Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 279 - CONTRACTING TO PROVIDE EMERGENCY RESPONSE SERVICES › Subchapter A - INTRODUCTION › Section 279.3 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
					 have the following meanings, unless the context clearly indicates
					 otherwise:
(1) Alarm call--A signal
				  transmitted from the equipment to the provider's response center indicating
				  that an individual needs immediate assistance.
(2) Call button--An electronic device that,
				  when pressed, triggers an alarm call to the provider's response center to alert
				  the provider that an individual needs immediate assistance. The device may be
				  held in the hand, worn around the neck, hung on a garment, or kept within an
				  individual's reach.
(3) Case
				  manager--A DADS employee who is responsible for case management activities for
				  an individual, including eligibility determination, enrollment, assessment and
				  reassessment of the individual's need, service plan development, and
				  intercession on the individual's behalf.
(4) CBA--Community Based Alternatives. A
				  Medicaid waiver program that provides services to eligible adults who are aged
				  or disabled or both as an alternative to institutional care in a nursing
				  facility. CBA services are provided in accordance with the waiver provisions of
				  §1915(c) of the Social Security Act (42 U.S.C. §1396n(c)).
(5) CCAD--Community Care for Aged and
				  Disabled. A group of DADS programs that provide a variety of Title XX-funded
				  community-based services.
(6)
				  Contract--A written agreement between DADS and a provider to provide ERS to an
				  individual in exchange for payment.
(7) Contract manager--A DADS employee who is
				  responsible for the overall management of a contract with a provider.
(8) Coordinator--A provider employee who is
				  responsible for the management and provision of ERS and who ensures that
				  services are delivered as described in this chapter.
(9) CWP--Consolidated Waiver Program. A
				  Medicaid waiver program that provides home and community-based services to
				  people who are eligible for care in a nursing facility care or an intermediate
				  care facility for persons with mental retardation or related conditions
				  (ICF-MR/RC). CWP services are provided in accordance with the waiver provisions
				  of §1915(c) of the Social Security Act (42 U.S.C.
				  §1396n(c)).
(10)
				  DADS--Department of Aging and Disability Services.
(11) Day--Any reference to a day means a
				  calendar day, unless otherwise specified in the text. A calendar day includes
				  weekends and holidays.
(12)
				  ERS--Emergency response services. A CCAD program and a service provided through
				  the CBA and CWP programs that provides electronic monitoring services for
				  functionally impaired adults who live alone or who are functionally isolated in
				  the community. In the CBA and CWP programs, ERS helps assure health and safety
				  in the community.
(13)
				  Equipment--The system used in an individual's home to provide electronic
				  monitoring services.
(14) Imminent
				  danger--An immediate, real threat to a person's safety.
(15) Individual--A person who has been
				  determined eligible to receive ERS. A reference in this chapter to "individual"
				  includes the individual's representative, unless the context indicates
				  otherwise.
(16) Installer--A
				  volunteer, a subcontractor, or an employee of a provider who connects,
				  maintains, or repairs the equipment.
(17) Institution--A hospital, a nursing
				  facility, a state mental retardation facility, a state mental health facility,
				  or an ICF-MR/RC.
(18) Monitor--A
				  volunteer, a subcontractor, or an employee of a provider who monitors ERS and
				  ensures that an alarm call is responded to immediately.
(19) Negotiated referral--A request from a
				  case manager to a provider to begin services on a particular date due to an
				  individual's needs, or a service start date that is negotiated between the case
				  manager and the provider.
(20)
				  Provider--An entity that has a contract with DADS to provide ERS.
(21) Public service personnel--A staff member
				  of a sheriff's department, police department, emergency medical service, or
				  fire department.
(22) Reckless
				  behavior--Acting with conscious indifference to the consequences.
(23) Representative--An individual's spouse,
				  other responsible party, or legal representative.
(24) Responder--A person designated by an
				  individual to respond to an emergency call activated by the individual. A
				  responder may be a relative, a neighbor, or a volunteer.
(25) Response center--The site where a
				  provider's ERS monitoring system is located.
(26) Routine referral--A request from a case
				  manager to a provider to begin ERS for which the case manager determines that
				  an individual's needs do not require a negotiated referral.
(27) Subcontractor--An organization or an
				  individual who delivers a component of ERS for the provider for a fee and is
				  not an employee or volunteer of the provider.
(28) Suspension--A temporary stoppage of ERS
				  to an individual without loss of the individual's ERS eligibility.
(29) System check--A successful activation of
				  the call button by an individual or a test of the equipment by the
				  provider.
(30) Termination--A
				  permanent stoppage of ERS to an individual by DADS.
(31) Working day--Any day except Saturday,
				  Sunday, a state holiday, or a federal holiday.