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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 304DIAGNOSTIC ASSESSMENT
SUBCHAPTER AGENERAL PROVISIONS
RULE §304.102Definitions

The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise.

  (1) ABL--Adaptive behavior level. The categorization of an individual's functioning level of adaptive behavior into one of five levels ranging from minimal limitations (0) through profound limitations (IV).

  (2) Adaptive behavior--The effectiveness with or degree to which an individual meets the standards of personal independence and social responsibility expected of the individual's age and cultural group as assessed by a standardized measure.

  (3) ASD--Autism spectrum disorder. As described in the most current Diagnostic and Statistical Manual of Mental Disorders (DSM), a disorder characterized by persistent impairment in reciprocal social communication and social interaction and restricted, repetitive patterns of behavior, interests, or activities. These symptoms are present from early childhood and limit or impair everyday functioning.

  (4) Asperger disorder--A neurodevelopmental disorder characterized by severe, sustained, clinically significant impairment of social interaction or communication skills and restricted, repetitive, and stereotyped patterns of behavior or interests. Symptoms may present later during the individual's development. Since the expanded definition of ASD in the DSM, effective 2013, Asperger disorder is subsumed under the diagnosis of ASD.

  (5) Authorized provider--A person who is:

    (A) a physician licensed to practice in Texas;

    (B) a psychologist licensed to practice in Texas; or

    (C) a certified authorized provider.

  (6) Certified authorized provider--A person who is certified by the Texas Health and Human Services Commission (HHSC) as described in §304.302 of this chapter (relating to Certified Authorized Provider).

  (7) Developmental period--The period of time between birth and before the individual reaches 18 years of age.

  (8) Diagnostic assessment--An assessment, including a determination of intellectual disability (DID), conducted to determine if an individual meets the criteria for a diagnosis of intellectual disability (ID), ASD, or a related condition.

  (9) Diagnostic assessment report--The written report from a diagnostic assessment not conducted by an authorized provider employed by or contracting with a local intellectual and developmental disability authority (LIDDA) or state supported living center (SSLC), including reports completed by private entities or schools.

  (10) DID--Determination of intellectual disability. An assessment conducted in accordance with §304.401 of this chapter (relating to Conducting a Determination of Intellectual Disability) by an authorized provider to determine if an individual meets the criteria for a diagnosis of intellectual disability as defined in paragraph (15) of this section.

  (11) DID report--Determination of intellectual disability report. The findings of the DID conducted by an authorized provider employed by or contracting with a LIDDA or SSLC written in accordance with §304.402 of this chapter (relating to The Determination of Intellectual Disability Report).

  (12) DSM--The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.

  (13) Endorsement--The process by which a previous assessment report, including a DID report, which meets the requirements in §304.402 of this chapter, is determined by an authorized provider to be a current representation of the individual's functioning for the purposes of diagnosis and service eligibility. When appropriate, an endorsement is completed in lieu of a DID.

  (14) HHSC--Texas Health and Human Services Commission.

  (15) ID--Intellectual disability. Consistent with Texas Health and Safety Code (THSC), §591.003, significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period.

  (16) Individual--A person who is the subject of a diagnostic assessment or who has been determined to be in the LIDDA priority population.

  (17) LAR--Legally authorized representative. A person authorized by law to act on behalf of an individual with regard to a matter described in this chapter, and who may be a parent, guardian, or managing conservator of a minor individual, or a guardian of an adult individual.

  (18) LIDDA--Local intellectual and developmental disability authority. An entity designated in accordance with THSC, §533A.035(a).

  (19) LIDDA priority population--Local intellectual and developmental disability authority priority population. A group comprised of persons who meet one or more of the following descriptions:

    (A) a person with an ID;

    (B) a person with ASD;

    (C) a person with a related condition on the current HHSC-approved list of related conditions, available on the HHSC website, who is eligible for and enrolling in services in the Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID) Program, the Home and Community-based Services (HCS) Program, the Texas Home Living (TxHmL) Program or other HHSC-approved programs;

    (D) a nursing facility resident who is eligible for specialized services for an ID or a related condition pursuant to §1919(e)(7) of the Social Security Act (United States Code, Title 42, §1396r(e)(7));

    (E) a child who is eligible for Early Childhood Intervention services through HHSC; or

    (F) a person diagnosed by an authorized provider as having a pervasive developmental disorder (PDD) or Asperger disorder through a diagnostic assessment completed before 2013.

  (20) LIDDA services--Local intellectual and developmental disability authority services. Services provided by or through a LIDDA that are funded with general revenue pursuant to a performance contract with HHSC.

  (21) PDD--Pervasive developmental disorder. A severe and pervasive impairment in the developmental areas of reciprocal social interaction skills or communication skills, or the presence of stereotyped behaviors, interests, and activities manifested during the individual's development. Since the expanded definition of ASD in the DSM, effective 2013, PDD is subsumed under the diagnosis of ASD.

  (22) Related condition--As defined in the Code of Federal Regulations (CFR), Title 42, §435.1010, a severe and chronic disability that:

    (A) is attributable to:

      (i) cerebral palsy or epilepsy; or

      (ii) any other condition, other than mental illness, found to be closely related to an ID because the condition results in impairment of general intellectual functioning or adaptive behavior similar to that of persons with an ID, and requires treatment or services similar to those required for persons with an ID;

    (B) is manifested before the person reaches age 22;

    (C) is likely to continue indefinitely; and

    (D) results in substantial functional limitation in three or more of the following areas of major life activity:

      (i) self-care;

      (ii) understanding and use of language;

      (iii) learning;

      (iv) mobility;

      (v) self-direction; and

      (vi) capacity for independent living.

  (23) Residential care facility--A facility defined in THSC, §591.003.

  (24) SSLC--State supported living center.

  (25) Subaverage general intellectual functioning--Consistent with THSC, §591.003, measured intelligence on standardized general intelligence tests of two or more standard deviations (not including standard error of measurement adjustments) below the age-group mean for the tests used.

  (26) TAC--Texas Administrative Code.

  (27) THSC--Texas Health and Safety Code.


Source Note: The provisions of this §304.102 adopted to be effective November 30, 2021, 46 TexReg 8062

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