Spreadsheet: 33d9d3fc-5c05-4649-9e70-723b6969780f
Sheet: Sheet1

Agency | Management Standards/Policies/ Memorandums of Understanding | Policy Reference ID | Topic/Chapter/ Section | Observations
Department of Assistive & Rehabilitative Services (DARS) | Management Standard: Rehabilitation Policy Manual |  |  | 6.3.2 [NAME] and Procedures for Unsuccessful Closures (of case accounts): --contact the parole or probation officer,  AA or NA sponsor, or other persons who may know the consumer's whereabouts or can contact the consumer. Does not specifically address youth in the juvenile justice system.
Department of Assistive & Rehabilitative Services (DARS) | Memorandum of Understanding | Between DARS Early Childhood Intervention (ECI)  & TEA | Defining roles & responsibilities between agencies | Relating to children with disabilities. Does not specifically address youth in the juvenile justice system.
Department of Assistive & Rehabilitative Services (DARS) | Policy: Human Resources Code | HR Code Chapter 73 Interagency Council on Early Childhood Intervention Services | Facilities and Services for Children | Does not specifically address youth in the juvenile justice system.
Texas Commission on Jail Standards (TCJS) | Policy: Texas Administrative Code (TAC) | Title 37; Part 9; Chapter 273; Rule 273.1 | Public Safety & Corrections/ Health Services | The owner/operator of each facility shall provide medical, mental, and dental services in accordance with the approved health services plan. These services may include, but shall not be limited to, the services of a licensed physician, professional and allied health personnel, hospital, or similar services. Does not specifically address youth in the juvenile justice system.
Texas Department of Aging and Disability Services (DADS) | No documents received |  |  | The following response was received from the Texas Department of Aging and Disability Services (DADS): [We] received your request for information regarding mental health services for youth and families of color.  DADS provides residential care for persons with mental retardation.  [NAME] concerning mental health programs can be requested through the Texas Department of State Health Services."
Texas Department of Criminal Justice (TDCJ) | Management Standard: Administrative Directive | AD-06.07 (Rev. 4)/ Authority - Sections 499.102(a)(7) and (8) 501.051 and 501.059 Texas Government Code; Reference: American Correctional Association (ACA) Standard 4-4344. | Access to Health Services | "....TDCJ shall provide all incarcerated offenders with full access to health services... daily including ...sick call, routine appointments, chronic disease appointments, specialty clinics, medical treatment, diagnostic appointments, and emergency services." This program is part of the state criminal justice system.
Texas Department of Criminal Justice (TDCJ) | Management Standard: Administrative Directive | AD-06.17 (Rev. 4)/ Authority - Sections 493.006 and 494.022, Texas Government Code; Reference: American Correctional Association (ACA) Standards 4-4362, 4-4363 and 4-4365 | Health Summary for Classification | TDCJ "...shall establish guidelines for the timely completion, review, update and dissemination of information contained in an offender's HSM-18, "Health Summary for Classification." The Unit Classification Committee (UCC) shall use this information for housing, work assignment and disciplinary measures." This program is part of the state criminal justice system.
Texas Department of Criminal Justice (TDCJ) | Management Standard: Administrative Directive | AD-07.02 (Rev. 6)/ Authority - Sections 19.004 and 19.005, Texas Education Code; Reference: American Correctional Association (ACA) Standards: 4-4474, 4-4477, and 4-4464 | Offender Participation in Educational Programs and Services | TDCJ "...incarcerated offenders are allowed to participate in educational programs and services in accordance with policies established by the institution providing the service." This program is part of the state criminal justice system.
Texas Department of Criminal Justice (TDCJ) | Management Standard: Executive Directive | ED-02.39 (Rev. 1)/ Prison Deterrence Education Programs: Authority - Section 493.006(b) Texas Government Code | Prison Deterrence Education Programs: include Adult Education Program and Life Decisions Program, designed for ages 17+ | Prison Deterrence Education Programs include Adult Education Program and "Life Decisions Program" (an external education program), designed for ages 17+. This program is part of the state criminal justice system.
Texas Department of Criminal Justice (TDCJ) | Management Standard: Operations Manual | "Enabling Legislation and Authority:" House Bill 327 (1995); Texas Family Code, Title 3, Juvenile Justice Code, Section 54.02, 54.04; Government Code, Title 4. Executive Branch, Chapter 499.053 Transfers from Texas Youth Commission | The Challenge Opportunity Understanding Respect Acceptance Growth Education (COURAGE) Program and Young Adult Transition Offenders (YATO) Operations Manual ["...placement and programming for young offenders certified as adults or transferred from the Texas Youth Commission who are under the age 18 [age 14-17]" | TDCJ's "...Challenge Opportunity Understanding Respect Acceptance Growth Education (COURAGE) program was created to provide placement and programming for young offenders certified as adults or transferred from the Texas Youth Commission who are under the age 18 [age 14-17]. PORTIONS OF MANUAL RELEVANT TO MH: Staff Development in …Cultural Awareness …Crisis Prevention and Intervention...Substance Abuse Treatment Services, Mental Health Issues...Case Management Planning and Implementation." “…Youthful offenders more suited for a medical unit of assignment or who are mentally impaired shall be transferred to the appropriate special needs facility.” This program is part of the state criminal justice system.
Texas Department of Criminal Justice (TDCJ): Texas Correctional Office on Offenders with Medical or Mental Impairments (TCCOOMMI) | Policy: Grant | [NAME] Diversionary Program (Texas Juvenile Probation Commission) [also submitted by TJPC] | Text of Grant Requirement/  Commentary/ Methodology | The Special Needs Diversionary Program (SNDP) is a grant designed to increase the availability of effective services to juvenile offenders with mental health needs.  The Commission is working in coordination with the Texas Correctional Office on Offenders with Medical or Mental Impairments (TCOOMMI) and in cooperation with mental health and mental retardation agencies, to implement programs that provide services to youth under the jurisdiction of local juvenile probation departments. Details identification, assessment and service delivery components
Texas Department of Family and Protective Services (DFPS) | No documents received |  |  | Told by the department that: "Mental health policies were under the Texas Department of Mental Health and Mental Retardation (MHMR), which combined with the Texas Rehabilitative Services (TRC) to form the Texas Department of Assistive and Rehabilitative Services (DARS)...Department of Aging and Disability (DADS) and Department of State Health Services (DSHS) as well." [NAME] comment: "Assistance concerning mental health programs can be requested through the Texas Department of State Health Services."
Texas Department of State Health Services (TDSHS) | Management Standard: Case Management for Children and Pregnant Women (CPW) Response | ED-02.39 (Rev. 1); Authority - Section 493.006(b) Texas Government Code | CPW Eligibility & Needs Assessment Policy | *Eligibility for Case Management Services; Assessment of all health-related needs; *Procedure for applying; *Interagency cooperation/ coordination - Case Management for Children and Pregnant Women (CPW) provides services to children with a health condition/health risk, birth through 20 years of age. Together, the case manager and family shall assess the medical, social, educational and other medically necessary service needs of the eligible recipient. Does not specifically address youth in the juvenile justice system.
Texas Department of State Health Services (TDSHS) | Management Standard: Community Resource Coordination Group (CRCG) State Work Group |  | Includes 3 staff members representing DSHS in mental health, substance abuse and children with special care needs; MOU (above) | Includes 3 staff members representing DSHS in mental health, substance abuse and children with special care needs; MOU (see above). CRCG's have been used effectively by court-involved youth.
Texas Department of State Health Services (TDSHS) | Management Standard: Mental Health Handbook of Consumer Rights |  | Handbook of rights guaranteed while receiving services within DSHS | "This handbook is provided to make you aware of the rights guaranteed to you while you are receiving services within the Department of State Health Services (DSHS) system. This listing of rights is not complete, but rather, it should increase your awareness that you retain your rights as a citizen unless there is a specific reason to restrict them under law or court order." -- [NAME] relevant: "Your parent/conservator (if you are a minor), or your legal guardian, has the right to participate in the development of the treatment plan. You have the right to request that any other person that you choose take part in the development of the treatment plan. Your request should be reasonably considered and you will be informed of the reasons for any denial. Staff must document in your medical record that the parent, guardian, conservator, or other person of your choice was contacted and invited to participate."
Texas Department of State Health Services (TDSHS) | Management Standard: Resiliency and Disease Management Utilization Management Guidelines Children’s Services |  | Specific Service Packages for types of mental health issues faced by children & adolescents | Service Packages:  * 1.1 Externalizing Disorders ["...targeted for children and adolescents with externalizing disorders (e.g., ADD/ADHD, Conduct or Oppositional Defiant Disorder) and a moderate level of functional impairment."];  * 1.2 Internalizing Disorders ["...targeted for children and adolescents with internalizing disorders (depressive or anxiety disorders) and a moderate level of functional impairment."];  * 2.1 Multi-systemic Therapy ["...targeted to youth with externalizing disorders and high levels of severe disruptive or aggressive behaviors who are in the juvenile justice system and at high risk of out-of-home placement or further penetration in the juvenile justice system due to presenting behaviors."];  * 2.2 Externalizing Disorders ["...targeted to children and adolescents with externalizing disorders and moderate to high functional impairment at home, school or in the community."];  * 2.3  Internalizing Disorders ["...targeted to children and adolescents with depressive or anxiety disorders and a moderate to high level of problem severity or functional impairment."];  * 2.4 Major [NAME] ([NAME], Schizophrenia, Major Depression with Psychotic Features, and other psychotic disorders) ["...targeted for children and adolescents who are diagnosed with [NAME], Schizophrenia, Major Depression with Psychosis, or other psychotic disorders and are not yet stable on medication."];  * 4 Aftercare Services ["...targeted to children and adolescents who have stabilized in terms of problem severity and functioning and require only medication and medication management to maintain their stability."];  * 0 Crisis Services ["Services in this package are brief interventions provided in the community or a residential setting that will ameliorate the crisis situation and prevent utilization of more intensive services."];  * 5 Crisis Follow-Up Services ["...targeted toward youth who have been discharged from crisis services or hospitalization. Youth may enter the Service Package because they are ineligible for further community-based treatment through the Local Mental Health Authority or because they need brief follow-up while awaiting access to services with a non-LMHA provider in the community."]
Texas Department of State Health Services (TDSHS) | Management Standard: Teen's Bill of Rights (in inpatient settings) | Reference to TEA Guidelines | Rights, modified for juveniles regarding basic rights, personal rights, care and treatment rights. | Rights, modified for juveniles regarding basic rights, personal rights, care and treatment rights. Modifications include: "You have the right to be treated in a part of this hospital that is separate from adult patients"; parent/guardian permissions; "The hospital has to have someone come in to teach you so you don't fall behind in your schoolwork. [Editor's note: As required by Texas Education Agency (TEA) guidelines.]; "You have the right to be treated by people who have special education in the treatment of teenagers who have conditions like yours."
Texas Department of State Health Services (TDSHS) | Management Standard: The 2009 Mental Health Performance Contract | Refers to 25 Texas Administrative Code (TAC) Chapter 412, [NAME]); also references Continuing Care Plan, as defined in 25 TAC Chapter 412, [NAME], Mental Health Services – Admission, Continuity, and Discharge; Texas Health & Safety Code §614.013 and §614.017 (continuity of care for offenders with mental impairments); Title 37, TAC, Chapter 87, [NAME], Special Needs Offender Programs, §87.79, [NAME] and Mentally Retarded Youth; Texas Government Code §531.055 (Community Resource Coordination Groups [CRCGs]); 34 CFR part 300 (Assistance to States for the Education of Children with Disabilities);  25 TAC, Chapter 412, [NAME], Mental Health Community Standards; refers to Resiliency & Disease Management (see entry on manual for this). | The Authority Attachment/ Statement of Work for "Maintain[ing] and updat[ing] the Local Service Area Plan ([NAME])" while adhering to TAC " | Statement of work for DSHS (as designated Local Mental Health authority [LMHA] for the Local Service Area [LSA]) to, among other roles:  "Update and ensure implementation of jail and detention diversion strategies for adult clients with serious mental illness and child or adolescent clients with serious emotional disturbances."  "Coordination of Service System with Community and DSHS" including with CSCD, DFPS, TEA, & TYC."
Texas Department of State Health Services (TDSHS) | Management Standard: The 2009 Mental Health Performance Contract | References: Title 7 of the Health and Safety Code §534.053(a)(1); Title 7 of the Health and Safety Code §534.053(a) (1), (2), (3), (4), (5), (6), (7) | The Children's Attachment and the [NAME]'s Attachment/ Statement of Work regarding Services & Eligibility Requirements & Populations Served | Statement of Work: Services include --> Services, Medication Services, Rehabilitative Services, Residential Services, Crisis Services. Also discussed:        Service Requirements, MH Children's Service Targets, [NAME], Disease Management Outcomes – Child and Adolescent  Mental Health Services,  Populations served:           "1. Child and Adolescent Mental Health (MH) Priority Population – children ages 3 through 17 with a diagnosis of mental illness (excluding a single diagnosis of substance abuse, mental retardation, autism or pervasive development disorder) who exhibit serious emotional, behavioral or mental disorders and who:                1. Have a serious functional impairment; or                2. Are at risk of disruption of a preferred living or child care environment due to psychiatric symptoms; or                3. Are enrolled in a school system’s special education program because of serious emotional disturbance."/ Statement of Work: Services include --> Services, Medication Services, Rehabilitative Services, Specialized Services, Residential Services. Also discussed:       Service Requirements, Service Targets, Performance Measures & outcomes.         "Adult Mental Health (MH) Priority Population - Adults who have severe and persistent mental illnesses such as schizophrenia, major depression, bipolar disorder, or other severely disabling mental disorders which require crisis resolution or ongoing and long-term support and treatment. Adult MH Target Population - Adults who have a diagnosis of schizophrenia, bipolar disorder, and severe major depression."
Texas Department of State Health Services (TDSHS) | Management Standard: The Resiliency and Disease Management Program Manual (RDM) | "...the Texas legislature proposed House [NAME] (HB) 2292, which included provisions calling for a focus on disease management and jail diversion strategies for specific major mental illnesses. This bill was signed into law and became effective September 1, 2004, providing additional support for the sweeping changes occurring in the Texas public mental health system. To underscore its focus on recovery, the transformation became known as Resiliency and Disease Management (RDM)." | Key components of the mental health system created to support RDM are: Uniform Assessment (UA) [Child, Adolescent (age 13-17), Adult]; Service Packages; Utilization Management (UM); Contracts with Local Mental Health Authorities [LMHAs]; Quality Management; Data Management; Funding Strategies | "This manual is intended to provide the reader with an overview of the Resiliency and Disease Management initiative in the Texas public Mental Health system."   Key components of the mental health system created to support RDM are: Uniform Assessment (UA) [Child, Adolescent (age 13-17), Adult]; Service Packages; Utilization Management (UM); Contracts with Local Mental Health Authorities [LMHAs]; Quality Management; Data Management; Funding Strategies.
Texas Department of State Health Services (TDSHS) | Management Standard: The Texas Integrated Funding Initiative (TIFI) Consortium | Authorized under Texas Government Code 531 [NAME] (Senate [NAME], 76th Legislature, Regular Session 1999) | Includes representation from HHSC, DSHS (CSHCN-Children with Special Health Care Needs), DFPS, TEA, TYC, TJPC | Includes representation from HHSC, DSHS (CSHCN-Children with Special Health Care Needs), DFPS, TEA, TYC, TJPC --- "The vision...is to develop systems of care in local communities for all Texas children with severe emotional disturbances and their families through the integration of federal, state and local funds, and other resources."
Texas Department of State Health Services (TDSHS) | Management Standard: Waco Treatment Center for Youth Parent Handbook |  | "Waco Center for Youth is a psychiatric treatment facility that serves teenagers, ages 13 through 17, with emotional difficulties and/or behavioral problems" | "Waco Center for Youth is a psychiatric treatment facility that serves teenagers, ages 13 through 17, with emotional difficulties and/or behavioral problems. [NAME] for Youth bases its treatment philosophy on the belief that both behavior change and an understanding of self and others are equally important in achieving significant long-term success in treatment. The mission of our program is “to give each youth a chance for change” by providing comprehensive psychiatric residential treatment services to emotionally disturbed adolescents in the state of Texas. Our facility is operated by the Texas Department of Mental Health and Mental Retardation and is accredited by the Joint Commission on Accreditation of Health Care Facilities. Our treatment approach utilizes a structured group therapeutic milieu, provides a nurturing environment, and develops an individualized program that integrates family, behavioral, interpersonal, and group dynamics into the treatment process. Further, our program promotes academic achievement and encourages individual success. Our comprehensive therapeutic services includes the following: Adolescent Psychiatric Services, Treatment Services, Specialized Treatment Services, Aftercare Services, Medical Services, Nursing/Residential Services, Education, Food & Nutrition Services, Chaplaincy Services, Community Relations."
Texas Department of State Health Services (TDSHS) | Memorandum of Understanding | Authorized by Texas Health & Safety Code, Section 614.013 | Between TDCJ's CSCD-Community Justice Assistance Division & DSHS | "For the purpose of establishing a continuity of care system for offenders with mental illness or mental retardation (mental impairments)....a MOU that identifies methods for identifying offenders with mental impairments in the criminal justice system and collecting and reporting prevalence rate data to TCOOMMI...developing rules etc. for the coordination of care of and the exchange of information with mental impairments...identifying the services needed by offenders with mental impairments to reenter the community successfully...establishing a process to report implementation activities to TCOOMMI."    ANYTHING SPECIFICALLY RELEVANT TO JUVENILES? "DSHS --> continuity of care relevant to juveniles/adults - "sharing information/cross-referencing data with local and state correctional, juvenile justice and criminal justice entities"
Texas Department of State Health Services (TDSHS) | Memorandum of Understanding | Pursuant to Texas Government Code, [NAME], Chapter 531, Section 531.055 | Between HHSC, DADS, DARS, DFPS, DSHS, TCOOMMI, TDCJ, TDHCA, TEA, TJCP, TWC, TYC | Purpose: implementation of statewide system of county-based, multiagency community resource coordination groups (CRCGs) to coordinate services for persons of all ages, including children, youth and adults needing multiagency services and whose needs can be met only through interagency coordination and cooperation....sets forth the intention of the agencies, the local CRCGs, and HHSC to work together to ensure that the strategic plan for delivering health and human services in TX..."
Texas Department of State Health Services (TDSHS) | Policy: Promoting Independence Advisory Committee (PIAC) | In compliance with Texas Government Code 532.02441(i) | Submits annual report to Executive Commissioner of HHSC/ Work with DADS, CSCHCN, HHSC | Submits annual report to Executive Commissioner of HHSC with  (1) recommendations for Texas' Promoting Independence Plan for complying with the US Supreme Court's Olmstead v. LC Decision (June 1999);  (2) Info on how TX is meeting goals of its own plan and [NAME] requirements;  (3) Statement of values and principles that underlie all activities encompassed by Promoting Independence Initiative [Title II of Americans with Disabilities Act that individuals must have opportunity to live in 'most integrated setting'   Does not specifically address youth in the juvenile justice system.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 401 Mental Health Administration | Local Mental Health Authority Notification and Appeal | THE PROCESS - NOT JUVENILE SPECIFIC: "The TXMHMR service system is dedicated to providing mental health and mental retardation services/supports which are viewed as satisfactory by persons receiving those services/supports and their legally authorized representatives. Therefore, local authorities and their contractors shall take steps to assure that these persons:    (1) have a method to express their concerns or dissatisfaction;    (2) are assisted to do so in a constructive way; and    (3) have their concerns or dissatisfaction addressed through a review process."
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 404 Protection of Clients and Staff -- Mental Health Services | Rights of Persons Receiving Mental Health Services | Application; Definitions; Rights (including right to receive treatment regardless of age, some rights extending to guardian/parent) - rights specific to minors:     (1) The right to treatment by persons who have specialized education and training in the emotional, mental health, and chemical dependency problems and treatment of minors.    (2) The right to receive inpatient services in an area separated from adults receiving services.    (3) The right to regular communication with the individual's family. Other than in keeping with the general rules of the facility, this right may only be limited when the limitation is necessary to protect the individual's welfare in keeping with procedures outlined in §404.155(a)(2) of this title (relating to Rights of Persons Receiving Residential Mental Health Services).  ALSO - Teens & Children to have separate "Bill of Rights" geared towards them (in Spanish & English & other languages spoken by those admitted)
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 405 Patient Care -- Mental Health Services | Life-Sustaining Treatment/  [NAME] (ECT)/ Death of Persons Served by TXMHMR Facilities or Community Mental Health and Mental Retardation Centers/ Human Immunodeficiency Virus (HIV) Prevention, Testing, and Treatment | Most is not specifically related to juveniles/minors. No person under age 16 shall receive ECT
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 409 Mental Health Services -- Medicaid Programs | Adverse Actions | Not specific to juveniles
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 411 State Mental Health Authority Responsibilities | Advisory Committees/ Interagency Agreements/ Community MHMR Centers/ Standards of Care and Treatment in Psychiatric Hospitals/ Standards of Care and Treatment in Psychiatric Hospitals/ Standards of Care and Treatment in Crisis Stabilization Unit/ Standards for Services to Individuals with Co-Occurring Psychiatric and Substance use Disorders (COPSD) | RULE §411.63	Interagency Coordination of Special Education Services to Students with Disabilities in Residential Facilities (a) Texas Department of Mental Health and Mental Retardation (TDMHMR) adopts by reference a rule of the Texas Education Agency (TEA) in 19 TAC §89.1115 (relating to Memorandum of Understanding Concerning Interagency Coordination of Special Education Services to Students with Disabilities in Residential Facilities).  (b) The TEA rule contains the text of an MOU between the following state agencies: TDMHMR; TEA; Texas Department of Human Services; Texas Department of Health; Texas Department of Protective and Regulatory Services; Texas Interagency Council on Early Childhood Intervention; Texas Commission on Alcohol and Drug Abuse; Texas Juvenile Probation Commission; and Texas Youth Commission. (c) The MOU concerns the provision of a free and appropriate education for school-age residents of residential facilities and is required by the Texas Education Code, §29.012(d); -----                                                                     RULE §411.483	Discharge Notices and Release of Minors (a) Discharge notice to family or LAR. [Legally Authorized Representative]    (1) In accordance with Texas Health and Safety Code, §576.007, before discharging a patient who is an adult, a hospital shall make a reasonable effort to notify the patient's family of the discharge if the patient grants permission for the notification.    (2) Except as provided by 42 CFR Part 2 and subsection (b) of this section, before discharging a patient who is 16 or 17 years of age and who is not or has not been married, a hospital shall make a reasonable effort to notify the patient's LAR of the discharge.    (3) Except as provided by subsection (b) of this section, before discharging a patient who is younger than 16 years of age and who is not or has not been married, a hospital shall notify the patient's LAR of the discharge.  (b) Disclosure harmful to patient. As permitted by Texas Health and Safety Code, §611.0045(b), a hospital may deny a patient's LAR access to any portion of the patient's record if the hospital determines that the disclosure of such portion would be harmful to the patient's physical, mental, or emotional health.  (c) Release of minors. Except as required by §411.485(e) of this title, (relating to Discharge of an Involuntary Patient), upon discharge, the hospital may release a minor younger than 16 years of age only to the minor's LAR or the LAR's designee.  (d) Notice of protection and advocacy system. Upon discharge, the hospital shall provide the patient with written notification of the existence, purpose, telephone number, and address of the protection and advocacy system established in Texas, which is Advocacy, Inc., as required by Texas Health and Safety Code, §576.008; -----  RULE §411.490	Staff Member [NAME] (4) A staff member routinely providing treatment to, working with, or providing consultation about a patient who is younger than 18 years of age shall receive training in the aspects of growth and development (including physical, emotional, cognitive, educational and social) and the treatment needs of patients in the following age groups:      (A) early childhood (1-5 years of age);      (B) late childhood (6-13 years of age); and      (C) adolescent (14-17 years of age).;--- RULE §411.624	Protection of a Patient (a) Modifying the environment and monitoring the patient. A CSU shall protect a patient by taking the following measures: (c) Separation of patients under 18 years of age. In accordance with Texas Health and Safety Code, §321.002, a CSU shall keep patients who are under the age of 18 years separate from patients who are over the age of 18 years.;---             RULE §411.653	Definitions The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:   (2) Adolescent--A person who is 13 through 17 years of age.    (3) Adult--A person who is 18 years of age or older.    (4) Child--A person who is 0 through 12 years of age; ----- RULE §411.658	Specialty Competencies of Staff Providing Services to Individuals with COPSD (a) Entities must ensure that services to individuals are age-appropriate and are provided by staff within their scope of practice who have the following minimum knowledge, technical, and interpersonal competencies prior to providing services:    (1) Knowledge competencies:     (B) knowledge of the impact of substance use disorders on developmental, social, and physical growth and development of children and adolescents;      (C) knowledge of interpersonal and family dynamics and their impact on individuals;
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Contracts Management for Local Authorities  Charges for Community Services | Parents of children under age 18 responsible for financial burden (or for being assessed for assistance)
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter D: Mental Health Services – Admission, Continuity, and Discharge Continuity of Services – State Mental Retardation Facilities | RULE §412.162	Determining County of Residence; (b) Minors.   (1) Except as provided by paragraph (2) of this subsection, a minor's county of residence is the county in which the minor's LAR's permanent residence is located.   (2) A minor's county of residence is the county in which the minor currently resides if:  (A) it cannot be determined in which county the minor's LAR's permanent residence is located;  (B) a state agency is the minor's LAR; or  (C) the minor does not have an LAR.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter D: Mental Health Services – Admission, Continuity, and Discharge Continuity of Services – State Mental Retardation Facilities RULE §412.173 | Admission Criteria For Adolescent Forensic Unit at North Texas State Hospital--Vernon Campus (a) A person may be admitted to the Adolescent Forensic Unit at North Texas State Hospital-Vernon Campus only if the person is at least 13 but younger than 18 years of age (an "adolescent") and meets the criteria described in paragraph (1), (2), or (3) of this subsection.   (1) Condition of probation or parole. The adolescent's admission to the Adolescent Forensic Unit at North Texas State Hospital-Vernon Campus will fulfill a condition of probation or parole for a juvenile offense and the adolescent:     (A) on the basis of a clinical evaluation, is determined to be in need of specialized mental health treatment in a secure treatment setting to address violent behavior or delinquent conduct;     (B) has co-occurring psychiatric and substance use disorder; and     (C) has exhausted available community resources for treatment and has been recommended for admission by the local Community Resource Coordinating Group (CRCG).   (2) Commitment under Texas Family Code, Chapter 55. The adolescent has been committed to a residential care facility under the Texas Family Code, Chapter 55, [NAME] or D.   (3) Determined manifestly dangerous. The adolescent has been determined manifestly dangerous in accordance with Chapter 415, [NAME] of this title (concerning Determination of Manifest Dangerousness). (b) A person may not be admitted to the Adolescent Forensic Unit at North Texas State Hospital-Vernon Campus if the person is determined to have mental retardation.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter D: Mental Health Services – Admission, Continuity, and Discharge Continuity of Services – State Mental Retardation Facilities RULE §412.174 | Admission Criteria for Waco Center for Youth (a) A person may be admitted to Waco Center for Youth only if the person:   (1) is at least 10 but younger than 18 years of age and whose age at admission allows adequate time for treatment programming prior to reaching age 18 years;   (2) is diagnosed as emotionally or behaviorally disturbed;   (3) has a history of behavior adjustment problems;   (4) needs a structured treatment program in a residential facility; and   (5) meets either of the following criteria:     (A) the person is in the managing conservatorship of the Texas Department of Protective and Regulatory Services (TDPRS) and has been referred for admission by TDPRS; or     (B) the person is currently receiving LMHA services or inpatient services at a SMHF and has been referred for admission by:       (i) the LMHA after endorsement by the local Community Resource Coordinating Group (CRCG); or       (ii) the SMHF. (b) A person may not be admitted to Waco Center for Youth if the person:   (1) has been found to have engaged in delinquent conduct or conduct indicating a need for supervision under the Texas Family Code, Title 3;   (2) is acutely psychotic, suicidal, homicidal, or seriously violent; or   (3) is determined to have mental retardation.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter D: Mental Health Services – Admission, Continuity, and Discharge Continuity of Services – State Mental Retardation Facilities RULE §412.175 | Voluntary Admission (a) Request for voluntary admission.   (1) In accordance with Texas Health and Safety Code, §572.001(a) and (c), a request for voluntary admission of a person with a mental illness may only be made by:     (A) the person, if:       (i) he or she is 16 years of age or older; or       (ii) he or she is younger than 16 years of age and is or has been married; or     (B) the parent, managing conservator, or guardian of the person, if the person is younger than 18 years of age and is not and has not been married, except that a guardian or managing conservator acting as an employee or agent of the state or a political subdivision of the state may request voluntary admission of the person only with the person's consent.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter D: Mental Health Services – Admission, Continuity, and Discharge Continuity of Services – State Mental Retardation Facilities RULE §412.178 | Admission Procedures (a) When a SMHF admits a person, the SMHF shall promptly notify the designated LMHA of the admission and the admission status (i.e., voluntary, emergency detention, order of protective custody, court-ordered).   (1) If the LMHA that screened the person is not the person's designated LMHA, then the SMHF shall also notify the LMHA that screened the person.   (2) If the SMHF suspects that the person's county of residence status in CARE is incorrect, then the SMHF shall notify the affected LMHAs of the possible error. (b) In addition to the requirement in subsection (a) of this section, [NAME] for Youth shall notify the entity that referred the person for admission to [NAME] for Youth (i.e., Texas Department of Protective and Regulatory Services (TDPRS), LMHA, or SMHF).
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter D: Mental Health Services – Admission, Continuity, and Discharge Continuity of Services – State Mental Retardation Facilities RULE §412.202 | Special Considerations (d) Minors.   (1) To the extent permitted by medical privacy laws, the SMHF and designated LMHA shall make a reasonable effort to involve a minor's LAR or the LAR's designee.   (2) A minor committed to or placed in a SMHF under the Texas Family Code, Chapter 55, [NAME] or D, shall be discharged in accordance with the Texas Family Code, Chapter 55, [NAME] or D, as appropriate. (c) Discharge notice to family or LAR.   (1) In accordance with Texas Health and Safety Code, §576.007, before discharging a patient who is 18 years of age or older a SMHF shall make a reasonable effort to notify the patient's family of the discharge if the patient grants permission for the notification.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter D: Mental Health Services – Admission, Continuity, and Discharge Continuity of Services – State Mental Retardation Facilities RULE §412.207 | Procedures Upon Discharge or ATP   (2) Before discharging a patient who is 16 or 17 years of age, or younger than 16 years of age and is or has been married, a SMHF shall make a reasonable effort to notify the patient's family of the discharge if the patient grants permission for the notification.   (3) Before discharging a patient who is younger than 16 years of age and who is not or has not been married, a SMHF shall notify the patient's LAR of the discharge. (d) Release of minors. Upon discharge, the SMHF may release a minor younger than 16 years of age only to the minor's LAR or the LAR's designee.   (1) If the LAR or the LAR's designee is unwilling to retrieve the minor from the SMHF and the LAR is not a state agency, then the SMHF shall notify Child Protective Services (CPS) of its responsibility to retrieve the minor from the SMHF. If CPS is unwilling to retrieve the minor, then the SMHF or the designated LMHA may transport the minor to the administrative offices of CPS.   (2) If the LAR is unwilling to retrieve the minor from the SMHF and the LAR is a state agency, then the SMHF or designated LMHA may transport the minor to the administrative offices of the state agency.  (f) Notice to designated LMHA. At least 24 hours prior to a patient's discharge or ATP, but no later than 24 hours after discharge for a patient who is discharged unexpectedly, the SMHF shall notify the designated LMHA of the anticipated or unexpected discharge and convey the following information about the patient:   (1) identifying data, including address;   (2) legal status (e.g., regarding guardianship, charges pending, custody, if patient is a minor);   (3) the day and time the patient will be discharged or ATP;   (4) the patient's destination after discharge or ATP;   (5) pertinent medical information;   (6) current medications;   (7) behavioral data, including information regarding COPSD; and   (8) other pertinent treatment information, including the continuing care plan.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | [NAME] Mental Health Community Services Standards RULE §412.303	Definitions | RULE §412.303	Definitions The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:   (2) Adolescent--An individual who is at least 13 years of age, but younger than 18 years of age.    (8) Child--An individual who is at least three years of age, but younger than 13 years of age.    (60) Uniform assessment--An assessment tool developed by the department that includes, but is not limited to, the Adult Texas Recommended Assessment Guidelines (TRAG), the Children and Adolescent Texas Recommended Assessment Guidelines, and the department-approved algorithms.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | [NAME] Mental Health Community Services Standards RULE §412.312	Environment of Care and Safety | RULE §412.312	Environment of Care and Safety (c) Compliance with state and federal law. The provider must comply with all applicable state and federal law and regulations, including those relating to:  (d) Limited use of restraint or seclusion.      (A) necessary to address a behavioral health emergency, as defined in Chapter 415, [NAME] of this title (relating to Interventions in Mental Health Programs); and     (B) performed according to the department's rules described in Chapter 415, [NAME] of this title.  (2) Seclusion. Seclusion is prohibited in outpatient settings with the exception of partial hospitalization programs for children or adolescents. A provider may only use seclusion in those programs if the conditions in paragraph (1)(A) - (B) of this subsection are met.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | [NAME] Mental Health Community Services Standards RULE §412.313	Rights and Protection | RULE §412.313	Rights and Protection (a) Non-coercive policy. The LMHA, MCO, and provider must ensure that an individual's refusal of a particular mental health community service (e.g., psychoactive medication) does not preclude the individual from accessing other medically necessary mental health community services. (b) Non-discrimination. The LMHA, MCO, and provider may not unlawfully discriminate against any individual based on race, color, national origin, religion, sex, age, or disability. The LMHA and MCO and provider may not deny medically necessary mental health community services based on an individual's sexual orientation or political affiliation. (c) Initial and ongoing eligibility. In determining an individual's initial and ongoing eligibility for any service, an LMHA, MCO, and provider may not exclude an individual based on the following factors:   (1) the individual's past or present mental illness or substance use diagnosis or services;   (2) the individual's past or present involvement in the criminal or juvenile justice system;   (3) medications prescribed to the individual in the past or present;   (4) the presumption of the individual's inability to benefit from treatment;   (5) the individual's use or continued use of alcohol, tobacco, or other drugs; or   (6) the individual's level of success in prior treatment episodes. (d) Protection against abuse, neglect, and exploitation. The LMHA, MCO, and provider must comply with the requirements described in Chapter 414, [NAME] of this title (relating to Abuse, Neglect, and Exploitation in Local Authorities and Community Centers). (e) Dignity and rights. The LMHA, MCO, and provider must implement procedures that address the rights of individuals in compliance with applicable state and federal laws, regulations, and department rules described in Chapter 404, [NAME] of this title (relating to Rights of Persons Receiving Mental Health Services), and must provide individuals the right to choose from the list of providers within the LMHA's or MCO's network if there is more than one provider available.  (e) Communication with individuals. The LMHA, MCO, and provider must ensure effective communication with the individual and [NAME] (if applicable) in an understandable format as appropriate to meet the needs of individuals, which may require using:   (1) interpretative services;   (2) translated materials; or   (3) a staff member who can effectively respond to the cultural (e.g., customs, beliefs, actions, and values) and language needs of the individual and [NAME] (if applicable).
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | [NAME] Mental Health Community Services Standards RULE §412.316	Competency and Credentialing | RULE §412.316	Competency and Credentialing (a) Competency of staff members, including volunteers. The LMHA, MCO, and provider must implement a process to ensure the competency of staff members prior to providing services that, at a minimum:   (1) ensures services are provided by staff members who are operating within the scope of their license, job description, or contract specification;   (2) ensures that the mental health community services provided by peer providers are limited to mental health rehabilitative, supported employment, supported housing, parent support group, and family partner services; and   (3) defines competency-based expectations for each position as follows:     (A) required competencies must be included for all staff members, including adequate, accurate knowledge of:       (i) the nature of severe and persistent mental illness and serious emotional disturbances;       (ii) the recovery and resiliency model of mental illness and serious emotional disturbance;       (iii) the dignity and rights of an individual, as described in Chapter 404, [NAME] of this title (relating to Rights of Persons Receiving Mental Health Services);       (iv) identifying, preventing, and reporting abuse, neglect, and exploitation, in accordance with Chapter 414, [NAME] of this title (relating to Abuse, Neglect, and Exploitation in Local Authorities and Community Centers);       (v) individual confidentiality, as described in Chapter 414, [NAME] of this title (relating to Protected Health Information) and other relevant state and federal laws affecting confidentiality of medical records, including Title 42 CFR Part 2;       (vi) interacting with an individual who has a physical disability such as a hearing or visual impairment;       (vii) responding to an individual's language and cultural needs through knowledge of customs, beliefs, and values of various, racial, ethnic, religious, and social groups;       (viii) exposure control of blood borne pathogens;       (ix) identification of an individual as being in a crisis and accessing emergency or urgent care services;       (x) proper documentation of services provided; and       (xi) planning and training for responding to severe weather, disasters, and bioterrorism;     (B) critical competencies must be included for positions in which a staff member's primary job duties are related to individual service contacts and interactions and include, but are not limited to, adequate and accurate knowledge of:       (i) cardio pulmonary resuscitation (CPR);       (ii) first aid;       (iii) safe management of verbally and physically aggressive behavior;       (iv) utilization of assistive technology such as communication devices with individuals who are deaf or hard of hearing; and       (v) seizure response and assessment;     (C) specialty competencies must be included for positions in which a staff member performs specialized services and tasks and include adequate and accurate knowledge of specialized services and tasks, such as:       (i) the requirements of this subchapter;       (ii) age appropriate clinical assessment including the uniform assessment;       (iii) age appropriate engagement techniques (e.g., motivational interviewing);       (iv) use of telemedicine equipment;       (v) the utilization management guidelines;       (vi) developing and implementing an individualized treatment plan;       (vii) appropriate actions to take in a crisis (e.g., screening, intervention, management and if applicable, suicide/homicide precautions);       (viii) services for co-occurring psychiatric and substance use disorders described in Chapter 411, Subchapter N of this title (relating to Standards for Services to Individuals with Co-Occurring Psychiatric and Substance Use Disorders (COPSD));       (ix) accessing resources within the local community;       (x) strategies for effective advocacy and referral for an individual;       (xi) infection control;       (xii) recognition, reporting, and recording of side effects, contraindications, and drug interactions of psychoactive medication;       (xiii) age appropriate rehabilitative approaches;       (xiv) proficiency in specimen collection;       (xv) the peer-provider or consumer-operated service model;       (xvi) assessment and intervention with children, adolescents, and families; and       (xvii) clinical specialties directly related to the services to be performed.     (D) crisis hotline competencies must be included for positions in which a staff member routinely answers the crisis hotline and include adequate and accurate knowledge of:       (i) the nature of severe and persistent mental illness and serious emotional disturbances and COPSD;       (ii) behavioral health crisis situations;       (iii) operating a telephone system to access behavioral health crisis screening and response;       (iv) age appropriate crisis intervention and response;       (v) utilization of assistive technology such as communication devices with individuals who are deaf or hard of hearing;       (vi) advocacy for treatment in the most clinically appropriate, available environment; and       (vii) applicable privacy laws, rules, and regulations including those described in Chapter 414, [NAME] of this title (relating to Protected Health Information) and in Title 42 CFR Part 2.     (E) telemedicine competencies must be included for positions in which a staff member's job duties are related to assisting with telemedicine services and include adequate and accurate knowledge of:       (i) operation of the telemedicine equipment; and       (ii) how to use the equipment to adequately present the individual.   (4) requires staff members to demonstrate competencies in the following manner:     (A) all staff members must demonstrate required competencies before contact with individuals, confidential information, or protected health information and periodically throughout the staff member's tenure of employment or association with the LMHA, MCO, or provider;     (B) all staff members in positions that require critical competencies must demonstrate the critical competencies before contact with individuals and periodically throughout the staff member's or volunteer's tenure of employment or association with the LMHA, MCO, or provider;     (C) all staff members in positions that require specialty competencies must demonstrate the specialty competencies before providing the specialized service(s) or performing the specialized task(s) and periodically throughout the staff member's or volunteer's tenure of employment or association with the LMHA, MCO, or provider; and     (D) all staff members in positions that require crisis hotline competencies must demonstrate those competencies before providing crisis hotline services and at least annually throughout the staff member's or volunteer's tenure of employment or association with the LMHA, MCO, or provider. (b) Competency of crisis services providers. The LMHA and MCO must develop and implement policies and procedures governing the provision of crisis services to ensure that providers with which they contract or employ for the provision of crisis services are trained in:   (1) crisis access and age appropriate assessment and intervention services;   (2) advocacy for the most clinically appropriate, available environment; and   (3) community referral resources.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | [NAME] Mental Health Community Services Standards RULE §412.324	Additional Standards of Care Specific to Mental Health Community | RULE §412.324	Additional Standards of Care Specific to Mental Health Community Services for Children and Adolescents (a) Administration of the uniform assessment. The uniform assessment must be administered face-to-face or via telemedicine with the individual and the LAR (if applicable) or primary caregiver as clinically appropriate according to the child's or adolescent's age, functioning, and current living situation. (b) Age and developmentally appropriate mental health community services. All mental health community services delivered to children and adolescents by a provider must be, for each child and adolescent, age-appropriate, developmentally appropriate, and consistent with academic development. (c) Separation of individuals by age. A provider that delivers mental health community services to children and adolescents in group settings (e.g., residential, day programs, group therapy, partial hospitalization, and inpatient) must separate children and adolescents from adults. The provider must further separate children from adolescents according to age and developmental needs, unless there is a clinical or developmental justification in the medical record. (d) Transition to mental health community services for adults. The provider must develop a transition plan for each adolescent who will need mental health community services for adults. The transition plan must be developed in consultation with the adolescent (and LAR if applicable) and future providers with adequate time to allow both current and future providers to transition the adolescent into adult services without a disruption in services. The transition plan must include:   (1) a summary of the mental health community services and treatment the adolescent received as a child and adolescent;   (2) the adolescent's current status (e.g., diagnosis, medications, uniform assessment guideline calculation, and unmet needs);   (3) information from the adolescent and the LAR regarding the adolescent's strengths, preferences for mental health community services, and responsiveness to past interventions;   (4) a description of the mental health community services the adolescent will receive as an adult;   (5) a list of resources for other recovery supports such as volunteer opportunities, family or peer organizations, 12-step programs, churches, colleges, or community education;   (6) documentation that the adolescent's services continued throughout the transition without disruptions; and   (7) documentation of the follow up to ensure successful transition to adult services.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter I: Mental Health Case Management Services Subchapter P: Provider Network Development | RULE §412.403	Definitions The following words and terms, when used in this chapter, 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.    (5) Child--An individual who is at least three years of age, but younger than 13 years of age.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter I: Mental Health Case Management Services Subchapter P: Provider Network Development | RULE §412.407	MH Case Management Services (a) MH case management services assist an individual in gaining and coordinating access to necessary care and services appropriate to the individual's needs. There are two types of MH case management services:   (1) routine MH case management, for an adult, a child, or adolescent, which is primarily site-based; and   (2) intensive MH case management, for a child or adolescent, which is primarily community-based.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter I: Mental Health Case Management Services Subchapter P: Provider Network Development | RULE §412.409	Notification and Terminations (a) The provider must notify the department or its designee if the provider has reason to believe:   (1) the individual no longer meets the eligibility criteria for MH case management services as set forth in §412.405 of this title (relating to Eligibility for MH Case Management Services);   (2) the LAR of a child or adolescent has refused MH case management services on behalf of the child or adolescent;
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter I: Mental Health Case Management Services Subchapter P: Provider Network Development | RULE §412.411	Staff Training (a) A case manager and a supervisor of a case manager must receive training and demonstrate competency in the following areas:   (1) the requirements of this subchapter and of Chapter 412, [NAME], of this title (relating to Mental Health Community Services Standards);   (2) the nature of mental illness and serious emotional disturbance;   (3) the dignity and rights of an individual in accordance with Chapter 404, [NAME], of this title (relating to Rights of Persons Receiving Mental Health Services);   (4) awareness and sensitivity in communicating and coordinating services with an individual who has a special physical need such as a hearing or visual impairment;   (5) responding to an individual's language and cultural needs through knowledge of customs, beliefs, and values of various, racial, ethnic, religious, and social groups;   (6) identifying, preventing, and reporting abuse, neglect and exploitation in accordance with Chapter 414, [NAME], of this title (relating to Abuse, Neglect, and Exploitation in Local Authorities and Community Centers);   (7) the uniform assessment;   (8) the utilization management guidelines;   (9) developing and implementing an MH case management plan if the case manager is providing intensive MH case management services to a child or adolescent;   (10) identifying an individual in crisis;   (11) appropriate actions to take in managing a crisis;   (12) co-occurring psychiatric and substance use disorders, as described in Chapter 411, Subchapter N of this title (relating to Standards for Services to Individuals with Co-Occurring Psychiatric and Substance Use Disorders (COPSD));   (13) the developmental needs of children, adolescents, and adults;   (14) the wraparound planning process approved by the department, if the case manager is providing intensive MH case management services to a child or adolescent;   (15) health and human services available to children as described in Texas Government Code §531.0244, if the case manager is providing intensive MH case management services to a child or adolescent;   (16) the availability of resources within the local community; and   (17) strategies for advocating effectively for individuals. (b) The provider must document the training, competencies, and experience in the personnel record of each case manager and a supervisor of a case manager who received the training described in this section.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter I: Mental Health Case Management Services Subchapter P: Provider Network Development | RULE §412.415	Guidelines The following guidelines are referenced in this subchapter. For information about obtaining copies of the guidelines contact the Department of State Health Services, Community Mental Health and Substance Abuse Program Services, Mail Code 2018, P.O. Box 12668, [NAME], TX 78711-2668.   (1) Uniform assessment guidelines, which include:     (A) Adult Texas Recommended Assessment Guidelines;     (B) Texas Implementation of Medication Algorithms Scales for Adults; and     (C) Child and Adolescent Texas Recommended Authorization Guidelines.   (2) Utilization management guidelines, which include:     (A) Adult Utilization Management Guidelines; and     (B) Child and Adolescent Utilization Management Guidelines.   (3) MH Case Management Services Billing Guidelines.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 414 Rights and Protection of Persons Receiving Mental Health Services | Subchapter A: Protected Health Information | RULE §414.5	Regulations and Statutes Governing Confidentiality of Protected Health Information (c) State statutes. (11) Texas Family Code, Chapter 32, governs consent to treatment of a child by a non-parent or the child. (15) Texas Health and Safety Code, §572.004(i), requires notification of a minor individual's parent, managing conservator, or guardian when the minor, who has been voluntarily admitted to a state mental health facility by the parent, managing conservator, or guardian, files a written request for discharge.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 414 Rights and Protection of Persons Receiving Mental Health Services | Subchapter I: Consent to Treatment with Psychoactive Medication -- Mental Health Services | RULE §414.401	Purpose The purpose of this subchapter is to provide procedures for obtaining consent for treatment with psychoactive medications from patients receiving voluntary or involuntary mental health services. [General - No language specific to minors/juveniles except for definition of a minor]
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 414 Rights and Protection of Persons Receiving Mental Health Services | [NAME] | RULE §414.501	Purpose The purpose of this subchapter is to protect consumers at a facility, local authority, community center, or contract provider of residential services, and the property of those consumers. [No language specific to minors/juveniles]
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 414 Rights and Protection of Persons Receiving Mental Health Services | [NAME], Neglect and Exploitation in Local Authorities and Community Centers | RULE §414.551	Purpose The purpose of this subchapter is to implement §48.255(c) of the Human Resources Code, which requires TDMHMR to develop joint rules with the Texas Department of Protective and Regulatory Services (TDPRS) to facilitate investigations in local authorities and community centers and to describe the requirements for:   (1) reporting allegations of abuse, neglect, and exploitation of persons served;   (2) ensuring the safety and protections of persons served involved in allegations;   (3) facilitating investigations; and   (4) ensuring proper disciplinary or other action is taken when abuse, neglect, or exploitation is confirmed.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 414 Rights and Protection of Persons Receiving Mental Health Services | Subchapter P: Research in TDMHMR Facilities | RULE §414.751	Purpose The purpose of this subchapter is to establish uniform guidelines for the review, approval, conduct, and oversight of research in facilities that:   (1) ensure the protection of the rights, privacy, and welfare of human subjects involved in research;   (2) provide for the creation and utilization of a designated Institutional Review Board (IRB) for each facility electing to be involved in the conduct of research;   (3) provide for the investigation of allegations of misconduct in science related to research conducted at a facility; and   (4) conform with the requirements of Title 45, Code of Federal Regulations, Part 46 (Protection of Human Subjects), Subparts A, B, and D.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | Subchapter A: Prescribing Psychoactive Medication | RULE §415.1	Purpose (a) The purpose of this subchapter is to establish standards for prescribing psychoactive medication to patients served by the state mental health and mental retardation system in Texas.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | Subchapter A: Prescribing Psychoactive Medication | RULE §415.3	Definitions The following words and terms, when used in this subchapter, have the following meanings:   (2) Child psychiatrist--A physician who is certified by the American Board of Psychiatry and [NAME] and holds a subspecialty certificate in child and adolescent psychiatry, or who is board eligible, i.e., has an active approved application on file in the board office, or who is currently in training in an approved residency and is supervised by a board eligible or board-certified child and adolescent psychiatrist.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | Subchapter A: Prescribing Psychoactive Medication | RULE §415.11	Special Populations Special populations will be managed according to accepted guidelines as appropriate to their special needs.   (2) Children.     (A) Except in an emergency, if the prescribing professional is not a child psychiatrist, then prescribing psychoactive medication which falls outside accepted guidelines requires consultation from a child psychiatrist in addition to any other requirements.     (B) If the prescribing professional is a child psychiatrist, then use of polypharmacy is governed as indicated in §415.7 of this title (relating to Prescribing Parameters).
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | [NAME]: Use and Maintenance of TDMHMR Drug Formulary | RULE §415.101	Purpose The purpose of this subchapter is to provide policies and procedures governing the use and maintenance of the TDMHMR Drug Formulary.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | [NAME] in Mental Health Programs | RULE §415.251	Purpose The purpose of this subchapter is to ensure protection of the rights and well-being of individuals during the use of voluntary and involuntary interventions.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | [NAME] in Mental Health Programs | DIVISION 1	GENERAL PROVISIONS RULE §415.257	Staff Training (f) Registered nurses authorized to receive orders for restraint or seclusion, physicians authorized to give orders for restraint or seclusion, and physicians, physician assistants, and advanced practice nurses PMHNPs or PMH-CNSs who are authorized to perform evaluations of individuals who are restrained or secluded must receive training and demonstrate the competencies described in paragraph (d) of this section, and must receive training and demonstrate competence in:   (2) recognizing how age, weight, level of development or functioning, gender issues, ethnicity, and history of sexual or physical abuse may affect the way in which an individual reacts to physical contact;
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | [NAME] in Mental Health Programs | DIVISION 1	GENERAL PROVISIONS RULE §415.263	Time Limitation on an Order for Restraint or Seclusion Initiated in Response to a Behavioral Emergency (a) Original order. A physician may order restraint or seclusion for a period of time not to exceed:   (1) 15 minutes for personal restraint;   (2) one hour for mechanical restraint or seclusion for individuals under the age of 9;   (3) two hours for mechanical restraint or seclusion for individuals ages 9-17; and   (4) four hours for mechanical restraint or seclusion for individuals age 18 and older. (b) Renewed order. If the original order is about to expire and the clinically competent registered nurse has evaluated the individual face-to-face and determined the continuing existence of an emergency, the clinically competent registered nurse must contact the physician. A physician may renew the original order provided it would not result in the use of:   (1) personal restraint beyond 15 minutes total;   (2) mechanical restraint or seclusion beyond two hours total for individuals under age 9;   (3) mechanical restraint or seclusion beyond four hours total for individuals ages 9-17; or   (4) mechanical restraint or seclusion beyond eight hours total for individuals age 18 and older. (c) New order. The physician must issue a new order to continue restraint or seclusion beyond the time limits described in subsection (b) of this section. Prior to issuing a new order, the physician, or the physician assistant, or advanced practice nurse to whom the physician delegates the authority to evaluate an individual in restraint or seclusion, must perform a face-to-face evaluation of the individual. The new order is subject to the time limitations described in subsections (a) and (b) of this section.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | [NAME] Determination of Manifest Dangerousness | RULE §415.301	Purpose The purpose of this subchapter is to:   (1) establish the two types of review boards that conduct hearings to determine whether an individual is manifestly dangerous;   (2) define the elements to be considered in the determination of manifest dangerousness by review boards;   (3) describe which persons may and may not be subject to a hearing to determine manifest dangerousness;   (4) enumerate the rights of an individual who is subject to a hearing to determine manifest dangerousness;   (5) provide due process for individuals who have been determined manifestly dangerous; and   (6) provide procedures governing the transfer of an individual to the maximum security unit/secure adolescent unit (MSU/SAU) and from the MSU/SAU.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | [NAME] Determination of Manifest Dangerousness | RULE §415.304	Persons Who May and May Not Be Subject to a Hearing to Determine Manifest Dangerousness (a) Only an adult or adolescent who is committed by a court of law to a facility (as defined) may be subject to a hearing to determine manifest dangerousness. (b) The following persons may not be subject to a hearing to determine manifest dangerousness:   (1) an adult, adolescent, or child who is voluntarily admitted to a facility (as defined) or who is under an order of protective custody in accordance with the Texas Health and Safety Code, §574.022 or §593.044; and   (2) a child who is committed by a court of law to a facility (as defined).
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | [NAME] Determination of Manifest Dangerousness | RULE §415.305	Procedures and Requirements for All Review Boards (c) Qualification of certain members impaneled for a hearing.   (1) If the individual who is the subject of the hearing is an adolescent, then:     (A) at least one member must be a psychiatrist with training and experience in the care of adolescents; and     (B) at least two members must have training and experience in the care of adolescents as a provider of mental health services.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 417 TDMHMR and Facility Responsibilities | Subchapter A: Standard Operating Procedures | RULE §417.1	Purpose The purpose of this subchapter is to describe:   (1) the standard operating policies and procedures for state mental health facilities and state mental retardation facilities (SMHMRFs);   (2) requirements and rights of facilities; and   (3) rights protections for individuals receiving services from a facility.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 417 TDMHMR and Facility Responsibilities | Subchapter A: Standard Operating Procedures | RULE §417.3	Compliance with Nondiscrimination Laws Services, financial assistance, and other benefits of TDMHMR's programs and facility resources are provided in a manner that does not discriminate of the basis or race, gender, sexual orientation, age, color, national origin, disability, religion, or political affiliation in compliance with applicable state and federal law.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 417 TDMHMR and Facility Responsibilities | [NAME] Contract Management for TDMHMR Facilities and Central Office | RULE §417.51	Purpose The purpose of this subchapter is to provide rules governing the management of contracts by Texas Department of Mental Health and Mental Retardation (TDMHMR) facilities and Central Office.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 417 TDMHMR and Facility Responsibilities | [NAME] in TDMHMR Facilities | RULE §417.101	Purpose Pursuant to the Texas Health and Safety Code, Chapter 552, [NAME], and Chapter 593, [NAME], the purpose of this subchapter is to describe:   (1) the assessment of fees for clients' support, maintenance, and treatment at facilities of the Texas Department of Mental Health and Mental Retardation;   (2) the process to appeal an assessed fee(s); and   (3) the process to file a notice of [NAME].
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 417 TDMHMR and Facility Responsibilities | [NAME] in TDMHMR Facilities | RULE §417.104	Fee Assessment and Notification of Charges (c) Assessing fee(s) for minor clients.   (1) The following sources of funds are property from which the state may be reimbursed for a minor client's SMT and are considered separately in assessing a fee:     (A) third-party coverage of the minor client;     (B) the minor client's benefits from governmental and non-governmental agencies and institutions;     (C) child support ordered in a divorce proceeding and other personal income of the minor;     (D) real and/or personal property in the minor client's guardianship estate or owned by the minor client; and     (E) the income of the minor client's parents as authorized by the Texas Health and Safety Code, §552.017, §593.075, and §593.076, in accordance with the Taxable Income of Parents formula, referenced as Exhibit B in §417.108(2) of this title (relating to [NAME]).   (2) Pursuant to Texas Health and Safety Code, §593.077, a judgment in a divorce proceeding that provides for child support payments (as referenced in paragraph (1)(C) of this subsection) does not limit the fee that may be assessed (except that it may not exceed the current maximum rate), nor does the judgment exempt either parent from liability for the charges.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 417 TDMHMR and Facility Responsibilities | [NAME] Volunteer and Community Engagement | RULE §417.301	Purpose The purpose of this subchapter is to delineate policy and establish uniform operating standards for donors and volunteer services councils at the Department of State Health Services.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 417 TDMHMR and Facility Responsibilities | [NAME], Neglect, and Exploitation in TDMHMR Facilities | RULE §417.501	Purpose The purpose of this subchapter is to prescribe procedures:   (1) for effective reporting of allegations of abuse, neglect, and exploitation;   (2) for ensuring the safety and protection of persons served involved in allegations;   (3) for facilitating Texas Department of Protective and Regulatory Services investigations of allegations;   (4) for facilitating peer review of allegations involving clinical practice;   (5) for notifying appropriate licensing authorities and other individuals regarding issues relating to an allegation;   (6) for contesting the Adult Protective Services (APS) review of a finding of an investigation;   (7) for ensuring proper disciplinary action is taken; and   (8) for training staff in identifying, reporting, and preventing abuse, neglect, and exploitation.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 417 TDMHMR and Facility Responsibilities | [NAME], Neglect, and Exploitation in TDMHMR Facilities | RULE §417.502	Application (a) This subchapter apply to all facilities of the Texas Department of Mental Health and Mental Retardation and their agents. (b) All facilities are responsible for amending their contracts to ensure contractors' compliance as specified in §417.513 of this title (relating to Contractors). (c) This subchapter does not apply to:   (1) psychiatric hospitals licensed by the Texas Department of Health (TDH) under Chapter 577 of the Texas Health and Safety Code; or   (2) state-funded community hospitals, which are inpatient mental health facilities licensed by the Texas Department of Health under the Texas Health and Safety Code, Chapter 242, or operated by a university health system and exempted from licensure, that provides TDMHMR-funded inpatient mental health services pursuant to a contract between TDMHMR and a local authority.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 417 TDMHMR and Facility Responsibilities | [NAME] and Mediation of Certain Contract Claims Against TDMHMR | DIVISION 1		GENERAL RULE §417.901	Purpose The purpose of this subchapter is to describe the provisions for negotiation and mediation of certain contract claims against the Texas Department of Mental Health and Mental Retardation (TDMHMR), pursuant to the Government Code, §2260.052(c).
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | Subchapter J: Institutions for Mental Diseases | RULE §419.371	Purpose and Application The purpose of this subchapter is to describe the criteria used to determine whether a provider is eligible to receive Medicaid reimbursement for inpatient hospital services to people aged 65 and older in an institution for mental diseases (IMD) and to describe the methods by which patient and provider eligibility are established and reimbursement for covered services is accomplished. This subchapter applies to all IMD providers.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | [NAME] | RULE §419.451	Purpose The purpose of this subchapter is to describe the requirements for the provision of mental health rehabilitative services.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | [NAME] | RULE §419.454	General Requirements for Providers of MH Rehabilitative Services (d) Prohibitions against discrimination and retaliation. (1) A provider may not discriminate against an individual based on race, color, national origin, religion, sex, age, disability, co-occurring disorder or political affiliation. A provider may not deny MH rehabilitative services to an individual based on sexual orientation.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | [NAME] | RULE §419.455	Eligibility 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 severe and persistent mental illness or a child or adolescent with a serious emotional disturbance; and     (C) qualifies for a LOC; and   (2) a determination that there is a medical necessity for MH rehabilitative services for the individual has been made by an LPHA who is:     (A) an employee of the department;     (B) an employee of an entity designated to make such determinations on behalf of the department; or     (C) a contractor of an entity designated to make such determinations on behalf of the department, if the LPHA is not otherwise employed by or contracting with an entity providing MH rehabilitative services under arrangement with a provider.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | [NAME] | RULE §419.457	Crisis Intervention Services (a) Description. Crisis intervention services are interventions provided in response to a crisis in order to reduce symptoms of severe and persistent mental illness or serious emotional disturbance and to prevent admission of an individual to a more restrictive environment.  (b) Conditions.   (1) Crisis intervention services may be provided to:     (A) an adult; or     (B) a child or adolescent.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | [NAME] | RULE §419.458	Medication Training and Support Services (a) Description. Medication training and support services consists of instruction and guidance based on curricula promulgated by the department. The curricula include the Patient/Family Education Program Guidelines referenced in §419.468(3) of this title (relating to Guidelines), 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 severe and persistent mental illness or a child or adolescent's serious emotional disturbance;   (2) understanding the role of the individual's prescribed medications in reducing symptoms and increasing or maintaining the individual's functioning;   (3) identifying and managing the individual's symptoms and potential side-effects of the individual's medication;   (4) learning the contraindications of the individual's medication;   (5) understanding the overdose precautions of the individual's medication; and   (6) learning self-administration of the individual's medication. (b) Conditions.   (1) Medication training and support services may be provided to:     (A) an adult;     (B) an eligible child or adolescent; or     (C) the LAR or primary caregiver of an eligible child or adolescent.   (2) Medication training and support services provided to an adult may be provided:     (A) in a group; or     (B) one-to-one.   (3) Medication training and support services provided to a child or adolescent may be provided:     (A) in a group; or     (B) one-to-one, except that the LAR or primary caregiver may also be present.   (4) Medication training and support services provided to an LAR or primary caregiver may be provided:     (A) in a group; or     (B) one-to-one, except that the child or adolescent may also be present.   (5) Medication training and support services may be provided:     (A) on-site; or     (B) in-vivo.   (6) Medication training and support services provided to an adult must be provided by:     (A) a QMHP-CS;     (B) a CSSP;     (C) a peer provider; or     (D) a licensed medical personnel.   (7) Medication training and support services provided to a child, adolescent, LAR, or primary caregiver must be provided by:     (A) a QMHP-CS;     (B) a CSSP; or     (C) a licensed medical personnel.   (8) Medication training and support services may not be provided to an individual who is currently admitted to a CSU. (c) Frequency and duration. The provision of medication training and support services must be in accordance with the amount and duration for which the provider has obtained authorization in accordance with §419.456 of this title (relating to Service Authorization and Treatment Plan).
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | [NAME] | RULE §419.461	Skills Training and Development Services (a) Description.   (1) Skills training and development services is training provided to an eligible individual or the LAR or primary caregiver of an eligible child or adolescent. Such training:     (A) addresses severe and persistent mental illness or serious emotional disturbance 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.   (2) Skills training and development services include teaching an individual the following skills:     (A) skills for managing daily responsibilities (e.g., paying bills, attending school and performing chores);     (B) communication skills (e.g., effective communication and recognizing or change problematic communication styles);     (C) pro-social skills (e.g., replacing problematic behaviors with behaviors that are socially acceptable);     (D) problem-solving skills;     (E) assertiveness skills (e.g., resisting peer pressure, replacing aggressive behaviors with assertive behaviors, and expressing one's own opinion acceptably);     (F) social skills (e.g., selection of appropriate friends and healthy activities);     (G) stress reduction techniques (e.g., progressive muscle relaxation, deep breathing exercises, guided imagery, and selected visualization);     (H) anger management skills (e.g., identification of antecedents to anger, calming down, stopping and thinking before acting, handling criticism, avoiding and disengaging from explosive situations);     (I) skills to manage the symptoms of mental illness and to recognize and modify unreasonable beliefs, thoughts and expectations;     (J) skills to identify and utilize community resources and informal supports;     (K) skills to identify and utilize acceptable leisure time activities (e.g., identifying pleasurable leisure time activities that will foster acceptable behavior); and     (L) independent living skills (e.g., money management, accessing and using transportation, grocery shopping, maintaining housing, maintaining a job, and decision making).   (3) Skills training and development services include training an LAR or primary caregiver to assist the child or adolescent in learning the skills described in paragraph (2) of this subsection. (b) Conditions.   (1) Skills training and development services may be provided to:     (A) an eligible adult;     (B) an eligible child or adolescent; or     (C) the LAR or primary caregiver of a child or adolescent.   (2) Skills training and development services provided to an adult, child, adolescent, LAR or primary caregiver of a child or adolescent may be provided:     (A) one-to-one; or     (B) in a group.   (3) Skills training and development services may be provided:     (A) on-site; or     (B) in-vivo.   (4) Skills training and development services provided to a child or adolescent must be provided according to curricula approved by the department.   (6) Skills training and development services provided to a child or adolescent, LAR or primary caregiver must be provided by:     (A) a QMHP-CS; or     (B) a CSSP.   (7) Skills training and development services may not be provided to an individual who is currently admitted to a CSU. (c) Frequency and Duration. The provision of skills training and development services must be in accordance with the amount and duration for which the provider has obtained authorization in accordance with §419.456 of this title (relating to Service Authorization and Treatment Plan).
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | [NAME] | RULE §419.462	Day Programs for Acute Needs (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.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | [NAME] | RULE §419.464	Staff Member Training (a) Training of staff members. A provider must provide training to a staff member to ensure competency in the provision of MH rehabilitative services.  (a) Training of staff members. A provider must provide training to a staff member to ensure competency in the provision of MH rehabilitative services. Such training must be provided in accordance with the following:   (1) A staff member who provides MH rehabilitative services or supervises the provision of MH rehabilitative services must receive training and demonstrate competency in the following areas:     (A) the requirements of this subchapter and of Chapter 412, [NAME] of this title (relating to the Mental Health Community Services Standards);     (B) the nature of severe and persistent mental illness and serious emotional disturbances;     (C) the dignity and rights of an individual in accordance with Chapter 404, [NAME] of this title (relating to Rights of Persons Receiving Mental Health Services);     (D) identifying, preventing, and reporting abuse, neglect, and exploitation in accordance with Chapter 414, [NAME] of this title (relating to Abuse, Neglect, and Exploitation in Local Authorities and Community Centers);     (E) interacting with an individual who has a special physical need such as a hearing or visual impairment;     (F) responding to an individual's language and cultural needs through knowledge of customs, beliefs, and values of various, racial, ethnic, religious, and social groups;     (G) the uniform assessment;     (H) the utilization management guidelines;     (I) developing and implementing an individualized treatment plan;     (J) identifying an individual in crisis;     (K) appropriate actions to take in managing a crisis;     (L) skills training techniques;     (M) the treatment of co-occurring psychiatric and substance use disorders as described in Chapter 411, Subchapter N of this title (relating to Standards for Services to Individuals with Co-Occurring Psychiatric and Substance Use Disorders (COPSD));     (N) the availability of resources within the local community; and     (O) strategies for effectively advocating for an individual.   (2) A staff member who routinely provides or supervises the provision of Medicaid MH rehabilitative services to a child or adolescent must receive training and demonstrate competency in the following areas:     (A) the aspects of a child's growth and development (including physical, emotional, cognitive, educational and social) and the treatment needs of a child and adolescent; and     (B) the department's approved skills training curricula or one that has been reviewed and approved by the department.   (3) Except for the direct clinical supervision of a peer provider, which must be provided by an LPHA, the clinical supervision of the provision of MH rehabilitative services must be provided by a QMHP-CS. (b) Frequency. A staff member must receive the training required by subsection (a) of this section before assuming responsibilities in providing or supervising the provision of MH rehabilitative services. (c) Documentation of training. A provider must document that a staff member has successfully completed the training and has demonstrated competencies in the areas described in subsection (a) of this section.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | [NAME] | RULE §419.468	Guidelines The following guidelines are referenced in this subchapter. For information about obtaining copies of the guidelines contact the Department of State Health Services, Community Mental Health and Substance Abuse Services, Mail Code 2018, P.O. Box 12668, [NAME], TX 78711-2668.   (1) Uniform assessment guidelines, which include:     (C) Child and Adolescent Texas Recommended Authorization Guidelines.     (B) Child and Adolescent Utilization Management Guidelines.     (B) Child and Adolescent-Patient/Family Education Program.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Title 25, Part 1, Chapter 448, [NAME] [NAME] | Access to Services for Co-Occurring Psychiatric and Substance Use Disorders [COPSD] Clients and Additional Requirements for COPSD Programs | "Providers must establish and implement procedures to ensure the continuity between screening, assessment, treatment and referral services provided to clients." "(a) The services provided to a client with co-occurring psychiatric and substance use disorders (COPSD) must: (1) address both psychiatric and substance use disorders; (2) be provided within established practice guidelines for this population; and (3) facilitate individuals in accessing available services they need and choose, including self-help groups." - No specific mention of juveniles
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter D: Mental Health Services RULE §412.231 | Assessment and Intake Training Requirements at a SMHF (a) As required by Texas Health and Safety Code, §572.0025(e), if a SMHF's internal policy permits an assessment professional to determine whether a physician should conduct a preliminary examination on persons requesting voluntary admission, then the assessment professional shall receive at least eight hours of training in conducting an assessment.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 412 Local Mental Authority Responsibilities | Subchapter I: Mental Health Case Management Services Subchapter P: Provider Network Development | RULE §412.405	Eligibility for MH Case Management Services An individual is eligible for general revenue-funded MH case management services if the individual:   (1) is a resident of the State of Texas;   (2) is an adult with a severe and persistent mental illness, or a child or adolescent with a serious emotional disturbance;   (3) does not have a single diagnosis of mental retardation, pervasive developmental disorder, or substance use disorder; and   (4) qualifies for an LOC that includes MH case management services.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 415 Provider Clinical Responsibilities - Mental Health Services | Subchapter J: Preadmission Screening and Resident Review (PASARR) -- Mental Health Services | RULE §415.451	Purpose The purpose of this subchapter is to describe the responsibilities of local mental health and mental retardation authorities (MHMRAs) for providing specialized services and alternate placement services to nursing facility residents who have been identified through the Preadmission Screening and Resident Review (PASARR) process as needing such services.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Chapter 419 Mental Health Services -- Medicaid State Operating Agency Responsibilities | [NAME] | RULE §419.459	Psychosocial Rehabilitative Services (a) Description. Psychosocial rehabilitative services are social, educational, vocational, behavioral, and cognitive interventions provided by members of an individual's therapeutic team that address deficits in the individual's ability to develop and maintain social relationships, occupational or educational achievement, and independent living skills that are the result of a severe and persistent 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
Texas Department of State Health Services (TDSHS) | Policy: The Children's Policy Council (CPC) | House [NAME] of the 77th Texas Legislature | "...assists health and human services agencies in developing, implementing and administering family support policies and related long-term care and health programs for children" | "...assists health and human services agencies in developing, implementing and administering family support policies and related long-term care and health programs for children...comprised of a majority of relatives of consumers of long-term care and health programs for children, and a variety of members from community, faith, business and other organizations." Does not specifically address youth in the juvenile justice system.
Texas Department of State Health Services (TDSHS) | Policy: The Texas Government Code | Title 4: Executive Branch: Chapter 531.0244: Health and Human Services Commission | 531.0244. Ensuring Appropriate Care Setting for Persons with Disabilities; Sec. 531.02441.  Interagency Task Force on Ensuring Appropriate Care Settings for Persons with Disabilities; 531.02445.  Transition Services for Youth with Disabilities | "The executive commissioner shall monitor programs and services offered through health and human services agencies designed to assist youth with disabilities to transition from school-oriented living to post-schooling activities, services for adults, or community living."
Texas Department of State Health Services (TDSHS) | Policy: The Texas Health & Safety Code | Title 7; Chapter 534 | Title 7: Mental Health and Mental Retardation/ Chapter 534: Community Services (including information related to the Texas Correctional Office of Offenders with Medical or Mental Impairments [TCCOMMI]) | "A community center created under this subchapter is intended to be a vital component in a continuum of services for persons in this state who are mentally ill or mentally retarded...It is the policy of this state that community centers strive to develop services for persons who are mentally ill or mentally retarded, and may provide requested services to persons with a chemical dependency, that are effective alternatives to treatment in a large residential facility."   This code lays out everything that goes into a establishing a community center, including board of trustees, advisory committees, cooperation of department, budget, provision of services, screening & continuing care services, fees for services, financial & funding information, management team, eligibility for services, required community-based community services, discharge planning, designation of provider, contracts for certain community services, coordination of activities, respite care, standards of care, contract compliance, program monitoring, audits, contract renewal, local match requirement, health maintenance organizations, laws and rules.  "To the extent that resources are available, department shall:  (1) ensure that the services listed in this section available for children, including adolescents, as well as adults, in each service area;  (2) Emphasize early intervention services including adolescents, who meet the department ’s definition of being at high risk of developing severe emotional disturbances or severe mental illnesses; and  (3) Ensure that services listed in this section are available for defendants required to submit to mental health treatment under Article 17.032 or Section 5(a) or 11(d), Article 42.12, Code of Criminal Procedure."
Texas Department of State Health Services (TDSHS) | Policy: The Texas Register, Proposed Rules: Filed with the Office of the Secretary of State on January 22, 2009. Earliest possible date of adoption: March 8, 2009 | Title 25. Health Services; Part 1. DSHS; Chapter 412. Local Mental Health Authority Responsibilities; [NAME]: "The Executive Commissioner of the Health and Human Services Commission on behalf of the Department of State Health Services (department) proposes the repeal of §§412.301 - 412.322, and new §§412.301, 412.303, 412.304, 412.311 - 412.318, and 412.321 - 412.327, concerning mental health community services standards." | Division 3. Standards of Care/ 25 TAC §§412.321 - 412.327/  "...key components of Resiliency and Disease Management (RDM) are reflected throughout the proposed new rules" | "Repeal of the existing rules is necessary due to substantial changes being made to the rules to align them with existing service delivery requirements. Beginning with fiscal year 2005, the department began incorporating principles of Resiliency and Disease Management (RDM) into its overall approach to regulating the delivery of community mental health services. The core services affected by RDM include mental health rehabilitative and mental health case management services. However, key components of RDM are reflected throughout the proposed new rules.":    §412.321.Crisis Services.  (a) Coordinating provision of crisis services. (b) Immediate screening and assessment.  (c) LPHA consultation.  (d) Physician assessment.  (e) Documenting crisis services.  (f) Communication of crisis contacts.   §412.322.Provider Responsibilities for Treatment Planning and Service Authorization.  (a) Assessment and documentation.  (b) Diagnostics.  (c) Provision of services.  (d) Prerequisites to provision of services.  (e) Content and timeframe of treatment plan.  (f) Review of treatment plan.  (g) Revisions to the treatment plan.  (h) [NAME].   §412.323.Medication Services.  (a) Prescribing of psychoactive medication.  (b) Medication service delivery.
Texas Department of State Health Services (TDSHS) | Policy: Texas Administrative Code | Title 25; Chapter 38 - 38.2(5)(6)(8)(24); 38.3 (a) (b); 38.4 (b)(3)(B); 38.4 (b)(3)(E)(i)(II); 38.4(b)(4)(B) | Relevant to program: The Children with Special Health Care Needs Services Program (CSHCN) | §38.2(6) Definition of child with special health care needs               (6) Child with special health care needs--A person who:                          (A) is younger than 21 years of age and who has a chronic physical or developmental condition; or                          (B) has cystic fibrosis, regardless of the person's age; and                          (C) may have a behavioral or emotional condition that accompanies the person's physical or developmental condition. The term does not include a person who has behavioral or emotional condition without having an accompanying physical or developmental condition.   Definition of chronic developmental condition; emotional/behavioral condition; eligibility; treatment for outpatient mh services (limited to no more than 30 encounters by all practitioners per eligible client, per calendar year); treatment for inpatient psychiatric care (limited to 5 days/calendar year and count against 60 day inpatient hospital day/calendar year); case management services.
Texas Department of State Health Services (TDSHS) [Texas Health Steps] | Management Standard: 2009 TX Medicaid Provider Procedures Manual | Section 43.2.4.2 | THSteps Medicaid Children's Services (Comprehensive Care Program [CCP]) 43.4 | THSteps-CCP Overview "...an expansion of the EPSDT service as mandated by the OBRA of 1989, which requires all states to provide all medically necessary treatment for correction of physical or mental problems to THSteps-eligible clients when FFP is available, even if those services are not covered under the State's Medicaid plan." For clients from birth to through age 20.
Texas Department of State Health Services (TDSHS) [Texas Health Steps] | Management Standard: 2009 TX Medicaid Provider Procedures Manual | [NAME] (forms C.14-C.25) | Mental Health Interview Tools/Referral Forms for Children & Adolescents in English & Spanish | Mental Health Interview Tools/Referral Forms: Ages 0-2 years, 3-9 years, 10-12 years, 13-20 years; Mental Health Parent Questionnaire: Ages Birth-2 years, 3-9 years, 10-12 years, 13-20 years [In Spanish too]
Texas Department of State Health Services (TDSHS) [Texas Health Steps] | Management Standard: 2009 TX Medicaid Provider Procedures Manual | THSteps: Clinical Information (43.2)/ Screening Components with Additional Requirements/ Mental Health (43.2.4.2) | Texas Health Steps (THSteps) is for children from birth through 20 years of age who have Medicaid. Texas Health Steps provides regular medical and dental checkups and case management services to babies, children, teens, and young adults. | Texas Health Steps (THSteps) is for children from birth through 20 years of age who have Medicaid. Texas Health Steps provides regular medical and dental checkups and case management services to babies, children, teens, and young adults. --- "Whenever a mental health crisis is suspected, every effort must be made to secure a prompt mental health evaluation and any medically necessary treatment for the client."
Texas Department of State Health Services (TDSHS) [Texas Health Steps] | Management Standard: Online training for Texas Health Steps |  |  | THSteps includes mental health screening as a part of child and adolescent checkups to identify early mental and behavioral health disorders or their precursors and warning signs early in life.   Screening may reveal no, few, or several problems across these domains and the problems identified can range in severity from minor to significant.  For this reason, another important purpose of screening is to determine whether the problems identified in a domain are serious enough to warrant referral of the child or adolescent for a mental health evaluation and/or treatment. This purpose requires screening for the extent and intensity of any problems noted, as well as for the individual's resiliency and psychological and social resources.  An additional purpose of mental health screening is to determine whether a child is currently receiving or has previously received any form of treatment for a mental or behavioral health condition or disorder, including substance use, abuse, or dependency. If so, the dates, duration(s), and type(s) of treatment should be documented in the child's medical record, along with any treatment outcomes or follow-up recommendations.  It is usually efficient and highly effective to integrate mental health screening into the overall periodic checkup at every well-child visit.   If the completed screening is judged by the provider to be within normal limits, but the parent or client (particularly an older client) is concerned that the client has a mental health or behavioral health problem, the screener must refer the client for a comprehensive mental evaluation.  It is the responsibility of health care professionals who conduct mental health screening, including all primary care providers, to identify and establish referral relationships with a full continuum of behavioral and mental health resources in their local communities.
Texas Department of State Health Services (TDSHS) [Texas Health Steps] | Management Standard: Online training for Texas Health Steps [Cultural competency training] |  |  | The Texas Department of State Health Services defines cultural competence as a set of behaviors, attitudes, beliefs, and policies that enable a system, agency, or individual to work effectively in cross-cultural situations, based on the behavior, attitudes, and beliefs of the clients served and the multicultural staff providing service.  In this context, culture refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Competence implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by clients and their communities.  Berlin and Fowkes' LEARN model can be adapted to help primary care providers remember the essential elements of integrating cultural competence into the provision of health care to children and their families. In this model, each letter of LEARN represents an action verb associated with culturally competent service delivery within the ethical contexts of health care professions: L 	isten with sympathy and understanding to the perception of each health problem from the child's and/or caregivers' perspectives. E 	xplain your perceptions of each health problem and your strategy for its treatment. A 	cknowledge and discuss the differences and similarities between your perceptions and the perceptions of the child and the child's caregivers. R 	ecommend treatments taking into account the child's and family's cultural parameters and beliefs. Negotiate agreement. It is important to understand each family's way of understanding illness, its consequences, and how best to treat it, so that medical care and treatment fit in their cultural framework.
Texas Department of State Health Services (TDSHS) [Texas Health Steps] | Policy: Texas Administrative Code | TITLE 25; Pt. 1; Ch. 33; [NAME]. E; §33.60 | Health Services - DSHS/ Early and [NAME], Diagnosis, and Treatment/ Early and [NAME], Diagnosis, and Treatment | Clients are entitled to medical check-ups which include 'comprehensive health and developmental history, including physical and mental health and development'
Texas Education Agency (TEA) | Memorandum of Understanding | Developed pursuant to Texas Government Code, [NAME], Chapter 531, Section 531.055 | Coordinated Services to Persons Needing Services from More Than One Agency/ Between HHSC, DADS, DARS, DFPS, DSHS, TCOOMMI, TDCJ, TDHCA, TEA, TJCP, TWC, TYC | Purpose: implementation of statewide system of county-based, multiagency community resource coordination groups (CRCGs) to coordinate services for persons of all ages, including children, youth and adults needing multiagency services and whose needs can be met only through interagency coordination and cooperation....sets forth the intention of the agencies, the local CRCGs, and HHSC to work together to ensure that the strategic plan for delivering health and human services in TX includes appropriate plans for delivering coordinated services to persons with complex needs...the CRCGs provide a mechanism that enables local public and private agencies, organizations, and families to work together in collaboration to meet the needs of individuals which no one agency can meet."
Texas Education Agency (TEA) | Memorandum of Understanding |  | Department of Assistive and Rehabilitative Services (DARS) Early Childhood Intervention and the Texas Education Agency | Purpose re: children with disabilities: "enhance interagency collaboration and relationships...coordinate an effective system of activities, policies and procedures between TEA & ECI which guide and support the development and implementation of transition services for families of children with disabilities who are approaching age three"
Texas Education Agency (TEA) | Policy: Texas Administrative Code | Chapter 89: Commissioner's Rules Concerning Special Education Services | 89.1001. Scope and Applicability 89.1011. Referral for Full and Individual Initial Evaluation 89.1015. Time Line for All Notices 89.1035. Age Ranges for Student Elibility | "Special education services shall be provided to eligible students in accordance with [laws]; Education programs, under the direction and control of the Texas Youth Commission, Texas School for the Blind and Visually Impaired, Texas School for the Deaf, and schools within the Texas Department of Criminal Justice shall comply with state and federal law and regulations concerning the delivery of special education and related services to eligible students and shall be monitored by TEA..."  89.1011 Referral for Full and Individual Initial Evaluation: "Referrals...shall be part of the district's overall, general education or screening system. Prior to referral, students experiencing difficulty in the general classroom should be considered for all support services available to all students, such as tutorial; remedial; compensatory; response to scientific, research-based interventions; and other academic or behavior support services. If the student continues to experience difficulty in the general classroom after the provision of interventions, district personnel must refer the student for a full and individual initial evaluation. This referral for a full and individual initial evaluation may be initiated by school personnel, the student's parents or legal guardian, or another person involved in the education or care of the student."
Texas Education Agency (TEA) | Policy: Texas Administrative Code | Chapter 89: Commissioner's Rules Concerning Special Education Services | 89.1040. Eligibility Criteria 89.1045. Notice to Parents for Admission, Review, and [NAME] (ARD) Committee Meetings 89.1047. Procedures for Surrogate and [NAME] 89.1049. Parental Rights Regarding Adult Students 89.1050. The Admission, Review and [NAME] (ARD) Committee | Eligibility includes 'emotional disturbance'
Texas Education Agency (TEA) | Policy: Texas Administrative Code | Chapter 89: Commissioner's Rules Concerning Special Education Services | 89.1052. [NAME] in Juvenile Justice Alternative Education Programs (JJAEP) | Discretionary Placements in Juvenile Justice Alternative Education Programs (JJAEP); [under certain circumstances] "In a county with a JJAEP, the local school district shall invite the administrator of the [NAME] or the administrator's designee to an ARD meeting convened to discuss the expulsion of a student with a disability under one of the provisions listed in subsection (a) of this section, relating to the offenses for which a school district may expel a student. The notice of the meeting must be consistent with 34 Code of Federal Regulations. A copy of the student's current individualized education program (IEP) must be provided to the JJAEP administrator or designee with notice...an ARD must be convened to reconsider placement of the student in JJAEP, if the JJAEP administrator or designee provides written notice to the school district of specific concerns that the student's educational or behavioral needs cannot be met in the JJAEP.
Texas Education Agency (TEA) | Policy: Texas Administrative Code | Chapter 89: Commissioner's Rules Concerning Special Education Services | 89.1055. Content of the Individualized Education Program (IEP) 89.1056. Transfer of Assistive Technology Devices 89.1065. Extended School Year Services 89.1070. Graduation Requirements 89.1075. General Program Requirements and Local District Procedures 89.1076. Interventions and Sanctions 89.1080. Regional Day School Program for the Deaf 89.1085. Referral for the Texas School for the Blind and Visually Impaired and the Texas School for the Deaf Services 89.1090. Transportation of Students Placed in a Residential Setting, Including Texas School for the Blind and Visually Impaired and the Texas School for the Deaf Services 89.1096. Provision of Services for Students Placed by their Parents in Private Schools or Facilities 89.1100. MOU on Coordination of Services to Disabled Persons | strategies that may be addressed in IEP include: in-home and community-based training or viable alternatives that assist the student with acquisition of social/behavioral skills; positive behavior support strategies; parent/family training and support... etc.
Texas Education Agency (TEA) | Policy: Texas Administrative Code | Chapter 89: Commissioner's Rules Concerning Special Education Services | 89.1115. MOU Concerning Interagency Coordination of Special Education Services to Students with Disabilities in Residential Facilities 89.1121. Distribution of State Funds 89.1125. Allowable Expenditures of State Special Education Funds 89.1131. Qualifications of Special Education, Related Service, and Paraprofessional Personnel 89.1141. Education Service Center Regional Special Education Leadership 89.1150. Resolution of Disputes Between Parents and School Districts - General Provisions 89.1151. Due Process Hearings 89.1165. Request for a Hearing 89.1170. Impartial Hearing Officer 89.1180. [NAME] 89.1185. Hearing 89.1191. Special Rule for Expedited Due Process Hearings | Agencies that are a party to this include: TEA; TDHS; TDMHMR; TDH; PRS; ECI; TCADA; TJPC; TYC regarding responsibilities, regulatory and planning functions, providing notification; determining when a public school will provide educational services; measures to ensure safety of students and teachers; dispute resolution
Texas Health & Human Services Commission (HHSC) | Management Standard: Office of Program Coordination for Children and Youth  Community Resource Coordination Groups (CRCG) of Texas |  | Community Resource Coordination Groups (known as CRCGs) are local interagency groups, comprised of public and private providers who come together to develop individual services plans for children, youth, and adults whose needs can be met only through interagency coordination and cooperation. | What Are Community Resource Coordination Groups?  Community Resource Coordination Groups (CRCGs) are local interagency groups comprised of public and private agencies. Together, they develop service plans for individuals and families whose needs can be met only through interagency coordination and cooperation.  CRCGs originated when the Texas Legislature passed Senate Bill 298 into law in 1987. This bill directed state agencies serving children to develop a community-based approach to better coordinate services for children and youth who have multi-agency needs and require interagency coordination. More recently, communities have begun using this community-based approach to serve adults with complex needs. Who Serves on CRCGs?  CRCGs are organized and established on a county-by-county basis. CRCG members are from public and private sector agencies and organizations. Many CRCGs also include parents, consumers, or caregivers as members. CRCG members include the following representatives:      * Families, Consumers, and Caregivers     * Texas Health and Human Services Commission     * Texas Department of Aging and Disability Services     * Texas Department of Assistive and Rehabilitative Services     * Texas Department of Family and Protective Services     * Texas Department of State Health Services     * Texas Correctional Office on Offenders with Medical or Mental Impairments     * Texas Department of Criminal Justice     * Texas Department of Housing and Community Affairs     * Texas Education Agency     * Texas Juvenile Probation Commission     * Texas Workforce Commission     * Texas Youth Commission     * Private Child Serving Providers     * Private Adult Serving Providers  How Do CRCGs Help Their Communities?  CRCGs make it more likely for individuals and families to get the help they need before the situation becomes unsolvable. In many communities, CRCGs identify service gaps in their area and help plan for appropriate resources to meet their clients’ needs. As a result, more people get the services and support they need.
Texas Health & Human Services Commission (HHSC) | Management Standard: Special Medicaid Bulletin: Inpatient and Outpatient Behavioral Health Services  January 2009 |  | Inpatient & Outpatient Behavioral Health Overview | Behavioral health services...are benefits of Texas Medicaid when these services are provided to clients who are experiencing a significant behavior health issue that is causing distress, dysfunction, and/or maladaptive functioning as a result of a confirmed or suspected psychiatric condition, as defined in the current editions of the DSM.  Inpatient and Outpatient Behavioral Health Overview Inpatient Behavioral Health Services -Acute Care Hospital, Freestanding/State Psychiatric Facilities -Medicaid Clinical Criteria - Initial Inpatient Psychiatric Stay -Physician, Psychiatrist, Psychologist, NP, CNS, and PA Services -Court-Ordered Services -Electroconvulsive Therapy (ECT) -Family Counseling -Hospital Discharge -Inpatient Consultations -Narcosynthesis -Pharmacological Management Services -Psychiatric Diagnostic Interviews -Psychological and Neuropsychological Testing -Inpatient Psychotherapy/Counseling Outpatient Behavioral Health Services -Annual Encounters/Visit Limitations -Authorization Requirements After the Annual Encounter/Visit Limitation has been met -Psychiatrist, NP, CNS, and PA Services - CDTF Services -Court-Ordered and DFPS-Directed Services -Pharmacological Regiment Oversight and Management Services -Psychiatric  Diagnostic Interviews -Psychological and Neuropsychological Testing -Outpatient Psychotherapy/Counseling -Initial Outpatient Psychotherapy/Counseling - Individual, Group or Family -Subsequent Outpatient Psychotherapy/Counseling - Individual, Group or Family -Insight Oriented Behavior Modifying and/or Supportive Outpatient Psychotherapy/Counseling -Family Therapy -Additional Benefit Changes  "Inpatient psychiatric treatment in a nationally-accredited freestanding psychiatric facility or a nationally-accredited state psychiatric hospital is a benefit of Texas Medicaid for clients 20 years of age or younger who are eligible for THSteps benefits at the time of the service request and service delivery. Admissions to freestanding and state psychiatric facilities must be medically necessary unless the admission is court ordered for a mental health commitment or a condition of probation.   Family Counseling p. 7
Texas Health & Human Services Commission (HHSC) | Policy: Government Code | Title 4: Subtitle I: Chapter 531. Health and Human Services Commission: 531.251 | General Provisions; Organization of Commission/ Developing Local Mental Health Care Systems for Certain Children/ Pilot Project Consortium; Expansion Plan | (a) The commission shall for a consortium to develop criteria for and implement the expansion of the Texas Integrated Funding Initiative pilot project and to develop local mental health care systems in communities for minors who are receiving residential mental health services or who are at risk of residential placement to receive mental health services. The consortium must include representatives of the Texas Department of Mental Health and Mental Retardation, Department of Protective and Regulatory Services, Texas Education Agency, Texas Youth Commission, Texas Juvenile Probation Commission, and Texas Commission on Alcohol and Drug Abuse and an equal number of family advocates. (b) The commission and the consortium shall: (1) develop a model and guidelines for the delivery of mental health services and support to a minor, initiated before the person's 18th birthday, including best practices in the financing, administration, governance, and delivery of those services; (2) establish a plan to expand the Texas Integrated Funding Initiative so that the initiative may operate in up to six communities; and (3) identify appropriate sources of state and federal funding to finance mental health services under the initiative from a central fund for expansion communities. Added by Acts 1999, [NAME]., ch. 446, Sec. 1, eff. June 18, 1999
Texas Health & Human Services Commission (HHSC) | Policy: Government Code Title 4. Executive Branch | [NAME] and Human Services Commission | [NAME]; Organization of Commission | Each health and human services agency, The Texas Council on Offenders with Mental Impairments, the Texas Department of Criminal Justice, the Texas Department of Housing and Community Affairs, The Texas Education Agency, the Texas Workforce Commission, and the Texas Youth Commission shall adopt a joint memorandum of understanding to promote a system of local-level interagency staffing groups to coordinate services for persons needing multiagency services.
Texas Health & Human Services Commission (HHSC) | Policy: Report to the Governor and the 79th Legislature, Submitted by the State Texas Integrated Funding Initiative Consortium in Cooperation with the Texas Health And Human Services Commission | Relevant to: House Bill 2292, Section 2.166 78th Legislature, Regular Session, 2003 House [NAME] (H.B.) 2292, Section 2.166, passed by the 78th Texas Legislature, Regular Session, 2003, charged the State Texas Integrated Funding Initiative (TIFI) Consortium with the development of a summary report based on the evaluations submitted to the State Consortium by local Community Resource Coordinating Groups (CRCGs). According to this legislative charge, the State Consortium's report must include recommendations for policy and statutory changes at each agency involved in the provision of system of care services for children with severe emotional disturbances and their families, and the outcome(s) expected from the implementation of each recommendation. | Systems of Care for Children with Severe Emotional Disturbance and Their Families | Recommendations to the Legislature from the State TIFI Consortium 1. Appropriate new funds to create and integrat statewide system for purchasing behavioral health care services that promote the well-being of children, youth and their families, encourage a seamless system of care which is accessible, continuously available, and emphasizes prevention and early intervention, resiliency, recovery and rehabilitation. Place these new appropriations into one fund shared and governed by child-serving state agencies with representation of family and advocacy organizations, to coordinate and ensure access to services in the least restrictive, most effective settings. 2. Direct state agencies that provide health and human services, educational services, and juvenile justice services to pair a designated agency staff member with an identified family/youth partner to serve on the State TIFI Consortium. 3. Direct the Regional Councils of Government (COG) to build or enhance existing regional or local collaborative infrastructures to develop a community master plan for children, youth and families. This master plan should identify barriers to accessing behavioral health services, direct local resources to remove those barriers, and promote positive social-emotional development for all children and youth. 4. Provide that parent/guardian(s) of a child/youth needing mental health services or treatment who voluntarily relinquish the custody of a child, but retain some partial conservatorship interest in the child, shall have: -notice of any and all treatment (including medical, service coordination, educational, etc.) prior to treatment or as soon as possible, and -The opportunity to participate in the decision-making processes for the child's behavioral health treatment. 5. Restore the Children's Health Insurance Program (CHIP) behavioral health benefits to fiscal year 2000 service levels, including eligibility, cost sharing, mental health, substance abuse and services for co-occurring disorders. Consider the incorporation of system of care practices into the design of the restored benefits package, including wraparound planning, flexible funds and other family supports. 6. Restore all health insurance policies regulated by the State mandated benefits that prevent or treat illnesses or disabilities in children and youth that were excluded by: -Senate Bill (S.B.) 541, 78th Texas Legislature, Regular Session, 2003, and/or  -S.B. 10, 78th Texas Legislature, Regular Session, 2003 7. Restore all prevention and early intervention funding including: -Monies previously appropriated at fiscal year 2002 levels for Department of Family and Protective Services and the Texas Youth Commission - Texas Education Agency's Non-Educational Community-Based Support funding level to the original 2 million dollars 8. Increase the quality and availability of a trained public workforce for child and youth services in underserved areas of Texas through mechanisms such as incentives and tuition waivers for continued years of service, identification and use of federal funds for tuition, supported internships/externships, loan forgiveness for mental health professionals willing to work in underserved areas for designated timeframes, and expande collaborations among state agencies, universities, colleges, and the Texas Higher Education Coordinating Board. 9. Direct the Legislative Budget Board (LBB) to incorporate requirements int he guidelines for each child and youth-serving state agency's strategic plan to ensure family/youth involvement in planning and policy development related to behavioral health services needs. The proposal should be cost neutral for the family/youth representatives and reflect the core values and guiding principles of system of care. 10. Direct DSHS to review and augment current continuity of care rules related to behavioral health services to ensure children and youth discharged from residentially based treatment will have immediate access to behavioral health services, provided by local mental health authorities, at the level and intensity they require.
Texas Health & Human Services Commission (HHSC) | Policy: Senate Bill 103 Executive Summary and Agency Reports Submitted by the Health and Human Services Commission July 1, 2008 | The 80th Legislature Regular Session, 2007, enacted Senate [NAME] (S.B.) 103, Section 20, relating to access for females less than 18 years of age to facilities, services, and treatments available through the health and human services (HHS) and juvenile corrections programs. The measure amended the Texas Government Code by adding Section 531.016 in Chapter 531, Supchapter A, directing the Texas Health and Human Services Commission (HHSC), the Texas Youth Commission (TYC), and the Texas Juvenile Probation Commission (TJPC) to periodically review, document, and compare the accessibility and funding of facilities, services, and treatments provided to females under 18 to that of males in the same age group. Additionally, each HHS that provides services that are subject to the areas of review specified in the legislation are to identify existing services within the agency in the allocation and expenditures of money and services for females under 18 years of age in comparison to males in the same age group. Therefore, the Department of State Health Services (DSHS) and the Department of Family and Protective Services (DFPS) were added to the list of covered agencies, in addition to the named agencies: HHSC, TJPC, and TYC. |  | This is the first consolidated report since the new legislation (S.B. 103, Section 20, 80th Legislature, regular Session, 2007) and the third since the original legislation (HB 1758, 77th Legislature, Regular Session, 2001).   HHSC reviewed all agency reports in an effort to provide this executive summary and analyze the basic conclusions of each agency. As a result of this analysis, HHSC did not identify any systemic barriers to access to services by females under the age of 18. During the review, HHSC and the identified agencies specifically analyzed the nature of the services, their eligibility criteria, and the targeted populations for these specific services. Based on this information, it was noted that females under the age of 18 years have access to the specific services mentioned in the bill on either a first-come, first-served basis, or have exclusive access to some services due to the nature of the service (e.g. teen pregnancy services). No eligibility criteria, no intake processes, and no specific service issues reflected barriers to accessibility based on a gender bias, for individuals under the age of 18 years.    TYC: "TYC's formalized 'specialized treatment programs' (i.e. substance abuse, violent offender, sex offender treatment, etc.), with the except of mental health treatment, were generally less accessible to young females when compared to young males.  Although females had higher rates of violent offenses, the agency's Capital and Serious Violent Offender program is offered only to males at the Giddings State School. The program was offered to females at the Giddings State School during the first half of fiscal year 2007;  however all female participants were over the age of 18 years. The [NAME] State Juvenile Correctional Complex provided females with cognitive-behavioral treatment designed to increase problem-solving skills and these skills were emphasized in all aspects of the program.  Mental Health Services: Gender discrepancies in the mental health services for youth outlined in SB 103 are primarily related to referral base. As most youth served in bill-related mental health services are referred by the juvenile justice system, gender discrepancy is related to the disproportionate  number of males vs. females served. Regardless of gender, clinically appropriate interventions are used for each child and adolescent in DSHS mental health services....the impact of mental health services delivered to girls actually outpaces the impact of mental health services delivered to boys are far as percentages of those receiving treatment who maintain or improve in targeted areas of healthy functioning.   DFPS: Community Youth Development (CYD): program that contracts with fiscal agents to develop juvenile delinquency prevention programs in zip codes that have a high incidence of juvenile crime. Approaches used by communities to prevent delinquency have included mentoring, youth employment programs, career preparation, and alternative recreation activities. Communities prioritize and fund specific prevention services identified as needed locally. Available in 15-targeted Texas zip codes.   Services to At-Risk Youth (STAR): Through contracts with community agencies, STAR offers family crisis intervention counseling, short-term emergency residential care, and individual and family counseling to youth up to age 17 who experience conflict at home, have been truant or delinquent, or have run away. STAR services are available in all 254 Texas counties. Each STAR contractor also provides universal child abuse prevention services, ranging from local media campaigns to informational brochures and parenting classes.  Youth Resiliency (YR): A variety of services are available across the state that is designed to increase known protective factors to improve youth resiliency, while preventing juvenile delinquency. Programs must also foster strong community collaboration to provide for a continuum of services for youth participants. YR services are available in 14 Texas counties.   Texas Runaway and [NAME]: offer crisis intervention, telephone counseling, and referrals to troubled youth and families.
Texas Health & Human Services Commission (HHSC) | Policy: Systems of Care -SAMHSA (Substance Abuse & Mental Health Services Administration) | "In a system of care, mental health, education, child welfare, juvenile justice, and other agencies work together to ensure that children with mental, emotional, and behavioral problems and their families have access to the services and supports they need to succeed. These services and support may include diagnostic and evaluation services, outpatient treatment, emergency services (24 hours a day, 7 days a week), case management, intensive home-based services, day treatment, respite care, therapeutic foster care, and services that will help young people make the transition to adult systems of care.  Systems of care are developed on the premise that the mental health needs of children, adolescents, and their families can be met within their home, school, and community environments. These systems are also developed around the principles of being child-centered, family-driven, strength-based, and culturally competent and involving interagency collaboration. The Child, Adolescent, and Family Branch embrace and promote these core systems of care.  The goal of systems of care programs is to build innovative community treatment programs for children with serious emotional disturbances and their families. | Austin - The Travis County Children's Mental Health Partnership; The Children's Partnership | The Travis County Children's Mental Health Partnership is developing an organized system of care for children with severe emotional disorders and their families. The goal is to build on existing collaborative and family supports at the State and local levels. Activities include coordination and integration of families and child service systems to provide a full continuum of culturally competent, family-based individualized services. The Texas Health and Human Services Commission is working in partnership with the Travis County community to expand services and increase flexible funding through the utilization of a consolidated, independent resource pool with contributions from public child-serving agencies including child welfare, juvenile justice, mental health, education, and health and human services. A wraparound approach is being used to create individualized service plans for full care coordination, help families keep children in community care, and reduce out-of-home placements.
Texas Health & Human Services Commission (HHSC) | Policy: Texas Administrative Code | Chapter 358 | Medicaid Eligibility | 358.100 Definitions: "An individual who is unable to engage in any substantial, gainful activity because of any medically determinable physical or mental impairment that can be expected to result in death or has lasted or can be expected to last for a continuous period of at least 12 months"  358.105 Description of Eligible Clients Eligible recipients include: TANF Recipients, eligible pregnant women in children, medically needy recipients, certain children in approved foster care plans, individuals receiving SSI, individuals who were denied SSI benefits b/c of an increase in/receipt of RSDI disabled children's benefits  385.305 Eligibility requirements for the Aged, Blind or Disabled To meet eligibility requirements for SSI-related MAO programs, individual must be aged, blind, or disabled...(3) A child who is under 18 and is not engaged in substantial, gainful activity is considered disabled if he suffers from any medically determinable physical or mental impairment of comparable severity to that which would preclude an adult from engaging in substantial, gainful activity.   358.410 Deeming of Resources (b)(1) If a disabled child under 18 lives with his parents in the same household, the department must deem to the child certain resources of the parents. If a parent is a TANF caretaker or a client, his resources are not counted.  (2) to determine the amount of resources deemed to an eligible child, the department: (A) applies any appropriate resources exclusion to the resources of the parents to determine countable resources. Pension funds owned by a parent are excluded from resources for deeming purposes: (B) deems to the child any resources in excess of the individual resource limit for one parent or the couple resource limit for two parents. If more than one child is potentially eligible for an SSI-related Medicaid program, the amount to be deemed is equally divided among otherwise eligible children. None of the parents' resources are deemed to ineligible children.
Texas Health and Human Services Commission (HHSC) | Policy: Texas Integrated Funding Initiative Office of Program Coordination for Children and Youth | http://www.hhsc.state.tx.us/tifi/ Texas Government Code 531 [NAME] (Senate [NAME], 76th Legislature, Regular Session, 1999) directed the Health and Human Services Commission to form a consortium with representation from the following state agencies (reconfigured per House Bill 2292, 78th Legislature, Regular Session, 2003): Texas Department of State Health Services, and Texas Department of Family and Protective Services. Additionally, the TIFI Consortium includes the Texas Education Agency, Texas Youth Commission, Texas Juvenile Probation Commission, and an equal number of family representatives. |  | The Texas Integrated Funding Initiative supports a flexible funding collaboration among agencies, families and community groups in order to serve children/youth with severe emotional disturbance, and their families, by developing systems of care that focus on the families’ unique strengths and cultures by assisting children and families to lead healthy lives within their communities.  In 1999, Senate [NAME], 76th Legislature, Regular Session, 1999 created the TIFI Consortium and authorized up to six Texas Integrated Funding Initiative sites.  The vision of TIFI is to develop systems of care in local communities for all Texas children with severe emotional disturbances, and their families, through the integration of federal, state, and local funds, and other resources.  TIFI focuses on developing systems of care for children and youth with complex mental health needs, with families as full partners in the planning, implementation and evaluation of individual service programs based on their child’s mental health and/or behavioral health (mental health, substance abuse or co-occurring mental disorders) needs.   TIFI promotes the following goals for developing local integrated systems of care:      * To recognize families as valuable and essential partners in the development and implementation of an integrated service delivery system;     * To foster and maintain local control to allow for better decision-making and enhance community development; and     * To support communities in managing funds and providers through a single local entity to produce better outcomes for children and their families.  Primary Partners  Families with children having complex mental health needs are TIFI’s primary partners. Children and their families must be at the center of systems change processes.Their life experiences, resources and supports in raising their children provide a more complete picture of how professionals can identify needs and match appropriate individualized supports and services.  Secondary Partners      * TIFI is an initiative to restructure systems and partner with families at all levels of systems of care development. Creating successful integrated systems requires a wide range of participation.     * Communities:  TIFI provides an opportunity for community members and public and private service providers to have a voice and choice in service delivery through a wraparound approach.  A wraparound approach helps create systems that fit the diverse needs of children and families in their communities.      TIFI Communities work closely with local Community Resource Coordination Groups (CRCGs), and there is a CRCG serving children and youth available for all 254 Texas counties.       *   State Systems: TIFI provides an opportunity for child-serving state agencies and private sector organizations/associations to enhance interagency coordination and collaboration to better serve children with complex mental health needs and their families. These enhancements may include promoting individualized services move beyond traditional child-centered mental health services to encompass more comprehensive supports for the entire family. By reducing duplication of services and maximizing resources, an integrated funding approach promotes more efficient and cost-effective service delivery systems.  Department of State Health Services (TIFI Contract Management) (DSHS) Department of Family and Protective Services (DFPS) Texas Education Agency (TEA) Texas Juvenile Probation Commission (TJPC) Texas Youth Commission (TYC) Community Resource Coordination Groups (CRCG)      Establish a plan to expand the Texas Integrated Funding Initiative in order that the initiative may operate in up to six communities; and 50 percent state agency representation from five child-serving agencies.  The members of the Consortium and the Commission have been charged to do the following tasks as outlined in the Texas Government Code.     1. Develop a model and guidelines for the delivery of mental health services and support to a minor, initiated before the person's 18th birthday, including best practices in the financing, administration, governance, and delivery of those services;    2. Establish a plan to expand the Texas Integrated Funding Initiative so that the initiative may operate in up to six communities; and    3. Identify appropriate sources of state and federal funding to finance mental health services.  Additionally, the Consortium promotes the provision of technical assistance to expansion sites in order to develop local systems of care and assist in the sharing of knowledge, development and resources across sites.  The Texas Health and Human Services Commission provides funding to local expansion communities through competitive community grant awards.
Texas Juvenile Probation Commission (TJPC) | Management Standard: Policy and Procedure Manual | Special Needs Diversionary Program (with Texas Council on Offenders with Mental Impairments [TCOMI]) | Program Guidelines and Overview | The implementation of the Special Needs Diversionary Program by the Texas Juvenile Probation Commission (TJPC) will be conducted through the activities of data analysis, on-site monitoring, formal program summary review, and technical assistance.   A) Target population: Children who will be served through this program are those who 1. have received a disposition of deferred adjudication, probation, or pending court under court ordered conditions of release, and are being supervised in the community by the juvenile court; and  2. are found to have a DSM-IV Axis I diagnosis other than or in addition to substance abuse, mental retardation, autism, or pervasive developmental disorder; and  3. are at risk of removal from the home due to psychiatric symptoms or have been determined by the school system to be in special education due to serious emotional disturbance, or have a serious functional impairment as measured by the current Global Assessment of Functioning (GAF) Scale of 50 or less; and  4. have at least one family member in the household who is willing to actively participate in the program.  B) Referral into the Special Needs Diversionary Program Criteria: Each of the following activities shall be completed to determine eligibility for the program: 1. MAYSI-2 Massachusetts Youth Screening Inventory 2. Voice DISC-4 3. Clinical Assessment: Those children whose Voice DISC 4 scores indicate a need for further assessment shall be referred for clinical evaluation and determination of program eligibility by a licensed mental health professional.  4. Family Suitability Interview:  1. A family suitability interview shall be completed for each child found to meet the requirements for services through this program. 2. The purpose of this interview is to determine whether the child has a family member available for participation in the program. 3. If there is no supportive family member available to participate in the program, the child should be referred for services through another program.  5. Medicaid/Chip Screening  C.) Implementing the Prevalence Study (2002) D) Prevalence Study Data Submission  IV. Monitoring and Program Review: County juvenile boards and the Executive Directors of the Mental Health and Mental Retardation Centers (MHMR) of the funded projects are responsible for the assurance that the Specialized Diversionary Program teams are in compliance with the guidelines as established by TJPC and TCOMI.
Texas Juvenile Probation Commission (TJPC) | Management Standard: Special Needs Diversionary Program | Section Number: (E) Four:  Case Management | Special Needs Diversionary Program/ Transition and Aftercare | The implementation of the Special Needs Diversionary Program by the Texas Juvenile Probation Commission (TJPC) will be conducted through the activities of data analysis, on-site monitoring, formal program summary review, and technical assistance.
Texas Juvenile Probation Commission (TJPC) | Management Standard: Special Needs Diversionary Program for Mentally Ill Juvenile Offender, FY 2007 Published March 2008 |  |  | Studies by the Criminal Justice Policy Council in 2001 indicated a substantial percentage of juveniles in the criminal justice system had mental health problems and only a small portion of these juveniles were receiving mental health services. To address this need for services, the Legislature in 2001 appropriated $2 million in new funding to the Texas Juvenile Probation Commission (TJPC) and $5 million in new funding to the Texas Correctional Office on Offenders with Medical and Mental Impairments (TCOOMMI)...as part of the Enhanced Mental Health Services Initiative for the adult and juvenile justice systems.   The intent of this specialized funding was to provide mental health treatment and specialized supervision in order to rehabilitate juvenile offenders and prevent them from committing more crimes. This funding lead to the creation of the Special Needs Diversionary Program (SNDP) administered in a collaborative model by the TJPC and TCOOMMI.   The program involves specialized juvenile probation officers from local juvenile probation departments and professional mental health staff from the local mental health centers that work together to coordinate intensive community based management services. The program offers both mental health services, probation services and parental support and education. It also requires frequent weekly contact with the juvenile, involvement with the family and small specialized caseloads. SNDP began providing services in the 8 urban regions of the State September 2001 and expanded to 11 small and medium counties in January 2002.
Texas Juvenile Probation Commission (TJPC) | Policy: Data Compliance Resources Manuals | Title 37 Texas Administrative Code - Chapter 341 | Quality Assurance Monitoring (341.47) | Placement facilities provide a wide variety of services to juveniles and are either secure or non-secure facilities. Most facilities provide ancillary services that interrelate with the primary service. Some of the types of ancillary services include but are not limited to substance abuse, family living, sex offender and mental health.Mental Health and Mental Retardation   (M) - This type of program shall provide services to juveniles diagnosed as mentally retarded or mentally ill. Program eligibility shall be limited to those juveniles meeting state defined mental health priority population criteria or the state service definition for mental retardation. A professional who is licensed or certified in Texas or an agency qualified to conduct assessments of psychological, psychiatric, emotional or mental health functioning, and/or general intellectual functioning (mental retardation) shall determine the eligibility of the juvenile to enter the program. Program services shall be provided by qualified mental health professionals or by an agency/vendor qualified to provide mental health and/or mental retardation services.
Texas Juvenile Probation Commission (TJPC) | Policy: Grant | [NAME] Diversionary Program [also submitted by TCCOOMMI] | Text of Grant Requirement/  Commentary/ Methodology | lThe Special Needs Diversionary Program (SNDP) is a grant designed to increase the availability of effective services to juvenile offenders with mental health needs.  The Commission is working in coordination with the Texas Correctional Office on Offenders with Medical or Mental Impairments (TCOOMMI) and in cooperation with mental health and mental retardation agencies, to implement programs that provide services to youth under the jurisdiction of local juvenile probation departments.
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.06.45 | Chapter: Other Special Populations - Females, Youth with MH Problems, Youth w/ Cognitive Impairment Section: Youth with Mental Health Problem Title: Referral to TCOOMMI | 06.45 a. All youth with mental health problems will be screened for eligibility for Texas Correctional Office for Offenders with Medical and Mental Impairments (TCOOMMI) services and those meeting the criteria will be referred for services. [NAME] 1. All youth, upon earning [NAME] and within 90 days of his/her minimum length of stay, must be screened for eligibility for TCOOMMI services. 2. All eligible youth will be referred for TCOOMMI services prior to release from a residential program. The eligibility criteria are: A. For youth 17 years and younger: Have a DSM-IV Axis I diagnosis other than or in addition to conduct disorder, substance abuse disorder, mental retardation, autism, pervasive developmental disorder or a V code diagnosis. B. Youth 18 years of age and over: i. Have a DSM-IV Axis I diagnosis of schizophrenia or Bipolar disorder; or ii. Have a DSM-IV Axis I diagnosis of Major Depression and a GAF of 50 or below C. Youths not currently meeting eligibility criteria should be referred to TCOOMMI for mental health evaluation if they have met eligibility criteria in the previous six (6) months and staff believe youth needs services. D. Youths not meeting eligibility criteria currently or during the previous six (6) months may be referred to TCOOMMI for mental health evaluation if the Associate Psychologist or Psychologist believes the youth would need services. The Associate Psychologist or Psychologist submits to the PSW a psychological update with clinical justification for a referral which is emailed with the referral to TCOOMMI.
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.07.09 | Chapter: Admission Criteria for Specialized Programs & Orientation Section: Specialized Programs for Admission Criteria Title: Assignment to Mental Health Treatment Program | a. Youth assigned to a Mental Health Treatment Program will meet specific criteria. [NAME] 1. To outline the assignment process to a Mental Health Treatment Program (MHTP). 2. To outline staff responsibilities when youth are identified as appropriate for assignment to a MHTP. [NAME]. Youth are assigned to a MHTP based upon an assessed Mental Health Priority of 2 on the Priority Placement for Specialized Treatment, their confirmed position on a centralized priority list for placement, and bed availability at a MHTP.
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.09.01 | Chapter: Specialized Programs Section: Mental Health Treatment Program Title: Pre-Admission Assessment | [NAME] The Mental Health Treatment Program will conduct a 30-day Pre-Admission Assessment to determine eligibility for admission and to assess clinical needs and treatment interventions for each youth that is referred.
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.09.04 | Chapter: Specialized Programs Section: Mental Health Treatment Program Title: Program Orientation | [NAME] Each youth and his/her parent or guardian will receive an orientation to the Mental Health Treatment Program (MHTP) within the specified timeframes.
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.09.11 | Chapter: Specialized Programs Section: Mental Health Treatment Program Title: Individual Case Planning | Youth will receive an Individual Case Plan (ICP) that addresses offense specific issues, specialized mental health needs, and approved adaptations.
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.09.23 | Chapter: Specialized Programs Section: Mental Health Treatment Program Title: Individual Counseling | Youth will receive at least three (3) hours of Individual Counseling per month.
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.09.25 | Chapter: Specialized Programs Section: Mental Health Treatment Program Title: Transition ICP | [NAME] Youth released from a MHTP to a transitional placement or home placement will receive a comprehensive Transition Individual Case Plan (ICP) that addresses their mental health risk and protective factors. b. Purpose To describe the content of a plan to support the youth's transition to a transitional placement or home placement, by specifically addressing his/her mental health needs.
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | [NAME] | Chapter: Specialized Programs Section: Mental Health Treatment Program Title: Program Release or Discharge | A discharge summary will be prepared on all youth being released from a Mental Health Treatment Program (MHTP)
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.11.39 | Chapter: Halfway Houses Section: Transition/Release/Transfer  Title: Referral to TCOOMMI | a. All youth in a transitional placement will be screened for eligibility for Texas Correctional Office for Offenders with Medical and Mental Impairments (TCOOMMI) services and those meeting the criteria will be referred for services. (c) 1. All youth must be screened for eligibility for TCOOMMI services prior to release to parole 2. All eligible youth will be referred to TCOOMMI services prior to release from a residential program. 3. For those youth meeting eligibility criteria, the Transitional Placement Primary Service Worker (PSW) will coordinate the needed mental health services with the TCOOMMI designee at the referral Mental Health Authority (MHA) in a county to which the youth is transitioning. TCOOMMI does not provide services for youth in TYC Halfway Houses (HWH).
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.12.45 | Chapter: Parole Section: Special Populations Title: Transition Planning for Youth with Sexual Behavior Problems Returning Home Where the Victim/Potential Victim Resides | The Parole Officer will participate in transition planning for youth adjudicated for a sexual offense returning to a home where the victim or potential victim resides.
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.12.49 | Chapter: Parole Section: Special Populations Title: Referral to TCOOMMI | (a) All youth with mental health problems will be screened for eligibility for Texas Correctional Office for Offenders with Medical and Mental Health Impairments (TCOOMMI) and those meeting the criteria will be referred for services.  (c) 1. The Parole Officer who reviews the youth with a Priority I, II, or III on the Priority Placement for Specialized Treatment, CCF-003, on psychotropic medications or in Special Education for emotional disturbance to learn if the youth was referred for TCOOMMI services. 2. If the youth was not referred by the Primary Service Worker (PSW) in the residential placement, the Parole Officer screens the youth for eligibility. The eligibility criteria are: A. For youth 17 years and younger: Have a DSM-IV Axis I diagnosis other than or in addition to conduct disorder, substance related disorder, mental retardation, autism, pervasive developmental disorder or a V code diagnosis B. Youth 18 years of age and over: i. Have a DSM-IV Axis I diagnosis of schizophrenia or Bipolar disorder, OR ii. Have a DSM-IV Axis I diagnosis of Major Depression WITH a GAF of 50 or below. 3. For those youth meeting eligibility criteria, the Parole Officer completes a Referral to TCOOMMI
Texas Youth Commission (TYC) | Management Standard: Case Management Standard | CMS.12.51 | Chapter: Parole Section: Special Populations Title: Parole Officer Role with TCOOMMI | a. Standard. The Parole Officers of youth receiving Texas Correctional Office for Offenders with Medical and Mental Impairments (TCOOMMI) services will be actively involved in the ongoing coordination of the youth's mental health services. [NAME]. To outline the role and responsibilities of the Parole Officer with TCOOMMI/mental  health services providers of TYC youth receiving TCOOMMI services. [NAME] 1. Following the completion of the referral to TCOOMMI by the residential PSW and while the youth remains residential care, the Parole Officer maintains contact with the residential Primary Service Worker (PSW) and ensures that the youth's participation in TCOOMMI program is incorporated into the youth's transition ICP and the Conditions of Parole. 2. Upon the youth's release to parole, the Parole Officer is responsible for the following activities: A. Entering the youth's participation in TCOOMMI services on the 120 data entry screen, B. Ensuring that the TCOOMMI services are incorporated into the Parole ICP and the Conditions of Parole, C. Participating in interdisciplinary treatment team meetings with TCOOMMI providers. D. Providing information to the interdisciplinary treatment team about the youth's progress on parole, and E. Incorporating adaptations to the Parole Phase and Parole Program recommended by treatment providers because of the youth's mental health problems.
Texas Youth Commission (TYC) | Management Standard: Special Education Operating Guidelines | Transition Planning and the IEP |  | With respect to student involvement in decision regarding transition services, federal law provides that the local education agency (LEA) shall invite a student with a disability of any age to attend his or her ARD committee meeting if a purpose of the meeting will be the consideration of the student's transition service needs under 34 CFR 300.320(b)(1) or needed transition services under 34 CFR 300.320(b)(2); or both.
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP.85.5 | Chapter: Admission and Placement Subchapter: Commitment and Reception  Rule: Assessment/ Evaluation | (a) The purpose of this rule is to establish the assessment process of each youth initially admitted to the Texas Youth Commission (TYC). The assessment process includes summarizing admission information, conducting diagnostic evaluations, identifying classification, and developing an initial placement category recommendation by the classification unit. (b) The youth classification process will be completed within two weeks of receipt of the youth at the Marlin Orientation and Assessment Unit. (c) Intake staff at the appropriate diagnostic unit conducts the following routine evaluations: (1) completion of the Common Application (CCF-002); (2) social summary; (3) risk/needs assessment; (4) religious preference assessment; (5) recreation interest; (6) psychological evaluation (if one has not been completed within the last year). Residential treatment centers require an updated clinical interview for current status within six months prior to placement; (7) physical and dental examinations; (8) educational assessment; (9) substance abuse screening and assessment; (10) career interests and experience; (11) psychiatric interview of youth when: (A) a youth has been identified during admission as being currently prescribed psychotropic medication; or (B) a youth has been prescribed psychotropic medication with in the past six (6) months; and (12) assessment of behavior while at the facility
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP.87.1 | Chapter: Treatment Subchapter: Program Planning Rule: Case Planning | The purpose of this rule is to ensure the case management of each youth is individualized to the extent possible and is based on the youth's need for services. Youth needs are identified and corresponding long-term and short-term objectives are developed within the agency's resources to facilitate the youth's progress in the Resocialization program. The resulting case plan is reviewed regularly and revised when necessary.
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP 87.51 | Chapter: Treatment Subchapter: Special Needs Offender Programs Rule: Special Needs Offenders | 87.51 I. Rule (a). Purpose. The purpose of this rule is to identify the process by which youth committed to the Texas Youth Commission (TYC) are determined eligible for, subsequently placed in, and then released from specialized treatment programs. (b) Explanation of Terms Used (1) Specialized Treatment Programs - TYC approved and funded programs for the following specialized treatment populations: (A) mental health impaired offenders (B) mentally retarded offenders; (C) sex offenders; (D) chemically dependent drug offenders; and (E) capital and serious violent offenders (2) Specialized aftercare - Outpatient services provided by qualified providers to TYC youth in the community who are identified as mental health impaired offenders, sex offenders, o chemically dependent offenders. (c) All TYC youth will be assessed and prioritized for admission to specialized treatment programs based on offense, diagnosis, and/or risk. (d) Youth successfully completing specialized treatment programs will receive six (6) months of specialized aftercare as resources are available.
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP.87.63 | Chapter: Treatment Subchapter B: Special Needs Offender Programs Rule: .63 [NAME] Residential Treatment Center | 1. The purpose of this rule is to provide for referral and placement of appropriate youth at Corsicana Residential Treatment Center (CRTC) main campus. 2. Referrals will be accepted by the centralized placement unit on youth who meet criteria for a serious emotional disturbance and with a current DSM-IV-R diagnosis other than conduct disorder as made by a psychiatrist or doctoral psychologist. 3. The centralized placement unit will screen all referral packets and may reject or accept for further review any referral. 4. The CRTC staff may accept, reject or accept as a conditional placement a youth referred. 5. A youth accepted as a conditional placement is assessed by the Corsicana staff for a period of 30 days immediately following admission. Youth  not able to benefit from the program or who cannot function in the residential treatment center open setting may be returned to the sending facility. If the youth is an initial placement, a contingency alternative placement will be agreed upon in advance to allow for direct transfer from Corsicana to the placement in the event the youth is deemed inappropriate to remain.
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP.87.67 | Chapter 87: Treatment Subchapter B: Special Needs Offender Programs Rule 67: Corsicana Stabilization Unit | The purpose of this rule is to establish criteria and procedures for admission and evaluation for specialized treatment services in the Corsicana Stabilization Unit (CSU), for psychiatrically disturbed Texas Youth Commission (TYC) youth. [NAME] 1. Admissions criteria. Youth who may be admitted to the CSU at the Corsicana Residential Treatment Center are those who meet the following criteria: A. youth demonstrates a serious dysfunction in behavior, judgment, thinking, or mood; and B. the dysfunction is a result of a current neurological deficit and/or emotional disturbance and/or psychiatric disorder, e.g. psychosis, major affective disorder, organic disorder, or anxiety disorder; and the dysfunction is not the result of a primary conduct disorder or antisocial personality disorder; and C. the youth's behavior presents a risk of serious harm to the youth or others; or D. the youth, if not treated, will continue to suffer severe and abnormal mental, emotional, or physical distress and will continue to experience deterioration in his/her ability to function independently, as evidenced by the youth's inability to attend to basic needs, such as food, health, personal hygiene, or safety; and E. the stabilization unit is the least-restrictive intervention alternative that is appropriate and available to safely and effectively meet the treatment needs and to control the dysfunctional behavior.  d. Program Requirements. 1. The program focus will be on stabilization of the psychiatric dysfunction. 2. Services are provided in a self-contained unit at the TYC Corsicana Residential Treatment Center 3. An individualized treatment program reflecting treatment goals and objectives shall be developed for and with each youth. 4. The treatment team shall review the youth's progress weekly. 5. By the end of 90 days from the date of admission due process hearing, a youth shall be returned to the referring source or referred to CPU for appropriate placement unless an extension becomes effective at that time.
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP.91.91 | Chapter: Program Services Subchapter: Health Care Services Rule: Psychopharmacoptherapy | 1. The purpose of this policy is to provide for the use of psychopharmacotherapy as an established method of treatment for emotionally disturbed adolescents for the clinical relief of symptoms distressing to the youth or interfering with normal functioning.  2. Medical or pharmaceutical experimentation or research using Texas Youth Commission (TYC) youth is strictly prohibited. 3. Psychotropic drugs shall not be administered for purposes of punishment or for program management or control. Psychotropic medication may only be prescribed for youth who have had a physical examination by a physician. 4. Psychotropic medication shall be given only to a youth who has a diagnosed psychiatric disorder. A diagnostic assessment shall be performed by the prescribing physician prior to initiating a psychotropic drug order. Indication for the drug therapy must be documented. Every effort will be made to ensure that prescribing is a collaborative effort between the youth and clinician, necessitating, whenever reasonable or possible, the sharing of information such as treatment objectives, disadvantages, available alternatives, and side effects. 5. The lowest dosage that will maintain the desired therapeutic effect shall be considered the proper dosage. 6. The oral route will be the preferred method of administration in the absence of specific contraindications. 7. Standing orders will not be utilized for psychotropic drugs, except where psychiatric mid-level practitioners are used to provide services under a supervising psychiatrist. The use of standing orders must comply with applicable state regulations. 8. Psychotropic medication may not be administered against the will of a youth except in a medication related emergency as specified in (GAP) 91.92 of this title.
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP.91.92 | Chapter: Program Services Subchapter: Health Care Services Rule: Psychotropic Medication-Related Emergencies | 1. The purpose of this rule is to establish criteria and procedure for administering a psychotropic drug in a medication-related emergency where a youth cannot or will not give consent for the administration. 2. Criteria 2. A medication-related emergency is defined as a situation in which it is immediately necessary to administer the medication to prevent harmful behaviors associated with a diagnosed psychiatric condition and to prevent: 1. imminent and substantial harm to the youth because the youth is overtly engaging in behaviors that could result in serious bodily harm or death; or 2. imminent physical harm to another because of attempts or acts the youth overtly or continually makes or commits.
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP.95.55 | Chapter: Youth Discipline Subchapter B: Due Process Hearing Procedures Rule 55: Level II Hearing Procedure | 1. The purpose of this rule is to establish a procedure to be followed when the second highest level of due process is afforded a youth. The Level II hearing procedure is appropriate due process in the following instances: 1. disciplinary transfer; 2. disciplinary extension in length of stay; 3. demotion of one or more phases in the behavior area; 4. admission to a behavior management program (BMP); 5. admission to the aggression management program (AMP); 6. with a few exceptions in procedure; 1. admission to the Corsicana Stabilization Unit, Corsicana Residential Treatment Center; and 2. extension of time to treat a psychiatric disorder in connection with a Corsicana Stabilization Unit placement at the Corsicana Residential Treatment Center (as appropriate); or 7. deposit of contraband money into the student benefit fund found in possession of a youth while in a residential program
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP.95.71 | Chapter: Youth Discipline Subchapter B: Due Process Hearing Procedures Rule .71: Mental Health Status Review Hearings Procedure | 1. The purpose of this rule is to establish the rules and procedure to be followed when the mental health status of a youth must be evaluated by professionals in order to provide appropriate care. A mental health status review hearing is appropriate due process for reviewing mental health status and which may result in one of the following types of actions. 1. admission into the Corsicana Stabilization Unit at the Corsicana Residential Treatment Center 2. extension of time to treat the psychiatric disorder 2. Applicability 3. A mental health status review hearing is a level II heaing with several procedural exceptions. Conduct of a mental health status review hearing shall be consistent with that of a Level II due process hearing (GAP) 95.55 of this title (relating to Level II Hearing Procedure with the exceptions herein). 4. Procedure 1. Decision Makers 1. The facility administrator of the Corsicana Residential Treatment Center (CRTC) will appoint a three person panel to conduct the review hearing. The panel shall be composed of a psychiatrist, a non-physician mental health professional and a member of the facility's management team, none of whom have direct or primary responsibility in the youth's current treatment or diagnosis. 2. Single Function Hearing 3. Location (Corsicana Residential Treatment Center) 4. Advocate. The youth's advocate is appointed by the facility administrator and must be competent to address mental health issues to be raised at the hearing. 5. The hearing shall not be conducted by teleconference. 6. To protect the confidential nature of the hearing, persons other than the youth, the youth's advocate, staff representative, and the youth's parent(s) may be excluded from the hearing room at the discretion of the chairperson: however, any person except the youth's advocate may be excluded from the hearing room if their presence causes undue disruption or delay of the hearing or when hearing matters being discussed are of a very sensitive nature. The reason(s) for the exclusions are stated on the record. 7. Panel Decision 1. Following the presentation of evidence, the panel may meet outside the presence of the youth to discuss matters presented. The panel shall decide whether the appropriate criteria have been established. The decision of the panel shall be by majority vote, as long as the psychiatrist is in the majority when the recommendation is for admission or extension. 2. The chairperson will re-convene the hearing and announce the panel's decision. 3. The youth shall be informed of his/her right to appeal the executive director. The pendency of an appeal shall not preclude implentation of the decision.
Texas Youth Commission (TYC) | Policy: General Administrative Policy | [NAME] | Chapter: Treatment Subchapter: Special Needs Offender Programs Rule: Emergency Mental Health Admission | [NAME] (a) Purpose. The purpose of this rule is to provide for obtaining immediate emergency care for psychiatrically disturbed youth.  (b) Applicability. For placement in non-emergency situations see GAP 87.67 of this title. (c) TYC staff may, in an emergency, place a youth who meets criteria directly in the Corsicana Stabilization Unit at Corsicana or in a psychiatric hospital. (d) Emergency Placement Criteria. Because of dangerous behavior due to apparent psychiatric disturbance, a youth may be placed in a psychiatric hospital/stabilization unit when necessary to prevent the youth's imminent serious harm to self or others. 87.79 The purpose of this rule is to provide criteria and a process whereby the Texas Youth Commission (TYC) discharges from custody youth who have completed of stay requirements and who are unable to complete the agency's rehabilitation programs because of mental illness or mental retardation. (g)Procedure for Discharge of Youth with Mental Disability 1. Mental Illness A. For youth who meet discharge criteria for mental illness and not already receiving court-ordered mental health services, a TYC psychiatrist shall examine the youth to determine if he/she meets eligibility criteria for court-ordered mental health services listed in Section 574.034, Health and Safety Code. i. If the youth does not require court-ordered mental health services, the agency shall refer the youth for outpatient psychiatric treatment to the Mental Health Authority (MHA) in the youth's home county. ii. If the youth does meet criteria for court-ordered mental health services, the agency will file a sworn application for such services as provided in [NAME], Chapter 574, Health and Safety Code
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP.87.69 | Chapter: Treatment Subchapter: Special Needs Offender Programs Rule: Commitment to State Mental Hospitals | [NAME] (a) Purpose. The purpose of this rule is to establish a procedure whereby TYC staff may seek admission to a State Hospital operated by the Texas Department of Mental Health and Mental Retardation (TDMHMR) for TYC youth who are in need of mental health treatment. (b) Applicability. This rule applies when admission to the TYC psychiatric unit is not feasible (See GAP 87.67)
Texas Youth Commission (TYC) | Policy: General Administrative Policy | GAP.87.79 | Chapter: Treatment Subchapter: Special Needs Offender Programs Rule: Discharge of Mentally Ill and Mentally Retarded Youth | [NAME] (a) Purpose. The purpose of this rule is to provide criteria and a process whereby the Texas Youth Commission (TYC) discharges from custody youth who have completed length of stay requirements and who are unable to complete the agency's rehabilitation programs because of mental illness or mental retardation.