Section 404.153 - [Effective until 11/29/2024] DefinitionsThe following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.
(1) Aversive conditioning--A highly restrictive behavior intervention designed to eliminate undesirable behavior patterns through learned associations with unpleasant stimuli or tasks.(2) Behavior interventions--Interventions to increase socially adaptive behavior and to modify maladaptive or problem behaviors and replace them with behaviors and skills that are adaptive and socially productive. Also referred to as "behavior management," "behavior training," "behavior therapy," and related terms.(3) Community center--A community mental health and mental retardation center established under the Texas Health and Safety Code, Title 7, Chapter 534.(4) Department--The Texas Department of Mental Health and Mental Retardation.(5) Department facilities--The state hospitals and state centers which provide mental health services, and their respective community-based programs.(6) Emergency--A situation in which, in the opinion of the treating physician, the immediate use of medication, or, in the opinion of the treating physician or other appropriate professional, the immediate use of restrictive techniques is essential to interrupt imminent physical danger to self or others.(7) Ethics Committee--A Texas Board of MHMR-approved body composed of clinicians, consumers, family members, and outside experts convened for the purpose of reviewing and resolving issues surrounding clinical care and treatment.(8) Hospital--A general or special hospital as defined in the Health and Safety Code, § 241.003(4) and § 241.003(11), that includes an identifiable part of the hospital for the provision of mental health services.(9) Informed consent--The knowing written consent of an individual or the individual's legally authorized representative, so situated as to be able to exercise free power of choice without undue inducement or any element of force, fraud, deceit, duress, or other form of constraint or coercion. The basic elements of information necessary for informed consent include all of the following presented in language or format easily understood by the individual: (A) a thorough explanation of the procedures to be followed and their purposes, including identification of any experimental procedures;(B) a description of any attendant discomforts and reasonably expected risks;(C) a description of any reasonably expected benefits;(D) a disclosure of any appropriate alternative procedures as well as their reasonably expected risks and benefits, including those that might result if no procedure is utilized;(E) an offer to answer any questions about the procedures; and(F) an instruction that the individual can withdraw consent and stop participating in the program or activity at any time without prejudice to the individual. Withdrawal of consent may be in any form, including noncompliance, active resistance, or a verbal or other expression of unwillingness to continue participating in any aspect of the program.(10) Highly restrictive interventions--Any intervention (e.g., aversive conditioning) that poses potentially increased physical, emotional, or psychological distress to the individual upon whom it is imposed.(11) Inpatient services--Residential services provided in a department facility, a licensed hospital unit, a licensed crisis stabilization unit, or a psychiatric hospital.(12) Intrusive searches--The tactile and/or visual examination of an individual's partially clothed (a state of undress that would not be acceptable in public) or fully unclothed body, personal belongings, or space designated for the storage of the individual's personal belongings. Intrusive searches do not include: (A) routine searches of belongings for contraband at the time of admission, return from pass, or transfer;(B) superficial external pat-downs by staff of the same sex;(C) daily room checks for housekeeping and chore completion;(D) physical assessments by nurses and physicians; and(E) searches of the person's outer clothing, hair, or mouth, unless the search is resisted by the person, in which case all procedures for intrusive searches are to be followed.(13) Mental health services--Includes all services concerned with research, prevention, and detection of mental disorders and disabilities and all services necessary to treat, care for, supervise, and rehabilitate mentally disordered and disabled persons, including persons mentally disordered and disabled from alcoholism and drug addiction.(14) Office of Consumer Services and Rights Protection (CSRP)--The office located within the department's central office which maintains the toll-free telephone line 1-800-252-8154 to receive rights-related complaints from persons receiving services at department facilities and community centers and which is responsible for assisting persons receiving mental health services with needed services and rights protection.(15) Psychiatric hospital-- (A) An establishment licensed by the Texas Department of Health under the Texas Health and Safety Code, Chapter 577, offering inpatient services, including treatment, facilities, and beds for use beyond 24 hours, for the primary purpose of providing psychiatric assessment and diagnostic services and psychiatric inpatient care and treatment for mental illness. Such services must be more intensive than room, board, personal services, and general medical and nursing care. Although substance abuse services may be offered, a majority of beds (51%) must be dedicated to the treatment of mental illness in adults and/or children. Services other than those of an inpatient nature are not licensed or regulated by the Texas Department of Health and are considered only to the extent that they affect the stated resources for the inpatient components; or(B) That identifiable part of a hospital in which diagnosis, treatment, and care for persons with mental illness is provided and that is licensed by the Texas Department of Health under the Texas Health and Safety Code, Chapter 241.(16) Residential services--Twenty-four hour services provided and/or contracted by the department or a community center (e.g., structured group residential programs, halfway houses, hospital units providing MH services, licensed crisis stabilization units, etc.) or a psychiatric hospital.(17) Rights protection officer--An employee appointed by the head of a department facility or community center to protect and advocate for the rights of persons receiving mental health services.(18) Unusual medications--Medication that has not been approved by the Food and Drug Administration for use in the United States, or medication that is being used to treat conditions for which its use has not been demonstrated through rational scientific theory and evidence in biomedical literature, controlled clinical trials, or expert medical opinion.25 Tex. Admin. Code § 404.153
The provisions of this §404.153 adopted to be effective December 10, 1993, 18 TexReg 8790; amended to be effective October 1, 1996, 21 TexReg 8505