Texas Administrative Code (Last Updated: March 27,2024) |
TITLE 26. HEALTH AND HUMAN SERVICES |
PART 1. HEALTH AND HUMAN SERVICES COMMISSION |
CHAPTER 301. IDD-BH CONTRACTOR ADMINISTRATOR FUNCTIONS |
SUBCHAPTER F. PROVIDER NETWORK DEVELOPMENT |
SECTION 301.255. Definitions
Latest version.
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The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.
(1) Critical infrastructure--The resources necessary to ensure services are available without significant disruption to the individuals served by the LMHA and to allow the LMHA to fulfill its obligations under the performance contract. (2) Department--The Texas Department of State Health Services. (3) Discrete services--Individual services provided as part of a defined level of care. (4) External provider--An organization that provides mental health services that is not an LMHA, or an individual who provides mental health services who is not an employee of an LMHA. (5) Individual--An individual seeking or receiving mental health services through an LMHA, or the individual's legally authorized representative. (6) Legally authorized representative (LAR)--A person authorized by law to act on behalf of an individual with regard to a matter described in this subchapter, including, but not limited to, a parent, guardian, or managing conservator. (7) Licensed psychiatric hospital--A hospital that is: (A) A private psychiatric hospital licensed under Texas Health and Safety Code, Chapter 577, and Chapter 134 of this title (relating to Private Psychiatric Hospitals and Crisis Stabilization Units) rules; or (B) an identifiable inpatient mental health services unit in a hospital licensed under Health and Safety Code, Chapter 241, and Chapter 133 of this title (relating to Hospital) rules. (8) LOC or level of care--A designation given to the department's standardized packages of mental health services which specify the amount, and duration of mental health services to be provided to an individual, based on the uniform assessment and utilization management guidelines referenced in §416.17 of this title (relating to Guidelines). (9) Local Authority Network Advisory Committee (LANAC)--The committee established under Health and Safety Code, §533.0351 to advise the department on technical and administrative issues that directly affect LMHA responsibilities. The committee has equal numbers of representatives from eight stakeholder groups. (10) Local mental health authority (LMHA)--An entity designated as a local mental health authority according to the Health and Safety Code, §533.035(a). (11) Local service area--A geographic area composed of one or more Texas counties defining the population that may receive mental health services through an LMHA. (12) Network development--The addition of new provider organizations, services, or capacity to an LMHA's external provider network. (13) Performance contract--The contract between the department and an LMHA that is in effect at the time of an action required under this subchapter. (14) Planning and Network Advisory Committee (PNAC)--The advisory committee of local stakeholders established by an LMHA as required by the performance contract. (15) Provider or service provider--An organization or person who delivers mental health services. (16) Qualified provider--A provider that is: (A) a practitioner with the minimum qualifications required by the performance contract; or (B) an organization that demonstrates the ability to provide services described in the performance contract, as specified in the department's approved procurement template. (17) Routine outpatient services--Services available in a level of care, excluding inpatient, residential and most crisis services. Routine outpatient services include office-based crisis intervention provided as part of rehabilitation services during normal business hours but exclude all other crisis services. (18) Service capacity--The estimated number of individuals that can be served in each level of care with available resources. (19) Specialized services--Services that are not generally provided by the individual's treatment team, including stand-alone crisis and residential services. Source Note: The provisions of this §301.255 adopted to be effective January 1, 2015, 39 TexReg 10478; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237