Texas Administrative Code › Title 40 - SOCIAL SERVICES AND ASSISTANCE › Part 1 - DEPARTMENT OF AGING AND DISABILITY SERVICES › Chapter 48 - COMMUNITY CARE FOR AGED AND DISABLED › Subchapter A - DEFINITIONS › Section 48.1201 - Definitions of Program Terms

Current through Reg. 49, No. 28; July 12, 2024
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.