1 Tex. Admin. Code § 353.1403 - Definitions
The following words and terms, when used in this subchapter, have the following meanings unless the context clearly indicates otherwise.
(1) Adult--An individual who
is age 21 or older.
(2)
CFP--Certified Family Partner. A person who meets the credentialing
requirements in §
353.1415(d) of
this subchapter (relating to Staff Member Credentialing).
(3) CFR--Code of Federal
Regulations.
(4) Child or youth--An
individual who is under age 21.
(5)
Clinical supervision--An LPHA's or QMHP-CS's oversight of a staff member who
delivers mental health targeted case management and mental health
rehabilitative services to ensure that services are clinically appropriate and
in compliance with this subchapter.
(6) Community data--Additional information
gathered during the uniform assessment.
(7) CSSP--Community services specialist. A
staff member of a local mental health authority who has documented full-time
experience in the provision of mental health targeted case management and
mental health rehabilitative services prior to August 31, 2004. See definition
in 25 TAC § 412.303(relating to Definitions).
(8) Comprehensive provider agency--An entity
that provides or subcontracts for the delivery of the full array of mental
health targeted case management and mental health rehabilitative services set
forth in Chapter 354, Subchapter M of this title (relating to Mental Health
Targeted Case Management and Mental Health Rehabilitation), with the exception
of §
354.2715 of this title (relating to
Day Programs for Acute Needs).
(9)
Credentialing--A process by which the comprehensive provider agency reviews and
approves a staff member's educational background, work experience, and
licensure status (as applicable) to ensure that the staff member meets
requirements for staff member credentialing as outlined in §353.1415. The
process includes primary source verification of credentials, establishing and
applying specific criteria and prerequisites to determine the staff member's
initial and ongoing competency, and assessing and validating the staff member's
qualifications to deliver care.
(10) HHSC--The Texas Health and Human
Services Commission, or its designee.
(11) Individual--A person seeking or
receiving mental health targeted case management, mental health rehabilitative
services, or both under this subchapter.
(12) Intensive case management--A level of
mental health targeted case management that includes a focused effort to
coordinate community resources, uses evidence-based wraparound process planning
to address a child's or youth's unmet needs across life domains, and assists a
child or youth in gaining access to necessary care and services appropriate to
the child's or youth's needs.
(13)
Intensive case management plan--A written document that is part of the medical
record for a child or youth receiving intensive case management and is
developed by a case manager, in collaboration with the child or youth and the
child's or youth's LAR or primary caregiver, that identifies services needed by
the child or youth and sets forth a plan for how the child or youth may gain
access to the identified services.
(14) LAR--Legally authorized representative.
A person authorized by law to act on behalf of an individual with regard to a
matter described in this subchapter, including a parent, guardian, or managing
conservator of a minor, or the guardian of an adult.
(15) Life domains--Areas of life, including
safety, health, emotional, psychological, social, educational, cultural, and
legal.
(16) LPHA--Licensed
Practitioner of the Healing Arts. A staff member who is:
(A) a physician;
(B) a licensed professional
counselor;
(C) a licensed clinical
social worker;
(D) a licensed
psychologist;
(E) an advanced
practice registered nurse;
(F) a
physician assistant; or
(G) a
licensed marriage and family therapist.
(17) Management information system--An
information system designed to plan, organize, staff, direct, and control the
operations and clinical decision-making of a managed care organization or
comprehensive provider agency.
(18)
Medication training and support services--Medication training and support
services consist of education and guidance about medications and their possible
side effects.
(19) Mental health
rehabilitative services--Services that are individualized, age-appropriate, and
provide training and instructional guidance that restore an individual's
functional deficits due to serious mental illness or serious emotional
disturbance. The services are designed to improve or maintain the individual's
ability to remain in the community as a fully integrated and functioning member
of that community.
(20) Mental
health targeted case management--Services furnished to assist individuals with
severe mental illness and functional impairments or serious emotional disorders
and functional impairments to gain access to needed medical, social,
educational, and other services.
(21) Peer provider--Staff with lived
experience with a mental health condition who meet the credentialing
requirements in §
353.1415(c) of
this subchapter.
(22)
Pharmacological management--In-depth management of psychopharmacological agents
to treat an individual's mental health symptoms.
(23) Primary caregiver--A person 18 years of
age or older who has:
(A) actual care,
control, and possession of a child or youth; or
(B) assumed responsibility for providing
shelter and care for an adult.
(24) Psychiatric diagnostic evaluation--An
integrated biopsychosocial assessment, including history, mental status, and
recommendations.
(25)
QMHP-CS--Qualified Mental Health Professional-Community Services. Staff who
meet the credentialing requirements in §
353.1415(a) of
this subchapter.
(26)
Re-credentialing--The periodic process of reevaluating a staff member's
competency and qualifications.
(27)
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.
(28) Recovery or
treatment plan (recovery/treatment plan)--A written plan that:
(A) is developed with the individual, the LAR
if required, other persons whose inclusion is requested by the individual or
LAR and who agree to participate, and a QMHP-CS or LPHA;
(B) is completed in conjunction with the
uniform assessment;
(C) is amended
at any time based on an individual's needs;
(D) guides the recovery process and fosters
resiliency;
(E) identifies the
individual's changing strengths, capacities, goals, preferences, needs, and
desired outcomes; and
(F)
identifies services and supports to meet the individual's goals, preferences,
needs and desired outcomes.
(29) Referral and linkage--Activities that
help link an individual with medical, social, educational, and other providers
that are capable of providing needed services.
(30) Staff member--Comprehensive provider
agency personnel, including a full-time or part-time employee, contractor, or
intern, but excluding a volunteer.
(31) Strengths-based--The concept used in
service delivery that identifies, builds on, and enhances the capabilities,
knowledge, skills, and assets of the individual, LAR, or primary caregiver, and
family, their community, and other team members. The focus is on increasing
functional strengths and assets rather than on the elimination of
deficits.
(32) UA--Uniform
assessment. A required assessment that assists in determining the medical
necessity of services. For adults, the UA includes the Adult Needs and
Strengths Assessment (ANSA), community data, relevant rating scales, diagnostic
information, and any other state-required assessment tools and procedures. For
children or youth, the UA includes the Child and Adolescent Needs and Strengths
(CANS) assessment, community data, relevant rating scales, diagnostic
information, and any other state-required assessment tools and
processes.
(33) Utilization
management guidelines--Guidelines developed by HHSC that establish the type,
amount, and duration of mental health targeted case management services and
mental health rehabilitative services for each individual.
(34) Wraparound Process Planning--A
strengths-based approach used in intensive case management to develop an
intensive case management plan that addresses the child's or youth's unmet
needs across life domains.
Notes
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