| (F) the signature and date of the individual, legally
authorized representative (LAR), and the program provider.
(39) In person or in-person--Within the physical presence
of another person who is awake. In person or in-person does not include
using videoconferencing or a telephone.
(40) Individual--A person enrolled in the TxHmL Program.
(41) Initial IPC--The first IPC for an individual developed
before the individual's enrollment into the TxHmL Program.
(42) Inpatient chemical dependency treatment facility--A
facility licensed in accordance with THSC Chapter 464, Facilities
Treating Persons with a Chemical Dependency.
(43) Intellectual disability--This term has the meaning
set forth in §304.102 of this title.
(44) IPC--Individual plan of care. A written plan that:
(A) states:
(i) the type and amount of each TxHmL Program service
and each CFC service, except for CFC support management, to be provided
to an individual during an IPC year;
(ii) the services and supports to be provided to the
individual through resources other than TxHmL Program services or
CFC services, including natural supports, medical services, and educational
services; and
(iii) if an individual will receive CFC support management;
and
(B) is authorized by HHSC.
(45) IPC cost--Estimated annual cost of TxHmL Program
services included on an IPC.
(46) IPC year--The effective period of an initial IPC
and renewal IPC as described in this paragraph.
(A) Except as provided in subparagraph (B) of this
paragraph, the IPC year for an initial and renewal IPC is a 365-calendar
day period starting on the begin date of the initial or renewal IPC.
(B) If the begin date of an initial or renewal IPC
is March 1 or later in a year before a leap year or January 1 - February
28 of a leap year, the IPC year for the initial or renewal IPC is
a 366-calendar day period starting on the begin date of the initial
or renewal IPC.
(C) A revised IPC does not change the begin or end
date of an IPC year.
(47) LAR--Legally authorized representative. A person
authorized by law to act on behalf of a person with regard to a matter
described in this subchapter, including a parent, guardian, or managing
conservator of a minor; a guardian of an adult; an agent appointed
under a power of attorney; or a representative payee appointed by
the Social Security Administration. An LAR, such as an agent appointed
under a power of attorney or representative payee appointed by the
Social Security Administration, may have limited authority to act
on behalf of a person.
(48) LIDDA--Local intellectual and developmental disability
authority. An entity designated by the executive commissioner of HHSC,
in accordance with THSC §533A.035.
(49) LOC--Level of care. A determination given to an
applicant or individual as part of the eligibility determination process
based on data submitted on the ID/RC Assessment.
(50) LON--Level of need. An assignment given by HHSC
to an applicant or individual that is derived from the ICAP service
level score and from selected items on the ID/RC Assessment.
(51) Managed care organization--This term has the meaning
set forth in Texas Government Code §536.001.
(52) MAO Medicaid--Medical Assistance Only Medicaid.
A type of Medicaid by which an applicant or individual qualifies financially
for Medicaid assistance but does not receive Supplemental Security
Income (SSI) benefits.
(53) Medicaid HCBS--Medicaid home and community-based
services. Medicaid services provided to an individual in an individual's
home and community, rather than in a facility.
(54) Mental health facility--A facility licensed in
accordance with THSC Chapter 577, Private Mental Hospitals and Other
Mental Health Facilities.
(55) Military family member--A person who is the spouse
or child (regardless of age) of:
(A) a military member; or
(B) a former military member.
(56) Military member--A member of the United States
military serving in the Army, Navy, Air Force, Marine Corps, Coast
Guard, or Space Force on active duty who has declared and maintains
Texas as the member's state of legal residence in the manner provided
by the applicable military branch.
(57) Natural supports--Unpaid persons, including family
members, volunteers, neighbors, and friends, who voluntarily assist
an individual to achieve the individual's identified goals.
(58) Neglect--A negligent act or omission that caused
physical or emotional injury or death to an individual or placed an
individual at risk of physical or emotional injury or death.
(59) Nursing facility--A facility licensed in accordance
with THSC Chapter 242.
(60) PDP--Person-directed plan. A plan developed with
an applicant or individual and LAR using an HHSC form that:
(A) describes the supports and services necessary to
achieve the desired outcomes identified by the applicant or individual
and LAR and to ensure the applicant's or individual's health and safety;
and
(B) includes the setting for each service, which must
be selected by the individual or LAR from setting options.
(61) Performance contract--A written agreement between
HHSC and a LIDDA for the performance of delegated functions, including
those described in THSC §533A.035.
(62) Physical abuse--Any of the following:
(A) an act or failure to act performed knowingly, recklessly,
or intentionally, including incitement to act, that caused physical
injury or death to an individual or placed an individual at risk of
physical injury or death;
(B) an act of inappropriate or excessive force or corporal
punishment, regardless of whether the act results in a physical injury
to an individual;
(C) the use of a restraint on an individual not in
compliance with federal and state laws, rules, and regulations; or
(D) seclusion.
(63) Platform--This term has the meaning set forth
in Texas Government Code §531.001(4-d).
(64) Post-move monitoring visit--A visit conducted
by the service coordinator in accordance with the Intellectual and
Developmental Disability Preadmission Screening and Resident Review
(IDD-PASRR) Handbook.
(65) Pre-move site review--A review conducted by the
service coordinator in accordance with HHSC's IDD PASRR Handbook.
(66) Professional therapies--Services that consist
of the following:
(A) audiology services;
(B) behavioral support;
(C) dietary services;
(D) occupational therapy services;
(E) physical therapy services; and
(F) speech and language pathology.
(67) Program provider--A person, as defined in 40 TAC
§49.102 (relating to Definitions), that has a contract with HHSC
to provide TxHmL Program services, excluding an FMSA.
(68) Provisional contract--A contract that HHSC enters
into with a program provider in accordance with 40 TAC §49.208
(relating to Provisional Contract Application Approval) that has a
term of no more than three years, not including any extension agreed
to in accordance with 40 TAC §49.208(e).
(69) Related condition--A severe and chronic disability
that:
(A) is attributed to:
(i) cerebral palsy or epilepsy; or
(ii) any other condition, other than mental illness,
found to be closely related to an intellectual disability because
the condition results in impairment of general intellectual functioning
or adaptive behavior similar to that of individuals with an intellectual
disability, and requires treatment or services similar to those required
for individuals with an intellectual disability;
(B) is manifested before the individual reaches age
22;
(C) is likely to continue indefinitely; and
(D) results in substantial functional limitation in
at least three of the following areas of major life activity:
(i) self-care;
(ii) understanding and use of language;
(iii) learning;
(iv) mobility;
(v) self-direction; and
Cont'd... |
