Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 278 - ADULT FOSTER CARE (AFC) PROGRAM › Subchapter A - IN-HOME AND FAMILY SUPPORT PROGRAM › Section 278.23 - Definitions for the Transition to Life in the Community (TLC) Program

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in the portions of
					 this chapter applying to the TLC program (§§48.2721-48.2725), have
					 the following meanings, unless the content clearly indicates otherwise.
(1) Case manager--An employee of the Texas
				  Department of Human Services (DHS) who provides case management services, or an
				  employee of an agency that has contracted with DHS to provide relocation
				  services or case management services. The case manager determines eligibility
				  and benefit levels in the TLC program, subject to final approval by
				  DHS.
(2) CBA--The Community Based
				  Alternatives program, a Medicaid waiver program, based on the Social Security
				  Act, §1915(c), which provides a comprehensive array of community-based
				  services for adults age 21 and older who meet the medical necessity criteria
				  for nursing facility care, and who meet all other eligibility criteria for this
				  waiver.
(3) CLASS--The Community
				  Living Assistance and Support Services program, a Medicaid waiver program,
				  based on the Social Security Act, §1915(c), which provides a comprehensive
				  array of community-based services for certain individuals who qualify for an
				  intermediate care facility for the mentally retarded (ICF-MR) VIII level of
				  care, and who meet all other eligibility criteria for this waiver. This program
				  operates in designated counties in Texas.
(4) Community setting--A community setting is
				  any living arrangement chosen by the individual that allows that individual to
				  receive services from the particular waiver program or other community care
				  program providing services to that individual. A community setting is a
				  long-term living arrangement other than a nursing facility; state hospital;
				  state school; medical, rehabilitation, or psychiatric hospital; school for the
				  deaf or blind, Texas Youth Commission facility, Texas Department of Criminal
				  Justice facility, or ICF-MR facility.
(5) DB-MD--The Deaf-Blind with Multiple
				  Disabilities program, a Medicaid waiver program, based on the Social Security
				  Act, §1915(c), which provides a comprehensive array of community-based
				  services for certain individuals who qualify for an intermediate care facility
				  for the mentally retarded (ICF-MR) VIII level of care, and who meet all other
				  eligibility criteria for this waiver. This program operates in designated
				  counties in Texas.
(6) DHS--The
				  Texas Department of Human Services.
(7) Institutional setting--A long-term care
				  nursing facility licensed by DHS.
(8) MDCP--The Medically Dependent Children
				  Program, a Medicaid waiver program, based on the Social Security Act,
				  §1915(c), which provides community-based services to individuals under the
				  age of 21 years who meet the medical necessity criteria for nursing facility or
				  hospital care, and who meet all other eligibility criteria for this
				  waiver.
(9) Promoting
				  Independence--An initiative of the Texas Department of Human Services, under
				  the direction of the Texas Health and Human Services Commission (HHSC), to
				  promote opportunities for a person with a disability to live in the most
				  appropriate care setting of his choice.
(10) TLC--The Promoting Independence
				  Transition to Life in the Community program, a component of the In-home and
				  Family Support Program (IHFSP), which provides a one-time financial grant or
				  other short-term financial assistance to individuals to help them move from a
				  Medicaid-funded residence in a nursing facility into a community setting. The
				  rules and procedures described in §§48.2701-48.2711 do not apply to
				  §§48.2721-48.2725, which govern TLC services. An individual may not
				  receive services under §§48.2701-48.2711 concurrently with services
				  received through the program described in §§48.2721-48.2725. An
				  individual who has received TLC services and wants services described in
				  §§48.2701-48.2711 must apply under the request and application
				  procedures described in those sections.