The following words and terms, when used in this subchapter,
have the following meanings unless the context clearly indicates otherwise.
(1) Applicant--A Texas resident seeking services in
the Texas Home Living Program (TxHmL).
(2) Calendar day--Any day, including weekends and holidays.
(3) CDS employer--Consumer directed services employer.
This term has the same meaning as the term "employer" set forth in
40 TAC §41.103 (relating to Definitions).
(4) CDS option--Consumer directed services option.
This term has the meaning set forth in 40 TAC §41.103.
(5) CFC--Community First Choice. A state plan option
governed by Code of Federal Regulations, Title 42, Chapter 441, Subpart
K, regarding Home and Community-Based Attendant Services and Supports
State Plan Option (Community First Choice).
(6) CFC PAS/HAB--CFC personal assistance services/habilitation.
(7) CMS--Centers for Medicare & Medicaid Services.
The federal agency within the United States Department of Health and
Human Services that administers the Medicare and Medicaid programs.
(8) Community setting--A setting accessible to the
general public within an individual's community.
(9) Day habilitation--A TxHmL Program service that
provides assistance with acquiring, retaining, or improving self-help,
socialization, and adaptive skills provided in a location other than
the residence of an individual.
(10) DFPS--The Department of Family and Protective
Services.
(11) FMSA--Financial management services agency. This
term has the meaning set forth in 40 TAC §41.103.
(12) HHSC--The Texas Health and Human Services Commission.
(13) Hospital--A public or private institution licensed
or exempt from licensure in accordance with Texas Health and Safety
Code (THSC) Chapters 13, 241, 261, or 552.
(14) ICAP--Inventory for Client and Agency Planning.
(15) ID/RC Assessment--Intellectual Disability/Related
Conditions Assessment. A form used by HHSC for level of care determination
and level of need assignment.
(16) Implementation plan--A written document developed
by a program provider for an individual that, for each TxHmL Program
service and CFC service on the individual's individual plan of care
(IPC) to be provided by the program provider except for community
support and CFC support management, includes:
(A) a list of outcomes identified in the person-directed
plan that will be addressed using TxHmL Program services and CFC services;
(B) specific objectives to address the outcomes required
by subparagraph (A) of this paragraph that are:
(i) observable, measurable, and outcome-oriented; and
(ii) derived from assessments of the individual's strengths,
personal goals, and needs;
(C) a target date for completion of each objective;
(D) the number of units of TxHmL Program services and
CFC services needed to complete each objective;
(E) the frequency and duration of TxHmL Program services
and CFC services needed to complete each objective; and
(F) the signature and date of the individual, legally
authorized representative, and the program provider.
(17) Individual--A person enrolled in the TxHmL Program.
(18) Individualized skills and socialization provider--A
legal entity licensed in accordance with Chapter 559, Subchapter H
of this title (relating to Individualized Skills and Socialization
Provider Requirements).
(19) Initial IPC--The first IPC for an individual developed
before the individual's enrollment into the TxHmL Program.
(20) IPC--Individual plan of care. A written plan that:
(A) states:
(i) the type and amount of each TxHmL Program service
and each CFC service, except for CFC support management, to be provided
to an individual during an IPC year;
(ii) the services and supports to be provided to the
individual through resources other than TxHmL Program services or
CFC services, including natural supports, medical services, and educational
services; and
(iii) if an individual will receive CFC support management;
and
(B) is authorized by HHSC.
(21) IPC year--The effective period of an initial IPC
and renewal IPC as described in this paragraph.
(A) Except as provided in subparagraph (B) of this
paragraph, the IPC year for an initial and renewal IPC is a 365-calendar
day period starting on the begin date of the initial or renewal IPC.
(B) If the begin date of an initial or renewal IPC
is March 1 or later in a year before a leap year or January 1 - February
28 of a leap year, the IPC year for the initial or renewal IPC is
a 366-calendar day period starting on the begin date of the initial
or renewal IPC.
(C) A revised IPC does not change the begin or end
date of an IPC year.
(22) LAR--Legally authorized representative. A person
authorized by law to act on behalf of a person with regard to a matter
described in this subchapter, including a parent, guardian, or managing
conservator of a minor; a guardian of an adult; an agent appointed
under a power of attorney; or a representative payee appointed by
the Social Security Administration. An LAR, such as an agent appointed
under a power of attorney or representative payee appointed by the
Social Security Administration, may have limited authority to act
on behalf of a person.
(23) LOC--Level of care. A determination given to an
applicant or individual as part of the eligibility determination process
based on data submitted on the ID/RC Assessment.
(24) LON--Level of need. An assignment given by HHSC
to an applicant or individual that is derived from the ICAP service
level score and from selected items on the ID/RC Assessment.
(25) Medicaid HCBS--Medicaid home and community-based
services. Medicaid services provided to an individual in an individual's
home and community, rather than in a facility.
(26) Nursing facility--A facility licensed in accordance
with THSC Chapter 242.
(27) PDP--Person-directed plan. A plan developed using
an HHSC form that describes the supports and services necessary to
achieve the desired outcomes identified by the applicant or individual
and LAR and to ensure the applicant's or individual's health and safety.
(28) Program provider--A person, as defined in 40 TAC §49.102
(relating to Definitions), that has a contract with HHSC to provide
TxHmL Program services, excluding a financial management services
agency.
(29) Renewal IPC--An IPC required to be developed for
an individual at least 30 but not more than 90 calendar days before
the expiration of the individual's IPC in accordance with rules governing
the TxHmL Program.
(30) Revised IPC--An initial IPC or renewal IPC that
is revised during the IPC year in accordance with rules governing
the TxHmL Program to add a new TxHmL Program service or CFC service
or change the amount of an existing service.
(31) Service coordinator--An employee of a local intellectual
and developmental disability authority who provides service coordination
to an individual.
(32) Service provider--A person who directly provides
a TxHmL Program service or CFC service to an individual.
(33) TAC--Texas Administrative Code. A compilation
of state agency rules published by the Texas Secretary of State in
accordance with Texas Government Code, Chapter 2002, Subchapter C.
(34) TxHmL Program--The Texas Home Living Program.
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