application for emergency detention is filed in accordance with Texas Health and Safety Code §573.011;

    (B) a peace officer or emergency medical services personnel of an emergency medical services provider transporting the individual in accordance with a memorandum of understanding executed in accordance with Texas Health and Safety Code §573.005 files a notification of detention completed by the peace officer in accordance with Texas Health and Safety Code §573.002(a); or

    (C) the LAR transporting their adult ward, without the assistance of a peace officer, in accordance with Texas Health and Safety Code §573.003, files an application for detention in accordance with Texas Health and Safety Code §573.004.

  (51) Psychosocial rehabilitative services--Services that assist an individual in regaining and maintaining daily living skills required to function effectively in the community.

  (52) QMHP-CS--Qualified mental health professional-community services. A staff member who is credentialed as a QMHP-CS who has demonstrated and documented competency in the work to be performed and:

    (A) has a bachelor's degree from an accredited college or university with a minimum number of hours that is equivalent to a major in psychology, social work, medicine, nursing, rehabilitation, counseling, sociology, human growth and development, gerontology, special education, educational psychology, early childhood education, or early childhood intervention;

    (B) is an RN; or

    (C) completes an alternative credentialing process as determined by an LMHA or LBHA in accordance with HHSC requirements.

  (53) Recovery--A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

  (54) Recovery or treatment plan--A written plan:

    (A) is developed in collaboration with the individual, and the individual's LAR or adult caregiver if applicable, and a QMHP-CS or LPHA;

    (B) is amended at any time based on an individual's needs or requests;

    (C) guides the recovery process and fostering resiliency;

    (D) is completed in conjunction with the assessment tool adopted by HHSC;

    (E) identifies the individual's changing strengths, capacities, goals, preferences, needs, and desired outcomes; and

    (F) includes recommended services and supports or reasons for the exclusion of services and supports.

  (55) Restraints--Any personal, mechanical, or chemical restraint defined in 25 TAC §415.253 (relating to Definitions).

  (56) RN--Registered nurse. A staff member licensed as a registered nurse by the Texas Board of Nursing in accordance with Texas Occupations Code Chapter 301.

  (57) Screening--Activities performed by a QMHP-CS to:

    (A) collect triage information either in person, or through telephone or telehealth interviews with an individual or collateral contact;

    (B) determine if the individual's need is emergent, urgent, or routine, and conducted before the in person or telehealth assessment to determine the need for emergency services; and

    (C) determine the need for immediate assessment and mental health treatment recommendations.

  (58) Seclusion--The involuntary separation of an individual from other individuals for any period of time and or the placement of the individual alone in an area from which the individual is prevented from leaving, as defined in 25 TAC §415.253(28).

  (59) SED--Serious emotional disturbance. A diagnosed mental health disorder that substantially disrupts a child's or adolescent's ability to function socially, academically, and emotionally in accordance with Texas Government Code, §531.251.

  (60) Serious physical injury--An injury determined by a physician, or physician-delegated PA or APRN, to require treatment by an appropriately licensed medical professional or licensed healthcare professional, or in an emergency department or licensed hospital.

  (61) Stabilize--With respect to an emergency medical condition, to provide such medical treatment of the condition necessary to assure, within reasonable medical probability, that no material deterioration of the condition is likely to result from or occur during the individual's transfer from a facility or, if the emergency medical condition for a woman is that she is in labor, that the woman has delivered the child and the placenta.

  (62) Staff member--Personnel including a full-time and part-time employee, contractor, or intern, but excluding a volunteer.

  (63) Staffing plan--A written plan that:

    (A) demonstrates the number, qualifications, and responsibilities of staff members, including the administrator or designee, are appropriate for the size and scope of the services provided and that workloads are reasonable to meet the needs of individuals receiving services; and

    (B) identifies staffing patterns, hours of coverage, and plans for providing back-up staff in emergencies.

  (64) Substance use disorder--The use of one or more drugs, including alcohol, which significantly and negatively impacts one or more major areas of life functioning and which meets the criteria described in the current edition of the Diagnostic Statistical Manual of Mental Disorders for substance use disorders.

  (65) TAC--Texas Administrative Code.

  (66) Telehealth service--A health-care service, other than telemedicine medical services, delivered by a health professional licensed, certified or otherwise entitled to practice in Texas and acting within the scope of the health professional's license, certification or entitlement to an individual at a different physical location other than the health professional using telecommunications or information technology, in accordance with Texas Occupation Code §111.001(3).

  (67) Telemedicine medical service--A health-care service delivered to an individual at a different physical location using telecommunications or information technology by:

    (A) a physician licensed in Texas; or

    (B) a health professional who acts under the delegation and supervision of a physician licensed in Texas and within the scope of the health professional's license in Texas.

  (68) Transfer--The movement (including the discharge) of an individual outside a facility at the facility's direction, but it does not include such a movement of an individual who has been declared dead or leaves the facility without the facility's permission.

  (69) Treating physician--A physician who coordinates and oversees an individual's treatment.

  (70) Unit--A discrete and identifiable area of an inpatient mental health facility that includes individuals' rooms or other living areas and is separated from another similar area:

    (A) by a locked door;

    (B) by a floor; or

    (C) because the other similar area is in a different building.

  (71) UP--Unlicensed person. A person, not licensed as a health care provider, who provides certain health related tasks and functions in a complementary or assistive role to the RN in providing direct care of an individual or carrying out common nursing functions as described in 22 TAC Chapter 224 (relating to Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments) and care in conformity with this chapter:

    (A) who is monetarily compensated, including nurse aides, assistants, attendants, technicians, and other individuals providing care or assistance of health-related services; or

    (B) who is a professional nursing student, not licensed as an RN or LVN, providing care for monetary compensation and not as part of their formal education.

  (72) Voluntarily admitted individual--An individual receiving facility services based on an admission in accordance with:

    (A) §306.55 of this subchapter (relating to Voluntary Admission Criteria and Intake Process); or

    (B) §306.59 of this subchapter (relating to Voluntary Treatment Following Involuntary Admission).

Source Note: The provisions of this §306.45 adopted to be effective May 27, 2021, 46 TexReg 3257

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