| (39) Individual--A person with an intellectual disability
or a condition related to an intellectual disability who is receiving
services from a facility.
(40) Individual support plan (ISP)--An integrated,
coherent, person-directed plan that reflects an individual's preferences,
strengths, needs, and personal vision, as well as the protections,
supports, and services the individual will receive to accomplish identified
goals and objectives.
(41) Interdisciplinary team (IDT)--A team consisting
of an individual, the individual's legally authorized representative
(LAR) and qualified developmental disability professional, other professionals
dictated by the individual's strengths, preferences, and needs, and
staff who regularly and directly provide services and supports to
the individual. The team is responsible for assessing the individual's
treatment, training, and habilitation needs and making recommendations
for services based on the personal goals and preferences of the individual
using a person-directed planning process, including recommendations
on whether the individual is best served in a facility or community
setting.
(42) Legally adequate consent--Consent from a person
who:
(A) is not a minor and has not been adjudicated incompetent
to manage the person's personal affairs by an appropriate court of
law;
(B) has been informed of and understands:
(i) the nature, purpose, consequences, risks, and benefits
of the medication, treatment, or procedure for which the consent is
given;
(ii) alternatives to the medication, treatment, or
procedure for which the consent is given;
(iii) that withdrawing or refusing to give consent
will not prejudice the future provision of care and services; and
(iv) the method of administration, if the person is
giving consent for an unusual or hazardous treatment procedure, experimental
research, organ transplantation, or nontherapeutic surgery; and
(C) consents voluntarily, free from coercion or undue
influence.
(43) Legally authorized representative (LAR)--A person
authorized by law to act on behalf of an individual, including a parent,
guardian, or managing conservator of a minor individual, or a guardian
of an adult individual.
(44) Life-sustaining medical treatment--Treatment that,
based on reasonable medical judgment, sustains the life of an individual
and without which the individual will die. The term includes both
life-sustaining medications and artificial life support such as mechanical
breathing machines, kidney dialysis treatment, and artificial nutrition
and hydration. The term does not include the administration of pain
management medication or the performance of a medical procedure considered
necessary to provide comfort care or any other medical care provided
to alleviate an individual's pain.
(45) Mechanical restraint--Any device attached or adjacent
to an individual's body that he or she cannot easily remove that restricts
freedom of movement or normal access to his or her body. The term
does not include a protective device.
(46) Medical emergency--Any illness or injury that
requires immediate assessment and treatment by medical staff for conditions
considered to be life threatening, including, but not limited to,
respiratory or cardiac arrest, choking, extreme difficulty in breathing,
status epilepticus, allergic reaction to an insect sting, snake bite,
extreme pain in the chest or abdomen, poisoning, hemorrhage, loss
of consciousness, sudden loss of function of a body part, injuries
resulting in broken bones, possible neck or back injuries, or severe
burns.
(47) Medical intervention--Treatment by a licensed
medical doctor, osteopath, podiatrist, dentist, physician assistant,
or advanced practice registered nurse in accordance with general acceptable
clinical practice.
(48) Medical restraint--A health-related protection
prescribed by a primary care provider (PCP) or dentist that is necessary
for the conduct of a specific medical or dental procedure, or is only
necessary for protection during the time that a medical or dental
condition exists, for the purpose of preventing an individual from
inhibiting or undoing medical or dental treatment. Medical restraint
includes pre-treatment sedation.
(49) Medical restraint plan--A component of the ISP
action plan that provides instructions for staff on how to effectively
and safely carry out medical restraint procedures. The plan is developed
with input from the PCP or dentist and meaningful input from the individual
and LAR and includes a description of the individual's behaviors that
do not allow for a safe and effective implementation of needed medical
or dental procedures, information about the types of restraints that
have been most effective with the individual, a description of the
criteria for releasing the restraint, and reporting requirements.
A medical restraint plan is not considered a therapeutic intervention
and may be adjusted depending upon the individual's progress in the
ISP action plan.
(50) Medication-related emergency--A situation in which
it is immediately necessary to administer medication to an individual
to prevent:
(A) imminent probable death or substantial bodily harm
to the individual because the individual:
(i) overtly or continually is threatening or attempting
to commit suicide or serious bodily harm; or
(ii) is behaving in a manner that indicates that the
individual is unable to satisfy the individual's need for nourishment,
essential medical care, or self-protection; or
(B) imminent physical or emotional harm to another
because of threats, attempts, or other acts the individual overtly
or continually makes or commits.
(51) Mental health services provider--Has the meaning
assigned in Texas Civil Practice and Remedies Code, Chapter 81.
(52) Neglect--An act or failure to act that, with regard
to an individual, meets the definition of "neglect" in Chapter
711, Subchapter A of this title (relating to Introduction), or the
definition of "neglect" in the CMS State Operations Manual,
Appendix J, Guidance to Surveyors: Intermediate Care Facilities for
Individuals with Intellectual Disabilities, available at www.cms.gov.
(53) Peer review--A review of clinical or professional
practice of a doctor, pharmacist, licensed vocational nurse, or registered
nurse conducted by his or her professional peers.
(54) Perpetrator--A person who has committed abuse,
neglect, or exploitation.
(55) Person--Includes a corporation, organization,
governmental subdivision or agency, or any other legal entity.
(56) Physical restraint--Any manual method that restricts
freedom of movement or normal access to one's body, including hand
or arm holding to escort an individual over his or her resistance
to being escorted. Physical restraint does not include brief and limited
use of physical guidance, positioning, or prompting techniques used
to redirect an individual or assist, support, or protect the individual
during a functional therapeutic or physical exercise activity; response
blocking and brief redirection used to interrupt an individual's limbs
or body without the use of force so that the occurrence of challenging
behavior is prevented; holding an individual, without the use of force,
to calm or comfort, or hand holding to escort an individual from one
area to another without resistance from the individual; and response
interruption used to interrupt an individual's behavior, using facility-approved
techniques.
(57) Physician on duty--The physician designated by
the facility's medical director to provide medical care or respond
to emergencies outside regular working hours.
(58) Positive behavior support plan (PBSP)--A comprehensive,
individualized plan that contains intervention strategies designed
to modify the environment, teach or increase adaptive skills, and
reduce or prevent the occurrence of target behaviors through interventions
that build on an individual's strengths and preferences, without using
aversive or punishment contingencies.
(59) Preponderance of the evidence--Evidence that is
of greater weight or more convincing than the evidence that is offered
in opposition to it; that is, evidence that, as a whole, shows that
the fact sought to be proved is more probable than not.
(60) Primary care provider (PCP)--A physician, advanced
practice registered nurse, or physician assistant who provides primary
care to a defined population of patients. The PCP is involved in health
promotion, disease prevention, health maintenance, and diagnosis and
treatment of acute and chronic illnesses.
Cont'd... |
