The following words and terms, when used in this subchapter,
have the following meanings, unless the context clearly indicates
otherwise:
(1) Actively involved person--For an individual who
lacks the ability to provide legally adequate consent and who does
not have a legally authorized representative (LAR), a person whose
significant and ongoing involvement with the individual is determined
by the individual's designated MRA to be supportive of the individual
based on the person's:
(A) observed interactions with the individual;
(B) knowledge of and sensitivity to the individual's
preferences, values, and beliefs;
(C) availability to the individual for assistance or
support; and
(D) advocacy for the individual's preferences, values,
and beliefs.
(2) CARE--DADS Client Assignment and Registration System.
(3) CFC services--Community First Choice services.
State plan services described in 1 Texas Administrative Code (TAC)
Chapter 354, Subchapter A, Division 27 (relating to Community First
Choice).
(4) DADS--The Department of Aging and Disability Services.
(5) Department--The Department of Aging and Disability
Services.
(6) Designated LIDDA--As identified in DADS data system,
the LIDDA responsible for assisting an individual and LAR or actively
involved person to access services and supports.
(7) Designated MRA--Designated LIDDA.
(8) Duration--The specified period of time during which
service coordination is provided to an individual.
(9) Frequency--The minimum number of times during a
specified period that an individual is to be contacted by a service
coordinator based on the individual's need for contacts as determined
by person-directed planning.
(10) General revenue--Funds appropriated by the Texas
Legislature for use by DADS.
(11) HCS Program--The Home and Community-based Services
Program. A program operated by DADS as authorized by the Centers for
Medicare and Medicaid Services in accordance with §1915(c) of
the Social Security Act.
(12) 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.
(13) ICF/IID level-of-care--A level-of-care described
in §9.238 of this title (relating to ICF/MR Level of Care I Criteria)
or §9.239 of this title (relating to ICF/MR Level of Care VIII
Criteria).
(14) ICF/IID Program--The Intermediate Care Facilities
for Individuals with an Intellectual Disability or Related Conditions
Program. A program operated by DADS that provides Medicaid-funded
residential services to individuals with an intellectual disability
or related conditions, as described in §1905(d) of the Social
Security Act.
(15) ICF/MR--ICF/IID.
(16) ICF/MR Program--ICF/IID Program.
(17) Individual--A person who is or is believed to
be a member of the LIDDA priority population.
(18) Institution--One of the following:
(A) an ICF/IID;
(B) a nursing facility;
(C) an assisted living facility licensed or subject
to being licensed in accordance with THSC, Chapter 247;
(D) a residential child-care operation licensed or
subject to being licensed by the Department of Family and Protective
Services unless it is a foster family home or a foster group home;
(E) a facility licensed or subject to being licensed
by the Department of State Health Services;
(F) a facility operated by the Department of Assistive
and Rehabilitative Services; or
(G) a prison.
(19) Institution for mental diseases (IMD)--As defined
in 25 TAC §419.373, a hospital of more than 16 beds that is primarily
engaged in providing psychiatric diagnosis, treatment, and care of
individuals with mental diseases, including medical care, nursing
care, and related services.
(20) Intellectual disability--Consistent with Texas
Health and Safety Code (THSC), §591.003, significantly subaverage
general intellectual functioning existing concurrently with deficits
in adaptive behavior and manifested during the developmental period.
(21) 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 who may be a parent, guardian,
or managing conservator of a child, or the guardian of an adult.
(22) LIDDA--Local intellectual and developmental disability
authority. An entity designated by the executive commissioner of the
Texas Health and Human Services Commission in accordance with THSC, §533A.035.
(23) LIDDA priority population--A population as defined
in §5.153 of this title (relating to Definitions).
(24) Local service area--A geographic area composed
of one or more Texas counties.
(25) MCO--Managed care organization. This term has
the meaning set forth in Texas Government Code, §536.001.
(26) Mental retardation--Intellectual disability.
(27) Mental retardation priority population or MR priority
population--LIDDA priority population.
(28) MRA (mental retardation authority)--LIDDA.
(29) Parent Case Management Program--A program that
utilizes experienced, trained parents of individuals with disabilities
to provide case management for other families.
(30) Partners in Policy Making--A leadership training
program administered by the Texas Planning Council for Developmental
Disabilities for self-advocates and parents.
(31) 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.
(32) Person-directed planning--A philosophy and planning
process that empowers an individual and, on the individual's behalf,
an LAR or actively involved person, to direct the development of a
plan of services and supports.
(33) Plan of services and supports--A written plan
that:
(A) describes the desired outcomes identified by the
individual, or LAR or actively involved person on behalf of the individual;
(B) describes the services and supports to be provided
to the individual, including service coordination; and
(C) identifies the frequency, in accordance with §2.556(d)(1)
of this subchapter (relating to LIDDA's Responsibilities), and duration
of service coordination to be provided to the individual.
(34) Related condition--Consistent with Code of Federal
Regulations, Title 42, §435.1010, a severe and chronic disability
that:
(A) is attributable 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 persons with an intellectual
disability, and requires treatment or services similar to those required
for those persons with an intellectual disability;
(B) is manifested before the person reaches 22 years
of age;
(C) is likely to continue indefinitely; and
(D) results in substantial functional limitation in
three or more 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
(vi) capacity for independent living.
(35) Relative--A person related to the individual within
the fourth degree of consanguinity or within the second degree of
affinity.
(36) Service coordination--Assistance in accessing
medical, social, educational, and other appropriate services and supports
that will help an individual achieve a quality of life and community
participation acceptable to the individual (and LAR on the individual's
behalf) as follows:
(A) crisis prevention and management--linking and assisting
the individual and LAR or actively involved person to secure services
and supports that will enable them to prevent or manage a crisis;
(B) monitoring--ensuring that the individual receives
needed services, evaluating the effectiveness and adequacy of services,
and determining if identified outcomes are meeting the individual's
needs and desires as indicated by the individual and LAR or actively
involved person;
(C) assessment--identifying the individual's needs
and the services and supports that address those needs as they relate
to the nature of the individual's presenting problem and disability;
and
(D) service planning and coordination--identifying,
arranging, advocating, collaborating with other agencies, and linking
for the delivery of outcome-focused services and supports that address
the individual's needs and desires as indicated by the individual
and LAR or actively involved person.
(37) State MH facility (state mental health facility)--A
state hospital or state center with an inpatient psychiatric component
operated by the Department of State Health Services.
(38) State supported living center--A state-supported
and structured residential facility that is an ICF/IID operated by
DADS to provide persons with an intellectual disability a variety
of services, including medical treatment, specialized therapy, and
training in the acquisition of personal, social, and vocational skills,
but does not include a community-based facility owned by DADS.
(39) Subaverage general intellectual functioning--Consistent
with THSC, §591.003, measured intelligence on standardized general
intelligence tests of two or more standard deviations (not including
standard error of measurement adjustments) below the age-group mean
for the tests used.
(40) THSC--Texas Health and Safety Code.
(41) TxHmL Program--The Texas Home Living Program.
A program operated by DADS as authorized by the Centers for Medicare
and Medicaid Services in accordance with §1915(c) of the Social
Security Act.
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| Source Note: The provisions of this §2.553 adopted to be effective August 31, 2004, 29 TexReg 8313; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective August 1, 2005, 30 TexReg 4334; amended to be effective June 1, 2010, 35 TexReg 4439; amended to be effective March 20, 2016, 41 TexReg 1864 |
