The following words and terms, when used in the portions of this chapter
applying to the TLC program (§§48.2721-48.2725), have the following
meanings, unless the content clearly indicates otherwise.
(1) Case manager--An employee of the Texas Department of Human
Services (DHS) who provides case management services, or an employee of an
agency that has contracted with DHS to provide relocation services or case
management services. The case manager determines eligibility and benefit levels
in the TLC program, subject to final approval by DHS.
(2) CBA--The Community Based Alternatives program, a Medicaid
waiver program, based on the Social Security Act, §1915(c), which provides
a comprehensive array of community-based services for adults age 21 and older
who meet the medical necessity criteria for nursing facility care, and who
meet all other eligibility criteria for this waiver.
(3) CLASS--The Community Living Assistance and Support Services
program, a Medicaid waiver program, based on the Social Security Act, §1915(c),
which provides a comprehensive array of community-based services for certain
individuals who qualify for an intermediate care facility for the mentally
retarded (ICF-MR) VIII level of care, and who meet all other eligibility criteria
for this waiver. This program operates in designated counties in Texas.
(4) Community setting--A community setting is any living arrangement
chosen by the individual that allows that individual to receive services from
the particular waiver program or other community care program providing services
to that individual. A community setting is a long-term living arrangement
other than a nursing facility; state hospital; state school; medical, rehabilitation,
or psychiatric hospital; school for the deaf or blind, Texas Youth Commission
facility, Texas Department of Criminal Justice facility, or ICF-MR facility.
(5) DB-MD--The Deaf-Blind with Multiple Disabilities program,
a Medicaid waiver program, based on the Social Security Act, §1915(c),
which provides a comprehensive array of community-based services for certain
individuals who qualify for an intermediate care facility for the mentally
retarded (ICF-MR) VIII level of care, and who meet all other eligibility criteria
for this waiver. This program operates in designated counties in Texas.
(6) DHS--The Texas Department of Human Services.
(7) Institutional setting--A long-term care nursing facility
licensed by DHS.
(8) MDCP--The Medically Dependent Children Program, a Medicaid
waiver program, based on the Social Security Act, §1915(c), which provides
community-based services to individuals under the age of 21 years who meet
the medical necessity criteria for nursing facility or hospital care, and
who meet all other eligibility criteria for this waiver.
(9) Promoting Independence--An initiative of the Texas Department
of Human Services, under the direction of the Texas Health and Human Services
Commission (HHSC), to promote opportunities for a person with a disability
to live in the most appropriate care setting of his choice.
(10) TLC--The Promoting Independence Transition to Life in
the Community program, a component of the In-home and Family Support Program
(IHFSP), which provides a one-time financial grant or other short-term financial
assistance to individuals to help them move from a Medicaid-funded residence
in a nursing facility into a community setting. The rules and procedures described
in §§48.2701-48.2711 do not apply to §§48.2721-48.2725,
which govern TLC services. An individual may not receive services under §§48.2701-48.2711
concurrently with services received through the program described in §§48.2721-48.2725.
An individual who has received TLC services and wants services described in §§48.2701-48.2711
must apply under the request and application procedures described in those
sections.
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