Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 263 - HOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) › Subchapter A - GENERAL PROVISIONS › Section 263.5 - Description of HCS Program Services

Current through Reg. 49, No. 28; July 12, 2024
(a) HCS Program
				  services are described in this section and in Appendix C of the HCS Program
				  waiver application approved by CMS and available on the HHSC website.
(1) Adaptive aids are devices, controls, or
				  items that are necessary to address specific needs identified in an
				  individual's service plan. Adaptive aids enable an individual to maintain or
				  increase the ability to perform ADLs or the ability to perceive, control, or
				  communicate with the environment in which the individual lives.
(2) Audiology is the provision of audiology
				  as defined in the Texas Occupations Code Chapter 401.
(3) Speech and language pathology is the
				  provision of speech-language pathology as defined in the Texas Occupations Code
				  Chapter 401.
(4) Occupational
				  therapy is the provision of occupational therapy as described in the Texas
				  Occupations Code Chapter 454.
(5)
				  Physical therapy is the provision of physical therapy as defined in the Texas
				  Occupations Code Chapter 453.
(6)
				  Dietary services are the provision of nutrition services as defined in the
				  Texas Occupations Code Chapter 701.
(7) Behavioral support is the provision of
				  specialized interventions that:
(A) assist an
				  individual to increase adaptive behaviors to replace or modify maladaptive or
				  socially unacceptable behaviors that prevent or interfere with the individual's
				  inclusion in home and family life or community life; and
(B) improve an individual's quality of
				  life.
(8) Social work is
				  the provision of social work as defined in Texas Occupations Code Chapter
				  505.
(9) Cognitive rehabilitation
				  therapy is assistance to an individual in learning or relearning cognitive
				  skills that have been lost or altered as a result of damage to brain
				  cells/chemistry in order to enable the individual to compensate for the lost
				  cognitive functions, including reinforcing, strengthening, or reestablishing
				  previously learned patterns of behavior, or establishing new patterns of
				  cognitive activity or compensatory mechanisms for impaired neurological
				  systems.
(10) Day habilitation is
				  assistance with acquiring, retaining, or improving self-help, socialization,
				  and adaptive skills provided in a location other than the residence of an
				  individual. Day habilitation does not include in-home day
				  habilitation.
(11) In-home day
				  habilitation is assistance with acquiring, retaining, or improving self-help,
				  socialization, and adaptive skills provided in an individual's
				  residence.
(12) Dental treatment
				  is:
(A) emergency dental treatment;
(B) preventive dental treatment;
(C) therapeutic dental treatment;
				  and
(D) orthodontic dental
				  treatment, excluding cosmetic orthodontia.
(13) Minor home modifications are physical
				  adaptations to an individual's home to address specific needs identified by an
				  individual's service planning team and include pre-enrollment minor home
				  modifications which are modifications completed before an applicant is
				  discharged from a nursing facility, an ICF/IID, or a GRO and before the
				  effective date of the applicant's enrollment in the HCS Program.
(14) Licensed vocational nursing is the
				  provision of licensed vocational nursing as defined in the Texas Occupations
				  Code Chapter 301.
(15) Registered
				  nursing is the provision of professional nursing as defined in the Texas
				  Occupations Code Chapter 301.
(16)
				  Specialized registered nursing is the provision of registered nursing to an
				  individual who has a tracheostomy or is dependent on a ventilator.
(17) Specialized licensed vocational nursing
				  is the provision of licensed vocational nursing to an individual who has a
				  tracheostomy or is dependent on a ventilator.
(18) Supported home living is transportation
				  of an individual with a residential type of "own/family home."
(19) Host home/companion care is residential
				  assistance provided in a residence that is owned or leased by the service
				  provider of host home/companion care or the individual and is not owned or
				  leased by the program provider. The service provider of host home/companion
				  care must live in the same residence as the individual receiving the
				  service.
(20) Supervised living is
				  residential assistance provided in a three-person residence or four-person
				  residence in which service providers are present in the residence and are able
				  to respond to the needs of individuals during normal sleeping hours.
(21) Residential support is residential
				  assistance provided in a three-person residence or four-person residence in
				  which service providers are present and awake in the residence whenever an
				  individual is present in the residence.
(22) Respite is temporary relief for an
				  unpaid caregiver in a location other than the individual's home for an
				  individual who has a residential type of "own/family home."
(23) In-home respite is temporary relief for
				  an unpaid caregiver in the individual's home for an individual who has a
				  residential type of "own/family home."
(24) Employment assistance is assistance to
				  help an individual locate paid employment in the community.
(25) Supported employment is assistance, in
				  order to sustain competitive employment, to an individual who, because of a
				  disability, requires intensive, ongoing support to be self-employed, work from
				  home, or perform in a work setting at which individuals without disabilities
				  are employed.
(26) TAS is
				  assistance to an applicant in setting up a household in the community before
				  being discharged from a nursing facility, an ICF/IID, or a GRO and before
				  enrolling in the HCS Program and consists of:
(A) for an applicant whose initial IPC does
				  not include residential support, supervised living, or host home/companion
				  care:
(i) paying security deposits required to
				  lease a home, including an apartment, or to establish utility services for a
				  home;
(ii) purchasing essential
				  furnishings for a home, including a table, a bed, chairs, window blinds, eating
				  utensils, and food preparation items;
(iii) paying for expenses required to move
				  personal items, including furniture and clothing, into a home;
(iv) paying for services to ensure the health
				  and safety of the applicant in a home, including pest eradication, allergen
				  control, or a one-time cleaning before occupancy; and
(v) purchasing essential supplies for a home,
				  including toilet paper, towels, and bed linens; and
(B) for an applicant whose initial IPC
				  includes residential support, supervised living, or host home/companion care:
(i) purchasing bedroom furniture;
(ii) purchasing personal linens for the
				  bedroom and bathroom; and
(iii)
				  paying for allergen control.