| (31) Hospice--An entity that is primarily engaged in
providing care to terminally ill individuals and is approved by DADS
to participate in the Medicaid Hospice Program in accordance with §30.30
of this title (relating to General Contracting Requirements).
(32) ICAP (Inventory for Client and Agency Planning)--A
validated, standardized assessment that measures the level of supervision
an individual requires and, thus, the amount and intensity of services
and supports an individual needs.
(33) ICF/IID Program--The Intermediate Care Facilities
for Individuals with an Intellectual Disability Program, which provides
Medicaid-funded residential services to individuals with an intellectual
disability or related conditions.
(34) ICF/MR Program--ICF/IID Program.
(35) ID/RC Assessment Form--A form used by DADS for
LOC determination and LON assignment.
(36) IDT (interdisciplinary team)--A group of people
assembled by the program provider who possess the knowledge, skills,
and expertise to assess an individual's needs and make recommendations
for the individual's IPP. The group includes the individual, LAR,
intellectual disability professionals and paraprofessionals and, with
approval from the individual or LAR, other concerned persons.
(37) Individual--A person enrolled in the ICF/IID Program.
(38) Intellectual disability--Significant sub-average
general intellectual functioning existing concurrently with deficits
in adaptive behavior and manifested during the developmental period.
(39) IPP (individual program plan)--A plan developed
by an individual's IDT that identifies the individual's training,
treatment, and habilitation needs and describes services to meet those
needs.
(40) IQ (intelligence quotient)--A score reflecting
the level of an individual's intelligence as determined by the administration
of a standardized intelligence test.
(41) LAR (legally authorized representative)--A person
authorized by law to act on behalf of an individual with regard to
a matter described in this subchapter, and may include a parent, guardian,
managing conservator of a minor individual, a guardian of an adult
individual, or legal representative of a deceased individual.
(42) LOC (level of care)--A determination given by
DADS to an individual as part of the eligibility process based on
data submitted on the ID/RC Assessment Form.
(43) Local authority--An entity to which the Health
and Human Services Commission's authority and responsibility described
in TSHC §531.002(11) has been delegated.
(44) LON (level of need)--An assignment given by DADS
to an individual upon which reimbursement for ICF/IID Program services
is based. The LON assignment is derived from the service level score
obtained from the administration of the ICAP to the individual and
from selected items on the ID/RC Assessment Form.
(45) Long Term Care Plan--The plan required by THSC, §533.062,
which is developed by DADS and specifies, in part, the capacity of
the ICF/IID Program in Texas.
(46) Major dental treatment--A dental treatment, intervention,
or diagnostic procedure that:
(A) has a significant recovery period;
(B) presents a significant risk;
(C) employs a general anesthetic; or
(D) in the opinion of the individual's physician,
involves a significant invasion of bodily integrity that requires
an incision or the extraction of bodily fluids that produces substantial
pain, discomfort, or debilitation.
(47) Major medical treatment--A medical, surgical,
or diagnostic procedure or intervention that:
(A) has a significant recovery period;
(B) presents a significant risk;
(C) employs a general anesthetic; or
(D) in the opinion of the individual's physician, involves
a significant invasion of bodily integrity that requires an incision
or the extraction of bodily fluids that produces substantial pain,
discomfort, or debilitation.
(48) Medical necessity--The need for a treatment decision
that is essential to avoid adversely affecting an individual's mental
or physical health or the quality of care rendered.
(49) Mental retardation--Intellectual disability.
(50) MRA (mental retardation authority)--A local authority.
(51) MR/RC--ID/RC Assessment Form.
(52) Natural support network--Those persons, including
family members, church members, neighbors, and friends, who assist
and sustain an individual with supports that occur naturally within
the individual's environment and that are not reimbursed or purposely
developed by a person or system.
(53) Negative practice--A procedure in which an individual
is required, after an inappropriate behavior, to repeatedly engage
in an activity that is similar to the inappropriate behavior.
(54) Non-state operated facility--A facility for which
the program provider is an entity other than DADS, such as a community
center or private organization.
(55) Occupational therapist (OT)--A person licensed
by the Texas Board of Occupational Therapy Examiners to practice occupational
therapy, as defined in Texas Occupations Code §454.002(4).
(56) PDP (person-directed plan)--A plan of services
and supports developed under the direction of an individual or LAR
with the support of a local authority or program provider staff and
other people chosen by the individual or LAR.
(57) Permanency planning--A philosophy and planning
process that focuses on the outcome of family support for an individual
under 22 years of age by facilitating a permanent living arrangement
in which the primary feature is an enduring and nurturing parental
relationship.
(58) Permanency Planning Review Screen--A screen in
CARE that, when completed by a local authority, identifies community
supports needed to achieve an individual's permanency planning outcomes
and provides information necessary for approval of the individual's
initial and continued residence in a facility.
(59) Personal funds--The funds that belong to an individual,
including earned income, social security benefits, gifts, and inheritances.
(60) Personal hold--
(A) A manual method, except for physical guidance or
prompting of brief duration, used to restrict:
(i) free movement or normal functioning of all or a
portion of an individual's body; or
(ii) normal access by an individual to a portion of
the individual's body.
(B) Physical guidance or prompting of brief duration
becomes a physical restraint if the individual resists the guidance
or prompting.
(61) Petty cash fund--Personal funds managed by a program
provider that are maintained for individuals' cash expenditures.
(62) Physical restraint--A manual method, or a physical
or mechanical device, material, or equipment attached or adjacent
to an individual's body that the individual cannot remove easily,
that restricts freedom of movement or normal access to an individual's
body. This term includes a personal hold.
(63) Physical therapist (PT)--A person licensed by
the Texas Board of Physical Therapy Examiners to practice physical
therapy, as defined in Texas Occupations Code §453.001(4).
(64) Pooled account--A trust fund account containing
the personal funds of more than one individual.
(65) Professional--A person who is licensed or certified
by the State of Texas in a health or human services occupation or
who meets DADS criteria to be a case manager, service coordinator,
qualified intellectual disability professional, or certified psychologist
as described in §5.161 of this title (relating to TDMHMR-Certified
Psychologist).
(66) Program provider--An entity with whom DADS has
a provider agreement.
(67) Provider agreement--A written agreement between
DADS and a program provider that obligates the program provider to
deliver ICF/IID Program services.
(68) Provider applicant--An entity seeking to participate
as a program provider.
(69) Psychoactive medication--Any medication prescribed
for the treatment of symptoms of psychosis or other severe mental
or emotional disorders and that is used to exercise an effect upon
the central nervous system for the purposes of influencing and modifying
behavior, cognition, or affective state.
(70) Qualified intellectual disability professional
(QIDP)--A person with at least a bachelor's degree who has at least
one year of experience working with persons with an intellectual disability
or related conditions.
(71) Qualified rehabilitation professional (QRP)--A
person who holds one or more of the following certifications in good
standing:
Cont'd... |
