26 Tex. Admin. Code § 263.2001 - Definitions
The following words and terms, when used in this subchapter, have the following meanings unless the context clearly indicates otherwise.
(1) Applicant--A Texas
resident seeking services in the Home and Community-based Services (HCS)
Program.
(2) Calendar day--Any day,
including weekends and holidays.
(3) CFC--Community First Choice. A state plan
option governed by Code of Federal Regulations, Title 42, Chapter 441, Subpart
K, regarding Home and Community-Based Attendant Services and Supports State
Plan Option (Community First Choice).
(4) CFC PAS/HAB--CFC personal assistance
services/habilitation.
(5)
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.
(6)
Community setting--A setting accessible to the general public within an
individual's community.
(7) Day
habilitation--An HCS Program service that provides assistance with acquiring,
retaining, or improving self-help, socialization, and adaptive skills provided
in a location other than the residence of an individual.
(8) DFPS--The Department of Family and
Protective Services.
(9) HCS
Program--The Home and Community-based Services Program.
(10) HHSC--The Texas Health and Human
Services Commission.
(11)
Hospital--A public or private institution licensed or exempt from licensure in
accordance with Texas Health and Safety Code (THSC) Chapters 13, 241, 261, or
552.
(12) ICAP--Inventory for
Client and Agency Planning.
(13)
ID/RC Assessment--Intellectual Disability/Related Conditions Assessment. A form
used by HHSC for level of care determination and level of need
assignment.
(14) Implementation
plan--A written document developed by a program provider for an individual
that, for each HCS Program service and CFC service on the individual's
individual plan of care (IPC) to be provided by the program provider, except
for supported home living and CFC support management, includes:
(A) a list of outcomes identified in the
person-directed plan that will be addressed using HCS Program services and CFC
services;
(B) specific objectives
to address the outcomes required by subparagraph (A) of this paragraph that
are:
(i) observable, measurable, and
outcome-oriented; and
(ii) derived
from assessments of the individual's strengths, personal goals, and
needs;
(C) a target date
for completion of each objective;
(D) the number of units of HCS Program
services and CFC services needed to complete each objective;
(E) the frequency and duration of HCS Program
services and CFC services needed to complete each objective; and
(F) the signature and date of the individual,
legally authorized representative, and the program provider.
(15) Individual--A person enrolled
in the HCS Program.
(16)
Individualized skills and socialization provider--A legal entity licensed in
accordance with Chapter 559, Subchapter H of this title (relating to
Individualized Skills and Socialization Provider Requirements).
(17) Initial IPC--The first IPC for an
individual developed before the individual's enrollment into the HCS
Program.
(18) IPC--Individual plan
of care. A written plan that:
(A) states:
(i) the type and amount of each HCS Program
service and each CFC service, except for CFC support management, to be provided
to the individual during an IPC year;
(ii) the services and supports to be provided
to the individual through resources other than HCS 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.
(19) 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.
(20) LAR--Legally authorized representative.
A person authorized by law to act on behalf of another person with regard to a
matter described in this chapter, 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.
(21) 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.
(22) LON--Level of need. An assignment given
by HHSC to an individual upon which reimbursement for certain services is
based.
(23) 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.
(24) Nursing facility--A facility licensed in
accordance with THSC Chapter 242.
(25) PDP--Person-directed plan. A plan
developed using an HHSC form that 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.
(26) Program provider--A person, as defined
in 40 TAC §
49.102(relating to Definitions),
that has a contract with HHSC to provide HCS Program services, excluding a
financial management services agency.
(27) Renewal IPC--An IPC developed for an
individual in accordance with the rules governing the HCS Program.
(28) Revised IPC--An initial IPC or a renewal
IPC that is revised during an IPC year in accordance with the rules governing
the HCS Program to add a new HCS Program service or CFC service or change the
amount of an existing service.
(29)
Service coordinator--An employee of a local intellectual and developmental
disability authority who provides service coordination to an
individual.
(30) Service
provider--A person who directly provides an HCS Program service or CFC service
to an individual.
(31) TAC--Texas
Administrative Code. A compilation of state agency rules published by the Texas
Secretary of State in accordance with Texas Government Code, Chapter 2002,
Subchapter C.
Notes
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