reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 405 - PATIENT CARE-MENTAL HEALTH SERVICES › Subchapter K - DEATHS OF INDIVIDUALS SERVED BY COMMUNITY MENTAL HEALTH CENTERS › Section 405.272 - Community Centers

Current through Reg. 49, No. 28; July 12, 2024
(a) Upon notification of a death requiring an administrative death review,
											  the community center CEO or designee shall appoint a physician or registered nurse as the investigating
											  officer, as defined in this subchapter, who shall begin a preliminary investigation based upon the deceased's
											  medical record, particularly the circumstances leading to the transfer to a facility or outpatient status
											  where death occurred, and other information he/she deems appropriate.
(b) Within seven working days of the knowledge of death, the CEO, and
											  investigating officer shall use the preliminary investigation information to determine whether the death
											  should be reviewed clinically, in compliance with §
										405.274 of this
											  subchapter (relating to Community Centers: Clinical Death Review).
(1) The
											  determination shall be based upon the possible need for review of clinical policies and procedures, the
											  opportunity for professional education, and/or the opportunity to improve patient care through medical
											  practice.
(2) It shall also be determined whether a preliminary
											  administrative death review should proceed before the completion of the clinical death review, addressing the
											  issue described in §
											405.275(c)(2)
											  of this subchapter (relating to Community Centers: Administrative Death Review) or should be deferred until
											  the submission of the recommendations of the clinical death review committee.
(3) The deliberations and findings of a preliminary administrative death
											  review will be considered at the final administrative death review after receipt of the recommendations of
											  the clinical death review committee.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 405 - PATIENT CARE-MENTAL HEALTH SERVICES › Subchapter K - DEATHS OF INDIVIDUALS SERVED BY COMMUNITY MENTAL HEALTH CENTERS › Section 405.274 - Community Centers: Clinical Death Review

Current through Reg. 49, No. 28; July 12, 2024
(a) Each community center shall develop and implement procedures consistent
											  with this subchapter for the timely reporting and review of deaths.
(b) Deaths subject to a clinical death review will be reviewed by a medical
											  review committee pursuant to the statutes that authorize peer review activities in the State of Texas,
											  consisting of the previously appointed investigating officer and at least two other medical/nursing
											  professionals (M.D., D.O., or R.N.), one of which should be a medical professional whom is neither an
											  employee of the community center nor was the deceased's attending physician (if such medical professional is
											  not available, then the effort to obtain external membership must be documented in the information sent to
											  the administrative death review committee). Of these three committee members, all must be either medical
											  doctors or registered nurses. The community center CEO shall appoint one of the three medical/nursing
											  professionals as chair of the clinical death review committee. For the purposes of this subchapter the term
											  employee does not refer to consultants or contractors. Additionally, the membership of the clinical death
											  review committee may include the community center CEO and/or the director of clinical quality assurance,
											  designee, or the person who is responsible for clinical quality assurance functions.
(1) Upon determination of the need for a clinical death review, the
											  investigating officer shall provide to the clinical death review committee:
(A) the individual's medical record;
(B) a copy of the death certificate, bearing a valid diagnosis, if
											  available;
(C) a copy of the preliminary or full autopsy report,
											  if available;
(D) the probable final diagnosis, including
											  contributory causes, and reasons for variance from the death certificate, if any; and
(E) a briefing of possible issues involving clinically related community
											  center operational policies and procedures and quality of medical care.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 405 - PATIENT CARE-MENTAL HEALTH SERVICES › Subchapter K - DEATHS OF INDIVIDUALS SERVED BY COMMUNITY MENTAL HEALTH CENTERS › Section 405.275 - Community Centers

Current through Reg. 49, No. 28; July 12, 2024
(a) The community center CEO shall convene an administrative death review
											  committee:
(1) immediately after the determination of the need for an
											  administrative death review, if a clinical death review was not conducted;
(2) when a preliminary administrative death review is to take place as
											  determined in §
											405.272(b)
											  of this subchapter (relating to Community Centers: Clinical Death Review Determinations); or
(3) immediately after the receipt of the information from the clinical
											  death review committee as described in §
											405.274(c)
											  of this subchapter (relating to Community Centers: Clinical Death Review).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 405 - PATIENT CARE-MENTAL HEALTH SERVICES › Subchapter K - DEATHS OF INDIVIDUALS SERVED BY COMMUNITY MENTAL HEALTH CENTERS › Section 405.276 - Reporting of Systemic Issues Emerging from Death Reviews

Current through Reg. 49, No. 28; July 12, 2024
Utilizing information gathered from the elements submitted in §
										405.275(f)(6)
													 and (g) of this subchapter (relating to Community Centers: Administrative
													 Death Review), the community center CEO shall report to the community center's board of trustees any systemic
													 issues emerging from death reviews and the corrective actions taken, on a routine basis or when
													 necessary.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 411 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - INTERAGENCY AGREEMENTS › Section 411.61 - Memorandum of Understanding Concerning Capacity Assessment for Self Care and Financial Management

Current through Reg. 49, No. 28; July 12, 2024
(a) Introduction And Legal Authority. The Texas Department of Mental Health
											  and Mental Retardation (TDMHMR) and Texas Department of Human Services (TDHS) enter into a memorandum of
											  understanding (MOU) in accordance with Texas Health and Safety Code (THSC), §533.044. The statute
											  requires the use of a uniform assessment tool to assess whether an elderly person, a person with mental
											  retardation, a person with a developmental disability, or a person who is suspected of being a person with
											  mental retardation or a developmental disability and who is receiving services in a facility regulated or
											  operated by TDMHMR or TDHS needs a guardian of the person or estate or both. TDMHMR and TDHS agree to require
											  the following entities, as indicated, to comply with the provisions of this MOU:
(1) TDMHMR: state facilities; local mental retardation authorities and
											  their contractors; and providers in the ICF/MR/RC or Medicaid waiver programs; and
(2) TDHS: nursing facilities.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 411 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - INTERAGENCY AGREEMENTS › Section 411.62 - Memorandum of Understanding concerning Continuity of Care System for Offenders with Mental Impairments

Current through Reg. 49, No. 28; July 12, 2024
(a) For the purpose of establishing a continuity of care system for
											  offenders with mental illnesses or mental retardation, the Texas Department of Criminal Justice (TDCJ), the
											  Texas Department of Mental Health and Mental Retardation (TDMHMR), local mental health and mental retardation
											  authorities (MHMRAs), and local community supervision and corrections' departments (CSCD's) agree to the
											  following:
(1) Authority and purpose. Senate Bill 252,
											  Acts 1993,
											  73rd Leg., Ch. 488, 1, and House Bill 1747, Acts 1997, 75th Leg., codified as
											  Texas Health and Safety Code, §
											614.013,
											  authorizes TDCJ, TDMHMR, local MHMRAs, and CSCD's (entities) to establish a memorandum of understanding that
											  identifies methods for:
(A) identifying persons with mental illness or
											  mental retardation involved in the criminal justice system;
(B)
											  developing interagency rules, policies and procedures for the coordination of the care of and exchange of
											  information on persons with mental illness or mental retardation by local and state criminal justice
											  agencies, TDMHMR, local MHMRAs, and CSCDs; and
(C) identifying
											  services needed by persons with mental illness or mental retardation to re-enter the community
											  successfully.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 411 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - INTERAGENCY AGREEMENTS › Section 411.63 - Interagency Coordination of Special Education Services to Students with Disabilities in Residential Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Texas Department of Mental Health and Mental Retardation (TDMHMR)
											  adopts by reference a rule of the Texas Education Agency (TEA) in 19 TAC §
										89.1115(relating
											  to Memorandum of Understanding Concerning Interagency Coordination of Special Education Services to Students
											  with Disabilities in Residential Facilities).
(b) The TEA rule
											  contains the text of an MOU between the following state agencies:
(1)
											  TDMHMR;
(2) TEA;
(3)
											  Texas Department of Human Services;
(4) Texas Department of
											  Health;
(5) Texas Department of Protective and Regulatory
											  Services;
(6) Texas Interagency Council on Early Childhood
											  Intervention;
(7) Texas Commission on Alcohol and Drug
											  Abuse;
(8) Texas Juvenile Probation Commission; and
(9) Texas Youth Commission.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 411 - STATE MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - INTERAGENCY AGREEMENTS › Section 411.64 - Memorandum of Understanding (MOU) on Relocation Pilot Program

Current through Reg. 49, No. 28; July 12, 2024
(a) Texas Department of Mental Health
											  and Mental Retardation (TDMHMR) adopts by reference a rule of the Texas Department of Human Services (TDHS)
											  contained in 40 TAC § 72.104(relating to Memorandum of Understanding on Relocation Pilot
											  Program).
(b) The TDHS rule contains the text of a memorandum of
											  understanding (MOU) between:
(1) TDMHMR;
(2) TDHS; and
(3) Texas
											  Department of Protective and Regulatory Services.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.51 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to comply with the Texas Health
													 and Safety Code, §
										534.052, §
										534.055, and §
										534.065.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.52 - Application

Current through Reg. 49, No. 28; July 12, 2024
This subchapter applies to all contracts for goods and services
													 awarded by a local authority.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.53 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this subchapter, have
													 the following meanings, unless the context clearly indicates otherwise:
(1) Application--Documents prepared by a respondent in response to a
											  request for applications.
(2) Best value--The optimum combination
											  of economy and quality that is the result of fair, efficient, and practical procurement decision-making and
											  which achieves the following objectives:
(A) promote fairness and
											  competition for local authority contracts;
(B) support the
											  delivery of services and benefits that best meets the needs of clients of programs administered by the local
											  authority;
(C) promote timely, high quality, and responsive
											  performance by contractors; and
(D) encourage and reward the
											  continuing participation of quality contractors.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.54 - Accountability

Current through Reg. 49, No. 28; July 12, 2024
(a) All purchases of goods and services must be made pursuant to a
											  contract.
(b) Conflicts of interests and standards of conduct for
											  local authority employees and officers.
(1) Conflicts of interest. Local
											  authority employees and officers may not have a conflict of interest in contracts management. An employee or
											  officer has a conflict of interest when the employee, officer, a partner of the employee or officer, or a
											  person related within the second degree of consanguinity or affinity to the employee or officer, has or
											  intends to have:
(A) employment with a respondent or contractor;
(B) paid consultation with a respondent or contractor;
(C) membership on a respondent's or contractor's board of
											  directors;
(D) ownership of 10% or more of the voting stock of
											  shares of a respondent or contractor;
(E) ownership of 10% or
											  more or $5,000 or more of the fair market value of a respondent or contractor; or
(F) income from a respondent or contractor in excess of 10% of the
											  employee's, officer's, or related person's gross income for the previous year.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.55 - Procurement

Current through Reg. 49, No. 28; July 12, 2024
(a) Procurement
											  method. The local authority must develop and enforce procurement procedures that comply with this subchapter.
(1) Goods and non-community services. The local authority must acquire
											  goods and non-community services by any procurement method described in the Uniform Grant and Contracts
											  Management Standards (UGMS), Section __.36(d), that provides the best value to the local authority.
(2) Community services. The local authority must acquire community services
											  by a procurement method described in this subchapter that provides the best value to the local authority. All
											  community services must be procured competitively in accordance with §
											412.58
											  of this title (relating to Competitive Procurement of Community Services Contracts) unless the local
											  authority determines that the community service(s):
(A) can be procured
											  non-competitively in accordance with §
												412.59 of
											  this title (relating to Non-competitive Procurement of Community Services Contracts); or
(B) should be procured through open enrollment in accordance with §
												412.60 of this title (relating to Open
											  Enrollment).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.56 - Community Services Contracting Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) The local authority is prohibited from
											  amending a community services contract:
(1) to increase the contract amount
											  by more than 25%; or
(2) to add a new community service unless
											  the contract was procured through open enrollment.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.58 - Competitive Procurement Methods for Community Services

Current through Reg. 49, No. 28; July 12, 2024
Competitive procurement methods for community services are as
													 follows.
(1) Informal solicitation.
(A) Determination. The local authority may competitively procure community
											  services through informal solicitation if the contract amount does not exceed $25,000.
(B) Solicitation.
(i) The local authority
											  must solicit business entities that provide the type of community service(s) being procured and attempt to
											  obtain at least three responses for the service's specifications. Solicitation and responses may be oral,
											  written, or electronic.
(ii) Documentation for informal
											  solicitation must include:
(I) the names and telephone numbers of the
											  business entities contacted and the date of contact;
(II) the
											  specifications for the community service(s); and
(III) all
											  responses.
(C) Award. The award of a
											  contract procured through informal solicitation is made in accordance with §
											412.55(c) of this title (relating
											  to Contract Procurement).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.59 - Non-Competitive Procurement of Community Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Determination. The local authority may procure community services
											  non-competitively only if:
(1) the procurement is pursuant to the Texas
											  Health and Safety Code, §
											533.017;
(2) the services are proprietary to a single source or only one source can
											  or will provide the service;
(3) the services will be provided by
											  a governmental entity;
(4) there exists an emergency situation in
											  which a delay may result in harm to a consumer who is to receive the community service;
(5) the services are for less than $5000 and the total amount was not
											  divided to qualify for a non-competitive procurement; or
(6) a
											  competitive procurement was attempted and either no qualified response or only one qualified response was
											  received.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.60 - Open Enrollment

Current through Reg. 49, No. 28; July 12, 2024
(a) Determination. The local authority may issue a Request for Applications
											  (RFA) to procure community services through open enrollment in accordance with this section.
(b) Solicitation.
(1) The local authority
											  must publish in a local newspaper or professional association newsletter an RFA Notice to providers of all
											  community services the local authority intends to procure through open enrollment. In addition, the local
											  authority must continuously and prominently display such RFA Notice at the local authority's administrative
											  office(s). At least once every two years the local authority must publish in a local newspaper or
											  professional association newsletter an RFA Notice to providers of all community services currently procured
											  through open enrollment. The RFA Notice must include:
(A) a brief
											  description of the types of community services the local authority intends to procure through open
											  enrollment;
(B) the geographic area to be served;
(C) the procedure for obtaining an application; and
(D) the date and time by which applications must be submitted, if
											  any.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.61 - Consumer Access to Participating Community Services Contractors in Provider Network

Current through Reg. 49, No. 28; July 12, 2024
(a) The local
											  authority must maintain, and make available to consumers, current information about each community services
											  contractor participating in its provider network. The information must represent all participating
											  contractors fairly and must be organized and relevant to consumers.
(b) The local authority must allow consumers to choose freely, without
											  influence by any local authority staff or representative, any contractor participating in the provider
											  network that provides the type of community service which the local authority has authorized for the
											  consumer.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.62 - Monitoring and Enforcing Community Services Contracts

Current through Reg. 49, No. 28; July 12, 2024
(a) Monitoring. The local authority must maintain
											  a contracts management system that ensures each community services contractor performs in accordance with the
											  provisions of the contract. The local authority shall monitor each community services contractor's compliance
											  with the contract and evaluate the contractor's provision of services, including:
(1) competency of the contractor to provide care;
(2) consumers' access to services;
(3) safety of the environment in which services are provided;
(4) continuity of care;
(5)
											  compliance with the performance expectations (referenced in §
											412.57(b)(13)
											  of this title (relating to Provisions for Community Services Contracts));
(6) satisfaction of consumers and family members with services provided;
											  and
(7) utilization of resources.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.63 - References

Current through Reg. 49, No. 28; July 12, 2024
The following laws and rules are referenced in this
													 subchapter:
(1) Texas Health and Safety Code, Chapter 250,
											  §533.007, §533.017, §533.035, §534.052. §534.055, §534.061, §534.065, and
											  §534.066;
(2) Tax Code, Chapter 171;
(3) Texas Civil Statutes, Article 2.45;
(4) Texas Government Code, Chapter 783, and §411.115;
(5) Title VI of the Civil Rights Act of 1964;
(6) Section 504 of the Rehabilitation Act of 1973;
(7) the Americans with Disabilities Act of 1990 (ADA);
(8) the Age Discrimination in Employment Act of 1967;
(9) 1 TAC, Part 1, Chapter 5, Subchapter A, Division 4;
(10) Chapter 414, Subchapter A of this title (relating to
											  Client-Identifying Information); and
(11) Chapter 414, Subchapter
											  K of this title (relating to Criminal History Clearances).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter B - CONTRACTS MANAGEMENT FOR LOCAL AUTHORITIES › Section 412.64 - Distribution

Current through Reg. 49, No. 28; July 12, 2024
This subchapter shall be distributed to:
(1) members of the Texas MHMR Board;
(2) executive, management, and program staff of Central Office;
(3) chairpersons, board of trustees or governing body, and executive
											  directors, all local authorities; and
(4) advocacy
											  organizations.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.101 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to comply with the Texas Health
													 and Safety Code, §
										534.067, by establishing a uniform fee
													 collection policy for local mental health authorities that:
(1) is
											  equitable;
(2) provides for collections; and
(3) maximizes contributions to local revenue.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.102 - Application

Current through Reg. 49, No. 28; July 12, 2024
(a) This subchapter applies to all local mental health authorities for
											  community services contracted for through the performance contract that the authority provides directly or
											  through subcontractors to members of the priority population. This subchapter also applies to persons in the
											  priority population, and parents of persons under age 18 years in the priority population, who are seeking or
											  receiving services.
(b) This subchapter does not apply to:
(1) programs and services that are prohibited by statute or regulation from
											  charging fees to persons served (e.g., Early Childhood Intervention Program);
(2) the department's In-Home and Family Support Program;
(3) inpatient services in a state mental health facility and non-crisis
											  residential services as described in the performance contract; and
(4) specialized services mandated by the Omnibus Budget Reconciliation Act
											  (OBRA) of 1987, as amended by OBRA 90, for preadmission screening and annual resident reviews (PASARR)
											  provided to non-Medicaid eligible persons.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.103 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this subchapter, have
													 the following meanings, unless the context clearly indicates otherwise.
(1) Ability to pay--The person has third-party coverage that will pay for
											  needed services, the person's maximum monthly fee is greater than zero, or the person has identified payment
											  for a needed service or services in an approved plan utilizing Social Security work incentive provisions
											  (i.e.,
Plan to Achieve Self-Sufficiency; Impairment Related Work Expense
).
(2) Community services or services--Except for inpatient services in a
											  state mental health facility and non-crisis residential services, the required and optional mental health
											  services described in the performance contract, including:
(A) 24-hour
											  emergency screening and rapid crisis stabilization services;
(B)
											  community-based crisis residential services or inpatient services in a mental health facility that is not a
											  state mental health facility;
(C) community-based assessments,
											  including the development of interdisciplinary treatment plans, and diagnosis and evaluation
											  services;
(D) family support services, including respite
											  care;
(E) case management services;
(F) medication-related services, including medication clinics, laboratory
											  monitoring, medication education, mental health maintenance education, and the provision of medication;
											  and
(G) psychosocial rehabilitation programs, including social
											  support activities, independent living skills, and vocational training.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.104 - Principles

Current through Reg. 49, No. 28; July 12, 2024
The department supports the following principles:
(1) Persons are charged for services based on their ability to
											  pay.
(2) Procedures for determining ability to pay are fair,
											  equitable, and consistently implemented.
(3) Paying for services
											  in accordance with his/her ability to pay reinforces the role of the person as a customer.
(4) Earned revenues are optimized.
(5) The department is the payer of last resort.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.105 - Accountability

Current through Reg. 49, No. 28; July 12, 2024
(a) Prohibition from denying services. Local mental health authorities are
											  prohibited from denying services to a person:
(1) because of the person's
											  inability to pay for the services;
(2) in crisis because:
(A) a financial assessment has not been completed;
(B) financial responsibility has not been determined;
(C) the person has a past-due account; or
(D) the person had his/her services involuntarily reduced or terminated for
											  non-payment under §
												412.109(d)
											  of this title (relating to Payments, Collections, and Non-payment); or
(3) pending resolution of an issue relating solely to payment for services,
											  including failure of the person (or parent) to comply with any requirement in subsections (c), (d), (e), and
											  (g) of this section.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.106 - Determination of Ability to Pay

Current through Reg. 49, No. 28; July 12, 2024
(a) Financial assessment. The LMHA must conduct
											  and document a financial assessment for each person within the first 30 days of services. The LMHA must
											  update each person's financial assessment at least annually and whenever a significant financial change (as
											  defined) occurs as long as the person continues to receive services. The financial assessment is accomplished
											  using the financial documentation listed in §
										412.105(d) of this title
											  (relating to Accountability), which represents the finances of the:
(1)
											  person who is age 18 years or older and the person's spouse; or
(2) parents of the person who is under age 18 years.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.107 - Standard Charges

Current through Reg. 49, No. 28; July 12, 2024
Each LMHA must establish, at least annually, a reasonable standard
													 charge for each community service as indicated in the performance contract. The standard charge must cover,
													 at a minimum, the LMHA's cost of ensuring the provision of the service.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.108 - Billing Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) Monthly account.
(1) The LMHA will
											  maintain a monthly account for each person that lists all services provided to the person during the month
											  and the standard charges for the services. Each service listed will indicate whether the service is:
(A) covered by Medicare third-party coverage;
(B) covered by non-Medicare third-party coverage;
(C) not covered by third-party coverage; or
(D) identified for payment in the person's approved plan utilizing Social
											  Security work incentive provisions.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.109 - Payments, Collections, and Non-Payment

Current through Reg. 49, No. 28; July 12, 2024
(a) Payment and collection.
(1) Persons (and parents) are responsible for promptly paying all charges
											  owed to the LMHA.
(2) The LMHAs are responsible for making
											  reasonable efforts to collect payments from all available funding sources before accessing the department's
											  funds to pay for persons' services.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.110 - Monthly Ability-to-Pay Fee Schedule

Current through Reg. 49, No. 28; July 12, 2024
The Monthly Ability-To-Pay Fee Schedule, referenced as Exhibit A in
													 §
										412.113 of this title (relating to Exhibit), is based
													 on 150% of the Federal Poverty Guidelines. The department may revise the Monthly Ability-To-Pay Fee Schedule,
													 based on any changes in the Federal Poverty Guidelines.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.111 - Training

Current through Reg. 49, No. 28; July 12, 2024
In accordance with a prescribed training program developed by the
													 department, all local mental health authority staff who are involved in implementing or explaining the
													 content of this subchapter must demonstrate competency prior to performing tasks related to charging for
													 community services and annually thereafter.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.112 - Brochure for Persons (and Parents)

Current through Reg. 49, No. 28; July 12, 2024
(a) The department will develop a brochure that
											  contains the policies for charging for community services that are contained in this subchapter, including:
(1) a general reference to the statutory trust exemption; and
(2) information related to claiming financial hardship.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.113 - Exhibit

Current through Reg. 49, No. 28; July 12, 2024
This subchapter references Exhibit A--The Monthly Ability-To-Pay Fee
													 Schedule, copies of which are available by contacting Mental Health and Substance Abuse Program Services,
													 Department of State Health Services, Mail Code 2018, P.O. Box 13247, Austin, TX 78711-2668.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.114 - References

Current through Reg. 49, No. 28; July 12, 2024
This subchapter references the following rules and statutes:
(1) Texas Health and Safety Code, §
										533.035 and §
										534.067;
(2) Omnibus Budget Reconciliation Act (OBRA) of 1987, as amended by OBRA
											  90; and
(3) Section
											  401.464 of this title
											  (relating to Notifications and Appeals Process).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 412 - LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES › Subchapter C - CHARGES FOR COMMUNITY SERVICES › Section 412.115 - Distribution

Current through Reg. 49, No. 28; July 12, 2024
This subchapter is distributed to:
(1) all members of the department's Advisory Council;
(2) executive, management, and program staff of the department;
(3) executive directors of all local mental health authorities;
											  and
(4) advocacy organizations.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.401 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to provide procedures for
													 obtaining consent for treatment with psychoactive medications from patients receiving voluntary or
													 involuntary mental health services.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.402 - Application

Current through Reg. 49, No. 28; July 12, 2024
This subchapter applies to the following facilities providing
													 inpatient mental health services:
(1) a state hospital or state
											  center operated by the Texas Department of Mental Health and Mental Retardation (TDMHMR);
(2) a psychiatric hospital licensed under Texas Health and Safety Code
											  (THSC), Chapter 577, and Chapter 134 of this title;
(3) an
											  identifiable mental health service unit of a hospital licensed under THSC, Chapter 241, and Chapter 133,
											  Subchapter A of this title;
(4) a crisis stabilization unit (CSU)
											  licensed under THSC, Chapter 577, and Chapter 134 of this title; and
(5) facilities operated by local mental health authorities or under
											  contract to local mental health authorities
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.403 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this subchapter, shall
													 have the following meanings, unless the context clearly indicates otherwise:
(1) Capacity--A patient's ability to:
(A)
											  understand the nature and consequences of a proposed treatment, including the benefits, risks, and
											  alternatives to the proposed treatment; and
(B) make a decision
											  whether to undergo the proposed treatment.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.404 - Information Required To Be Given

Current through Reg. 49, No. 28; July 12, 2024
(a) The treating physician, registered nurse
											  (RN), licensed vocational nurse (LVN), physician's assistant (PA), or registered pharmacist (RPh) will
											  explain to the patient and to the patient's legally authorized representative, the information in paragraphs
											  (1) - (10) of this subsection in simple, nontechnical language in the person's primary language, if possible.
											  If the explanation is not provided by the treating physician, he or she must confirm the explanation with the
											  patient and the patient's legally authorized representative, within two working days, not including weekends
											  or legal holidays:
(1) the nature of the patient's mental illness and
											  condition;
(2) the name of the medication and the beneficial
											  effects on the patient's mental illness or condition expected as a result of treatment with that
											  medication;
(3) the probable health and mental health
											  consequences to the patient of not taking the medication, including the occurrence, increase, or reoccurrence
											  of symptoms of mental illness;
(4) the existence of generally
											  accepted alternative forms of treatment, if any, that could reasonably be expected to achieve the same
											  benefits as the medication and why the physician rejects the alternative treatment;
(5) a description of the proposed course of treatment with medication
											  including any necessary evaluations and lab work;
(6) the fact
											  that side effects of varying degrees of severity are a risk of all medication;
(7) the relevant side effects of the medication, including:
(A) any side effects which are known to frequently occur in most
											  persons;
(B) any side effects to which the particular patient may
											  be predisposed; and
(C) the nature and possible occurrence of the
											  potentially irreversible symptoms of tardive dyskinesia;
(8) the need to advise mental health facility staff immediately if any of
											  these side effects occur;
(9) an instruction that the patient may
											  withdraw consent at any time without negative actions on the part of staff; and
(10) the patient's rights under this section.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.405 - Documentation of Informed Consent

Current through Reg. 49, No. 28; July 12, 2024
(a) Informed medication consent must be obtained
											  for each individual medication, not by medication class.
(b)
											  Informed consent for the administration of each psychoactive medication will be evidenced by a completed copy
											  of the department's form, Consent to Treatment with Psychoactive Medication (MHRS 9-7 form (or other format
											  including the same information)) executed by the patient or his or her LAR. A copy of which may be obtained
											  by contacting TDMHMR, Office of Policy Development, P.O. Box 12668, Austin, TX 78711-2668.
(1) Any time the medication regimen is altered in a way that would result
											  in a significant change in the risks or benefits for the patient, an explanation of the change will be
											  provided to the patient and the patient's legally authorized representative. The explanation will include
											  notification of the right to withdraw consent at any time.
(2) A
											  new consent will be obtained if a change to a different medication is prescribed.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.406 - Patients Admitted under Texas Statutes

Current through Reg. 49, No. 28; July 12, 2024
(a) Psychoactive medications will not be
											  administered to patients admitted to a mental health facility under the voluntary provisions of the Texas
											  Health and Safety Code (THSC) or detained at a mental health facility under the THSC emergency detention or
											  order of protective custody (OPC) provisions without informed consent from the patient or the patient's
											  legally authorized representative unless the patient is in an psychiatric emergency and medication is
											  administered as provided in §
										414.410 of this title (relating to
											  Psychiatric Emergencies).
(b) If an adult under a protective
											  custody order as provided by THSC, Chapter 574, Subchapter B, is a ward, the guardian of the person of the
											  ward may consent to the administration of psychoactive medication as prescribed by the ward's treating
											  physician regardless of the ward's expressed preferences regarding treatment with psychoactive
											  medication.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.407 - Patients Committed to Mental Health Facilities under Provisions of the Texas Health and Safety Code

Current through Reg. 49, No. 28; July 12, 2024
Psychoactive medications will not be administered to patients
													 committed to a mental health facility under an order for temporary or extended mental health services if the
													 patient or the patient's legally authorized representative refuses the medication unless:
(1) the patient is in a psychiatric emergency and medication is
											  administered as provided in §
										414.410 of this title (relating to
											  Psychiatric Emergencies);
(2) the patient does not have a legally
											  authorized representative and the administration of the medication, regardless of the patient's refusal, is
											  authorized by an order as outlined in THSC §§574.101 - 574.110; or
(3) the patient is a ward who is 18 years of age or older and the guardian
											  of the person of the ward consents to the administration of psychoactive medication regardless of the ward's
											  expressed preferences regarding treatment with psychoactive medication.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 414 - RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES › Subchapter I - CONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION - MENTAL HEALTH SERVICES › Section 414.408 - Patients Committed to Mental Health Facilities under Provisions Other than Those Found in the Texas Health and Safety Code (i.e., Code of Criminal Procedure, Family Code)

Current through Reg. 49, No. 28; July 12, 2024
(a) The decision to administer
											  medication to a patient committed to a TDMHMR mental health facility under provisions other than THSC
											  §574.034 or §574.035 must be is consistent with the holding in Sell v. United States, 123 S.Ct.2174
											  (2003).
(b) Nothing in this section is intended to preclude the
											  administration of psychoactive medication to any patient in a psychiatric emergency as provided for in §
										414.410 of this title (relating to
											  Psychiatric Emergencies).