40 Tex. Admin. Code § 2.253 - Definitions
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
(1) Actively
involved--Significant and ongoing involvement with the individual who does not
have the ability to provide legally adequate consent and who does not have an
LAR which the individual's planning team deems to be supportive based on the
following:
(A) observed interactions of the
person with the individual;
(B)
advocacy for the individual;
(C)
knowledge of and sensitivity to the individual's preferences, values and
beliefs; and
(D) availability to
the individual for assistance or support when needed.
(2) Applicant--An individual seeking
residential services in a state MR facility.
(3) CARE--DADS' Client Assignment and
Registration System, a database with demographic and other data about an
individual who is receiving services and supports or on whose behalf services
and supports have been requested.
(4) CLOIP--Community living options
information process. The activities described in §
2.274(a)(2) of
this subchapter (relating to Consideration of Living Options for Individuals
Residing in State MR Facilities) performed by a contract MRA to provide
information and education about community living options to an individual who
is 22 years of age or older residing in a state MR facility or to the
individual's LAR.
(5)
Commissioner--The commissioner of DADS.
(6) Consensus--A negotiated agreement that
all parties can and will support in implementation. The negotiation process
involves the open discussion of ideas with all parties encouraged to express
opinions.
(7) Contract MRA--An MRA
that has a contract with DADS to conduct the CLOIP.
(8) CRCG (Community Resource Coordination
Group)--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, available on the Health and
Human Services Commission website at
www.hhsc.state.tx.us/crcg/crcg.htm.
(9) DADS--The Department of Aging and
Disability Services.
(10) Dangerous
behavior--Behavior exhibited by an individual who is physically aggressive,
self-injurious, sexually aggressive, or seriously disruptive and requires a
written behavioral intervention plan to prevent or reduce serious physical
injury to the individual or others.
(11) Department--Department of Aging and
Disability Services.
(12)
Designated MRA--The MRA assigned to an individual in CARE.
(13) Discharge--The release by DADS of an
individual voluntarily admitted or committed by court order for residential
mental retardation services from the custody and care of a state MR facility
and termination of the individual's assignment to the state MR facility in
CARE.
(14) Emergency
admission/discharge agreement--A written agreement between the state MR
facility, the individual or LAR, and the designated MRA, sample copies of which
are available from the Department of Aging and Disability Services, Provider
Services Division, State Mental Retardation Facilities Section, P.O. Box
149030, Mail Code W-511, Austin, Texas 78714-9030, that describes:
(A) the purpose of the emergency admission,
including the circumstances that precipitated the need for the admission and
the expected outcomes from the admission;
(B) the responsibilities of each party
regarding the care, treatment, and discharge of the individual, including how
the terms of the agreement will be monitored;
(C) the length of time of the emergency
admission, which is that amount of time necessary to accomplish the purpose of
the admission; and
(D) the
anticipated date of discharge.
(15) Facility of record--The facility that
serves the local service area(s) assigned to the individual's designated
MRA.
(16) Family-based
alternative--A family setting in which the family provider or providers are
specially trained to provide support and in-home care for children with
disabilities or children who are medically fragile.
(17) Head of the facility--The superintendent
or director of a state MR facility.
(18) ICAP (Inventory for Client and Agency
Planning)--A validated, standardized assessment that measures the level of
supervision an individual requires and, thus, the amount and intensity of
services and supports the individual needs.
(19) ICAP service level--A designation that
identifies the level of services needed by an individual as determined by the
ICAP.
(20) IDT (Interdisciplinary
team)--Mental retardation professionals and paraprofessionals and other
concerned persons, as appropriate, who assess an individual's treatment,
training, and habilitation needs and make recommendations for services,
including recommendations of whether the individual is best served in a
facility or in a community setting.
(A) Team
membership always includes:
(i) the
individual;
(ii) the individual's
LAR, if any; and
(iii) persons
specified by an MRA or a state MR facility, as appropriate, who are
professionally qualified and/or certified or licensed with special training and
experience in the diagnosis, management, needs, and treatment of individuals
with mental retardation.
(B) Other participants in IDT meetings may
include:
(i) other concerned persons whose
inclusion is requested by the individual or the LAR;
(ii) at the discretion of the MRA or state MR
facility, persons who are directly involved in the delivery of mental
retardation services to the individual; and
(iii) if the individual is school eligible,
representatives of the appropriate school district.
(21) Individual--A person who has
or is believed to have mental retardation.
(22) Interstate transfer--The admission of an
individual to a state MR facility directly from a similar facility in another
state.
(23) IQ (intelligence
quotient)--A score reflecting the level of an individual's intelligence as
determined by the administration of a standardized intelligence test.
(24) 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 may include a parent,
guardian, or managing conservator of a minor, or the guardian of an
adult.
(25) Legally adequate
consent--Consent given by a person when each of the following conditions has
been met:
(A) legal status: The individual
giving the consent:
(i) is 18 years of age or
older, or younger than 18 years of age and is or has been married or had his or
her disabilities removed for general purposes by court order as described in
the Texas Family Code, Chapter 31; and
(ii) has not been determined by a court to
lack capacity to make decisions with regard to the matter for which consent is
being sought;
(B)
comprehension of information: The individual giving the consent has been
informed of and comprehends the nature, purpose, consequences, risks, and
benefits of and alternatives to the procedure, and the fact that withholding or
withdrawal of consent shall not prejudice the future provision of care and
services to the individual with mental retardation; and
(C) voluntariness: The consent has been given
voluntarily and free from coercion and undue influence.
(26) Less restrictive setting--A setting
which allows the greatest opportunity for the individual to be integrated into
the community.
(27) Local service
area--A geographic area composed of one or more Texas counties delimiting the
population which may receive services from a local MRA.
(28) Mental retardation--Consistent with
THSC, §591.003, significantly subaverage general intellectual functioning
existing concurrently with deficits in adaptive behavior and manifested during
the developmental period.
(29)
Minor--An individual under the age of 18.
(30) MRA (mental retardation authority)--An
entity to which the Health and Human Services Commission's authority and
responsibility described in THSC, §531.002(11) has been
delegated.
(31) Natural support
network--Those persons, including family members, church members, neighbors,
and friends, who assist and sustain an individual with supports that occur
naturally within the individual's environment and that are not reimbursed or
purposely developed by a person or system.
(32) Ombudsman--Consistent with THSC,
§533.039, an employee of DADS who is responsible for assisting an
individual or LAR if the individual is denied a service by DADS, a DADS program
or facility, or an MRA. The ombudsman must explain and provide information on
DADS and MRA services, facilities, and programs, and the rules, procedures, and
guidelines applicable to the individual denied services, and assist the
individual in gaining access to an appropriate program or in placing the
individual on an appropriate waiting list.
(33) 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.
(34) Planning team--A
group organized by the MRA and composed of:
(A) the individual;
(B) the individual's legally authorized
representative (LAR), if any;
(C)
actively-involved family members or friends of the individual who has neither
the ability to provide legally adequate consent nor an LAR;
(D) other concerned persons whose inclusion
is requested by the individual with the ability to provide legally adequate
consent or the LAR;
(E) a
representative from the designated MRA; and
(F) a representative from the individual's
provider.
(35)
PMRA--Persons with Mental Retardation Act, Texas Health and Safety Code, Title
7, Subtitle D.
(36) Provider--A
public or private entity that delivers community-based residential services and
supports for individuals, including, but not limited to, an intermediate care
facility for individuals with mental retardation (ICF/MR) or a nursing
facility. The term also includes a public or private entity that provides
waiver services.
(37) Related
services--Services for school eligible individuals as described in 19 TAC
§ 89.1060(relating to Definitions of Certain Related Services).
(38) Respite admission/discharge agreement--A
written agreement between the state MR facility, the individual or LAR, and
MRA, sample copies of which are available from the Department of Aging and
Disability Services, Provider Services Division, State Mental Retardation
Facilities Section, P.O. Box 149030, Mail Code W-511, Austin, Texas 78714-9030,
that describes:
(A) the purpose of the
respite admission including the circumstances that precipitated the need for
the admission and the expected outcomes from the admission;
(B) the length of time the individual will
receive respite services from the state MR facility; and
(C) the responsibilities of each party
regarding the care, treatment, and discharge of the individual.
(39) School eligible--A term
describing those individuals between the ages of three and 22 who are eligible
for public education services.
(40)
Service delivery system--All facility and community-based services and supports
operated or contracted for by DADS.
(41) Services and supports--Programs and
assistance for persons with mental retardation that may include a determination
of mental retardation, interdisciplinary team recommendations, education,
special training, supervision, care, treatment, rehabilitation, residential
care, and counseling, but does not include those services or programs that have
been explicitly delegated by law to other state agencies.
(42) Significantly 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.
(43) State MH facility (state mental health
facility)--A state hospital.
(44)
State MR facility (state mental retardation facility)--A state school or a
state center with a mental retardation residential component.
(45) State MR facility living options
instrument--A written document used to guide the discussion of living options
during a planning meeting that results in a recommendation by the IDT of
whether the individual should remain in the current living arrangement at the
state MR facility or move to an alternative living arrangement.
(46) THSC--Texas Health and Safety
Code.
(47) Waiver services--Home
and community-based services provided through a Medicaid waiver program
approved by Centers for Medicare and Medicaid Services (CMS) as described in
§1915(c) of the Social Security Act.
Notes
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