reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter F - MENTAL HEALTH AND REHABILITATIVE SERVICES › Section 306.331 - Fair Hearings and Reviews

Current through Reg. 49, No. 28; July 12, 2024
(a) Right of
				  Medicaid-eligible individual to request a fair hearing. Any Medicaid-eligible
				  individual whose request for eligibility for MH rehabilitative services is
				  denied or is not acted upon with reasonable promptness, or whose MH
				  rehabilitative services have been terminated, suspended, or reduced by the
				  department is entitled to a fair hearing in accordance with 1 TAC Chapter 357,
				  Subchapter A (relating to Uniform Fair Hearing Rules).
(b) Notice. The Medicaid provider must notify
				  the department or its designee if the provider has reason to believe that an
				  individual's MH rehabilitative services should be denied, reduced or
				  terminated.
(c) Right of
				  non-Medicaid eligible individual to request a review. Any individual who has
				  not applied for or is not eligible for Medicaid whose request for eligibility
				  for MH rehabilitative services is not acted upon with reasonable promptness, or
				  whose MH rehabilitative services have been terminated, suspended, or reduced by
				  a local mental health authority or its contractor is entitled to the right of
				  review and notification in accordance with the department's rules concerning
				  such matters for non-Medicaid-eligible individuals.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter F - MENTAL HEALTH AND REHABILITATIVE SERVICES › Section 306.333 - Guidelines

Current through Reg. 49, No. 28; July 12, 2024
The following guidelines are referenced in this subchapter.
					 For information about obtaining copies of the guidelines contact the Department
					 of State Health Services, Mental Health Program Services Section, Mail Code
					 2018, P.O. Box 149347, Austin, Texas 78714-9347, (512) 467-5427 or access them
					 electronically.
(1) The uniform
				  assessment guidelines are available at:
				  http://www.dshs.state.tx.us/mhprograms/RDMAssess.shtm.
(2) The utilization management guidelines for
				  adults and children are available at:
				  http://www.dshs.state.tx.us/mhprograms/RDMClinGuide.
(3) Patient and family education resources
				  are available at http://www.dshs.state.tx.us/mhsa/patient-family-ed/.
(4) Medicaid MH Rehabilitative Services
				  Billing Guidelines are available at:
				  http://www.dshs.state.tx.us/mhsa/rdm/billing/.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter G - USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY › Section 306.351 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to require the use and
					 maintenance of the Texas Health and Human Services Commission (HHSC)
					 Psychiatric Drug Formulary.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter G - USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY › Section 306.352 - Application

Current through Reg. 49, No. 28; July 12, 2024
(a) This subchapter applies to HHSC
				  facilities, HHSC-funded community behavioral health centers (including
				  substance use treatment providers), local authorities, and their respective
				  contractors for medications and medication-related services funded by HHSC. The
				  HHSC Psychiatric Drug Formulary in its entirety applies to all HHSC facilities
				  in all circumstances except when HHSC transfers an individual to a general
				  hospital to receive non-mental health acute care services.
(b) HHSC facilities and local authorities are
				  responsible for drafting contracts with their contractors that provide
				  HHSC-funded medications and medication-related services to ensure that
				  contractors comply with this subchapter.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter G - USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY › Section 306.353 - 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) Adverse drug
				  reaction--Any response to a drug that is noxious and unintended and occurs at
				  doses normally used in humans.
(2)
				  Contractor--An entity that provides HHSC-funded mental health services pursuant
				  to a contract with a service system component or HHSC.
(3) Drug entity--A specific chemical compound
				  and all its pharmaceutically equivalent salt forms that are used in the
				  diagnosis, cure, mitigation, treatment or prevention of disease.
(4) Emergency--A situation in which it is
				  immediately necessary to administer medication to an individual to prevent:
(A) imminent probable death or substantial
				  bodily harm to the individual because the individual:
(i) overtly or continually is threatening or
				  attempting to commit suicide or serious bodily harm; or
(ii) is behaving in a manner that indicates
				  that the individual is unable to satisfy the individual's need for nourishment,
				  essential medical care, or self-protection; or
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter G - USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY › Section 306.354 - General Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) HHSC
				  maintains a closed formulary (HHSC Psychiatric Drug Formulary) that lists drugs
				  approved by the PEFC for use by service system components and their
				  contractors.
(b) A drug is not
				  available for general use by service system components or their contractors
				  unless it is approved by the PEFC. Drugs not listed in the HHSC Psychiatric
				  Drug Formulary or Interim Formulary Update may not be used except under the
				  limited circumstances described in § 306.359 of this subchapter (relating
				  to Prescribing Non-formulary Drugs).
(c) The use of formulary drugs in unusual
				  clinical situations or the use of unusual drug combinations must be accompanied
				  by written justification in the individual's medical record. Additional
				  clinical consultation in these situations should occur as deemed necessary by
				  the prescribing practitioner.
(d)
				  Reserve drugs may be prescribed for use outside the guidelines described in the
				  formulary if the prescription is justified in the individual's medical record
				  and reviewed in audits of reserve drug use conducted by the service system
				  component as clinically indicated.
(e) Drug research conducted at an HHSC
				  facility is governed by 25 TAC Chapter 414, Subchapter P (relating to Research
				  in TDMHMR Facilities). Local authorities conducting drug research must comply
				  with all applicable state and federal laws, rules, and regulations, including
				  45 CFR Part 46, as required by § 301.325 of this title (relating to Rights
				  and Protection).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter G - USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY › Section 306.355 - Organization of HHSC Psychiatric Drug Formulary

Current through Reg. 49, No. 28; July 12, 2024
(a) Drugs are listed in the HHSC Psychiatric
				  Drug Formulary by their nonproprietary names. The list is based on a modified
				  format of the American Hospital Formulary Service Drug Information and includes
				  an alphabetical index. The use of proprietary names, which may follow in
				  parentheses, is for information purposes only and is not meant to be an
				  endorsement. Cost comparisons and prescribing information are provided as
				  determined necessary by the PEFC. The HHSC Psychiatric Drug Formulary provides
				  tables summarizing the recommended dosage ranges for the psychotropic drugs for
				  clinician reference. These tables are intended as guidelines and are not
				  intended to replace other references or the clinician's clinical judgment.
				  Clinicians should consult the approved Food and Drug Administration product
				  labeling or other clinical resources on the appropriate prescribing of
				  psychoactive medications. The HHSC Psychiatric Drug Formulary notes limitations
				  recommended by the PEFC regarding the use of a drug, including specific
				  limitations or guidelines for the use of a reserve drug.
(b) The Interim Formulary Update conforms to
				  the same format as the HHSC Psychiatric Drug Formulary and shall be
				  incorporated into the annual HHSC Psychiatric Drug Formulary.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter G - USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY › Section 306.356 - Responsibilities of the Psychiatric Executive Formulary Committee

Current through Reg. 49, No. 28; July 12, 2024
(a) The PEFC maintains and updates the HHSC
				  Psychiatric Drug Formulary by:
(1)
				  recommending standards of drug use that discourage unnecessary duplication of
				  therapeutic alternatives and encourage the highest standards of medical and
				  pharmacy practice;
(2)
				  periodically reviewing the drugs listed in the formulary to ensure consistency
				  with need, effectiveness, risk, and cost;
(3) consulting with experts in clinical
				  pharmacy, pharmacology, and other medical specialties as necessary to
				  objectively assess drugs under consideration; and
(4) considering the applications submitted in
				  accordance with § 306.357 of this subchapter (relating to Adding a Drug to
				  the HHSC Psychiatric Drug Formulary) or as:
(A) presented by committee members; or
(B) submitted by other qualified
				  persons at the invitation of the PEFC chairperson.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter G - USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY › Section 306.357 - Adding a Drug to the HHSC Psychiatric Drug Formulary

Current through Reg. 49, No. 28; July 12, 2024
(a) Applying to have a drug added to the HHSC
				  Psychiatric Drug Formulary.
(1) Any member of
				  the PEFC, any service system component practitioner, or any contract
				  practitioner may apply to have a drug added to the HHSC Psychiatric Drug
				  Formulary by completing the New Drug Application form found in the HHSC
				  Psychiatric Drug Formulary on the HHSC Psychiatric Formulary website.
(2) Include the following with the
				  New Drug Application form:
(A) published
				  articles in biomedical literature that substantiate the efficacy and safety of
				  the proposed drug;
(B) information
				  on the advantages of the proposed drug compared with similar formulary drugs;
(C) a list of formulary drugs that
				  the proposed drug would replace or supplement; and
(D) cost effectiveness data.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter G - USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY › Section 306.358 - Changing the HHSC Psychiatric Drug Formulary

Current through Reg. 49, No. 28; July 12, 2024
(a) Changes to the HHSC Psychiatric Drug
				  Formulary are based on need, effectiveness, risk, and cost as contained in
				  current and unbiased biomedical literature.
(b) The HHSC Psychiatric Drug Formulary is
				  updated and published once a year, at a minimum. Quarterly updates to the HHSC
				  Psychiatric Drug Formulary, if any, will be listed in an Interim Formulary
				  Update.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter G - USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY › Section 306.359 - Prescribing Non-formulary Drugs

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Non-formulary drugs may be prescribed:
(1) if
				  no formulary drug exists that is as safe or effective in the specified
				  situation;
(2) if a limited trial
				  of the drug is safer or more effective than any drug listed in the formulary,
				  based on available medical evidence and the prescribing practitioner's clinical
				  judgment;
(3) if the course of
				  therapy established prior to the individual's admission to the facility where
				  he or she is being treated would be interrupted; or
(4) in an emergency.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter G - USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY › Section 306.360 - Adverse Drug Reactions

Current through Reg. 49, No. 28; July 12, 2024
(a) Each local
				  authority shall develop written policies and procedures for reporting adverse
				  drug reactions to the Food and Drug Administration.
(b) HHSC shall develop written policies and
				  procedures for HHSC facilities for reporting adverse drug reactions to the Food
				  and Drug Administration.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter A - YOUTH EMPOWERMENT SERVICES (YES) › Section 307.1 - Purpose and Application

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose.
				  The purpose of this subchapter is to implement a pilot program, under the
				  waiver provisions of the federal Social Security Act, § 1915(c), that
				  prevents or reduces institutionalization of children and adolescents with
				  severe emotional disturbance (SED), enables more flexibility in providing
				  intensive community-based services for children and adolescents with SED, and
				  provides support for their families by improving access to services.
(b) Application. The subchapter applies to:
(1) persons and entities that have a Medicaid
				  provider agreement to provide the waiver program services, as described in this
				  subchapter;
(2) local mental health
				  authorities (LMHAs), which have administrative responsibilities under the
				  waiver program; and
(3) children
				  and adolescents who are applicants for or recipients of services under the
				  waiver program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter A - YOUTH EMPOWERMENT SERVICES (YES) › Section 307.3 - 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)
				  Adolescent--An individual who is at least 13 years of age, but younger than 19
				  years of age.
(2) Assessment--A set
				  of standardized assessment measures used by the department to determine level
				  of need as set forth in the approved waiver.
(3) Child--An individual who is at least
				  three years of age, but younger than 13 years of age.
(4) Department--Department of State Health
				  Services.
(5) LAR or legally
				  authorized representative--A person authorized by law to act on behalf of a
				  child or adolescent with regard to a matter described in this subchapter,
				  including, but not limited to, a parent, guardian, or managing
				  conservator.
(6) LMHA or local
				  mental health authority--An entity designated as the local mental authority by
				  the department in accordance with the Health and Safety Code, §
										533.035(a).
(7) LPHA or licensed practitioner of the
				  healing arts--A person who is:
(A) a
				  physician;
(B) a licensed
				  professional counselor;
(C) a
				  licensed clinical social worker;
(D) a licensed psychologist;
(E) an advanced practice nurse; or
(F) a licensed marriage and family
				  therapist.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter A - YOUTH EMPOWERMENT SERVICES (YES) › Section 307.5 - Eligibility Criteria

Current through Reg. 49, No. 28; July 12, 2024
(a) To participate
				  in the waiver program, the child or adolescent must meet the following
				  eligibility criteria:
(1) be eligible for
				  Medicaid, under a Medicaid Eligibility Group included in the approved
				  waiver;
(2) live in a county
				  included in the waiver program;
(3)
				  be reasonably expected to qualify for inpatient care under the Texas Medicaid
				  inpatient psychiatric admission guidelines, as defined in the approved waiver,
				  in the absence of waiver services;
(4) reside:
(A) in a non-institutional setting with the
				  child's or adolescent's LAR; or
(B)
				  in the child's or adolescent's own home or apartment, if legally emancipated;
				  and
(5) choose, or have
				  the LAR choose, the waiver program services as an alternative to care in an
				  inpatient psychiatric facility, in accordance with the provisions of the
				  approved waiver.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter A - YOUTH EMPOWERMENT SERVICES (YES) › Section 307.7 - Co-Payments

Current through Reg. 49, No. 28; July 12, 2024
The receipt of certain waiver program services may be
					 dependent upon the child's or adolescent's and/or LAR's ability to make a
					 co-payment.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter A - YOUTH EMPOWERMENT SERVICES (YES) › Section 307.9 - Individual Plan of Care (IPC)

Current through Reg. 49, No. 28; July 12, 2024
(a) Each child
				  and adolescent determined eligible to participate in the waiver program is
				  assigned a mental health case manager, subject to the rules in Chapter 412,
				  Subchapter I, of this title (relating to Mental Health Case Management
				  Services). The mental health case manager must coordinate with the child or
				  adolescent, LAR, waiver service providers and LMHA to develop an IPC that is
				  based upon the assessment.
(b) The
				  initial IPC must be reviewed by an LPHA at the LMHA that serves the geographic
				  area of the participant's residence before forwarding to the department for
				  approval. The IPC must be approved by the department before a provider can
				  begin delivering waiver program services. To be approved, the IPC must:
(1) promote the child's or adolescent's
				  inclusion into the community;
(2)
				  protect the child's or adolescent's health and welfare in the
				  community;
(3) supplement, rather
				  than replace, the child's or adolescent's natural and other non-waiver program
				  support systems and resources;
(4)
				  be designed to prevent or reduce the likelihood of the child's or adolescent's
				  admission to an inpatient psychiatric facility; and
(5) be the most appropriate type and amount
				  of services to meet the child's or adolescent's needs.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter A - YOUTH EMPOWERMENT SERVICES (YES) › Section 307.11 - Transition Planning

Current through Reg. 49, No. 28; July 12, 2024
(a) The LMHA is
				  required to develop a transition plan for an adolescent who will become 19
				  years of age while receiving services under the waiver program. The transition
				  plan must be developed at least six months prior to the month the adolescent
				  becomes 19 years of age to ensure that the adolescent is appropriately
				  transitioned to adult services.
(b)
				  The transition plan, required under subsection (a) of this section, must be
				  developed in consultation with the adolescent and, if appropriate, the LAR, as
				  well as future providers, allowing adequate time for a smooth transition of the
				  adolescent into adult services. The transition plan must include:
(1) a summary of the mental health community
				  services and treatment received while in the waiver program;
(2) the adolescent's current assessment,
				  e.g., diagnosis, medications, level of functioning, and unmet needs;
(3) information from the adolescent and the
				  LAR, if appropriate, regarding the adolescent's strengths, preferences for
				  mental health community services, and responsiveness to past interventions;
				  and
(4) an IPC that:
(A) indicates the mental health and other
				  community services the adolescent will receive at the point of becoming 19
				  years of age; and
(B) ensures the
				  adolescent will be provided a smooth transition to adult services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter A - YOUTH EMPOWERMENT SERVICES (YES) › Section 307.13 - Inquiry List

Current through Reg. 49, No. 28; July 12, 2024
(a) Inquiry List. A
				  list, maintained by each LMHA, of children and adolescents as defined by §
										307.3 of this title (relating to
				  Definitions) who are interested in receiving YES Waiver program services and
				  who reside in the LMHA's service area.
(1)
				  Only a child or adolescent or the child's or adolescent's LAR may place a
				  child's or adolescent's name on the inquiry list.
(2) The LMHA must assign the child or
				  adolescent a registration date on the inquiry list that is based on the
				  chronological date and time the phone call or voice message requesting YES
				  Waiver program services was received.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter A - YOUTH EMPOWERMENT SERVICES (YES) › Section 307.15 - Right to Fair Hearing

Current through Reg. 49, No. 28; July 12, 2024
The LMHA or the department must notify the child or
					 adolescent, and LAR, of the right to a fair hearing, conducted in accordance
					 with the rules in 1 Texas Administrative Code, Chapter 357, Subchapter A
					 (relating to Uniform Fair Hearing Rules), under the following
					 circumstances:
(1) a child or
				  adolescent is denied participation in the waiver program, unless the reason for
				  the denial is the program participation limit referred to in §
										307.5(c) of this title (relating
				  to Eligibility Criteria);
(2) a
				  child or adolescent is denied continued participation in the waiver program;
				  or
(3) waiver program services for
				  a child or adolescent are denied, reduced, suspended, or terminated.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter B - HOME AND COMMUNITY-BASED SERVICES-ADULT MENTAL HEALTH PROGRAM › Section 307.51 - Purpose and Application

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  purpose of this subchapter is to implement the Home and Community-Based
				  Services--Adult Mental Health (HCBS-AMH) program, providing home and
				  community-based services to individuals with a serious mental illness who are
				  eligible for or currently receiving Medicaid in accordance with the Medicaid
				  state plan and applicable state legislative direction.
(b) The subchapter applies to:
(1) a person or entity contracting with HHSC
				  to provide HCBS-AMH services, as described in this subchapter;
(2) an entity having administrative
				  responsibilities under this program; and
(3) an individual applying for or enrolled in
				  the HCBS-AMH program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter B - HOME AND COMMUNITY-BASED SERVICES-ADULT MENTAL HEALTH PROGRAM › Section 307.52 - 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) Activities of daily
				  living--Routine daily activities. These activities include:
(A) performing personal hygiene activities;
(B) dressing;
(C) meal planning and preparation;
(D) managing finances;
(E) shopping for food, clothing, and other
				  essential items;
(F) performing
				  essential household chores;
(G)
				  communicating by phone or other media;
(H) navigating public transportation;
(I) participating in the
				  community; and
(J) other activities
				  as defined by HHSC.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter B - HOME AND COMMUNITY-BASED SERVICES-ADULT MENTAL HEALTH PROGRAM › Section 307.53 - Eligibility Criteria and HCBS-AMH Assessment

Current through Reg. 49, No. 28; July 12, 2024
(a) To participate in the HCBS-AMH program,
				  an assessor must conduct an HCBS-AMH assessment on each individual for HHSC to
				  determine that the individual meets the needs-based eligibility criteria for
				  HCBS-AMH.
(1) The assessor must consult with
				  the individual, the individual's LAR, if applicable, treatment team, providers,
				  and other persons according to the needs and desire of the individual to
				  conduct the HCBS-AMH assessment.
(2) The HCBS-AMH assessment must:
(A) be conducted face-to-face as permitted
				  under Medicaid guidelines;
(B) take
				  into account the ability of the individual to perform two or more activities of
				  daily living; and
(C) assess the
				  individual's need for HCBS-AMH.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter B - HOME AND COMMUNITY-BASED SERVICES-ADULT MENTAL HEALTH PROGRAM › Section 307.54 - Individual Recovery Plan

Current through Reg. 49, No. 28; July 12, 2024
(a) An IRP
				  must:
(1) prepare for the individual's
				  effective transition to the community;
(2) promote the individual's inclusion into
				  the community;
(3) protect the
				  individual's health and welfare in the community;
(4) supplement, rather than replace, the
				  individual's natural support systems and resources;
(5) be designed to prevent or reduce the
				  individual's likelihood of:
(A) an inpatient
				  psychiatric facility admission;
(B)
				  a correctional facility admission; and
(C) an emergency department visit in which
				  services are delivered;
(6) include the most appropriate type and
				  amount of services to meet the individual's needs;
(7) prevent the provision of unnecessary or
				  inappropriate care;
(8) be based on
				  the individual's preferences, needs, and goals; and
(9) be developed with the individual, LAR,
				  individual's treatment team and providers, and other persons according to the
				  needs and desire of the individual.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter B - HOME AND COMMUNITY-BASED SERVICES-ADULT MENTAL HEALTH PROGRAM › Section 307.55 - Co-Payments

Current through Reg. 49, No. 28; July 12, 2024
A co-payment for HCBS-AMH services may be assessed as
					 described in 25 TAC §
										412.108
					 (relating to Billing Procedures).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter B - HOME AND COMMUNITY-BASED SERVICES-ADULT MENTAL HEALTH PROGRAM › Section 307.56 - Provider Qualifications and Contracting

Current through Reg. 49, No. 28; July 12, 2024
(a) A prospective provider may request and
				  submit an application to HHSC to provide HCBS-AMH at any time. The application
				  sets forth the qualifications to be a provider.
(b) HHSC must approve the provider and enter
				  into a contract with the provider before the provider serves any
				  individual.
(c) HCBS providers must
				  comply with any applicable federal or state law or rule.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter B - HOME AND COMMUNITY-BASED SERVICES-ADULT MENTAL HEALTH PROGRAM › Section 307.57 - Fair Hearings Process

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Right of an individual to request a fair hearing. Any individual whose request
				  for eligibility to receive HCBS-AMH is denied or is not acted upon with
				  reasonable promptness, or whose services have been terminated, suspended, or
				  reduced by HHSC, is entitled to a fair hearing in accordance with 1 TAC Chapter
				  357, Subchapter A (relating to Uniform Fair Hearing Rules).
(b) At any time, an individual may contact
				  the Ombudsman for additional information and resources by calling toll-free
				  (1-800-252-8154) or online at hhs.texas.gov/ombudsman.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.101 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to provide standards for
					 jail-based competency restoration services in pilot and county-based programs,
					 as required by the Texas Code of Criminal Procedure, Chapter 46B, relating to
					 Incompetency to Stand Trial. The programs include:
(1) mental health services;
(2) intellectual disability
				  services;
(3) co-occurring
				  psychiatric and substance use disorder treatment services;
(4) competency restoration education in the
				  county jail for an individual found incompetent to stand trial; and
(5) discharge planning services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.103 - Application

Current through Reg. 49, No. 28; July 12, 2024
This subchapter applies to an LMHA, LBHA, an LMHA or LBHA
					 subcontractor, a private provider, and a local unit of general purpose
					 government or city unit of government or a subcontractor of the unit of
					 government delivering jail-based competency restoration services authorized by
					 the Texas Code of Criminal Procedure, Chapter 46B.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.105 - 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) Competency
				  restoration--The treatment and education process for restoring an individual's
				  ability to consult with the individual's attorney with a reasonable degree of
				  rational understanding and a rational and factual understanding of the court
				  proceedings and charges against the individual.
(2) Competency restoration training module
				  (training module)--An HHSC-reviewed training module used by provider staff
				  members to provide legal education to an individual receiving competency
				  restoration services.
(3) Court--A
				  court of law presided over by a judge, judges, or a magistrate in civil and
				  criminal cases.
(4) HHSC--Texas
				  Health and Human Services Commission or its designee.
(5) 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.
(6) Individual--A person
				  receiving services under this subchapter.
(7) Inpatient mental health facility--A
				  mental health facility providing 24-hour residential and psychiatric services
				  and is:
(A) a facility operated by
				  HHSC;
(B) a private mental hospital
				  licensed by HHSC;
(C) a community
				  center, facility operated by or under contract with a community center or other
				  entity HHSC designates to provide mental health services;
(D) a local mental health authority or a
				  facility operated by or under contract with a local mental health
				  authority;
(E) an identifiable part
				  of a general hospital in which diagnosis, treatment, and care for an individual
				  with mental illness is provided and is licensed by HHSC; or
(F) a hospital operated by a federal
				  agency.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.107 - Program Eligibility Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The JBCR pilot program must meet the standards set forth in the Texas Code of
				  Criminal Procedure, Article 46B.090, and upon operation of program services,
				  the provider of the JBCR pilot program must be:
(1) an LMHA:
(A) in good standing with HHSC; and
(B) that demonstrates a history of successful
				  competency restoration outcomes; or
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.109 - Service Standards

Current through Reg. 49, No. 28; July 12, 2024
(a) A JBCR pilot
				  program must:
(1) use a multidisciplinary
				  treatment team to provide clinical treatment:
(A) focused on the objective of restoring the
				  individual to competency to stand trial; and
(B) similar to the clinical treatment
				  provided as part of a competency restoration program at an inpatient mental
				  health facility;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.111 - Provider Staff Member Training

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  provider must recruit, train, and maintain qualified provider staff members
				  with documented competency in accordance with Chapter 412, Subchapter G,
				  Division 2 of this title (relating to Organizational Standards), specifically:
(1)
											§
											301.327(e) of this title (relating
				  to Access to Mental Health Community Services);
(2)
											§
											301.329 of this title (relating to
				  Medical Records System); and
(3)
											§
											301.331 of this title (relating to
				  Competency and Credentialing).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.113 - Policies and Procedures

Current through Reg. 49, No. 28; July 12, 2024
A provider must develop and implement written policies and
					 procedures:
(1) describing
				  eligibility, intake and assessment, and treatment planning as described in
				  §
										307.121 of this subchapter
				  (relating to Treatment Planning), and transition and discharge processes to
				  include coordination and continuity of care planning with an LMHA, LBHA, or
				  LIDDA, or an LMHA, LBHA, or LIDDA subcontractor;
(2) describing how an individual is assessed
				  for:
(A) suicidality and
				  homicidality;
(B) the degree of
				  suicidality and homicidality; and
(C) the development of an individualized
				  suicide and homicide prevention plan;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.115 - Individual Eligibility

Current through Reg. 49, No. 28; July 12, 2024
(a) To be
				  eligible to participate in a JBCR program, the court must determine the
				  individual as IST pursuant to the Texas Code of Criminal Procedure, Chapter
				  46B.
(b) An LMHA, LBHA, or an LMHA
				  or LBHA subcontractor must:
(1) screen an
				  individual for outpatient competency restoration; and
(2) determine an individual ineligible for
				  those services before the individual is admitted into the JBCR
				  program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.117 - Admission

Current through Reg. 49, No. 28; July 12, 2024
(a) When a provider determines an individual
				  is eligible for a JBCR program:
(1) the
				  provider must ensure the individual will receive competency restoration
				  services no later than 72 hours after arriving at the JBCR program;
				  or
(2) the provider must inform the
				  court that the JBCR program is at capacity, and immediately report the
				  individual's name to HHSC for placement on the Clearinghouse, which HHSC uses
				  to track the list of pending admissions of criminal code commitments for
				  non-violent offenses.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.119 - Rights of Individuals Receiving JBCR Services

Current through Reg. 49, No. 28; July 12, 2024
A provider of JBCR services must:
(1) inform the individual receiving JBCR
				  services of the individual's rights in accordance with Chapter 404, Subchapter
				  E of Title 25 (relating to Rights of Persons Receiving Mental Health Services)
				  or 40 TAC Chapter 4, Subchapter C (relating to Rights of Individuals with an
				  Intellectual Disability), as applicable;
(2) provide the individual with a copy of the
				  rights handbook published for an individual receiving mental health services or
				  an individual with an ID; and
(3)
				  explain to the individual receiving JBCR services how to initiate a complaint
				  and how to contact:
(A) the HHS Office of the
				  Ombudsman for complaints against the JBCR provider;
(B) the Texas Commission on Jail Standards
				  for complaints against the county jail; and
(C) the Texas protection and advocacy
				  system.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.121 - Treatment Planning

Current through Reg. 49, No. 28; July 12, 2024
Within five days after admission to the JBCR program, based
					 on an individual's competency evaluation and provider assessment, the provider
					 must develop the individual's treatment plan to include:
(1) the individual's strengths, to assist the
				  individual in:
(A) overcoming barriers to
				  achieving a factual and rational understanding of legal proceedings;
				  and
(B) consulting with the
				  individual's lawyer with a reasonable degree of rational
				  understanding;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.123 - Competency Restoration Education

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  provider must submit the competency restoration training module for HHSC
				  review.
(b) Each individual must be
				  educated in multiple learning formats, which may include:
(1) discussion;
(2) written text;
(3) video; and
(4) experiential methods such as role-playing
				  or mock trial.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.125 - Procedures for Determining Competency Status in a JBCR Program

Current through Reg. 49, No. 28; July 12, 2024
(a) The psychiatrist for a JBCR pilot
				  program, or psychiatrist or psychologist for a county-based JBCR program, must
				  conduct at least two full psychiatric or psychological evaluations for each
				  individual. The psychiatrist or psychologist must:
(1) conduct the first evaluation no later
				  than the 21st day after the date JBCR program services began;
(2) conduct the second evaluation no later
				  than the 55th day after the date JBCR program services began; and
(3) subsequent to evaluations completed in
				  paragraphs (1) and (2) of this subsection, promptly submit a separate report
				  for each psychiatric or psychological evaluation to the court.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.127 - Preparation for Discharge from a JBCR Program

Current through Reg. 49, No. 28; July 12, 2024
(a) At any time an individual is restored to
				  competency, the psychiatrist or psychologist must collaborate with provider
				  staff members to coordinate the individual's continued services and supports
				  after discharge from the JBCR program to:
(1)
				  the county jail;
(2) the
				  LMHA;
(3) the LBHA;
(4) the LIDDA; or
(5) another mental health provider.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.129 - Outcome Measures

Current through Reg. 49, No. 28; July 12, 2024
A provider must collect and report data to HHSC on:
(1) individual outcomes:
(A) the number of individuals on felony
				  charges;
(B) the number of
				  individuals on misdemeanor charges;
(C) the average number of days for an
				  individual charged with a felony to be restored to competency;
(D) the average number of days for an
				  individual charged with a misdemeanor to be restored to competency;
(E) the number of individuals charged with a
				  misdemeanor and not restored to competency, for whom an extension was
				  sought;
(F) the number of
				  individuals restored to competency;
(G) the average length of time between
				  determination of non-restorability and transfer to a state mental health
				  facility or residential care facility;
(H) the percentage of individuals restored to
				  competency in 60 days or less;
(I)
				  the number of jail inmates found IST who were screened out of or deemed
				  inappropriate for the program and the reason why; and
(J) the number of individuals not restored to
				  competency and who were transferred to a state mental health facility or
				  residential care facility; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter C - JAIL-BASED COMPETENCY RESTORATION PROGRAM › Section 307.131 - Compliance with Statutes, Rules, and Other Documents

Current through Reg. 49, No. 28; July 12, 2024
(a) In addition to any applicable federal or
				  state law or rule, a provider must comply with:
(1) Texas Health and Safety Code, Chapter 574
				  (relating to Court-Ordered Mental Health Services);
(2) 25 TAC:
(A) Chapter 405, Subchapter K (relating to
				  Deaths of Persons Served by TXMHMR Facilities or Community Mental Health and
				  Mental Retardation Centers);
(B)
				  Chapter 306, Subchapter A of this title (relating to Standards for Services to
				  Individuals with Co-occurring Psychiatric and Substance Use Disorders
				  (COPSD));
(C) Chapter 414,
				  Subchapter I (relating to Consent to Treatment with Psychoactive
				  Medication--Mental Health Services);
(D) Chapter 414, Subchapter K (relating to
				  Criminal History and Registry Clearances);
(E) Chapter 414, Subchapter L (relating to
				  Abuse, Neglect, and Exploitation in Local Authorities and Community
				  Centers);
(F) Chapter 415,
				  Subchapter A (relating to Prescribing of Psychoactive Medication);
				  and
(G) Chapter 415, Subchapter F
				  (relating to Interventions in Mental Health Services); and
(3) 37 TAC Part 9 (relating to Texas
				  Commission on Jail Standards).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter D - OUTPATIENT COMPETENCY RESTORATION › Section 307.151 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to provide standards for
					 outpatient competency restoration (OCR) services provided to individuals
					 ordered to participate in an OCR program pursuant to the Texas Code of Criminal
					 Procedure Chapter 46B.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 307 - BEHAVIORAL HEALTH PROGRAMS › Subchapter D - OUTPATIENT COMPETENCY RESTORATION › Section 307.153 - Application

Current through Reg. 49, No. 28; July 12, 2024
This subchapter applies to:
(1) local mental health authorities (LMHAs),
				  local behavioral health authorities (LBHAs), and LMHA or LBHA subcontractors
				  that administer OCR programs; and
(2) other providers under contract with the
				  Texas Health and Human Services Commission to administer an OCR
				  program.