The following words and terms, when used in this chapter, have
the following meanings unless the context clearly indicates otherwise.
(1) Actively involved person--An individual who has
significant, ongoing, and supportive involvement with a designated
resident, as determined by the SPT based on the individual's:
(A) observed interactions with the designated resident;
(B) availability to the designated resident for assistance
or support when needed; and
(C) knowledge of, sensitivity to, and advocacy for
the designated resident's needs, preferences, values, and beliefs.
(2) Acute care hospital--A health care facility in
which an individual receives short-term treatment for a severe physical
injury or episode of physical illness, an urgent medical condition,
or recovery from surgery and:
(A) may include a long-term acute care hospital, an
emergency room within an acute care hospital, or an inpatient rehabilitation
hospital; and
(B) does not include a stand-alone psychiatric hospital
or a psychiatric hospital within an acute care hospital.
(3) Alternate placement assistance--Assistance provided
to a resident to locate and secure services chosen by the resident
or LAR that meets the resident's needs in a setting other than a NF.
Alternate placement assistance includes transition planning, pre-move
site review, and post-move monitoring.
(4) APRN--Advance practice registered nurse. An individual
licensed to practice professional nursing as an advance practice registered
nurse in accordance with Texas Occupations Code Chapter 301.
(5) Audio-only--An interactive, two-way audio communication
that uses only sound and that meets the privacy requirements of the
Health Insurance Portability and Accountability Act. Audio-only includes
the use of telephonic communication. Audio-only does not include audio-visual
or in-person communication.
(6) Audio-visual--An interactive, two-way audio and
video communication that conforms to privacy requirements under the
Health Insurance Portability and Accountability Act. Audio-visual
does not include audio-only or in-person communication.
(7) Behavioral support--An IHSS that:
(A) is assistance provided for a designated resident
to increase adaptive behaviors and to replace or modify maladaptive
behaviors that prevent or interfere with the designated resident's
interpersonal relationships across all service and social settings;
(B) is delivered in the NF or in a community setting;
and
(C) consists of:
(i) assessing the behaviors to be targeted in an appropriate
behavior support plan and analyzing those assessment findings;
(ii) developing an individualized behavior support
plan that reduces or eliminates the target behaviors, assisting the
designated resident in achieving the outcomes identified in the HSP;
(iii) training and consulting with the LAR, family
members, NF staff, other support providers, and the designated resident
about the purpose, objectives, and methods of the behavior support
plan;
(iv) implementing the behavior support plan or revisions
to the behavior support plan and documenting service delivery in accordance
with the IDD Habilitative Specialized Services Billing Guidelines;
(v) monitoring and evaluating the success of the behavior
support plan implementation;
(vi) revising the behavior support plan as necessary;
and
(vii) participating in SPT and IDT meetings.
(8) Business day--Any day except Saturday, Sunday,
or a national or state holiday listed in Texas Government Code §662.003(a)
or (b).
(9) Calendar day--Any day, including weekends and holidays.
(10) CMWC--Customized manual wheelchair. In accordance
with §554.2703(5) of this title (relating to Definitions) and
consistent with the requirements of Texas Human Resources Code §32.0425,
a wheelchair that consists of a manual mobility base and customized
seating system and is adapted and fabricated to meet the individualized
needs of a designated resident.
(11) Collateral contact--A person who is knowledgeable
about the individual seeking admission to a NF or the resident, such
as family members, previous providers or caregivers, and who may support
or corroborate information provided by the individual or resident.
(12) Coma--A state of unconsciousness characterized
by the inability to respond to sensory stimuli as documented by a
physician.
(13) Convalescent care--A type of care provided after
an individual's release from an acute care hospital that is part of
a medically prescribed period of recovery.
(14) Day habilitation--An IHSS that:
(A) is assistance provided for a designated resident
to acquire, retain, or improve self-help, socialization, and adaptive
skills necessary to successfully and actively participate in all service
and social settings;
(B) is delivered in a setting other than the designated
resident's NF;
(C) does not include services provided under the Day
Activity and Health Services program;
(D) includes expanded interactions, skills training
activities, and programs of greater intensity or frequency beyond
those a NF is required to provide by 42 Code of Federal Regulations
(CFR) §483.24; and
(E) consists of:
(i) individualized activities consistent with achieving
the outcomes identified in a designated resident's HSP to attain,
learn, maintain, or improve skills;
(ii) activities necessary to reinforce therapeutic
outcomes targeted by other support providers and other specialized
services;
(iii) services in a group setting at a location other
than a designated resident's NF for up to five days per week, six
hours per day, on a regularly scheduled basis;
(iv) personal assistance for a designated resident
who cannot manage personal care needs during the day habilitation
activity;
(v) transportation between the NF and the day habilitation
site, as well as during the day habilitation activity necessary for
a designated resident's participation in day habilitation activities;
and
(vi) participating in SPT and IDT meetings.
(15) DD--Developmental disability. A disability that
meets the criteria described in the definition of "persons with related
conditions" in 42 CFR §435.1010.
(16) Delirium--A serious disturbance in an individual's
mental abilities that results in a decreased awareness of the individual's
environment and confused thinking.
(17) Designated resident--An individual:
(A) whose PE or resident review is positive for ID
or DD;
(B) who is 21 years of age or older;
(C) who is a Medicaid recipient; and
(D) who is a resident or has transitioned to the community
from a NF within the previous 365 days.
(18) DME--Durable medical equipment. The items described
in §554.2703(10) of this title.
(19) Emergency protective services--Services furnished
by the Department of Family and Protective Services to an elderly
or disabled individual who has been determined to be in a state of
abuse, neglect, or exploitation.
(20) Employment assistance--An IHSS that:
(A) is assistance provided for a designated resident
who requires intensive help locating competitive employment in the
community; and
(B) consists of:
(i) identifying a designated resident's employment
preferences, job skills, and requirements for a work setting and work
conditions;
(ii) locating prospective employers offering employment
compatible with a designated resident's identified preferences, skills,
and requirements;
(iii) contacting prospective employers on a designated
resident's behalf and negotiating the designated resident's employment;
(iv) transporting a designated resident between the
NF and the site where employment assistance services are provided
and as necessary to help the designated resident locate competitive
employment in the community; and
(v) participating in SPT and IDT meetings.
(21) Essential supports--Those supports identified
in a transition plan that are critical to a designated resident's
health and safety and that are directly related to a designated resident's
successful transition to living in the community from residing in
a NF.
Cont'd... |
