The following words and terms, when used in this subchapter,
have the following meanings, unless the context clearly indicates
otherwise:
(1) Abuse--
(A) physical abuse;
(B) sexual abuse; or
(C) verbal or emotional abuse.
(2) Actively involved--Significant, ongoing, and supportive
involvement with an applicant or individual by a person, as determined
by the applicant's or individual's service planning team or program
provider, based on the person's:
(A) interactions with the applicant or individual;
(B) availability to the applicant or individual for
assistance or support when needed; and
(C) knowledge of, sensitivity to, and advocacy for
the applicant's or individual's needs, preferences, values, and beliefs.
(3) Actual harm--A negative outcome that compromises
an individual's physical, mental, or emotional well-being but does
not constitute an immediate threat.
(4) ADLs--Activities of daily living. Basic personal
everyday activities, including tasks such as eating, toileting, grooming,
dressing, bathing, and transferring.
(5) Alarm call--A signal transmitted from an individual's
CFC ERS equipment to the CFC ERS response center indicating that the
individual needs immediate assistance.
(6) Alleged perpetrator--A person alleged to have committed
an act of abuse, neglect, or exploitation of an individual.
(7) Applicant--A Texas resident seeking services in
the HCS Program.
(8) Behavioral emergency--A situation in which an individual's
severely aggressive, destructive, violent, or self-injurious behavior:
(A) poses a substantial risk of imminent probable death
of, or substantial bodily harm to, the individual or others;
(B) has not abated in response to attempted preventive
de-escalatory or redirection techniques;
(C) is not addressed in a written behavior support
plan; and
(D) does not occur during a medical or dental procedure.
(9) Business day--Any day except a Saturday, Sunday,
or national or state holiday listed in Texas Government Code §662.003(a)
or (b).
(10) Calendar day--Any day, including weekends and
holidays.
(11) CDS option--Consumer directed services option.
A service delivery option as defined in §41.103 of this title
(relating to Definitions).
(12) CFC--Community First Choice.
(13) CFC ERS--CFC emergency response services. Backup
systems and supports used to ensure continuity of services and supports.
CFC ERS includes electronic devices and an array of available technology,
personal emergency response systems, and other mobile communication
devices.
(14) CFC ERS provider--The entity directly providing
CFC ERS to an individual, which may be the program provider or a contractor
of the program provider.
(15) CFC FMS--The term used for FMS on the IPC of an
applicant or individual if the applicant or individual receives only
CFC PAS/HAB through the CDS option.
(16) CFC PAS/HAB--CFC personal assistance services/habilitation.
A service that:
(A) consists of:
(i) personal assistance services that provide assistance
to an individual in performing ADLs and IADLs based on the individual's
person-centered service plan, including:
(I) non-skilled assistance with the performance of
the ADLs and IADLs;
(II) household chores necessary to maintain the home
in a clean, sanitary, and safe environment;
(III) escort services, which consist of accompanying
and assisting an individual to access services or activities in the
community, but do not include transporting an individual; and
(IV) assistance with health-related tasks; and
(ii) habilitation that provides assistance to an individual
in acquiring, retaining, and improving self-help, socialization, and
daily living skills and training the individual on ADLs, IADLs, and
health-related tasks, such as:
(I) self-care;
(II) personal hygiene;
(III) household tasks;
(IV) mobility;
(V) money management;
(VI) community integration, including how to get around
in the community;
(VII) use of adaptive equipment;
(VIII) personal decision making;
(IX) reduction of challenging behaviors to allow individuals
to accomplish ADLs, IADLs, and health-related tasks; and
(X) self-administration of medication; and
(B) does not include transporting the individual, which
means driving the individual from one location to another.
(17) CFC support consultation--The term used for support
consultation on the IPC of an applicant or individual if the applicant
or individual receives only CFC PAS/HAB through the CDS option.
(18) CFC support management--Training regarding how
to select, manage, and dismiss an unlicensed service provider of CFC
PAS/HAB, as described in the HCS Handbook.
(19) Chemical restraint--A medication used to control
an individual's behavior or to restrict the individual's freedom of
movement that is not a standard treatment for the individual's medical
or psychological condition.
(20) CMS--Centers for Medicare & Medicaid Services.
The federal agency within the United States Department of Health and
Human Services that administers the Medicare and Medicaid programs.
(21) Cognitive rehabilitation therapy--A service that:
(A) assists an individual in learning or relearning
cognitive skills that have been lost or altered as a result of damage
to brain cells or brain chemistry in order to enable the individual
to compensate for lost cognitive functions; and
(B) includes reinforcing, strengthening, or reestablishing
previously learned patterns of behavior, or establishing new patterns
of cognitive activity or compensatory mechanisms for impaired neurological
systems.
(22) Competitive employment--Employment that pays an
individual at least minimum wage if the individual is not self-employed.
(23) Contract--A provisional contract or a standard
contract.
(24) Controlling person--A person who:
(A) has an ownership interest in a program provider;
(B) is an officer or director of a corporation that
is a program provider;
(C) is a partner in a partnership that is a program
provider;
(D) is a member or manager in a limited liability company
that is a program provider;
(E) is a trustee or trust manager of a trust that is
a program provider; or
(F) because of a personal, familial, or other relationship
with a program provider, is in a position of actual control or authority
with respect to the program provider, regardless of the person's title.
(25) CRCG--Community resource coordination group. A
local interagency group, composed of public and private agencies that
develops service plans for individuals whose needs can be met only
through interagency coordination and cooperation. The group's role
and responsibilities are described in the Memorandum of Understanding
on Coordinated Services to Persons Needing Services from More Than
One Agency, available on the HHSC website.
(26) Critical incident--An event listed in the HCS
Provider User Guide found on the HHSC website.
(27) Critical violation--A violation for which HHSC
may assess an administrative penalty before giving a program provider
an opportunity to correct the violation. A critical violation:
(A) is an immediate threat;
(B) has resulted in actual harm and is widespread;
(C) has resulted in actual harm and is a pattern; or
(D) has the potential to result in actual harm and
is widespread.
(28) DADS--HHSC.
(29) DARS--The Texas Workforce Commission.
(30) DFPS--The Department of Family and Protective
Services.
(31) Emergency--An unexpected situation in which the
absence of an immediate response could reasonably be expected to result
in risk to the health and safety of an individual or another person.
(32) Emergency situation--An unexpected situation involving
an individual's health, safety, or welfare, of which a person of ordinary
prudence would determine that the LAR should be informed, such as:
(A) an individual needing emergency medical care;
(B) an individual being removed from his residence
by law enforcement;
(C) an individual leaving his residence without notifying
a staff member or service provider and not being located; and
(D) an individual being moved from his residence to
protect the individual (for example, because of a hurricane, fire,
or flood).
(33) Exploitation--The illegal or improper act or process
of using, or attempting to use, an individual or the resources of
an individual for monetary or personal benefit, profit, or gain.
(34) Family-based alternative--A family setting in
which the family provider or providers are specially trained to provide
support and in-home care for children with disabilities or children
who are medically fragile.
(35) FMS--Financial management services. A service,
as defined in §41.103 of this title, that is provided to an individual
participating in the CDS option.
(36) FMSA--Financial management services agency. As
defined in §41.103 of this title, an entity that provides financial
management services to an individual participating in the CDS option.
(37) Follow-up survey--A review by HHSC of a program
provider to determine if the program provider has completed corrective
action.
(38) Former military member--A person who served in
the United States Army, Navy, Air Force, Marine Corps, or Coast Guard:
(A) who declared and maintained Texas as the person's
state of legal residence in the manner provided by the applicable
military branch while on active duty; and
(B) who was killed in action or died while in service,
or whose active duty otherwise ended.
(39) Four-person residence--A residence:
(A) that a program provider leases or owns;
(B) in which at least one person but no more than four
persons receive:
(i) residential support;
(ii) supervised living;
(iii) a non-HCS Program service similar to residential
support or supervised living (for example, services funded by DFPS
or by a person's own resources); or
(iv) respite;
(C) that, if it is the residence of four persons, at
least one of those persons receives residential support;
(D) that is not the residence of any persons other
than a service provider, the service provider's spouse or person with
whom the service provider has a spousal relationship, or a person
described in subparagraph (B) of this paragraph; and
(E) that is not a dwelling described in §9.155(a)(5)(H)
of this subchapter (relating to Eligibility Criteria and Suspension
of HCS Program Services and of CFC Services).
(40) Good cause--As used in §9.174(j) of this
subchapter (relating to Certification Principles: Service Delivery),
a reason outside the control of the CFC ERS provider, as determined
by HHSC.
(41) GRO--General residential operation. The term has
the meaning set forth in Texas Human Resources Code, §42.002.
(42) HCS Program--The Home and Community-based Services
Program operated by HHSC as authorized by CMS in accordance with §1915(c)
of the Social Security Act.
(43) Health-related tasks--Specific tasks related to
the needs of an individual, which can be delegated or assigned by
licensed health care professionals under state law to be performed
by a service provider of CFC PAS/HAB. These include tasks delegated
by an RN; health maintenance activities as defined in 22 TAC §225.4
(relating to Definitions), that may not require delegation; and activities
assigned to a service provider of CFC PAS/HAB by a licensed physical
therapist, occupational therapist, or speech-language pathologist.
(44) HHSC--The Texas Health and Human Services Commission.
(45) IADLs--Instrumental activities of daily living.
Activities related to living independently in the community, including
meal planning and preparation; managing finances; shopping for food,
clothing, and other essential items; performing essential household
chores; communicating by phone or other media; and traveling around
and participating in the community.
(46) ICAP--Inventory for Client and Agency Planning.
(47) ICF/IID--Intermediate care facility for individuals
with an intellectual disability or related conditions. An ICF/IID
is a facility in which ICF/IID Program is:
(A) licensed in accordance with THSC, Chapter 252;
or
Cont'd... |
