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 Home and Community-based Services (HCS) Program.
(2) Calendar day--Any day, including weekends and holidays.
(3) 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).
(4) CFC PAS/HAB--CFC personal assistance services/habilitation.
(5) 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.
(6) Community setting--A setting accessible to the
general public within an individual's community.
(7) Day habilitation--An HCS 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.
(8) DFPS--The Department of Family and Protective Services.
(9) HCS Program--The Home and Community-based Services
Program.
(10) HHSC--The Texas Health and Human Services Commission.
(11) 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.
(12) ICAP--Inventory for Client and Agency Planning.
(13) ID/RC Assessment--Intellectual Disability/Related
Conditions Assessment. A form used by HHSC for level of care determination
and level of need assignment.
(14) Implementation plan--A written document developed
by a program provider for an individual that, for each HCS Program
service and CFC service on the individual's individual plan of care
(IPC) to be provided by the program provider, except for supported
home living and CFC support management, includes:
(A) a list of outcomes identified in the person-directed
plan that will be addressed using HCS 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 HCS Program services and
CFC services needed to complete each objective;
(E) the frequency and duration of HCS 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.
(15) Individual--A person enrolled in the HCS Program.
(16) 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).
(17) Initial IPC--The first IPC for an individual developed
before the individual's enrollment into the HCS Program.
(18) IPC--Individual plan of care. A written plan that:
(A) states:
(i) the type and amount of each HCS Program service
and each CFC service, except for CFC support management, to be provided
to the individual during an IPC year;
(ii) the services and supports to be provided to the
individual through resources other than HCS 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.
(19) 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.
(20) LAR--Legally authorized representative. A person
authorized by law to act on behalf of another person with regard to
a matter described in this chapter, 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.
(21) 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.
(22) LON--Level of need. An assignment given by HHSC
to an individual upon which reimbursement for certain services is
based.
(23) 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.
(24) Nursing facility--A facility licensed in accordance
with THSC Chapter 242.
(25) 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.
(26) Program provider--A person, as defined in 40 TAC §49.102
(relating to Definitions), that has a contract with HHSC to provide
HCS Program services, excluding a financial management services agency.
(27) Renewal IPC--An IPC developed for an individual
in accordance with the rules governing the HCS Program.
(28) Revised IPC--An initial IPC or a renewal IPC that
is revised during an IPC year in accordance with the rules governing
the HCS Program to add a new HCS Program service or CFC service or
change the amount of an existing service.
(29) Service coordinator--An employee of a local intellectual
and developmental disability authority who provides service coordination
to an individual.
(30) Service provider--A person who directly provides
an HCS Program service or CFC service to an individual.
(31) 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.
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