| (v) dental sedation, which is sedation necessary to
perform dental treatment including non-routine anesthesia, (for example,
intravenous sedation, general anesthesia, or sedative therapy prior
to routine procedures) but not including administration of routine
local anesthesia only; and
(B) does not include cosmetic orthodontia.
(41) Developmental disability--As defined in the Developmental
Disabilities Assistance and Bill of Rights Act of 2000, Section 102(8),
a severe, chronic disability of an individual five years of age or
older that:
(A) is attributable to a mental or physical impairment
or combination of mental and physical impairments;
(B) is manifested before the individual attains 22
years of age;
(C) is likely to continue indefinitely; and
(D) results in substantial functional limitations in
three or more of the following areas of major life activity:
(i) self-care;
(ii) receptive and expressive language;
(iii) learning;
(iv) mobility;
(v) self-direction;
(vi) capacity for independent living; and
(vii) economic self-sufficiency.
(42) DFPS--Department of Family and Protective Services.
(43) Dietary services--A DBMD Program service that
provides nutrition services, as defined in Texas Occupations Code §701.002.
(44) Employment assistance--A DBMD Program service
that provides assistance to an individual to help the individual locate
competitive employment in the community to the same degree of access
as individuals not receiving DBMD Program services.
(45) Enrollment Individual Plan of Care (IPC)--The
first IPC for an individual developed before the individual's enrollment
into the DBMD Program.
(46) Enrollment Individual Program Plan (IPP)--The
first IPP for an individual developed before the individual's enrollment
into the DBMD Program in accordance with §260.65 of this chapter
(relating to Development of an Enrollment IPP).
(47) 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.
(48) FMS--Financial management services. A DBMD Program
service that is defined in 40 TAC §41.103 and provided to an
individual participating in the CDS option.
(49) FMSA--Financial management services agency. An
entity, as defined in 40 TAC §41.103, that provides FMS.
(50) Former military member--A person who served in
the United States Army, Navy, Air Force, Marine Corps, Coast Guard,
or Space Force:
(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.
(51) Functional behavior assessment--An evaluation
that is used to determine the underlying function or purpose of an
individual's behavior, so an effective behavior support plan can be
developed.
(52) Functions as a person with deafblindness--Situation
in which a person is determined:
(A) to have a progressive medical condition, manifested
before 22 years of age, that will result in the person having deafblindness;
or
(B) before attaining 22 years of age, to have limited
hearing or vision due to protracted inadequate use of either or both
of these senses.
(53) Good cause--As determined by HHSC, A reason outside
the control of a CFC ERS provider that is an acceptable reason for
the CFC ERS provider's failure to comply.
(54) HCSSA--Home and community support services agency.
An entity required to be licensed under Texas Health and Safety Code
(THSC) Chapter 142.
(55) Health-related tasks--Specific tasks related to
the needs of an individual that can be delegated or assigned by a
licensed healthcare professional under state law to be performed by
a service provider of CFC PAS/HAB. These include:
(A) tasks delegated by a registered nurse (RN);
(B) health maintenance activities, as defined in 22
TAC §225.4 (relating to Definitions), that may not require delegation;
and
(C) activities assigned to a service provider of CFC
PAS/HAB by a licensed physical therapist, occupational therapist,
or speech-language pathologist.
(56) HHSC--The Texas Health and Human Services Commission.
(57) Hospital--A public or private institution that
is licensed or is exempt from licensure in accordance with THSC Chapters
13, 241, 261, or 552.
(58) 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.
(59) 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 services are provided and that
is:
(A) licensed in accordance with THSC Chapter 252; or
(B) certified by HHSC, including a state supported
living center.
(60) ICF/IID Program--The Intermediate Care Facilities
for Individuals with an Intellectual Disability or Related Conditions
Program, which provides Medicaid-funded residential services to individuals
with an intellectual disability or related conditions.
(61) ID/RC Assessment--Intellectual Disability/Related
Conditions Assessment. An HHSC form used to determine the LOC for
an individual.
(62) Impairment to independent functioning--An adaptive
behavior level of II, III, or IV.
(63) Individual--A person seeking to enroll or who
is enrolled in the DBMD Program.
(64) Individual transportation plan--A written plan
developed by an individual's service planning team and documented
on the HHSC Individual Transportation Plan form. The form is used
to document how transportation as a residential habilitation activity
will be delivered to support an individual's desired goals and outcomes
for transportation as identified in the IPP.
(65) Inpatient chemical dependency treatment facility--A
facility licensed in accordance with THSC Chapter 464.
(66) In person or in-person--Within the physical presence
of another person. In person or in-person does not include using videoconferencing
or a telephone.
(67) Institution for mental diseases--Has the meaning
set forth in 42 CFR §435.1010.
(68) Institutional services--Medicaid-funded services
provided in a nursing facility or in an ICF/IID.
(69) Intellectual disability--Consistent with THSC §591.003,
significantly sub-average general intellectual functioning that is
concurrent with deficits in adaptive behavior and originates during
the developmental period.
(70) Intervener--A service provider with specialized
training and skills in deafblindness who, working with one individual
at a time, serves as a facilitator to involve an individual in home
and community services and activities, and who is classified as an
Intervener, Intervener I, Intervener II, or Intervener III in accordance
with Texas Government Code §531.0973.
(71) IPC--Individual plan of care. A written plan developed
by an individual's service planning team and documented on the HHSC
Individual Plan of Care form. An IPC:
(A) documents:
(i) the type and amount of each DBMD Program service
and each CFC service, except for CFC support management, to be provided
to the individual during an IPC year; and
(ii) if an individual will receive CFC support management;
and
(B) is authorized by HHSC.
(72) IPC period--The effective period of an enrollment
IPC and a renewal IPC as follows:
(A) for an enrollment IPC, the period of time from
the effective date of the enrollment IPC, as described in §260.67(a)(1)(F)
of this chapter (relating to Development of a Proposed Enrollment
IPC), through the last calendar day of the 11th month after the month
in which enrollment occurred; and
Cont'd... |
