| (a) For the purpose of this chapter, the term "agency"
has the meaning given by §48.401, Human Resources Code, as further
clarified in this rule. Any terms used within the definition of "agency"
have the meaning given by statute or elaborated upon by this chapter
or Title 40, Texas Administrative Code, Chapter 705 (relating to Adult
Protective Services). The purpose of this rule is to provide a non-exhaustive
list of agencies, the employees of which are subject to being listed
on the EMR if they are found to have committed reportable conduct.
The list is illustrative and not exclusionary. Employees of agencies
not specifically enumerated that are within the meaning of §48.401
continue to be eligible for the EMR without regard to whether the
agency is specifically enumerated below.
(b) The term "agency" means:
(1) a home and community support services agency licensed
under Chapter 142, Health and Safety Code;
(2) a person exempt from licensure who provides home
health, hospice, habilitation, or personal assistance services only
to persons receiving benefits under:
(A) the home and community-based services (HCS) waiver
program;
(B) the Texas home living (TxHmL) waiver program;
(C) the STAR + PLUS or other Medicaid managed care
program under the program's HCS or TxHmL certification; or
(D) Section 534.152, Government Code;
(3) an intermediate care facility for individuals with
an intellectual disability or related conditions (ICF-IID) licensed
under Chapter 252, Health and Safety Code; or
(4) a provider investigated by HHSC under Subchapter
F, Human Resources Code or §261.404, Family Code. Such providers
include:
(A) a facility as defined in §711.3 of this chapter
(relating to How are the terms in this chapter defined?);
(B) a community center, local mental health authority,
and local intellectual and developmental disability authority, as
defined in §711.3 of this chapter;
(C) a person who contracts with a health and human
services agency or managed care organization to provide home and community-based
services (HCBS) as that term is defined in §48.251, Human Resources
Code and which is the umbrella term for various long-term services
and supports within the Medicaid program, whether delivered in a fee-for-service,
managed care, or other service delivery model, and which includes
but is not limited to:
(i) Waiver programs including:
(I) community living assistance and support services
(CLASS);
(II) Deaf Blind Multiple Disabilities;
(III) HCS;
(IV) TxHmL;
(V) Medically Dependent Child Program (MDCP); and
(VI) Youth Empowerment Services (YES);
(ii) Community First Choice;
(iii) Texas Dual Eligible Integrated Care Project;
(iv) State plan services including:
(I) Community attendant services; and
(II) Personal attendant services;
(v) Managed Care Programs including:
(I) HCBS - Adult Mental Health;
(II) STAR + PLUS Managed Care program; and
(III) STAR Kid Managed Care program; and
(vi) any other program, project, waiver demonstration,
or service providing long-term services and supports through the Medicaid
program;
(D) a person who contracts with a Medicaid managed
care organization to provide behavioral health services as that term
is defined in §48.251 and which include but are not limited to:
(i) Targeted Case Management; and
(ii) Psychiatric Rehabilitation services;
(E) a managed care organization;
(F) an officer, employee, agent, contractor, or subcontractor
of a person or entity listed in subparagraphs (A) - (E) of this paragraph;
and
(G) an employee, fiscal agent, case manager, or service
coordinator of an individual employer participating in the consumer
directed service option, as defined by §531.051, Government Code.
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