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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 748MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS
SUBCHAPTER BDEFINITIONS AND SERVICES
DIVISION 1DEFINITIONS
RULE §748.43What do certain words and terms mean in this chapter?

The words and terms used in this chapter have the meanings assigned to them under §745.21 of this title (relating to What do the following words and terms mean when used in this chapter?), unless another meaning is assigned in this section or unless the context clearly indicates otherwise. The following words and terms have the following meanings, unless the context clearly indicates otherwise:

  (1) Accredited college or university--An institution of higher education accredited by one of the following regional accrediting entities:

    (A) The Southern Association of Colleges and Schools Commission on Colleges, a subdivision of the Southern Association of Colleges and Schools;

    (B) The Middle States Commission on Higher Education, a component of the Middle States Association of Colleges and Schools;

    (C) The Commission on Institutions of Higher Education, a subdivision of the New England Association of Schools and Colleges;

    (D) The Higher Learning Commission (formerly part of the North Central Association of Colleges and Schools);

    (E) The Northwest Commission on Colleges and Universities;

    (F) The Accrediting Commission for Senior Colleges and Universities, a subdivision of the Western Association of Schools and Colleges; or

    (G) The Accrediting Commission for Community and Junior Colleges, a subdivision of the Western Association of Schools and Colleges.

  (2) Activity space--An area or room used for child activities.

  (3) Adaptive functioning--Refers to how effectively a person copes with common life demands and how well the person meets standards of personal independence expected of someone in his particular age group, sociocultural background, and community setting.

  (4) Adult--A person 18 years old or older.

  (5) Caregiver--A person counted in the child/caregiver ratio, whose duties include the direct care, supervision, guidance, and protection of a child. This does not include a contract service provider who:

    (A) Provides a specific type of service to your operation for a limited number of hours per week or month; or

    (B) Works with one particular child.

  (6) Certified lifeguard--A person who has been trained in rescue techniques, lifesaving, and water safety by a qualified instructor from a recognized organization that awards a certificate upon successful completion of the training. A certified lifeguard ensures the safety of persons by preventing and responding to water related emergencies.

  (7) Chemical restraint--A prohibited type of emergency behavior intervention that uses chemicals or pharmaceuticals through topical application, oral administration, injection, or other means to immobilize or sedate a child as a mechanism of control. The use of a medication is not a chemical restraint under this chapter if the medication:

    (A) Is prescribed by a treating health-care professional;

    (B) Is administered solely for medical or dental reasons; and

    (C) Has a secondary effect of immobilizing or sedating a child.

  (8) Child in care--A child who is currently admitted as a resident of a general residential operation, regardless of whether the child is temporarily away from the operation, as in the case of a child at school or at work. Unless a child has been discharged from the operation, the child is considered a child in care.

  (9) Child passenger safety seat system--An infant or child passenger restraint system that meets the federal standards for crash-tested restraint systems as set by the National Highway Traffic Safety Administration.

  (10) Child/caregiver ratio--The maximum number of children for whom one caregiver can be responsible.

  (11) Childhood activities--Activities that are generally accepted as suitable for children of the same chronological age, level of maturity, and developmental level as determined by a reasonable and prudent parent standard as specified in §748.705 of this chapter (relating to What is the "reasonable and prudent parent standard"?). Examples of childhood activities include extracurricular activities, in-school and out-of-school activities, enrichment activities, cultural activities, and employment opportunities. Childhood activities include unsupervised childhood activities.

  (12) Contract service provider--A person or entity that is contracting with the operation to provide a service, whether paid or unpaid. Also referred to as "contract staff" and "contractor" in this chapter.

  (13) Corporation or other type of business entity--May include an association, corporation, nonprofit association, nonprofit corporation, nonprofit association with religious affiliation, nonprofit corporation with religious affiliation, limited liability company, political subdivision, or state agency. For purposes of this chapter, this definition does not include any type of "partnership," which is defined separately.

  (14) Cottage or cottage home--A living arrangement for children who are not receiving treatment services in which:

    (A) Each group of children has separate living quarters;

    (B) 12 or fewer children are in each group;

    (C) Primary caregivers live in the children's living quarters, 24 hours per day for at least four days a week or 15 days a month; and

    (D) Other caregivers are used only to meet the child-to-caregiver ratio in an emergency or to supplement care provided by the primary caregivers.

  (15) Counseling--A procedure used by professionals from various disciplines in guiding individuals, families, groups, and communities by such activities as delineating alternatives, helping to articulate goals, processing feelings and options, and providing needed information. This definition does not include career counseling.

  (16) Days--Calendar days, unless otherwise stated.

  (17) De-escalation--Strategies used to defuse a volatile situation, to assist a child to regain behavioral control, and to avoid a physical restraint or other behavioral intervention.

  (18) Department--The Texas Department of Family and Protective Services (DFPS).

  (19) Discipline--A form of guidance that is constructive or educational in nature and appropriate to the child's age, development, situation, and severity of the behavior.

  (20) Emergency behavior intervention (EBI)--Interventions used in an emergency situation, including personal restraints, mechanical restraints, emergency medication, and seclusion.

  (21) Emergency medication--A type of emergency behavior intervention that uses chemicals or pharmaceuticals through topical application, oral administration, injection, or other means to modify a child's behavior. The use of a medication is not an emergency medication under this chapter if the medication:

    (A) Is prescribed by a treating health-care professional;

    (B) Is administered solely for a medical or dental reason (e.g. Benadryl for an allergic reaction or medication to control seizures); and

    (C) Has a secondary effect of modifying a child's behavior.

  (22) Emergency situation--A situation in which attempted preventative de-escalatory or redirection techniques have not effectively reduced the potential for injury, so that intervention is immediately necessary to prevent:

    (A) Imminent probable death or substantial bodily harm to the child because the child attempts or continually threatens to commit suicide or substantial bodily harm; or

    (B) Imminent physical harm to another because of the child's overt acts, including attempting to harm others. These situations may include aggressive acts by the child, including serious incidents of shoving or grabbing others over their objections. These situations do not include verbal threats or verbal attacks.

  (23) Employee--A person an operation employs full-time or part-time to work for wages, salary, or other compensation. For the purposes of this chapter, employees include all operation staff and any owner who is present at the operation or transports any child in care.

  (24) Family members--An individual related to another individual within the third degree of consanguinity or affinity. For the definitions of consanguinity and affinity, see Chapter 745 of this title (relating to Licensing). The degree of the relationship is computed as described in Government Code, §573.023 (relating to Computation of Degree of Consanguinity) and §573.025 (relating to Computation of Degree of Affinity).

  (25) Field trip--A group activity conducted away from the operation.

  (26) Food service--The preparation or serving of meals or snacks.

  (27) Full-time--At least 30 hours per week.

  (28) Garbage--Food or items that when deteriorating cause offensive odors and/or attract rodents, insects, and other pests.

  (29) General Residential Operation--A residential child-care operation that provides child care for seven or more children or young adults. The care may include treatment services or programmatic services. These operations include formerly titled emergency shelters, operations providing basic child care, residential treatment centers, and halfway houses.

  (30) Governing body--A group of persons or officers of the corporation or other type of business entity having ultimate authority and responsibility for the operation.

  (31) Grounds--Includes any parcel of land where the operation is located and any building, other structure, body of water, play equipment, street, sidewalk, walkway, driveway, parking garage, or parking lot on the parcel. Also referred to as "premises" in this chapter.

  (32) Group of children--Children assigned to a specific caregiver or specific caregivers. Generally, the group stays with the assigned caregivers throughout the day and may move to different areas throughout the operation, indoors and out. For example, children who are assigned to specific caregivers occupying a unit or cottage are considered a group.

  (33) Health-care professional--A licensed physician, licensed advanced practice registered nurse (APRN), physician's assistant, licensed vocational nurse (LVN), licensed registered nurse (RN), or other licensed medical personnel providing health care to the child within the scope of the person's license. This does not include physicians, nurses, or other medical personnel not licensed to practice in the United States or in the country in which the person practices.

  (34) High-risk behavior--Behavior of a child that creates an immediate safety risk to self or others. Examples of high-risk behavior include suicide attempt, self-abuse, physical aggression causing bodily injury, chronic running away, substance abuse, fire-setting, and sexual aggression or perpetration.

  (35) Human services field--A field of study that contains coursework in the social sciences of psychology and social work including some counseling classes focusing on normal and abnormal human development and interpersonal relationship skills from an accredited college or university. Coursework in guidance counseling does not apply.

  (36) Immediate danger--A situation where a prudent person would conclude that bodily harm would occur if there were no immediate interventions. Immediate danger includes a serious risk of suicide, serious physical injury to self or others, or the probability of bodily harm resulting from a child running away. Immediate danger does not include:

    (A) Harm that might occur over time or at a later time; or

    (B) Verbal threats or verbal attacks.

  (37) Infant--A child from birth through 17 months.

  (38) Livestock--An animal raised for human consumption or an equine animal.

  (39) Living quarters--A structure or part of a structure where a group of children reside, such as a building, house, cottage, or unit.

  (40) Mechanical restraint--A type of emergency behavior intervention that uses the application of a device to restrict the free movement of all or part of a child's body in order to control physical activity.

  (41) Mental health professional--Refers to:

    (A) A psychiatrist licensed by the Texas Medical Board;

    (B) A psychologist licensed by the Texas State Board of Examiners of Psychologists;

    (C) A master's level social worker or higher licensed by the Texas State Board of Social Work Examiners;

    (D) A professional counselor licensed by the Texas State Board of Examiners of Professional Counselors;

    (E) A marriage and family therapist licensed by the Texas State Board of Examiners of Marriage and Family Therapists; and

    (F) A master's level or higher nurse licensed as an Advanced Practice Registered Nurse by the Texas Board of Nursing and board certified in Psychiatric/Mental Health.

  (42) Non-ambulatory--A child that is only able to move from place to place with assistance, such as a walker, crutches, a wheelchair, or prosthetic leg.

  (43) Non-mobile--A child that is not able to move from place to place, even with assistance.

  (44) Normalcy--See §748.701 of this chapter (relating to What is "normalcy"?).

Cont'd...

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