The following words and terms have the following meanings when
used in these sections, unless the context clearly indicates otherwise:
(1) Abuse--The willful infliction of injury, unreasonable
confinement, intimidation, or cruel punishment with resulting physical
harm, pain, or mental anguish; or the willful deprivation by a caretaker
or one's self of goods or services which are necessary to avoid physical
harm, mental anguish, or mental illness. (Chapter 48, Human Resources
Code)
(2) Activities of daily living (ADL)--Activities that
are essential to daily self-care; including bathing, dressing, grooming,
toileting, housekeeping, shopping, meal preparation, and others.
(3) Adult--A person 18 or older, or an emancipated
minor.
(4) Aged or elderly person--A person 65 or older.
(5) Applicant--A person initially requesting services.
(6) Attendant--A person who is employed by a provider
agency to give personal care or housekeeping services or both to an
eligible family care or primary home care client, according to a service
plan.
(7) Caregiver--A relative, guardian, representative
payee, or person who has contact with the client that is frequent
enough or regularly scheduled enough that a personal relationship
exists or the client perceives that person as having a role in helping
the client to meet basic needs.
(8) Caregiver support--An interval of rest or relief
from caregiving duties given to or arranged for the caregiver of a
DHS client.
(9) Client--A person determined eligible for Community
Care for the Aged and Disabled (CCAD) services.
(10) Community care--Services provided within the client's
own home, neighborhood, or community, as alternatives to institutional
care. Community care is sometimes called alternate care.
(11) Controlling interest--An owner who is a sole proprietor,
a partner owning 5.0% or more of the partnership, or a corporate stockholder
owning 5.0% or more of the outstanding stock of the contracted provider,
or a member of the board of directors.
(12) Disabled/incapacitated person--A person who,
because of physical, mental, or developmental impairment, is limited
temporarily or permanently in his capacity to adequately perform one
or more essential activities of daily living, which include, but are
not limited to, personal and health care, moving around, communicating,
and housekeeping.
(13) Earned income--Cash or liquid resources that a
client receives for services he performs as an employee or as a result
of self-employment. All other income is unearned income.
(14) Emancipated minor--A person under 18 who has the
power and capacity of an adult. This includes a minor who has had
the disabilities of minority removed by a court of law or a minor
who, with or without parental consent, has been married. Marriage
includes common-law marriage.
(15) Emotional or verbal abuse--Any use of verbal communication
or other behavior to humiliate, intimidate, vilify, degrade, or threaten
with harm.
(16) Expedited response--A face-to-face contact with
an applicant by the caseworker within five calendar days of the date
of the applicant's request for services.
(17) Exploitation--The illegal or improper act or process
of a caregiver or others using an adult's income and resources for
monetary or personal benefit, profit, or gain.
(18) Facility--A legal entity that contracts with the
department to deliver to clients day services or 24-hour residential
services.
(19) Fraud--A deliberate misrepresentation or intentional
concealment of information in order to receive or to be reimbursed
for the delivery of services to which the individual is not entitled.
(20) Functional need--An individual's requirement for
assistance with activities of daily living, caused by a physical or
mental limitation or disability.
(21) Immediate response--A face-to-face contact with
an applicant by the caseworker within 24 hours of the applicant's
request for services.
(22) Income eligible (I.E.)--An adult who, although
neither a Medicaid recipient nor a food stamp head of household or
spouse, nevertheless has income and resources equal to or less than
the eligibility level established by the department.
(23) Institution--A nursing home, an intermediate care
facility for the mentally retarded (ICF-MR), a state school, or a
state hospital.
(24) Liquid resource--Cash or financial instruments
that could be converted to cash within 20 workdays.
(25) Medicaid eligible--An individual eligible for
federal medical assistance as an SSI or TANF client, or eligible for
medical assistance only (MAO) in a nursing home or while living in
the community or through a federally approved waiver.
(26) Medicare eligible--An aged or disabled person
who is a recipient of Social Security or railroad retirement benefit
payments and meets eligibility criteria to have certain medical expenses
paid by the federal Medicare program.
(27) Neglect--The failure to provide for one's self
the goods or services which are necessary to avoid physical harm,
mental anguish, or mental illness; or the failure of a caretaker to
provide the goods or services. (Chapter 48, Human Resources Code)
(28) Personal leave--Any leave from a residential care
facility except for hospitalization or institutionalization. A day
of personal leave is any period of 24 consecutive hours.
(29) Prior approval--A regional nurse's authorization
that payment may be made to a provider agency, because a client meets
the medical criteria for the requested Medicaid service.
(30) Provider agency--An agency that has contracted
with DHS to provide the CCAD services that DHS has authorized for
eligible clients.
(31) Provisional contract--A time-limited contract.
(32) Resource--Any cash or other liquid assets or any
real or personal property owned by an individual and spouse that could
be converted to cash to use for support and maintenance.
(33) Responder--A person who responds to an emergency
response services (ERS) call activated by a client. Responders may
include relatives, neighbors, volunteers, or staff of a sheriff's
department, police department, emergency medical service, or fire
department.
(34) Sexual abuse--Sexual contact or conduct which
is without the voluntary, informed consent of the elderly or disabled
adult.
(35) Supplemental security income (SSI)--Monthly payments
made by the Social Security Administration (SSA) to an aged or disabled
individual who meets the requirements for public aid. SSA determines
eligibility for SSI.
(36) Support system--The network of family members,
close friends, and neighbors who are usually available and willing
to provide regular or occasional assistance to a person.
(37) Unearned income--Income received by a client from
sources other than self-employment or employee work activities.
(38) Unmet need--A requirement for assistance with
activities of daily living that cannot be met adequately on an ongoing
basis by friends, relatives, volunteers, or service agencies other
than DHS.
(39) Verbal referral--A referral made by the caseworker
to the provider agency in person or by telephone, no later than the
first workday after the caseworker's determination that the applicant
meets the criteria for an expedited or immediate response to a request
for service, and needs immediate service initiation.
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| Source Note: The provisions of this §271.1 adopted to be effective February 1, 1989, 13 TexReg 5751; amended to be effective June 1, 1991, 16 TexReg 2608; amended to be effective December 1, 2000, 25 TexReg 11081; transferred effective September 15, 2023, as published in the August 18, 2023, issue of the Texas Register, 48 TexReg 4523 |
