The following words and terms, when used in this subchapter,
have the following meanings, unless the context clearly indicates
otherwise:
(1) Abuse--Considered to be:
(A) physical abuse;
(B) sexual abuse; or
(C) verbal or emotional abuse.
(2) Actively involved--Significant, ongoing, and supportive
involvement with an applicant or individual by a person, as determined
by the applicant's or individual's service planning team or program
provider, based on the person's:
(A) interactions with the applicant or individual;
(B) availability to the applicant or individual for
assistance or support when needed; and
(C) knowledge of, sensitivity to, and advocacy for
the applicant's or individual's needs, preferences, values, and beliefs.
(3) Activities of daily living (ADL)--Basic personal
everyday activities, including tasks such as eating, toileting, grooming,
dressing, bathing, and transferring.
(4) Actual harm--A negative outcome that compromises
an individual's physical, mental, or emotional well-being but does
not constitute an immediate threat.
(5) Alarm call--A signal transmitted from an individual's
Community First Choice (CFC) emergency response services (ERS) equipment
to the CFC ERS response center indicating that the individual needs
immediate assistance.
(6) Alleged perpetrator--A person alleged to have committed
an act of abuse, neglect, or exploitation of an individual.
(7) Applicant--A Texas resident seeking services in
the Home and Community-based Services (HCS) Program.
(8) Behavioral emergency--A situation in which an individual's
severely aggressive, destructive, violent, or self-injurious behavior:
(A) poses a substantial risk of imminent probable death
of, or substantial bodily harm to, the individual or others;
(B) has not abated in response to preventive de-escalatory
or redirection techniques;
(C) is not addressed in a written behavior support
plan; and
(D) does not occur during a medical or dental procedure.
(9) Business day--Any day except a Saturday, Sunday,
or national or state holiday listed in Texas Government Code §662.003(a)
or (b).
(10) Calendar day--Any day, including weekends and
holidays.
(11) Centers for Medicare and Medicaid Services (CMS)--The
federal agency within the United States Department of Health and Human
Services that administers the Medicare and Medicaid programs.
(12) Certification standard--A minimum standard for
a program provider used by the Texas Health and Human Services Commission
(HHSC) during a survey to ensure health and safety of an individual.
Violations of a certification principle or standard are subject to
administrative penalties.
(13) CFC--Community First Choice.
(14) CFC emergency response services (CFC ERS)--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.
(15) 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.
(16) CFC Financial management services (CFC FMS)--The
term used for FMS on the individual plan of care (IPC) of an applicant
or individual if the applicant or individual receives only CFC personal
assistance services/habilitation (PAS/HAB) through the CDS option.
(17) CFC personal assistance services/habilitation
(CFC PAS/HAB). A service that:
(A) consists of:
(i) personal assistance services that aid an individual
in performing ADLs and instrumental activities of daily living (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
as 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 aids 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.
(18) 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.
(19) 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.
(20) 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.
(21) Cognitive rehabilitation therapy--A service that:
(A) assists an individual in learning or relearning
cognitive skills that have been lost or altered because of damage
to brain cells or brain chemistry in order to enable the individual
to compensate for lost cognitive functions; and
(B) includes reinforcing, strengthening, or reestablishing
previously learned patterns of behavior, or establishing new patterns
of cognitive activity or compensatory mechanisms for impaired neurological
systems.
(22) Community resource coordination group (CRCG)--A
local interagency group composed of public and private agencies that
develops service plans for individuals whose needs can be met only
through interagency coordination and cooperation. The group's role
and responsibilities are described in the Memorandum of Understanding
on Coordinated Services to Persons Needing Services from More Than
One Agency, which is available on the HHSC website.
(23) Competitive employment--Employment that pays an
individual at least minimum wage if the individual is not self-employed.
(24) Consumer directed services option (CDS option)--A
service delivery option in which an individual or legally authorized
representative employs and retains service providers and directs the
delivery of program services.
(25) Contract--A provisional contract or a standard
contract.
(26) 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.
(27) Critical incident--An event listed in the HCS Provider User Guide found on the HHSC
website.
(28) Critical violation--A violation for which HHSC
may assess an administrative penalty before giving a program provider
an opportunity to correct the violation. A critical violation:
(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
Cont'd... |
