26 Tex. Admin. Code § 331.5 - Definitions
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.
Notes
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