40 Tex. Admin. Code § 48.1201 - Definitions of Program Terms
The following words and terms have the following meanings when used in these sections, unless the context clearly indicates otherwise:
(1) Abuse--The willful
infliction of injury, unreasonable confinement, intimidation, or cruel
punishment with resulting physical harm, pain, or mental anguish; or the
willful deprivation by a caretaker or one's self of goods or services which are
necessary to avoid physical harm, mental anguish, or mental illness. (Chapter
48, Human Resources Code)
(2)
Activities of daily living (ADL)--Activities that are essential to daily
self-care; including bathing, dressing, grooming, toileting, housekeeping,
shopping, meal preparation, and others.
(3) Adult--A person 18 or older, or an
emancipated minor.
(4) Aged or
elderly person--A person 65 or older.
(5) Applicant--A person initially requesting
services.
(6) Attendant--A person
who is employed by a provider agency to give personal care or housekeeping
services or both to an eligible family care or primary home care client,
according to a service plan.
(7)
Caregiver--A relative, guardian, representative payee, or person who has
contact with the client that is frequent enough or regularly scheduled enough
that a personal relationship exists or the client perceives that person as
having a role in helping the client to meet basic needs.
(8) Caregiver support--An interval of rest or
relief from caregiving duties given to or arranged for the caregiver of a DHS
client.
(9) Client--A person
determined eligible for Community Care for the Aged and Disabled (CCAD)
services.
(10) Community
care--Services provided within the client's own home, neighborhood, or
community, as alternatives to institutional care. Community care is sometimes
called alternate care.
(11)
Controlling interest--An owner who is a sole proprietor, a partner owning 5.0%
or more of the partnership, or a corporate stockholder owning 5.0% or more of
the outstanding stock of the contracted provider, or a member of the board of
directors.
(12)
Disabled/incapacitated person--A person who, because of physical, mental, or
developmental impairment, is limited temporarily or permanently in his capacity
to adequately perform one or more essential activities of daily living, which
include, but are not limited to, personal and health care, moving around,
communicating, and housekeeping.
(13) Earned income--Cash or liquid resources
that a client receives for services he performs as an employee or as a result
of self-employment. All other income is unearned income.
(14) Emancipated minor--A person under 18 who
has the power and capacity of an adult. This includes a minor who has had the
disabilities of minority removed by a court of law or a minor who, with or
without parental consent, has been married. Marriage includes common-law
marriage.
(15) Emotional or verbal
abuse--Any use of verbal communication or other behavior to humiliate,
intimidate, vilify, degrade, or threaten with harm.
(16) Expedited response--A face-to-face
contact with an applicant by the caseworker within five calendar days of the
date of the applicant's request for services.
(17) Exploitation--The illegal or improper
act or process of a caregiver or others using an adult's income and resources
for monetary or personal benefit, profit, or gain.
(18) Facility--A legal entity that contracts
with the department to deliver to clients day services or 24-hour residential
services.
(19) Fraud--A deliberate
misrepresentation or intentional concealment of information in order to receive
or to be reimbursed for the delivery of services to which the individual is not
entitled.
(20) Functional need--An
individual's requirement for assistance with activities of daily living, caused
by a physical or mental limitation or disability.
(21) Immediate response--A face-to-face
contact with an applicant by the caseworker within 24 hours of the applicant's
request for services.
(22) Income
eligible (I.E.)--An adult who, although neither a Medicaid recipient nor a food
stamp head of household or spouse, nevertheless has income and resources equal
to or less than the eligibility level established by the department.
(23) Institution--A nursing home, an
intermediate care facility for the mentally retarded (ICF-MR), a state school,
or a state hospital.
(24) Liquid
resource--Cash or financial instruments that could be converted to cash within
20 workdays.
(25) Medicaid
eligible--An individual eligible for federal medical assistance as an SSI or
TANF client, or eligible for medical assistance only (MAO) in a nursing home or
while living in the community or through a federally approved waiver.
(26) Medicare eligible--An aged or disabled
person who is a recipient of Social Security or railroad retirement benefit
payments and meets eligibility criteria to have certain medical expenses paid
by the federal Medicare program.
(27) Neglect--The failure to provide for
one's self the goods or services which are necessary to avoid physical harm,
mental anguish, or mental illness; or the failure of a caretaker to provide the
goods or services. (Chapter 48, Human Resources Code)
(28) Personal leave--Any leave from a
residential care facility except for hospitalization or institutionalization. A
day of personal leave is any period of 24 consecutive hours.
(29) Prior approval--A regional nurse's
authorization that payment may be made to a provider agency, because a client
meets the medical criteria for the requested Medicaid service.
(30) Provider agency--An agency that has
contracted with DHS to provide the CCAD services that DHS has authorized for
eligible clients.
(31) Provisional
contract--A time-limited contract.
(32) Resource--Any cash or other liquid
assets or any real or personal property owned by an individual and spouse that
could be converted to cash to use for support and maintenance.
(33) Responder--A person who responds to an
emergency response services (ERS) call activated by a client. Responders may
include relatives, neighbors, volunteers, or staff of a sheriff's department,
police department, emergency medical service, or fire department.
(34) Sexual abuse--Sexual contact or conduct
which is without the voluntary, informed consent of the elderly or disabled
adult.
(35) Supplemental security
income (SSI)--Monthly payments made by the Social Security Administration (SSA)
to an aged or disabled individual who meets the requirements for public aid.
SSA determines eligibility for SSI.
(36) Support system--The network of family
members, close friends, and neighbors who are usually available and willing to
provide regular or occasional assistance to a person.
(37) Unearned income--Income received by a
client from sources other than self-employment or employee work
activities.
(38) Unmet need--A
requirement for assistance with activities of daily living that cannot be met
adequately on an ongoing basis by friends, relatives, volunteers, or service
agencies other than DHS.
(39)
Verbal referral--A referral made by the caseworker to the provider agency in
person or by telephone, no later than the first workday after the caseworker's
determination that the applicant meets the criteria for an expedited or
immediate response to a request for service, and needs immediate service
initiation.
Notes
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