Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 353 - MEDICAID MANAGED CARE › Subchapter P - MENTAL HEALTH TARGETED CASE MANAGEMENT AND MENTAL HEALTH REHABILITATION › Section 353.1403 - 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) Adult--An individual who
				  is age 21 or older.
(2)
				  CFP--Certified Family Partner. A person who meets the credentialing
				  requirements in § 353.1415(d) of this subchapter (relating to Staff Member
				  Credentialing).
(3) CFR--Code of
				  Federal Regulations.
(4) Child or
				  youth--An individual who is under age 21.
(5) Clinical supervision--An LPHA's or
				  QMHP-CS's oversight of a staff member who delivers mental health targeted case
				  management and mental health rehabilitative services to ensure that services
				  are clinically appropriate and in compliance with this subchapter.
(6) Community data--Additional information
				  gathered during the uniform assessment.
(7) CSSP--Community services specialist. A
				  staff member of a local mental health authority who has documented full-time
				  experience in the provision of mental health targeted case management and
				  mental health rehabilitative services prior to August 31, 2004. See definition
				  in 25 TAC §
										RSA
				  412.303(relating to Definitions).
(8) Comprehensive provider agency--An entity
				  that provides or subcontracts for the delivery of the full array of mental
				  health targeted case management and mental health rehabilitative services set
				  forth in Chapter 354, Subchapter M of this title (relating to Mental Health
				  Targeted Case Management and Mental Health Rehabilitation), with the exception
				  of § 354.2715 of this title (relating to Day Programs for Acute
				  Needs).
(9) Credentialing--A
				  process by which the comprehensive provider agency reviews and approves a staff
				  member's educational background, work experience, and licensure status (as
				  applicable) to ensure that the staff member meets requirements for staff member
				  credentialing as outlined in §353.1415. The process includes primary
				  source verification of credentials, establishing and applying specific criteria
				  and prerequisites to determine the staff member's initial and ongoing
				  competency, and assessing and validating the staff member's qualifications to
				  deliver care.
(10) HHSC--The Texas
				  Health and Human Services Commission, or its designee.
(11) Individual--A person seeking or
				  receiving mental health targeted case management, mental health rehabilitative
				  services, or both under this subchapter.
(12) Intensive case management--A level of
				  mental health targeted case management that includes a focused effort to
				  coordinate community resources, uses evidence-based wraparound process planning
				  to address a child's or youth's unmet needs across life domains, and assists a
				  child or youth in gaining access to necessary care and services appropriate to
				  the child's or youth's needs.
(13)
				  Intensive case management plan--A written document that is part of the medical
				  record for a child or youth receiving intensive case management and is
				  developed by a case manager, in collaboration with the child or youth and the
				  child's or youth's LAR or primary caregiver, that identifies services needed by
				  the child or youth and sets forth a plan for how the child or youth may gain
				  access to the identified services.
(14) LAR--Legally authorized representative.
				  A person authorized by law to act on behalf of an individual with regard to a
				  matter described in this subchapter, including a parent, guardian, or managing
				  conservator of a minor, or the guardian of an adult.
(15) Life domains--Areas of life, including
				  safety, health, emotional, psychological, social, educational, cultural, and
				  legal.
(16) LPHA--Licensed
				  Practitioner of the Healing Arts. A staff member who is:
(A) a physician;
(B) a licensed professional
				  counselor;
(C) a licensed clinical
				  social worker;
(D) a licensed
				  psychologist;
(E) an advanced
				  practice registered nurse;
(F) a
				  physician assistant; or
(G) a
				  licensed marriage and family therapist.