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 D - MENTAL HEALTH SERVICES-ADMISSION, CONTINUITY, AND DISCHARGE › Division 5 - DISCHARGE AND ABSENCES FROM A STATE MENTAL HEALTH FACILITY OR FACILITY WITH A CONTRACTED PSYCHIATRIC BED › Section 306.201 - Discharge Planning

Current through Reg. 49, No. 28; July 12, 2024
(a) At the time of
					 an individual's admission to an SMHF or facility with a CPB, the designated
					 LMHA or LBHA, if any, and the SMHF or facility with a CPB begins discharge
					 planning for the individual.
(b)
					 The designated LMHA or LBHA continuity of care worker or other designated
					 staff; the designated LIDDA continuity of care worker, if applicable; the
					 individual; the individual's LAR, if any; and any other person authorized by
					 the individual coordinates discharge planning with the SMHF or facility with a
					 CPB.
(1) Except for the SMHF or facility with
					 a CPB treatment team and the individual, involvement in discharge planning may
					 be through teleconference or video-conference calls.
(2) The SMHF or the facility with a CPB must
					 provide a minimum of 24-hour notification before scheduled staffings and
					 reviews to persons involved in discharge planning.
(3) The LMHA, LBHA, or LIDDA, if applicable,
					 and the SMHF or facility with a CPB involved in discharge planning must
					 coordinate all discharge planning activities and ensure the development and
					 completion of the discharge plan before the individual's discharge.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter D - MENTAL HEALTH SERVICES-ADMISSION, CONTINUITY, AND DISCHARGE › Division 5 - DISCHARGE AND ABSENCES FROM A STATE MENTAL HEALTH FACILITY OR FACILITY WITH A CONTRACTED PSYCHIATRIC BED › Section 306.202 - Special Considerations for Discharge Planning

Current through Reg. 49, No. 28; July 12, 2024
(a) Three Admissions Within 180 Days. An
					 individual admitted to an SMHF or a facility with a CPB three times within 180
					 days is considered at risk for future admission to inpatient services. To
					 prevent the unnecessary admissions to an inpatient facility, the designated
					 LMHA or LBHA must:
(1) during discharge
					 planning, review the individual's previous recovery or treatment plans to
					 determine the effectiveness of the clinical services received;
(2) include in the recovery or treatment
					 plan:
(A) non-clinical supports, such as those
					 provided by a peer specialist or recovery coach, identified to support the
					 individual's ongoing recovery; and
(B) recommendations for services and
					 interventions from the individual's current or previous care plan(s) that
					 support the individual's strengths and goals and prevent unnecessary admission
					 to an SMHF or facility with a CPB;
(3) determine the availability and level of
					 care "type, amount, scope and duration" of clinical and non-clinical supports,
					 such as those provided by a peer specialist or recovery coach, that promote
					 ongoing recovery and prevent unnecessary admission to an SMHF or facility with
					 a CPB; and
(4) consider
					 appropriateness of the individual's continued stay in the SMHF or facility with
					 a CPB.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter D - MENTAL HEALTH SERVICES-ADMISSION, CONTINUITY, AND DISCHARGE › Division 5 - DISCHARGE AND ABSENCES FROM A STATE MENTAL HEALTH FACILITY OR FACILITY WITH A CONTRACTED PSYCHIATRIC BED › Section 306.203 - Discharge of an Individual Voluntarily Receiving Treatment

Current through Reg. 49, No. 28; July 12, 2024
(a) An SMHF or facility with a CPB must
					 discharge an individual voluntarily receiving treatment if the administrator or
					 designee of the SMHF or facility with a CPB concludes that the individual can
					 no longer benefit from inpatient services based on the physician's
					 determination, as delineated in Division 5 of this subchapter (relating to
					 Discharge and Absences from a State Mental Health Facility or Facility with a
					 Contracted Psychiatric Bed).
(b) If
					 a written request for discharge is made by an individual voluntarily receiving
					 treatment or the individual's LAR:
(1) the
					 SMHF or facility with a CPB must discharge the individual in accordance with
					 Texas Health and Safety Code §
												572.004;
					 and
(2) the individual or
					 individual's LAR signs, dates, and documents the time on the discharge
					 request.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter D - MENTAL HEALTH SERVICES-ADMISSION, CONTINUITY, AND DISCHARGE › Division 5 - DISCHARGE AND ABSENCES FROM A STATE MENTAL HEALTH FACILITY OR FACILITY WITH A CONTRACTED PSYCHIATRIC BED › Section 306.204 - Discharge of an Individual Involuntarily Receiving Treatment

Current through Reg. 49, No. 28; July 12, 2024
(a) Discharge from emergency detention.
(1) Except as provided by § 306.178 of
					 this subchapter (relating to Voluntary Treatment Following Involuntary
					 Admission) and in accordance with Texas Health and Safety Code §
												573.021(b)
					 and §
												573.023(b),
					 an SMHF or facility with a CPB immediately discharges an individual under
					 emergency detention if:
(A) the SMHF
					 administrator, administrator of the facility with a CPB, or designee concludes,
					 based on a physician's determination, the individual no longer meets the
					 criteria in § 306.176(c)(1) of this subchapter (relating to Admission
					 Criteria for a Facility with a Contracted Psychiatric Bed Authorized by an LMHA
					 or LBHA or for a State Mental Health Facility for Emergency Detention);
					 or
(B) except as provided in
					 paragraph (2) of this subsection:
(i) 48 hours
					 has elapsed from the time the individual was presented to the SMHF or facility
					 with a CPB; and
(ii) the SMHF or
					 facility with a CPB has not obtained a court order for further detention of the
					 individual.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter D - MENTAL HEALTH SERVICES-ADMISSION, CONTINUITY, AND DISCHARGE › Division 5 - DISCHARGE AND ABSENCES FROM A STATE MENTAL HEALTH FACILITY OR FACILITY WITH A CONTRACTED PSYCHIATRIC BED › Section 306.205 - Pass or Furlough from a State Mental Health Facility or a Facility with a Contracted Psychiatric Bed

Current through Reg. 49, No. 28; July 12, 2024
(a) In
					 accordance with Texas Health and Safety Code §
											574.082, an
					 SMHF administrator, administrator of a facility with a CPB, or designee may, in
					 coordination with the designated LMHA or LBHA, authorize absences for an
					 individual involuntarily admitted under court order for inpatient mental health
					 services.
(1) If an individual's authorized
					 absence is to exceed 72 hours, the SMHF or facility with a CPB notifies the
					 committing court of the absence.
(2) The SMHF or facility with a CPB may not
					 authorize an absence that exceeds the expiration date of the individual's order
					 for inpatient mental health services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter D - MENTAL HEALTH SERVICES-ADMISSION, CONTINUITY, AND DISCHARGE › Division 5 - DISCHARGE AND ABSENCES FROM A STATE MENTAL HEALTH FACILITY OR FACILITY WITH A CONTRACTED PSYCHIATRIC BED › Section 306.206 - Absence for Trial Placement

Current through Reg. 49, No. 28; July 12, 2024
(a) An
					 individual who is under consideration for discharge as described in §
					 306.203 of this division (relating to Discharge of an Individual Voluntarily
					 Receiving Treatment) or § 306.204(c) of this division (relating to
					 Discharge of an Individual Involuntarily Receiving Treatment), may leave the
					 SMHF or facility with a CPB on ATP if the SMHF or facility with a CPB and the
					 designated LMHA or LBHA agree that an ATP will be beneficial in implementing
					 the individual's recovery or treatment plan. The designated LMHA or LBHA is
					 responsible for monitoring the individual while on ATP.
(b) Time frames for ATP.
(1) An individual admitted under
					 court-ordered inpatient mental health services may not be on ATP beyond the
					 expiration date of the individual's order for inpatient mental health
					 services.
(2) The initial ATP
					 period for any individual may not exceed 30 days.
(3) The SMHF or facility with a CPB may
					 extend an initial ATP period up to 30 days if:
(A) requested by the designated LMHA or LBHA;
					 and
(B) clinically
					 justified.
(4) Approval
					 by the following persons is required for any ATP that exceeds 60 days:
(A) the SMHF administrator or designee, or
					 the administrator of the facility with a CPB or designee; and
(B) the designated LMHA or LBHA executive
					 director or designee.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter D - MENTAL HEALTH SERVICES-ADMISSION, CONTINUITY, AND DISCHARGE › Division 5 - DISCHARGE AND ABSENCES FROM A STATE MENTAL HEALTH FACILITY OR FACILITY WITH A CONTRACTED PSYCHIATRIC BED › Section 306.207 - Post Discharge or Absence for Trial Placement

Current through Reg. 49, No. 28; July 12, 2024
The designated LMHA or LBHA is responsible for contacting
						the individual following discharge or ATP from an SMHF or a facility with a CPB
						and for implementing the individual's recovery or treatment plan in accordance
						with this section.
(1) LMHA or LBHA
					 contact after discharge or ATP.
(A) The
					 designated LMHA or LBHA makes face-to-face contact with an individual within
					 seven days after discharge or ATP of an individual who is:
(i) discharged or on ATP from an SMHF or
					 facility with a CPB and referred to the LMHA or LBHA for services or supports
					 as indicated in the recovery or treatment plan;
(ii) discharged from an LMHA or LBHA-network
					 provider of inpatient services and referred to the LMHA or LBHA for services or
					 supports as indicated in the recovery or treatment plan;
(iii) discharged from an alternate provider
					 of inpatient services and receiving LMHA or LBHA services from the designated
					 LMHA or LBHA at the time of admission and who, upon discharge, is referred to
					 the LMHA or LBHA for services or supports as indicated in the recovery or
					 treatment plan;
(iv) discharged
					 from the LMHA's or LBHA's crisis stabilization unit or any overnight crisis
					 facility and referred to the LMHA or LBHA for services or supports as indicated
					 in the discharge plan; or
(v) an
					 offender with special needs discharged from an SMHF or facility with a CPB
					 returning to jail.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter D - MENTAL HEALTH SERVICES-ADMISSION, CONTINUITY, AND DISCHARGE › Division 6 - TRAINING › Section 306.221 - Screening and Intake Assessment Training Requirements at a State Mental Health Facility and a Facility with a Contracted Psychiatric Bed

Current through Reg. 49, No. 28; July 12, 2024
(a) Screening training. As required by Texas
					 Health and Safety Code §
											572.0025(e),
					 an SMHF or facility with a CPB staff member whose responsibilities include
					 conducting a screening described in Division 3 of this subchapter (relating to
					 Admission to a State Mental Health Facility or Facility with a Contracted
					 Psychiatric Bed--Provider Responsibilities) must receive at least eight hours
					 of training in the SMHF's or facility with a CPB's screening.
(1) The screening training must provide
					 instruction regarding:
(A) obtaining relevant
					 information about the individual, including information about finances,
					 third-party coverage or insurance benefits, and advance directives;
(B) explaining, orally and in writing, the
					 individual's rights described in 25 TAC Chapter 404, Subchapter E (relating to
					 Rights of Persons Receiving Mental Health Services);
(C) explaining, orally and in writing, the
					 SMHF's or facility with a CPB's services and treatment as they relate to the
					 individual;
(D) explaining, orally
					 and in writing, the existence, purpose, telephone number, and address of the
					 protection and advocacy system established in Texas, pursuant to Texas Health
					 and Safety Code §
													576.008;
					 and
(E) determining whether an
					 individual comprehends the information provided in accordance with
					 subparagraphs (B) - (D) of this paragraph.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.251 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The subchapter describes requirements for providing mental
					 health case management services (MH case management services) funded by or
					 through the department.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.253 - Application

Current through Reg. 49, No. 28; July 12, 2024
The subchapter applies to providers of MH case management
					 services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.255 - 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) Adolescent--An
				  individual who is at least 13 years of age, but younger than 18 years of
				  age.
(2) Adult--An individual who
				  is 18 years of age or older.
(3)
				  Assessment or reassessment--A systematic process for determining an
				  individual's need for any clinically necessary medical, educational, social, or
				  other services (e.g., taking client history, gathering information from other
				  sources, identifying the needs of the individual, and completing related
				  documentation).
(4) Business
				  day--Any day except a Saturday, Sunday, or legal holiday listed in the Texas
				  Government Code, §
										662.021.
(5) Case manager--An employee who provides MH
				  case management services.
(6)
				  Child--An individual who is at least three years of age, but younger than 13
				  years of age.
(7) CFR--Code of
				  Federal Regulations.
(8) Community
				  based--A description of the location where routine or intensive case management
				  services are provided (i.e., in an individual's community).
(9) Community mental health center or
				  CMHC--An entity established in accordance with the Texas Health and Safety
				  Code, §
										534.001, as a
				  community mental health center or a community mental health and mental
				  retardation center.
(10) Community
				  resources--People or entities providing services that address the identified
				  needs of individuals receiving MH case management services (e.g., providers of
				  medical care, food, clothing, child care, employment, or housing).
(11) Community services specialist or CSSP--A
				  staff member who, as of August 31, 2004:
(A)
				  has received:
(i) a high school diploma;
				  or
(ii) a high school equivalency
				  certificate issued in accordance with the law of the issuing state;
				  and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.257 - Provider Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  provider must comply with Subchapter G of this chapter (relating to Mental
				  Health Community Services Standards).
(b) The provider must assign a case manager
				  to an individual within two business days after receiving notification from the
				  department or its designee that the individual has been authorized to receive
				  MH case management services.
(c)
				  The provider must ensure that an alternate case manager acts as the
				  individual's assigned case manager if an individual's assigned case manager is
				  not available.
(d) The provider
				  must maintain case manager-to-individual ratios sufficient to perform the
				  responsibilities of a case manager in accordance with this
				  subchapter.
(e) The provider is
				  responsible for a case manager's compliance 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 E - MENTAL HEALTH CASE MANAGEMENT › Section 306.259 - Eligibility for MH Case Management Services

Current through Reg. 49, No. 28; July 12, 2024
For an individual to be eligible for MH case management
					 services, the individual must:
(1) be
				  a resident of the State of Texas;
(2) be an adult with a severe and persistent
				  mental illness, or a child or adolescent with a serious emotional disturbance
				  who may have a diagnosis described in paragraph (3) of this section;
(3) not have a single diagnosis of an
				  intellectual or developmental disability or a substance use disorder;
				  and
(4) qualify for an LOC that
				  includes MH case management services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.261 - Authorization for MH Case Management Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A provider must:
(1) ensure that a QMHP-CS administers the
				  uniform assessment to the individual at intervals specified by the department
				  and obtain a recommended LOC for the individual;
(2) evaluate the clinical needs of the
				  individual to determine if the amount of MH case management services associated
				  with the recommended LOC described in the utilization management guidelines is
				  sufficient to meet those needs; and
(3) ensure that an LPHA reviews the
				  recommended LOC and verifies whether the services are medically
				  necessary.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.263 - MH Case Management Services Standards

Current through Reg. 49, No. 28; July 12, 2024
(a) Assessment. An individual is assessed
				  according to §
										306.261 of this title (relating to
				  Authorization for MH Case Management Services) to determine the LOC necessary
				  to address the individual's needs. If the individual needs either routine or
				  intensive case management the provider must assign a case manager according to
				  §
										306.257(b) of this title (relating
				  to Provider Requirements). MH case management services, as well as attempts to
				  provide case management, must be documented according to §
										306.275 of this title (relating to
				  Documenting MH Case Management Services).
(1)
				  MH case management services must:
(A) be
				  delivered according to the department's utilization management guidelines,
				  which are described in §
												306.279 of this title (relating to
				  Fair Hearings and Appeal Processes); and
(B) include regular, but at least annual,
				  monitoring of service effectiveness and proactive crisis planning and
				  management.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.265 - Making a Complaint

Current through Reg. 49, No. 28; July 12, 2024
A provider must, in accordance with Chapter 404, Subchapter
					 E of Title 25 (relating to Rights of Persons Receiving Mental Health Services),
					 notify the individual or LAR and, if the individual is a child or adolescent,
					 the primary caregiver in writing of the process for making a complaint to the
					 provider's client rights officer.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.267 - Service Limitations

Current through Reg. 49, No. 28; July 12, 2024
(a) A case
				  manager must not provide MH case management services to an individual if a dual
				  relationship exists.
(b) Activities
				  that do not constitute MH case management services are identified in the
				  department's
MH Case Management Billing Guidelines
as
				  referenced in §
										306.281 of this title (relating to
				  Guidelines).
(c) The provider must
				  ensure that a conflict of interest does not exist if the same case manager is
				  providing other, non-case management services.
(d) The provider must ensure that providers
				  of case management services cannot authorize services.
(e) The receipt of MH case management
				  services cannot be conditioned upon receipt of other services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.269 - Notification and Terminations

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Notification. The provider must notify the department or its designee if the
				  provider has reason to believe that:
(1) the
				  individual no longer meets the eligibility criteria for MH case management
				  services as set forth in §
											306.259 of this title (relating to
				  Eligibility for MH Case Management Services);
(2) the LAR of an individual has refused MH
				  case management services on behalf of the individual;
(3) the adult or LAR has refused MH case
				  management services;
(4) the
				  provider cannot locate the individual and the provider has documented multiple
				  attempts to locate the individual over a period of two consecutive
				  months;
(5) the individual has
				  died;
(6) the individual has
				  established or intends to establish residency outside of the provider's service
				  area; or
(7) if MH case management
				  services are terminated for any reason described in paragraphs (1) - (6) of
				  this subsection, the provider shall document the reason for terminating MH case
				  management services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.271 - MH Case Management Employee Qualifications

Current through Reg. 49, No. 28; July 12, 2024
(a) A case manager must be:
(1) a QMHP-CS or a CSSP;
(2) an employee of the provider;
				  and
(3) competent according to
				  §
											306.273 of this title (relating to
				  MH Case Management Employee Competencies).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.273 - MH Case Management Employee Competencies

Current through Reg. 49, No. 28; July 12, 2024
(a) The provider must implement a process to
				  ensure the competency of a case manager and a case manager supervisor that, at
				  a minimum, ensures:
(1) an accurate knowledge
				  of the requirements of this subchapter and the following subchapters of this
				  title:
(A) Chapter 412, Subchapter G of Title
				  25 (relating to Mental Health Community Services Standards);
(B) Chapter 404, Subchapter E of Title 25
				  (relating to Rights of Persons Receiving Mental Health Services);
(C) Chapter 414, Subchapter L of Title 25
				  (relating to Abuse, Neglect, and Exploitation in Local Authorities and
				  Community Centers); and
(D) Chapter
				  306, Subchapter A of this title (relating to Standards for Services to
				  Individuals with Co-Occurring Psychiatric and Substance Use Disorders
				  (COPSD));
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.275 - Documenting MH Case Management Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Location of documentation. MH case management services, as well as attempts to
				  provide MH case management services, as described in this section, must be
				  documented in the individual's medical record.
(1) For routine case management, the case
				  manager must document the information required by §
											306.263(b)(3) - (6) of this title
				  (relating to MH Case Management Services Standards), as well as the steps taken
				  to meet the individual's goals and needs as required by §
											306.263(b)(7) of this title, in
				  the individual's medical record.
(2) For intensive case management:
(A) the assigned case manager must include
				  the intensive case management plan required by §
												306.263(c)(1) of this title in the
				  individual's medical record; and
(B) the assigned case manager must document
				  steps taken to meet the individual's goals and needs as required by §
												306.263(c)(7) of this title in the
				  individual's progress notes.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.277 - Medicaid Reimbursement

Current through Reg. 49, No. 28; July 12, 2024
(a) In
				  accordance with §
										306.263 of this title (relating to
				  MH Case Management Services Standards), a billable event is a face-to-face
				  contact during which the case manager provides an MH case management service to
				  an:
(1) individual who is Medicaid eligible;
				  or
(2) LAR on behalf of a child or
				  adolescent who is Medicaid eligible.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 306 - BEHAVIORAL HEALTH DELIVERY SYSTEM › Subchapter E - MENTAL HEALTH CASE MANAGEMENT › Section 306.279 - Fair Hearings and Appeal Processes

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 case management
				  services is denied or is not acted upon with reasonable promptness, or whose MH
				  case management 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) Right of non-Medicaid eligible individual
				  to request an appeal. Any individual who has not applied for or is not eligible
				  for Medicaid whose request for eligibility for MH case management services is
				  denied or is not acted upon with reasonable promptness, or whose MH case
				  management services have been terminated, suspended, or reduced by a local
				  mental health authority or its contractor, is entitled to notification and
				  right of appeal 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 E - MENTAL HEALTH CASE MANAGEMENT › Section 306.281 - Guidelines

Current through Reg. 49, No. 28; July 12, 2024
The following guidelines, as revised, are referenced in
					 this subchapter. For information about obtaining copies of the guidelines
					 contact the Department of State Health Services, Mental Health Program
					 Services, P.O. Box 149347, Mail Code 2018, Austin, TX 78714-9347, (512)
					 467-5427 or access them electronically.
(1) Uniform assessment guidelines are
				  available online at:
				  http://www.dshs.state.tx.us/mhprograms/RDMAssess.shtm.
(2) Utilization management guidelines for
				  adults and children are available online at:
				  http://www.dshs.state.tx.us/mhprograms/RDMClinGuide.shtm.
(3)
MH Case Management Billing
				  Guidelines
are available at:
				  http://www.dshs.state.tx.us/Layouts/ContentPage.aspx?PageID=35712&id=8589961742&terms=billing+guidelines.
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 306.301 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to describe the
					 requirements for providing mental health (MH) rehabilitative services that
					 includes the following:
(1) crisis
				  intervention services;
(2)
				  medication training and support services;
(3) psychosocial rehabilitative
				  services;
(4) skills training and
				  development services; and
(5) day
				  programs for acute needs.
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 306.303 - Application

Current through Reg. 49, No. 28; July 12, 2024
This subchapter applies to providers of MH rehabilitative
					 services funded through Medicaid, or a general revenue contract with the
					 department.
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 306.305 - 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) Adolescent--An
				  individual who is at least 13 years of age, but younger than 18 years of
				  age.
(2) Adult--An individual who
				  is 18 years of age or older.
(3)
				  APRN or Advanced practice registered nurse--A staff member who is a registered
				  nurse approved by the Texas Board of Nursing as a clinical nurse specialist in
				  psychiatric/mental health or nurse practitioner in psychiatric/mental health,
				  in accordance with Texas Occupations Code, Chapter 301. The term is synonymous
				  with "advanced nurse practitioner."
(4) Authorization period--The duration for
				  which the provider has obtained authorization in accordance with §
										306.311(a) of this title (relating
				  to Service Authorization and Recovery Plan).
(5) Business day--Any day except a Saturday,
				  Sunday, or legal holiday listed in Texas Government Code, §
										662.021.
(6) CFP or Certified family partner--A person
				  who:
(A) is 18 years of age or
				  older;
(B) has received:
(i) a high school diploma; or
(ii) a high school equivalency certificate
				  issued in accordance with the laws applicable to the issuing agency;
(C) has at least one year of lived
				  experience raising a child or adolescent with an emotional or mental health
				  issues as a parent or LAR;
(D) has
				  at least one year of experience navigating a child-service system (e.g., mental
				  health, juvenile justice, social security, or special education) as a parent or
				  LAR; and
(E) has successfully
				  completed the certified family partner (CFP) training and passed the
				  certification examination recognized by the department.
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 306.307 - General Requirements for Providers of MH Rehabilitative Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Compliance with MH community standards.
				  In addition to complying with this subchapter, a provider must also comply with
				  Chapter 301, Subchapter G of this title (relating to Mental Health Community
				  Services Standards) in the provision of MH rehabilitative services, as
				  described in §
										301.305(a)(4) and (b) of this
				  title (relating to Responsibility for Compliance).
(b) Staff supervision and oversight. A
				  provider must develop policies and procedures in accordance with this
				  subchapter for the supervision and oversight of staff members who provide MH
				  rehabilitative services. Staff members who provide supervision must have
				  experience in providing rehabilitative services and training in supervising
				  rehabilitative services. The MH rehabilitative services provided by a:
(1) CFP must be directly supervised by a
				  staff member who is credentialed as a QMHP-CS at minimum and who must have at
				  least one year experience in the department-approved recovery and resilience
				  protocol;
(2) peer provider must be
				  under the direct clinical supervision of an LPHA;
(3) CSSP must be clinically supervised by a
				  QMHP-CS;
(4) QMHP-CS must be
				  clinically supervised by at least another QMHP-CS; and
(5) QMHP-CS supervisor of another QMHP-CS
				  must be clinically supervised by an LPHA.
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 306.309 - Eligibility

Current through Reg. 49, No. 28; July 12, 2024
An individual is eligible for MH rehabilitative services
					 if:
(1) the individual:
(A) is a resident of the State of
				  Texas;
(B) is an adult with a
				  serious mental illness or a child or adolescent with a serious emotional
				  disturbance (SED); and
(C)
				  qualifies for an LOC; and
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 306.311 - Service Authorization and Recovery Plan

Current through Reg. 49, No. 28; July 12, 2024
(a) Prerequisites to providing services. With
				  the exception of crisis intervention services:
(1) the provider must obtain prior
				  authorization from the department or its designee for the MH rehabilitative
				  services to be provided in accordance with the uniform assessment, which is
				  referenced in §
											306.333 of this title (relating to
				  Guidelines); and the utilization management guidelines, which are referenced in
				  §
											306.333 of this title;
				  and
(2) an LPHA must determine
				  whether the need for MH rehabilitative services meets the definition of medical
				  necessity.
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 306.313 - Crisis Intervention Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Description. Crisis intervention services are interventions provided in
				  response to a crisis in order to reduce or manage symptoms of serious mental
				  illness or SED and to prevent admission of an individual to a more restrictive
				  environment. Crisis intervention services consist of the following
				  interventions:
(1) an assessment of
				  dangerousness of the individual to self or others;
(2) the coordination of emergency care
				  services in accordance with §
											301.327 of this title (relating to
				  Access to Mental Health Community Services);
(3) behavior skills training to assist the
				  individual in reducing distress and managing symptoms;
(4) problem-solving;
(5) reality orientation to help the
				  individual identify and manage his or symptoms of serious mental illness or
				  SED; and
(6) providing instruction,
				  structure, and emotional support to the individual in adapting to and coping
				  with immediate stressors.
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 306.315 - Medication Training and Support Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Description. Medication training and
				  support services consist of education and guidance about medications and their
				  possible side effects. The department has reviewed and approved the use of the
				  materials that are available on the department's internet site at:
				  http://www.dshs.state.tx.us/mhsa/patient-family-ed/ and other materials which
				  have been formally reviewed and approved by the department, to assist an
				  individual in:
(1) understanding the nature
				  of an adult's serious mental illness or a child's or adolescent's
				  SED;
(2) understanding the concepts
				  of recovery and resilience within the context of the serious mental
				  illness;
(3) understanding the role
				  of the individual's prescribed medications in reducing symptoms and increasing
				  or maintaining the individual's functioning;
(4) identifying and managing the individual's
				  symptoms and potential side effects of the individual's medication;
(5) learning the contraindications of the
				  individual's medication;
(6)
				  understanding the overdose precautions of the individual's medication;
				  and
(7) learning
				  self-administration of the individual's medication.
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 306.317 - Psychosocial Rehabilitative Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Description. Psychosocial rehabilitative services are social, behavioral, and
				  cognitive interventions provided by members of an individual's therapeutic team
				  that build on strengths and focus on restoring the individual's ability to
				  develop and maintain social relationships, occupational or educational
				  achievement, and other independent living skills that are affected by or the
				  result of a serious mental illness in adults. Psychosocial rehabilitative
				  services may also address the impact of co-occurring disorders upon the
				  individual's ability to reduce symptomology and increase daily functioning.
				  Psychosocial rehabilitative services that include, but are not limited to, the
				  following component services:
(1) independent
				  living services;
(2) coordination
				  services;
(3) employment related
				  services;
(4) housing related
				  services;
(5) medication related
				  services; and
(6) crisis related
				  services.
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 306.319 - Skills Training and Development Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Description.
(1) Skills training and development services
				  is training provided to an eligible individual or the LAR or primary caregiver
				  of an eligible adult, child, or adolescent. Such training:
(A) addresses serious mental illness or SED
				  and symptom-related problems that interfere with the individual's functioning
				  and living, working, and learning environment;
(B) provides opportunities for the individual
				  to acquire and improve skills needed to function as appropriately and
				  independently as possible in the community; and
(C) facilitates the individual's community
				  integration and increases his or her community tenure.
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 306.321 - Day Programs for Acute Needs

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Description. Day programs for acute needs provide short term, intensive
				  treatment to an individual who requires multidisciplinary treatment in order to
				  stabilize acute psychiatric symptoms or prevent admission to a more restrictive
				  setting. Day programs for acute needs:
(1)
				  are provided in a highly structured and safe environment with constant
				  supervision;
(2) ensure an
				  opportunity for frequent interaction between an individual and staff
				  members;
(3) are services that are
				  goal oriented and focus on:
(A) reality
				  orientation;
(B) symptom reduction
				  and management;
(C) appropriate
				  social behavior;
(D) improving peer
				  interactions;
(E) improving stress
				  tolerance;
(F) the development of
				  coping skills; and
(4)
				  consist of the following component services:
(A) psychiatric nursing services;
(B) pharmacological instruction;
(C) symptom management training;
				  and
(D) functional skills
				  training.
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 306.323 - Documentation Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) MH
				  rehabilitative services documentation. A rehabilitative services provider must
				  document the following for all MH rehabilitative services:
(1) the name of the individual to whom the
				  service was provided;
(2) the type
				  of service provided;
(3) the
				  specific goal or objective addressed, modality, and method used to provide the
				  service;
(4) the date the service
				  was provided;
(5) the begin and end
				  time of the service;
(6) the
				  location where the service was provided;
(7) the signature of the staff member
				  providing the service and a notation of their credential (e.g., a QMHP-CS, a
				  pharmacist, a CSSP, a CFP, or a peer provider);
(8) any pertinent event or behavior relating
				  to the individual's treatment which occurs during the provision of the
				  service;
(9) any pertinent
				  information required to be documented by the curricula, protocol, or practice
				  approved by the department; and
(10) the outcome or response, as applicable:
(A) for crisis intervention service, the
				  outcome of the crisis;
(B) for
				  psychosocial coordination services, the outcome of the services;
(C) for day programs for acute needs, the
				  progress or lack of progress in stabilizing the individual's acute psychiatric
				  symptoms; or
(D) for all other
				  services, the individual's response, including the progress or lack of progress
				  in achieving recovery plan goals and objectives.
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 306.325 - Staff Member Competency and Training

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  General competency of staff members. In accordance with §
										301.331 of this title (relating to
				  Competency and Credentialing), a provider must ensure the competency of staff
				  members prior to providing services.
(b) MH rehabilitative services training and
				  competency of staff members. A provider must ensure that staff members
				  providing MH rehabilitative services receive initial training and ensure the
				  competency of a staff member who provides or supervises the provision MH
				  rehabilitative services in the following areas:
(1) the nature of serious mental illness and
				  SED;
(2) the concepts of recovery
				  and resilience;
(3) the
				  department-approved curricula, protocol, or practice;
(4) the rehabilitative practice techniques
				  found in curricula, program practices, and protocols; and
(5) the prevalence of health risk
				  factors.
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 306.327 - Medicaid Reimbursement

Current through Reg. 49, No. 28; July 12, 2024
(a) Billable
				  and non-billable activities.
(1) A Medicaid
				  provider may only bill for medically necessary MH rehabilitative services that
				  are provided face-to-face to:
(A) a
				  Medicaid-eligible individual;
(B)
				  the LAR of a Medicaid-eligible adult (on behalf of the adult); or
(C) the LAR or primary caregiver of a
				  Medicaid-eligible child or adolescent (on behalf of the child or
				  adolescent).
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 306.329 - Medicaid Provider Participation Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) Qualifications. To become a Medicaid
				  provider of MH rehabilitative services, an entity must:
(1) be established as a community mental
				  health center in accordance with Texas Health and Safety Code, §
											534.001, that:
(A) provides services comparable to MH
				  rehabilitative services and the services described in the Texas Health and
				  Safety Code, §
												534.053(a)(1)
				  - (7);
(B) is in compliance with Chapter 412,
				  Subchapter G of this title (relating to Mental Health Community Services
				  Standards);
(C) conducts criminal
				  history clearances on all contractors delivering MH rehabilitative services and
				  all employees and applicants of the Medicaid provider to whom an offer of
				  employment is made and ensures that individuals do not come in contact with and
				  are not provided services by an employee or contractor of the Medicaid provider
				  (or employee or contractor of contractors delivering MH rehabilitative services
				  under a contract with the Medicaid provider) who has a conviction for any of
				  the criminal offenses listed in Texas Health and Safety Code, §
												250.006,
				  or for any criminal offense that the Medicaid provider has determined to be a
				  contraindication to employment; and
(D) has a Medicaid provider agreement with
				  the department to provide MH rehabilitative services; or