Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 352 - COMPREHENSIVE REHABILITATION SERVICES › Section 352.5 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this subchapter,
				  have the following meanings for the Comprehensive Rehabilitation Services (CRS)
				  Program unless the context clearly indicates otherwise:
(1) Ancillary services--Goods and services
				that support core CRS services but are not primary interventions. Examples of
				ancillary services include supplies, medications, and transportation.
(2) Aquatic therapy--A type of therapy that
				involves an exercise method in water to improve a person's range of motion,
				flexibility, muscular strength and toning, cardiovascular endurance, fitness,
				and/or mobility.
(3) Art therapy--A
				type of therapy in which persons use art media, the creative process, and the
				resulting artwork to explore their feelings, reconcile emotional conflicts,
				foster self-awareness, manage behavior, develop social skills, improve reality
				orientation, reduce anxiety, and/or increase self-esteem.
(4) Audiological services--Evaluation and
				treatment of hearing, balance, or related disorders.
(5) Basic Living Requirements (BLR)--A
				framework for determining whether the consumer should pay any of the cost of
				services which considers the family's net monthly income, liquid assets, and
				expenses an eligible consumer can reasonably be expected to incur including but
				not limited to home mortgage or rent payments, prescribed diet or medicine
				expenses, and other medical or disability related expenses.
(6) Behavior management--A set of coordinated
				services that provide a person with specialized interventions designed to
				increase adaptive behaviors and to reduce maladaptive or socially unacceptable
				behaviors, up to and including violent dyscontrol, that prevent or interfere
				with the person's inclusion within the home environment and the
				community.
(7) Case
				management--Services that assist consumers in the planning, coordination,
				monitoring, and evaluation of services with emphasis on quality of care,
				continuity of services, and cost-effectiveness.
(8) Certified professional--A person with the
				knowledge, experience, and skills to perform a specific job who is paid for
				performing that job. The person's expertise is verified by a certificate earned
				by passing an exam that is accredited by an organization or association that
				monitors and upholds prescribed standards for the profession involved. Examples
				of certified professionals include a certified brain injury specialist,
				certified nursing assistant, certified medical assistant, certified medication
				aide, and certified nurse aide.
(9)
				Chemical dependency services--Planned services that are structured to help a
				person abstain from using drugs and/or alcohol. Services include identifying
				and changing behavior patterns that are maladaptive, destructive, or injurious
				to health and which are related to or result from substance-related disorders,
				and identifying and changing behavior patterns to restore appropriate levels of
				physical, psychological, and social functioning.
(10) Cognitive rehabilitation therapy
				(CRT)--A type of therapy that helps a person to learn or relearn cognitive
				skills that have been lost or altered due to a traumatic brain injury. Services
				will enable the person to compensate for lost cognitive functions and include
				reinforcing, strengthening, or reestablishing previously learned patterns of
				behavior, or establishing new patterns of cognitive activity or compensatory
				mechanisms for impaired neurological systems.
(11) Consumer participation--A monthly
				contribution the consumer (client) may be required to pay for participation in
				the Comprehensive Rehabilitation Services (CRS) Program.
(12) Core services--A set of fundamental
				services that are essential to rehabilitation of persons who have a traumatic
				brain injury or traumatic spinal cord injury or both. Specific core services
				are based on assessed individualized needs.
(13) CRS Program--Comprehensive
				Rehabilitation Services Program.
(14) Dietary and nutritional
				services--Services that develop a prescribed diet to meet basic or special
				therapeutic nutritional needs.
(15)
				Durable medical equipment and supplies--Equipment that provides therapeutic
				benefits to a person whose medical conditions require the equipment and
				supplies.
(16) Family and caregiver
				education and training services--Information that provides a foundation for
				relationships with a person who has a traumatic brain injury or traumatic
				spinal cord injury, or both.
(17)
				Family therapy--A specialized type of psychotherapy that helps families and
				caregivers in intimate relationships to nurture healing and
				development.
(18) Group therapy--A
				type of therapy with two or more persons in addition to a therapist who have a
				common therapeutic purpose or to achieve a common goal.
(19) Home modification--The use of assistive
				or adaptive equipment or devices that may be installed in a person's home to
				enable the person to perform household tasks. This equipment must be removable
				from the residence without causing permanent damage to the property. Examples
				include grab bars in bathrooms or portable ramps for persons who use
				wheelchairs or who have other mobility impairments.
(20) Interdisciplinary team (IDT)--A team of
				professionals that closely coordinates services to achieve treatment goals in
				order to minimize a consumer's physical or cognitive disabilities and to
				maximize functional capacity.
(21)
				Individual therapy--A collaborative process between a therapist and person that
				is intended to facilitate change and improve quality of life.
(22) Inpatient comprehensive medical
				rehabilitation--Services provided, as recommended by an interdisciplinary team
				in a hospital setting, to address medical and rehabilitation issues that
				require 24-hour-a-day nursing services. These services are available to people
				who have a traumatic brain injury or traumatic spinal cord injury, or
				both.
(23) Individualized written
				rehabilitation plan (IWRP)--A plan developed by CRS staff, which outlines the
				goals, services, and other aspects of service provision in the CRS Program. It
				may include elements of the individualized program plan developed by the
				provider and other members of the interdisciplinary team.
(24) Lawful permanent resident--Any person
				not a citizen of the United States who is residing in the United States per
				legally recognized and lawfully recorded documentation identifying them as
				such. A lawful permanent resident is also known as a "Permanent Resident
				Alien," "Resident Alien Permit Holder," and "Green Card Holder."
(25) Licensed professional--A person who has
				completed a prescribed program of study in a health field, and who has obtained
				a license indicating his or her competence to practice in that field. Examples
				of licensed professionals include a registered nurse, physician, and social
				worker.
(26) Limited
				skilled-nursing--Skilled-nursing for a limited time. This service involves
				providing or delegating personal care services and medication administration
				consistent with rules established by the Texas Board of Nursing; assessing a
				patient to determine the care required; and delivering temporary skilled
				nursing services for minor illness, injury, or emergency for a period not to
				exceed 30 days.
(27) Liquid
				assets--Cash and assets from savings or other accounts.
(28) Massage therapy--A type of therapy
				involving the manipulation of soft tissue by hand or through a mechanical or
				electrical apparatus for therapeutic purposes. Massage therapy constitutes a
				health care service if the massage therapy is for therapeutic
				purposes.
(29) Medical
				services--Services or supplies that are needed for the diagnosis or treatment
				of medical conditions.
(30) Mental
				restoration services--Limited or short term psychiatric services, including
				treatment and psychotherapy, for mental conditions that are stable or slowly
				progressive.
(31) Music therapy--A
				type of therapy using musical or rhythmic interventions to restore, maintain,
				or improve a person's social or emotional functioning, mental processing, or
				physical health.
(32) Net Monthly
				Income--Monthly take-home pay after taxes and other payroll
				deductions.
(33) Neuropsychological
				and neuropsychiatric services--A comprehensive battery of tests to evaluate
				neurocognitive, behavioral, and emotional strengths and weaknesses and their
				relationship to normal and abnormal central nervous system
				functioning.
(34) Occupational
				therapy--A type of therapy using evaluation and treatment to develop, recover,
				or maintain the daily living skills of persons who have a physical, mental,
				and/or cognitive disorder consistent with Occupational Therapy Practice Act,
				Occupations Code.
(35) Orthosis--A
				custom-fabricated or custom-fitted medical device designed to provide for the
				support, alignment, prevention, or correction of a neuromuscular or
				musculoskeletal disease, injury, or deformity, consistent with the Orthotics
				and Prosthetics Act, Occupations Code.
(36) Outpatient services--Medical treatment,
				without admittance to a hospital that corrects or modifies a stable or slowly
				progressive physical or mental impairment that constitutes a substantial
				impediment to independence. These services are available to people who have a
				traumatic brain injury or traumatic spinal cord injury, or both.
(37) Over-the-counter medication--Medication
				that can be obtained without a prescription.
(38) PABI--Post-acute brain injury--A brain
				injury at the post-acute stage, which is when the patient is medically stable
				and deemed ready to engage in intensive rehabilitation.
(39) Paraprofessional--A person to whom a
				particular aspect of a professional task is delegated, but who is not licensed
				as a fully qualified professional. A paraprofessional is qualified, through
				experience, training, or a combination thereof, to provide services.
				Paraprofessionals must have, at a minimum, a high school diploma or its
				equivalent.
(40) Personal
				assistance services--Services provided in a residential setting to a person who
				needs prompts and hands-on supports to participate in services. Services may
				include, but are not limited to, providing order, safety, and cleanliness
				assistance; assisting with medication or therapeutic regimens; preparing and
				serving meals; assisting with laundry; providing supervision and care to meet
				basic needs; and ensuring evacuation in case of an emergency.
(41) Personal attendant care
				services--Services provided in a home setting to persons with approved medical
				needs only, and only when provision of services in the home setting is
				necessary to enable the person to participate in CRS service arrays, which may
				include assistance with toileting routines, transferring, bathing, dressing,
				medications, meals, and activities of daily living.
(42) Physical restoration services--Services
				that correct or substantially modify, within a reasonable period of time, a
				physical condition that is stable or slowly progressive.
(43) Physical therapy--A type of therapy that
				prevents, identifies, corrects, or alleviates acute or prolonged movement
				dysfunction or pain of anatomical or physiological origin.
(44) Post-acute brain injury
				services--Services provided as recommended by an interdisciplinary team to
				address deficits in functional and cognitive skills based on individualized
				assessed needs. Services may include behavior management, the development of
				coping skills, and compensatory strategies. These services may be provided on a
				residential or non-residential basis.
(45) Post-acute rehabilitation
				services--Post-acute brain injury services and post-acute spinal cord injury
				services.
(46) Post-acute spinal
				cord injury services--Services provided as recommended by an interdisciplinary
				team to address deficits in functional skills based on individualized assessed
				needs. These services are provided in the home and in the community
				(non-residential settings).
(47)
				Prescription medication--A medicine that legally requires a medical
				prescription to be dispensed.
(48)
				Prosthesis--A custom-fabricated or custom-fitted medical device used to replace
				a missing limb, appendage, or other external human body part but that is not
				surgically implanted, consistent with the Orthotics and Prosthetics Act,
				Occupations Code. Accordingly, the term includes an artificial limb, hand, or
				foot.
(49) Provider--An entity
				under contract with DARS to provide Comprehensive Rehabilitation
				Services.
(50) Provider type--A
				term that refers to the types of service providers within the CRS Program,
				consisting of certified professionals, licensed professionals, and
				paraprofessionals.
(51) Rancho Los
				Amigos Levels of Cognitive Functioning Scale--A scale developed at the Rancho
				Los Amigos Hospital in Downey, California, that describes eight levels of
				post-brain injury cognitive function. At "Level IV - Confused/Agitated," the
				patient is in a heightened state of activity with severely decreased ability to
				process information. The patient is detached from the present and responds
				primarily to his or her own internal confusion and behavior is frequently
				bizarre and non-purposeful relative to the patient's immediate
				environment.
(52) Recreational
				therapy--A type of therapy involving recreational or leisure activities that
				assist in the restoration, remediation, or rehabilitation of a person's level
				of functioning and independence in life activities, and that promote health and
				wellness and reduce or eliminate the activity limitations associated with
				traumatic brain injury, traumatic spinal cord injury, or both.
(53) Rehabilitation technology--Equipment or
				technology designed to help persons with disabilities perform tasks that would
				otherwise require assistance.
(54)
				Room and board--Shelter, facilities and food, including the customary and usual
				diets in residential settings and prescribed nutritional meals or
				supplements.
(55) Service arrays--A
				set of services provided to eligible persons who have a traumatic brain injury,
				traumatic spinal cord injury, or both; services are based on assessed
				individualized rehabilitation needs that consist of outpatient services,
				inpatient comprehensive medical rehabilitation services, post-acute brain
				injury services, and post-acute spinal cord injury services.
(56) Speech-language pathology--The
				application of nonmedical principles, methods, and procedures for measurement,
				testing, evaluation, prediction, counseling, habilitation, rehabilitation, or
				instruction related to the development and disorders of communication,
				including speech, voice, language, oral pharyngeal function, or cognitive
				processes, for the purpose of evaluating, preventing, or modifying or offering
				to evaluate, prevent, or modify those disorders and conditions in an individual
				or a group, consistent with the Occupations Code.
(57) Texas resident--A person who lives in
				Texas as evidenced by one of the following unexpired documents: a Texas
				driver's license, an identification card with an address issued by a
				governmental entity, a utility bill with an address, a voter registration card,
				a vehicle registration receipt, or other document approved by the Department of
				Assistive and Rehabilitative Services.
(58) Third-party payer--A company,
				organization, insurer, or government agency other than DARS that makes payment
				for goods and services provided to a consumer.
(59) Transportation--Travel and related
				expenses.
(60) Traumatic brain
				injury (TBI)--An injury to the brain that is not degenerative or congenital;
				and caused by an external physical force, which may produce a diminished or
				altered state of consciousness, resulting in temporary or permanent impairment
				of cognitive abilities and/or physical functioning, and partial or total
				functional disability and/or psychosocial maladjustment.
(61) Traumatic spinal cord injury (SCI)--An
				acute, traumatic lesion of neural elements in the spinal canal resulting in any
				degree of temporary or permanent sensory or motor deficit, and/or bladder or
				bowel dysfunction.
(62) Vision
				services--A sequence of neurosensory and neuromuscular activities individually
				prescribed and monitored by the doctor to develop, rehabilitate, and enhance
				visual skills.