The following words and terms, when used in this subchapter,
have the following meanings unless the context clearly indicates otherwise.
(1) Absence--When an individual, previously admitted
to an SMHF and not discharged from the SMHF, is physically away from
the SMHF for any reason, including hospitalization, home visit, special
activity, unauthorized departure, or absence for trial placement.
(A) An individual's acceptance to an SMHF's custody
or a facility with a CPB for inpatient services, based on:
(i) a physician's order issued in accordance with §306.175(h)(2)(C)
of this subchapter (relating to Voluntary Admission Criteria for a
Facility with a Contracted Psychiatric Bed Authorized by an LMHA or
LBHA or for a State Mental Health Facility);
(ii) a physician's order issued in accordance with §306.176(c)(3)
of this subchapter (relating to Admission Criteria for a Facility
with a Contracted Psychiatric Bed Authorized by an LMHA or LBHA or
for a State Mental Health Facility for Emergency Detention);
(iii) a court's order of protective custody issued
in accordance with Texas Health and Safety Code §574.022;
(iv) a court's order for temporary inpatient mental
health services issued in accordance with Texas Health and Safety
Code §574.034, or Texas Family Code Chapter 55;
(v) a court's order for extended inpatient mental health
services issued in accordance with Texas Health and Safety Code §574.035,
or Texas Family Code Chapter 55; or
(vi) a court's order for commitment issued in accordance
with the Texas Code of Criminal Procedure, Chapter 46B or Chapter
(B) The acceptance of an individual in the mental health
priority population into LMHA or LBHA services.
(3) Adolescent--An individual at least 13 years of
age, but younger than 18 years of age.
(4) Adult--An individual at least 18 years of age or
(5) Advance directive--As used in this subchapter,
(A) an instruction made under Texas Health and Safety
Code §§166.032, 166.034 or 166.035 to administer, withhold,
or withdraw life-sustaining treatment in the event of a terminal or
(B) an out-of-hospital DNR order, as defined by Texas
Health and Safety Code §166.081;
(C) a medical power of attorney under Texas Health
and Safety Code, Chapter 166, Subchapter D; or
(D) a declaration for mental health treatment for preferences
or instructions regarding mental health treatment in accordance with
Civil Practice and Remedies Code Chapter 137.
(6) Alternate provider--An entity that provides mental
health services or substance use disorder treatment services in the
community but not pursuant to a contract or memorandum of understanding
with an LMHA or LBHA.
(7) APRN--Advanced practice registered nurse. A registered
nurse licensed by the Texas Board of Nursing to practice as an advanced
practice registered nurse as provided by Texas Occupations Code §301.152.
(8) Assessment--The administrative process an SMHF
or a facility with a CPB uses to gather information from a prospective
patient, including a medical history and the problem for which the
prospective patient is seeking treatment, to determine whether a prospective
patient should be examined by a physician to determine if admission
is clinically justified, as defined by Texas Health and Safety Code §572.0025(h)(2).
(9) Assessment professional--In accordance with Texas
Health and Safety Code §572.0025(c)-(d), a staff member of an
SMHF or facility with a CPB whose responsibilities include conducting
the intake assessment described in §306.175(g) and §306.176(e)
of this subchapter, and who is:
(A) a physician licensed to practice medicine under
Texas Occupations Code, Chapter 155;
(B) a physician assistant licensed under Texas Occupations
Code, Chapter 204;
(C) an APRN licensed under Texas Occupations Code,
(D) a registered nurse licensed under Texas Occupations
Code, Chapter 301;
(E) a psychologist licensed under Texas Occupations
Code, Chapter 501;
(F) a psychological associate licensed under Texas
Occupations Code, Chapter 501;
(G) a licensed professional counselor licensed under
Texas Occupations Code, Chapter 503;
(H) a licensed social worker licensed under Texas Occupations
Code, Chapter 505; or
(I) a licensed marriage and family therapist licensed
under Texas Occupations Code, Chapter 502.
(10) ATP--Absence for trial placement. When an individual,
currently admitted to an SMHF, is physically away from the SMHF for
the SMHF to evaluate the individual's adjustment to a particular living
arrangement before the individual's discharge and as a potential residence
following discharge. An ATP is a type of furlough, as referenced in
Texas Health and Safety Code, Chapter 574, Subchapter F.
(11) Business day--Any day except a Saturday, Sunday,
or legal holiday listed in Texas Government Code §662.021.
(12) Capacity--An individual's ability to understand
and appreciate the nature and consequences of a decision regarding
the individual's medical treatment, and the ability of the individual
to reach an informed decision in the matter.
(13) Child--An individual at least three years of age,
but younger than 13 years of age.
(14) Continuity of care--Activities designed to ensure
an individual is provided uninterrupted services during a transition
between inpatient and outpatient services and that assist the individual
and the individual's LAR in identifying, accessing, and coordinating
LMHA or LBHA services and other appropriate services and supports
in the community needed by the individual, including:
(A) assisting with admissions and discharges;
(B) facilitating access to appropriate services and
supports in the community, including identifying and connecting the
individual with community resources, and coordinating the provision
(C) participating in developing and reviewing the individual's
recovery or treatment plan;
(D) promoting implementation of the individual's recovery
or treatment plan; and
(E) coordinating notification of continuity of care
services between the individual and the individual's family and any
other person providing support as authorized by the individual, and
LAR, if any.
(15) Continuity of care worker--An LMHA, LBHA, or LIDDA
staff member responsible for providing continuity of care services.
The staff member may collaborate with a peer specialist, recovery
specialist, or family partner to provide continuity of services.
(16) COPSD--Co-occurring psychiatric and substance
(17) COPSD model--An application of evidence-based
practices for an individual diagnosed with co-occurring conditions
of mental illness and substance use disorder.
(18) CPB--Contracted psychiatric bed. A state-funded
contracted psychiatric bed that:
(A) is authorized by an LMHA or LBHA; and
(B) is used for inpatient care in the community, and
this does not include a crisis respite unit, crisis residential unit,
an extended observation unit, or a crisis stabilization unit.
(19) CRCG--Community Resource Coordination Group. A
local interagency group comprised of public and private providers
who collaborate to develop individualized service plans for individuals
whose needs may be met through interagency coordination and cooperation.
CRCGs are established and operate in accordance with a Memorandum
of Understanding on Services for Persons Needing Multiagency Services,
required by Texas Government Code §531.055.
(20) Crisis--A situation in which:
(A) an individual presents an immediate danger to self
(B) an individual's mental or physical health is at
risk of serious deterioration; or
(C) an individual believes he presents an immediate
danger to self or others, or the individual's mental or physical health
is at risk of serious deterioration.
(21) Crisis treatment alternatives--Community-based
facilities or units providing short-term, residential crisis treatment
to ameliorate a behavioral health crisis in the least restrictive
environment, including crisis stabilization units, extended observation
units, crisis residential units, and crisis respite units. The intensity
and scope of services varies by facility type and is available in
a local service area based upon the local needs and characteristics
of the community.
(22) Day--Calendar day.
(23) DD--Developmental disability. As listed in the
Texas Health and Safety Code §531.002, an individual with a severe,
chronic disability attributable to a mental or physical impairment
or a combination of mental and physical impairments that:
(A) manifests before the person reaches 22 years of
(B) is likely to continue indefinitely;
(C) reflects 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) results 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.
(24) Designated LMHA or LBHA--The LMHA or LBHA:
(A) that serves the individual's county of residence,
which is determined in accordance with §306.162 of this subchapter
(relating to Determining County of Residence); or
(B) that does not serve the individual's county of
residence but has taken responsibility for ensuring the individual's
LMHA or LBHA services.
(A) From an SMHF or a facility with a CPB: The release
of an individual from the custody and care of a provider of inpatient
(B) From LMHA or LBHA services: The termination of
LMHA or LBHA services delivered to an individual by an LMHA or LBHA.
(26) Discharged unexpectedly--A discharge from an SMHF
or facility with a CPB:
(A) due to an individual's unauthorized departure;
(B) at the individual's request;
(C) due to a court releasing the individual;
(D) due to the death of the individual; or
(E) due to the execution of an arrest warrant for the
(27) Emergency medical condition--A medical condition
manifesting itself by acute symptoms of sufficient severity (including
severe pain, psychiatric disturbances, or symptoms of substance use
disorder) such that the absence of immediate medical attention could
reasonably 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)
or others in serious jeopardy;
(B) serious impairment to bodily functions;
(C) serious dysfunction of any bodily organ or part;
(D) serious disfigurement; or
(E) in the case of a pregnant woman having contractions:
(i) inadequate time to affect a safe transfer to another
hospital before delivery; or
(ii) a transfer posing a threat to the health and safety
of the woman or the unborn child.
(28) Face-to-face--A form of contact occurring in person
or through the use of audiovisual or other telecommunications technology.
(29) Facility--A care facility including a state mental
health facility, private psychiatric hospital, medical hospital, and
community setting, but does not include a nursing facility or an assisted
(30) HHSC--Texas Health and Human Services Commission
or its designee.
(31) 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 originating before age 18.
(32) Individual--A person seeking or receiving services
under this subchapter.
(33) Individual involuntarily receiving treatment--An
individual receiving inpatient services based on an admission to a
state mental health facility or a facility with a CPB made in accordance
(A) §306.176 of this subchapter;
(B) §306.177 of this subchapter (relating to Admission
Criteria Under Order of Protective Custody or Court-ordered Inpatient
Mental Health Services);