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Rule §363.602 Definitions

Published: 2015

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The following words and terms when used in this subchapter
have the following meanings, unless the context clearly indicates
  (1) Activities of Daily Living (ADL)--Activities that
include, but are not limited to, eating, toileting, personal hygiene,
dressing, bathing, transferring, positioning, and locomotion or mobility.

  (2) Assessment--An evaluation conducted with the recipient
and responsible adult to determine the recipient's need for services.
  (3) Attendant--A person who provides direct care to
a recipient.
  (4) Consumer Directed Services (CDS)--A service delivery
option in which a recipient or legally authorized representative employs
and retains service providers and directs the delivery of program
  (5) Cueing--Indirect intervention provided during the
delivery of personal care services to prompt or instruct a recipient
with a cognitive impairment or behavioral condition in the performance
of ADLs or IADLs to ensure the recipient performs the task properly.
  (6) Delegation--Has the meaning assigned by 22 TAC §225.4
(relating to Definitions).
  (7) Dependents--Any member of a household, other than
the recipient, whose care and support is the legal responsibility
of the responsible adult. A dependent includes a disabled adult family
member living in the household. Care and support includes meeting
the medical, educational, and psychosocial needs of a dependent.
  (8) Early and Periodic Screening, Diagnosis, and Treatment
Comprehensive Care Program (EPSDT-CCP)--A mandatory Medicaid program
for individuals from birth through 20 years of age who meet certain
economic eligibility criteria. In Texas EPSDT-CCP is called the Texas
Health Steps Comprehensive Care Program (THSteps-CCP).
  (9) Financial Management Services (FMS)--Services delivered
by the Financial Management Services Agency to an employer such as
orientation, training, support, assistance with and approval of budgets,
and processing payroll and payables on behalf of the employer.
  (10) Financial Management Services Agency (FMSA)--An
entity that is certified by the Department of Aging and Disability
Services (DADS) and is contracted with HHSC and/or a Managed Care
Organization (MCO) to provide financial management services (FMS).
  (11) HHSC--The Health and Human Services Commission
or its designee.
  (12) Health Maintenance Activities (HMAs)--Has the
meaning assigned by 22 TAC §225.4 (relating to Definitions) and §225.8
(relating to Health Maintenance Activities Not Requiring Delegation).
  (13) Home and Community Support Services Agency (HCSSA)--A
public or private agency or organization that provides home and community
supports and is licensed under 40 TAC Chapter 97 (relating to Licensing
Standards for Home and Community Support Services Agencies).
  (14) Instrumental Activities of Daily Living (IADLs)--Activities
include, but are not limited to, meal preparation, grocery or household
shopping, light housework, laundry, telephone use or other communication,
escort or assistance with transportation services, medication assistance
and, money management.
  (15) Intervening--Direct contact or intervention provided
by an attendant during the delivery of personal care services to a
recipient with a physical or cognitive impairment in the performance
of ADLs or IADLs to ensure the task is performed properly.
  (16) Legally authorized representative (LAR)--A person
authorized or required by law to act on behalf of an individual with
regard to a matter described in this chapter, including a parent of
a minor, step-parent of a minor, guardian of a minor, managing conservator
of a minor, or the guardian of an adult.
  (17) Managed Care Organization (MCO)--Has the meaning
assigned by 1 TAC §353.2 (relating to Definitions).
  (18) Personal Care Services (PCS)--Support services
provided to a person eligible for THSteps-CCP services who requires
assistance with ADLs or IADLs due to physical, cognitive, or behavioral
limitations related to his or her disability or chronic health condition.

  (19) Practitioner--A person who is currently licensed
in a state in which the person practices as a physician, advanced
practice nurse, or physician assistant.
  (20) Practitioner's Statement of Need (PSON)--The document
certifying that the individual has a physical, cognitive, or behavioral
limitation related to a disability or chronic health condition.
  (21) Recipient--An individual who is eligible to receive
services through the medical assistance program.
  (22) Redirecting--Intervention provided during the
delivery of PCS to divert, change direction, or give new direction
to a recipient with a cognitive or behavioral impairment in the performance
of ADLs or IADLs to ensure the recipient completes the task.
  (23) Responsible Adult--An individual, age 18 or older,
who has agreed to accept responsibility for providing food, shelter,
clothing, education, nurturing, and supervision for the recipient.
The term includes biological parents, adoptive parents, step-parents,
foster parents, legal guardians, court-appointed managing conservators
or the primary adult who is acting in the role of parent.
  (24) Texas Health Steps Comprehensive Care Program
(THSteps-CCP)--Medical, dental, and treatment services available as
a federally mandated service for eligible EPSDT Medicaid recipients
in Texas under the age of 21 years, pursuant to the EPSDT provision
of Title XIX of the Social Security Act, 42 U.S.C. §1396d(r)
and the Code of Federal Regulations, Title 42, §440.40(b).

Source Note: The provisions of this §363.602 adopted to be effective September 1, 2014, 39 TexReg 5890