The following terms, when used in this division, have the following
meanings unless the context clearly indicates otherwise.
(1) Activities of daily living (ADLs)--Basic personal
everyday activities including, but not limited to, tasks such as eating,
toileting, grooming, dressing, bathing, and transferring.
(2) CFC emergency response services--Back-up systems
and supports including electronic devices to ensure continuity of
services and supports.
(3) CFC habilitation--Acquisition, maintenance, and
enhancement of skills necessary for the individual to accomplish ADLs,
IADLs, and health-related tasks based on the individual's person-centered
service plan.
(4) CFC personal assistance services--Services provided
to assist an individual in performing ADLs, IADLs, and health-related
tasks based on the individual's person-centered service plan.
(5) CFC support management--Voluntary training on how
to select, manage, and dismiss attendants.
(6) CFR--Code of Federal Regulations.
(7) CLASS--The Community Living Assistance and Support
Services Program operated by DADS as authorized by the Centers for
Medicare & Medicaid Services in accordance with §1915(c)
of the Social Security Act.
(8) Consumer Directed Services (CDS) option--A service
delivery option in which an individual or legally authorized representative
employs and retains service providers and directs the delivery of
program services.
(9) DADS--The Texas Department of Aging and Disability
Services.
(10) DBMD--The Deaf Blind with Multiple Disabilities
Program operated by DADS as authorized by the Centers for Medicare &
Medicaid Services in accordance with §1915(c) of the Social Security
Act.
(11) DSHS--Texas Department of State Health Services.
(12) Financial Management Services (FMS)--Services
including, but not limited to, the following activities for individuals
using the CDS option: collect and process timesheets of the individual's
attendant care providers; process payroll, withholding, filing, and
payment of applicable Federal, State, and local employment related
taxes and insurance; separately track budget funds and expenditures
for each individual; track and report disbursements and balances of
each individual's funds; process and pay invoices for services in
the person-centered service plan; and provide individual periodic
reports of expenditures and the status of the approved service budget
to the individual and to HHSC.
(13) Financial management services agency (FMSA)--An
entity that is qualified by DADS and is contracted with HHSC and/or
an MCO to provide financial management services.
(14) Health-related tasks--In accordance with 42 CFR §441.505
and state law, specific tasks related to the needs of an individual
which include tasks delegated by a registered nurse, health maintenance
activities, and extension of therapy.
(15) HHSC--The Texas Health and Human Services Commission,
or its designee.
(16) Home and Community-based Services (HCS) Program--The
Home and Community-based Services Program operated by DADS as authorized
by the Centers for Medicare & Medicaid Services in accordance
with §1915(c) of the Social Security Act.
(17) Home and Community Support Services Agency (HCSSA)--Home
and Community Support Services Agency licensed by DADS in accordance
with Texas Health and Safety Code, Chapter 142.
(18) Intermediate care facility for individuals with
an intellectual disability or related conditions (ICF-IID)--A facility
providing care and services to individuals with intellectual disabilities
or related conditions as defined in §1905(d) of the Social Security
Act.
(19) Instrumental activities of daily living (IADLs)--Activities
related to living independently in the community including, but not
limited to, meal planning and preparation; managing finances; shopping
for food, clothing, and other essential items; performing essential
household chores; communicating by phone or other media; and traveling
around and participating in the community.
(20) Legally authorized representative (LAR)--A person
authorized by law to act on behalf of an individual with regard to
a matter described in this division, and may include a parent, guardian,
or managing conservator of a minor, or the guardian of an adult.
(21) Local Intellectual and Developmental Disability
Authority (LIDDA)--An entity designated by DADS in accordance with
the Texas Health and Safety Code, §533.035(a).
(22) Managed Care Organization (MCO)--An organization
contracted with HHSC in accordance with Chapter 353 of this title
(relating to Medicaid Managed Care).
(23) Medical Assistance Only (MAO)--An individual who
qualifies financially and functionally for Medicaid assistance but
does not receive Supplemental Security Income (SSI) benefits.
(24) Person-centered service planning--A documented
service planning process that includes people chosen by the individual,
is directed by the individual to the maximum extent possible, enables
the individual to make informed choices and decisions, is timely and
occurs at times and locations convenient to the individual, reflects
cultural considerations of the individual, includes strategies for
solving conflict or disagreement within the process, offers choices
to the individual regarding the services and supports they receive
and from whom, includes a method for the individual to require updates
to the plan, and records alternative settings that were considered
by the individual.
(25) Service Planning Team--For an individual receiving
CFC services, the group of people responsible for creating the individual's
person-centered service plan.
(26) Service responsibility option (SRO)--A service
delivery option in which an individual or LAR selects, trains, and
provides daily management of a service provider, while the fiscal,
personnel, and service back-up plan responsibilities remain with an
SRO provider.
(27) STAR Health--The managed care program that primarily
serves:
(A) children and youth in Texas Department of Family
and Protective Services (DFPS) conservatorship;
(B) young adults who voluntarily agree to continue
in a foster care placement (if the state as conservator elects to
place the child in managed care); and
(C) young adults who are eligible for Medicaid as a
result of their former foster care status through the month of their
21st birthday.
(28) STAR+PLUS--The managed care program that operates
under a federal waiver and primarily provides, arranges, and coordinates
preventive, primary, acute care, and long-term services and supports
to persons with disabilities and elderly persons age 65 and over who
qualify for Medicaid by virtue of their SSI or MAO status.
(29) STAR+PLUS home and community-based services (HCBS)--The
program that provides person-centered care services that are delivered
in the home or in a community setting, as authorized through a federal
waiver under §1115 of the Social Security Act, to qualified clients
who are 65 years of age or older, are blind, or have a disability,
as cost-effective alternatives to institutional care in nursing facilities.
(30) Supplemental Security Income (SSI)--The federal
cash assistance program of direct financial payments to people who
are 65 years of age or older, are blind, or have a disability administered
by the Social Security Administration (SSA) under Title XVI of the
Social Security Act.
(31) Texas Home Living (TxHmL)--The Texas Home Living
Program operated by DADS as authorized by the Centers for Medicare &
Medicaid Services in accordance with §1915(c) of the Social Security
Act.
|
