The following words and terms, when used in this subchapter,
have the following meanings for the Comprehensive Rehabilitation Services
(CRS) Program unless the context clearly indicates otherwise:
(1) Ancillary services--Goods and services that support
core CRS services but are not primary interventions. Examples of ancillary
services include supplies, medications, and transportation.
(2) Aquatic therapy--A type of therapy that involves
an exercise method in water to improve a person's range of motion,
flexibility, muscular strength and toning, cardiovascular endurance,
fitness, and/or mobility.
(3) Art therapy--A type of therapy in which persons
use art media, the creative process, and the resulting artwork to
explore their feelings, reconcile emotional conflicts, foster self-awareness,
manage behavior, develop social skills, improve reality orientation,
reduce anxiety, and/or increase self-esteem.
(4) Audiological services--Evaluation and treatment
of hearing, balance, or related disorders.
(5) Basic Living Requirements (BLR)--A framework for
determining whether the consumer should pay any of the cost of services
which considers the family's net monthly income, liquid assets, and
expenses an eligible consumer can reasonably be expected to incur
including but not limited to home mortgage or rent payments, prescribed
diet or medicine expenses, and other medical or disability related
(6) Behavior management--A set of coordinated services
that provide a person with specialized interventions designed to increase
adaptive behaviors and to reduce maladaptive or socially unacceptable
behaviors, up to and including violent dyscontrol, that prevent or
interfere with the person's inclusion within the home environment
and the community.
(7) Case management--Services that assist consumers
in the planning, coordination, monitoring, and evaluation of services
with emphasis on quality of care, continuity of services, and cost-effectiveness.
(8) Certified professional--A person with the knowledge,
experience, and skills to perform a specific job who is paid for performing
that job. The person's expertise is verified by a certificate earned
by passing an exam that is accredited by an organization or association
that monitors and upholds prescribed standards for the profession
involved. Examples of certified professionals include a certified
brain injury specialist, certified nursing assistant, certified medical
assistant, certified medication aide, and certified nurse aide.
(9) Chemical dependency services--Planned services
that are structured to help a person abstain from using drugs and/or
alcohol. Services include identifying and changing behavior patterns
that are maladaptive, destructive, or injurious to health and which
are related to or result from substance-related disorders, and identifying
and changing behavior patterns to restore appropriate levels of physical,
psychological, and social functioning.
(10) Cognitive rehabilitation therapy (CRT)--A type
of therapy that helps a person to learn or relearn cognitive skills
that have been lost or altered due to a traumatic brain injury. Services
will enable the person to compensate for lost cognitive functions
and include reinforcing, strengthening, or reestablishing previously
learned patterns of behavior, or establishing new patterns of cognitive
activity or compensatory mechanisms for impaired neurological systems.
(11) Consumer participation--A monthly contribution
the consumer (client) may be required to pay for participation in
the Comprehensive Rehabilitation Services (CRS) Program.
(12) Core services--A set of fundamental services
that are essential to rehabilitation of persons who have a traumatic
brain injury or traumatic spinal cord injury or both. Specific core
services are based on assessed individualized needs.
(13) CRS Program--Comprehensive Rehabilitation Services
(14) Dietary and nutritional services--Services that
develop a prescribed diet to meet basic or special therapeutic nutritional
(15) Durable medical equipment and supplies--Equipment
that provides therapeutic benefits to a person whose medical conditions
require the equipment and supplies.
(16) Family and caregiver education and training services--Information
that provides a foundation for relationships with a person who has
a traumatic brain injury or traumatic spinal cord injury, or both.
(17) Family therapy--A specialized type of psychotherapy
that helps families and caregivers in intimate relationships to nurture
healing and development.
(18) Group therapy--A type of therapy with two or more
persons in addition to a therapist who have a common therapeutic purpose
or to achieve a common goal.
(19) Home modification--The use of assistive or adaptive
equipment or devices that may be installed in a person's home to enable
the person to perform household tasks. This equipment must be removable
from the residence without causing permanent damage to the property.
Examples include grab bars in bathrooms or portable ramps for persons
who use wheelchairs or who have other mobility impairments.
(20) Interdisciplinary team (IDT)--A team of professionals
that closely coordinates services to achieve treatment goals in order
to minimize a consumer's physical or cognitive disabilities and to
maximize functional capacity.
(21) Individual therapy--A collaborative process between
a therapist and person that is intended to facilitate change and improve
quality of life.
(22) Inpatient comprehensive medical rehabilitation--Services
provided, as recommended by an interdisciplinary team in a hospital
setting, to address medical and rehabilitation issues that require
24-hour-a-day nursing services. These services are available to people
who have a traumatic brain injury or traumatic spinal cord injury,
(23) Individualized written rehabilitation plan (IWRP)--A
plan developed by CRS staff, which outlines the goals, services, and
other aspects of service provision in the CRS Program. It may include
elements of the individualized program plan developed by the provider
and other members of the interdisciplinary team.
(24) Lawful permanent resident--Any person not a citizen
of the United States who is residing in the United States per legally
recognized and lawfully recorded documentation identifying them as
such. A lawful permanent resident is also known as a "Permanent Resident
Alien," "Resident Alien Permit Holder," and "Green Card Holder."
(25) Licensed professional--A person who has completed
a prescribed program of study in a health field, and who has obtained
a license indicating his or her competence to practice in that field.
Examples of licensed professionals include a registered nurse, physician,
and social worker.
(26) Limited skilled-nursing--Skilled-nursing for a
limited time. This service involves providing or delegating personal
care services and medication administration consistent with rules
established by the Texas Board of Nursing; assessing a patient to
determine the care required; and delivering temporary skilled nursing
services for minor illness, injury, or emergency for a period not
to exceed 30 days.
(27) Liquid assets--Cash and assets from savings or
(28) Massage therapy--A type of therapy involving the
manipulation of soft tissue by hand or through a mechanical or electrical
apparatus for therapeutic purposes. Massage therapy constitutes a
health care service if the massage therapy is for therapeutic purposes.
(29) Medical services--Services or supplies that are
needed for the diagnosis or treatment of medical conditions.
(30) Mental restoration services--Limited or short
term psychiatric services, including treatment and psychotherapy,
for mental conditions that are stable or slowly progressive.
(31) Music therapy--A type of therapy using musical
or rhythmic interventions to restore, maintain, or improve a person's
social or emotional functioning, mental processing, or physical health.
(32) Net Monthly Income--Monthly take-home pay after
taxes and other payroll deductions.
(33) Neuropsychological and neuropsychiatric services--A
comprehensive battery of tests to evaluate neurocognitive, behavioral,
and emotional strengths and weaknesses and their relationship to normal
and abnormal central nervous system functioning.
(34) Occupational therapy--A type of therapy using
evaluation and treatment to develop, recover, or maintain the daily
living skills of persons who have a physical, mental, and/or cognitive
disorder consistent with Occupational Therapy Practice Act, Occupations
(35) Orthosis--A custom-fabricated or custom-fitted
medical device designed to provide for the support, alignment, prevention,
or correction of a neuromuscular or musculoskeletal disease, injury,
or deformity, consistent with the Orthotics and Prosthetics Act, Occupations
(36) Outpatient services--Medical treatment, without
admittance to a hospital that corrects or modifies a stable or slowly
progressive physical or mental impairment that constitutes a substantial
impediment to independence. These services are available to people
who have a traumatic brain injury or traumatic spinal cord injury,
(37) Over-the-counter medication--Medication that
can be obtained without a prescription.
(38) PABI--Post-acute brain injury--A brain injury
at the post-acute stage, which is when the patient is medically stable
and deemed ready to engage in intensive rehabilitation.
(39) Paraprofessional--A person to whom a particular
aspect of a professional task is delegated, but who is not licensed
as a fully qualified professional. A paraprofessional is qualified,
through experience, training, or a combination thereof, to provide
services. Paraprofessionals must have, at a minimum, a high school
diploma or its equivalent.
(40) Personal assistance services--Services provided
in a residential setting to a person who needs prompts and hands-on
supports to participate in services. Services may include, but are
not limited to, providing order, safety, and cleanliness assistance;
assisting with medication or therapeutic regimens; preparing and serving
meals; assisting with laundry; providing supervision and care to meet
basic needs; and ensuring evacuation in case of an emergency.
(41) Personal attendant care services--Services provided
in a home setting to persons with approved medical needs only, and
only when provision of services in the home setting is necessary to
enable the person to participate in CRS service arrays, which may
include assistance with toileting routines, transferring, bathing,
dressing, medications, meals, and activities of daily living.
(42) Physical restoration services--Services that
correct or substantially modify, within a reasonable period of time,
a physical condition that is stable or slowly progressive.
(43) Physical therapy--A type of therapy that prevents,
identifies, corrects, or alleviates acute or prolonged movement dysfunction
or pain of anatomical or physiological origin.
(44) Post-acute brain injury services--Services provided
as recommended by an interdisciplinary team to address deficits in
functional and cognitive skills based on individualized assessed needs.
Services may include behavior management, the development of coping
skills, and compensatory strategies. These services may be provided
on a residential or non-residential basis.
(45) Post-acute rehabilitation services--Post-acute
brain injury services and post-acute spinal cord injury services.
(46) Post-acute spinal cord injury services--Services
provided as recommended by an interdisciplinary team to address deficits
in functional skills based on individualized assessed needs. These
services are provided in the home and in the community (non-residential
(47) Prescription medication--A medicine that legally
requires a medical prescription to be dispensed.
(48) Prosthesis--A custom-fabricated or custom-fitted
medical device used to replace a missing limb, appendage, or other
external human body part but that is not surgically implanted, consistent
with the Orthotics and Prosthetics Act, Occupations Code. Accordingly,
the term includes an artificial limb, hand, or foot.
(49) Provider--An entity under contract with DARS to
provide Comprehensive Rehabilitation Services.
(50) Provider type--A term that refers to the types
of service providers within the CRS Program, consisting of certified
professionals, licensed professionals, and paraprofessionals.
(51) Rancho Los Amigos Levels of Cognitive Functioning
Scale--A scale developed at the Rancho Los Amigos Hospital in Downey,
California, that describes eight levels of post-brain injury cognitive
function. At "Level IV - Confused/Agitated," the patient is in a heightened
state of activity with severely decreased ability to process information.
The patient is detached from the present and responds primarily to
his or her own internal confusion and behavior is frequently bizarre
and non-purposeful relative to the patient's immediate environment.