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 a state hospital or CPB, and not discharged from the admitting facility, is physically away from the facility for any reason, including hospitalization, home visit, special activity, or unauthorized departure. (2) Admission--Includes: (A) an individual's acceptance to a state hospital or CPB for voluntary or involuntary inpatient or residential treatment services; or (B) the acceptance of an individual in the mental health priority population into LMHA or LBHA services. (3) Adolescent--An individual who is 13 years of age, but younger than 18 years of age. (4) Adult--An individual who is at least 18 years of age or older. (5) Advance directive--As used in this subchapter, includes: (A) an instruction made under Texas Health and Safety Code Chapter 166; or (B) a declaration for mental health treatment made in accordance with Civil Practice and Remedies Code Chapter 137. (6) Alternate provider--An entity that provides mental health services or SUD services in the community but does not provide these services under contract 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 a state hospital or CPB uses to gather information from an individual, including a medical history and the concerns for which the individual is seeking treatment, to determine whether the individual 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 a state hospital or CPB, whose responsibilities include conducting the intake assessment described in §306.175(g) of this subchapter (relating to Voluntary Admission Criteria for a State Hospital or a Facility with a Contracted Psychiatric Bed) and §306.176(e) of this subchapter (relating to Admission Criteria for a State Hospital or a Facility with a Contracted Psychiatric Bed for Emergency Detention), 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 Chapter 301; (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) Audio-only technology--A synchronous interactive, two-way audio communication that uses only sound and that conforms to privacy requirements of the Health Insurance Portability and Accountability Act. Audio-only includes the use of telephonic communication. Audio-only does not include audiovisual or in-person communication.(11) Audiovisual technology--A synchronous interactive, two-way audio and video communication that conforms to privacy requirements under the Health Insurance Portability and Accountability Act. Audiovisual does not include audio-only or in-person communication.(12) Business day--Any day except a Saturday, Sunday, or legal holiday listed in Texas Government Code §662.021. (13) 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. (14) Child--An individual who is at least three years of age, but younger than 13 years of age. (15) CoC liaison--Continuity of care liaison. A dedicated full-time staff member who is a QMHP-CS or LPHA that facilitates continuity of care. (16) 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 LAR, if applicable, 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 of services; (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 applicable. (17) Continuity of care worker--A LIDDA staff member responsible for providing continuity of care services. (18) COPSD--Co-occurring psychiatric and substance use disorder. (19) COPSD model--An application of evidence-based practices for an individual diagnosed with co-occurring conditions of psychiatric and substance use disorder. (20) CPB--Contracted psychiatric bed. A facility with an HHSC-contracted psychiatric bed that:(A) includes a community mental health hospital and a private psychiatric bed that: (i) is authorized by an LMHA or LBHA; and (ii) is used for inpatient care in the community; and (B) does not include a crisis respite unit, crisis residential unit, an extended observation unit, or a crisis stabilization unit. (21) 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, as required by Texas Government Code Chapter 522, Subchapter D. (22) Crisis--A situation in which: (A) an individual presents an immediate danger to self or others; (B) an individual's mental or physical health is at risk of serious deterioration; or (C) an individual believes the individual presents an immediate danger to self or others, or the individual's mental or physical health is at risk of serious deterioration. (23) Crisis treatment alternatives--Community-based facilities or units and services providing short-term, residential crisis treatment to ameliorate a behavioral health crisis in the least restrictive and most appropriate 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. (24) Day--A calendar day, unless otherwise specified. (25) DD--Developmental disability. A disability that meets the criteria described in Texas Health and Safety Code §531.002(15). (26) 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 services. (27) DFPS--Texas Department of Family and Protective Services or its designee.(28) Discharge--Means:(A) the release of an individual from the custody and care of a provider of inpatient services; or(B) the termination of LMHA or LBHA services delivered to an individual by the individual's LMHA or LBHA.(29) Discharge planning specialist--A designated state hospital staff member responsible for coordinating continuity of care services with a specific focus on an individual's community transition in accordance with Texas Health and Safety Code §534.0535. This term is synonymous with a "transition support specialist."(30) Discharged unexpectedly--A discharge from the custody and care of a provider of inpatient services: (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 individual. (31) DSM--Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.(32) Emergency medical condition--This term has the meaning assigned by the Emergency Medical Treatment and Active Labor Act (42 U.S.C. §1395dd), regarding Examination and treatment for emergency medical conditions and women in labor.(33) Family partner--An experienced, trained primary caregiver, such as the parent of an individual with a mental illness or serious emotional disturbance, who provides peer mentoring, education, and support to the caregivers of a child who is receiving mental health community services in accordance with Chapter 301, Subchapter G of this title (relating to Mental Health Community Services Standards).(34) Furlough--The authorization for an individual to leave from a state hospital or CPB for longer than a 72-hour period in accordance with Texas Health and Safety Code Chapter 574, Subchapter F.(35) HHSC--Texas Health and Human Services Commission or its designee. (36) ID--Intellectual disability. A disability that meets the criteria in Texas Health and Safety Code §591.003. (37) Individual--A person seeking or receiving services under this subchapter. (38) Inpatient services--Residential psychiatric treatment provided to an individual in: (A) a state hospital;(B) a CPB; (C) a hospital licensed under Texas Health and Safety Code Chapter 241 or Chapter 577; (D) a crisis stabilization unit licensed under Chapter 510 of this title (relating to Private Psychiatric Hospitals and Crisis Stabilization Units); or(E) any other type of mental health hospital. (39) In person or in-person--Within the physical presence of another person. In person or in-person does not include audiovisual or audio-only communication.(40) Intake assessment--The administrative process conducted by an assessment professional for: (A) gathering information about an individual, including the psychiatric and medical history, social history, symptomology, and support system; and(B) giving the individual information about the facility and the facility's treatment and services. (41) Involuntary admission--An individual receiving inpatient services based on an admission to a state hospital or CPB in accordance with:(A) §306.176 of this subchapter (relating to Admission Criteria for a State Hospital or a Facility with a Contracted Psychiatric Bed for Emergency Detention);(B) §306.177 of this subchapter (relating to Admission Criteria Under Order of Protective Custody or Court-ordered Inpatient Mental Health Services); (C) an order for temporary inpatient mental health services issued in accordance with Texas Health and Safety Code §574.034 or Texas Family Code Chapter 55;(D) an order for extended inpatient mental health services issued in accordance with Texas Health and Safety Code §574.035 or Texas Family Code Chapter 55; (E) an order for commitment issued as described in Texas Code of Criminal Procedure Chapter 46B; or(F) an order for commitment issued as described in Texas Code of Criminal Procedure Chapter 46C.(42) LAR--Legally authorized representative. A person authorized by state law to act on behalf of an individual. (43) LBHA--Local behavioral health authority. An entity designated as an LBHA by HHSC in accordance with Texas Health and Safety Code §533.0356(a).(44) LIDDA--Local intellectual and developmental disability authority. An entity designated by HHSC in accordance with Texas Health and Safety Code §533A.035(a). (45) LMHA--Local mental health authority. An entity designated as an LMHA by HHSC in accordance with Texas Health and Safety Code §533.035(a). (46) LMHA or LBHA network provider--An entity that provides mental health and SUD services in the community pursuant to a contract or memorandum of understanding with an LMHA or LBHA, including that part of an LMHA or LBHA directly providing mental health services. (47) LMHA or LBHA services--Inpatient mental health and outpatient mental health and SUD services provided by an LMHA or LBHA network provider to an individual in the individual's home community. (48) Local service area--A geographic area composed of one or more Texas counties defining the population that may receive services from an LMHA, LBHA, or LIDDA. (49) LPHA--Licensed practitioner of the healing arts. This term has the meaning as defined in §301.303 of this title (relating to Definitions).(50) Mental illness--This term has the meaning as assigned by Texas Health and Safety Code §571.003.(51) MH priority population--Mental health priority population. As identified in state performance contracts with LMHAs or LBHAs, those groups of children and adolescents with SED, or adults with severe and persistent mental illness, assessed as in need of mental health services. (52) Minor--An individual younger than 18 years of age who has not been emancipated under Texas Family Code Chapter 31. (53) Nursing facility--A Medicaid-certified facility licensed in accordance with Texas Health and Safety Code Chapter 242. (54) Offender with special needs--An individual who has a terminal or serious medical condition, a mental illness, an ID, a DD, or a physical disability, and is served by the Texas Correctional Office on Offenders with Medical or Mental Impairments as provided in Texas Health and Safety Code Chapter 614. (55) Ombudsman--The Ombudsman for Behavioral Health Access to Care established by HHSC in accordance with Texas Government Code §531.9933.(56) Outpatient management plan--The prescribed regimen of medical, psychiatric, or psychological care or treatment as defined in Texas Code of Criminal Procedure Article 46C.263(c).(57) PASRR--Preadmission screening and resident review as defined in §303.102 of this title (relating to Definitions).(58) Pass--The authorization for an individual to leave from a state hospital or CPB for not more than a 72-hour period in accordance with Texas Health and Safety Code Chapter 574, Subchapter F. (59) PE--PASRR level II evaluation. This term has the meaning as defined in §303.102 of this title.(60) 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). (61) Permanent residence--The physical location in the community where an individual lives, or if a minor, where the minor's parents or legal guardian lives. A post office box is not considered a permanent residence. (62) PL1--PASRR level I screening. This term has the meaning as defined in §303.102 of this title.(63) Preliminary examination--An assessment for medical stability and a psychiatric examination in accordance with Texas Health and Safety Code §573.022(a)(2). (64) QMHP-CS--Qualified mental health professional-community services. An LMHA or LBHA staff member who meets the qualifications and performs the functions described in Chapter 301, Subchapter G of this title (relating to Mental Health Community Services Standards). (65) Recovery--A process of change through which an individual improves the individual's health and wellness, lives a self-directed life, and strives to reach the individual's full potential. (66) Recovery or treatment plan--A written plan: (A) developed in collaboration with an individual or LAR and a QMHP-CS or LPHA as defined in §301.303 of this title; (B) amended at any time based on an individual's needs or requests; (C) that guides the recovery treatment process and fosters resiliency; (D) completed in conjunction with the uniform assessment; (E) that identifies the individual's changing strengths, capacities, goals, preferences, needs, and desired outcomes; and (F) that includes recommended services and supports or reasons for the exclusion of services and supports. (67) Screening--Activities to: (A) collect triage information through interviews with an individual or collateral contact; (B) determine if the individual's need is emergent, urgent, or routine, and conducted before the assessment to determine the need for emergency services; and (C) determine the need for an in-depth assessment. (68) SED--Serious emotional disturbance. A disorder that meets the criteria described in Texas Government Code §547.0051. (69) SSLC--State supported living center. Consistent with Texas Health and Safety Code §531.002, a residential facility operated by HHSC to provide an individual with an ID a variety of services, including medical treatment, specialized therapy, and training in the acquisition of personal, social, and vocational skills. (70) State hospital--Consistent with Texas Health and Safety Code §552.002, a mental health facility operated by HHSC, including Waco Center for Youth.(71) SUD--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 for SUD as described in the version of the DSM currently recognized by HHSC.(72) TAC--Texas Administrative Code. (73) TCOOMMI--Texas Correctional Office on Offenders with Medical or Mental Impairments or its designee. (74) Treating physician--A physician who coordinates and oversees an individual's treatment. (75) Treatment team--A group of treatment providers, working with an individual, the LAR, if applicable, and the LMHA, LBHA, or LIDDA in a coordinated manner to provide comprehensive mental health, SUD, and ID services to the individual. (76) Uniform assessment--An assessment tool adopted by HHSC under §301.353 of this title (relating to Provider Responsibilities for Treatment Planning and Service Authorization) used for recommending an individual's level of care. (77) Voluntary admission--An individual receiving inpatient services based on an admission made in accordance with:(A) §306.175 of this subchapter;(B) §306.178 of this subchapter (relating to Voluntary Treatment Following Involuntary Admission);(C) Texas Health and Safety Code §572.002; or(D) Texas Health and Safety Code §572.0025.