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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 566TEXAS HOME LIVING (TXHML) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS
RULE §566.3Definitions

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) Actual harm--A negative outcome that compromises an individual's physical, mental, or emotional well-being but does not constitute immediate threat.

  (3) ADLs--Activities of daily living. Basic personal everyday activities including tasks such as eating, toileting, grooming, dressing, bathing, and transferring.

  (4) 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.

  (5) Alleged perpetrator--A person alleged to have committed an act of abuse, neglect, or exploitation of an individual.

  (6) Applicant--A Texas resident seeking services in the TxHmL Program.

  (7) Business day--Any day except a Saturday, a Sunday, or a national or state holiday listed in Texas Government Code §662.003(a) or (b).

  (8) Calendar day--Any day, including weekends and holidays.

  (9) CDS option--Consumer directed services option. A service delivery option as defined in §41.103 of this title (relating to Definitions).

  (10) CFC--Community First Choice.

  (11) 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.

  (12) 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.

  (13) 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.

  (14) 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.

  (15) 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.

  (16) 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.

  (17) 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.

  (18) 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.

  (19) Competitive employment--Employment that pays an individual at least minimum wage if the individual is not self-employed.

  (20) Contract--A provisional contract or a standard contract.

  (21) 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.

  (22) Critical incident--An event listed in the TxHmL Provider User Guide found at www.hhsc.state.tx.us.

  (23) Critical violation--A violation for which HHSC may assess an administrative penalty before giving a program provider an opportunity to correct the violation and that:

    (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.

  (24) DADS--HHSC.

  (25) Department of Assistive and Rehabilitative Services--The Texas Workforce Commission.

  (26) DFPS--The Department of Family and Protective Services.

  (27) 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.

  (28) 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.

  (29) 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.

  (30) Follow-up survey--A review by HHSC of a program provider to determine if the program provider has completed corrective action.

  (31) 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.

  (32) Good cause--As used in §9.578 of this subchapter, (relating to Program Provider Certification Principles: Service Delivery), a reason outside the control of the CFC ERS provider, as determined by HHSC.

  (33) 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.

  (34) 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.

  (35) HHSC--The Texas Health and Human Services Commission.

  (36) 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.

  (37) ICAP--Inventory for Client and Agency Planning.

Cont'd...

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