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 L - INDIVIDUALIZED SKILLS AND SOCIALIZATION
Section 263.2001 - Definitions

Universal Citation: 26 TX Admin Code § 263.2001

Current through Reg. 50, No. 13; March 28, 2025

The following words and terms, when used in this subchapter, have the following meanings unless the context clearly indicates otherwise.

(1) Applicant--A Texas resident seeking services in the Home and Community-based Services (HCS) Program.

(2) Calendar day--Any day, including weekends and holidays.

(3) CFC--Community First Choice. A state plan option governed by Code of Federal Regulations, Title 42, Chapter 441, Subpart K, regarding Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice).

(4) CFC PAS/HAB--CFC personal assistance services/habilitation.

(5) CMS--Centers for Medicare & Medicaid Services. The federal agency within the United States Department of Health and Human Services that administers the Medicare and Medicaid programs.

(6) Community setting--A setting accessible to the general public within an individual's community.

(7) Day habilitation--An HCS Program service that provides assistance with acquiring, retaining, or improving self-help, socialization, and adaptive skills provided in a location other than the residence of an individual.

(8) DFPS--The Department of Family and Protective Services.

(9) HCS Program--The Home and Community-based Services Program.

(10) HHSC--The Texas Health and Human Services Commission.

(11) Hospital--A public or private institution licensed or exempt from licensure in accordance with Texas Health and Safety Code (THSC) Chapters 13, 241, 261, or 552.

(12) ICAP--Inventory for Client and Agency Planning.

(13) ID/RC Assessment--Intellectual Disability/Related Conditions Assessment. A form used by HHSC for level of care determination and level of need assignment.

(14) Implementation plan--A written document developed by a program provider for an individual that, for each HCS Program service and CFC service on the individual's individual plan of care (IPC) to be provided by the program provider, except for supported home living and CFC support management, includes:

(A) a list of outcomes identified in the person-directed plan that will be addressed using HCS Program services and CFC services;

(B) specific objectives to address the outcomes required by subparagraph (A) of this paragraph that are:
(i) observable, measurable, and outcome-oriented; and

(ii) derived from assessments of the individual's strengths, personal goals, and needs;

(C) a target date for completion of each objective;

(D) the number of units of HCS Program services and CFC services needed to complete each objective;

(E) the frequency and duration of HCS Program services and CFC services needed to complete each objective; and

(F) the signature and date of the individual, legally authorized representative, and the program provider.

(15) Individual--A person enrolled in the HCS Program.

(16) Individualized skills and socialization provider--A legal entity licensed in accordance with Chapter 559, Subchapter H of this title (relating to Individualized Skills and Socialization Provider Requirements).

(17) Initial IPC--The first IPC for an individual developed before the individual's enrollment into the HCS Program.

(18) IPC--Individual plan of care. A written plan that:

(A) states:
(i) the type and amount of each HCS Program service and each CFC service, except for CFC support management, to be provided to the individual during an IPC year;

(ii) the services and supports to be provided to the individual through resources other than HCS Program services or CFC services, including natural supports, medical services, and educational services; and

(iii) if an individual will receive CFC support management; and

(B) is authorized by HHSC.

(19) IPC year--The effective period of an initial IPC and renewal IPC as described in this paragraph.

(A) Except as provided in subparagraph (B) of this paragraph, the IPC year for an initial and renewal IPC is a 365-calendar day period starting on the begin date of the initial or renewal IPC.

(B) If the begin date of an initial or renewal IPC is March 1 or later in a year before a leap year or January 1 - February 28 of a leap year, the IPC year for the initial or renewal IPC is a 366-calendar day period starting on the begin date of the initial or renewal IPC.

(C) A revised IPC does not change the begin or end date of an IPC year.

(20) LAR--Legally authorized representative. A person authorized by law to act on behalf of another person with regard to a matter described in this chapter, including a parent, guardian, or managing conservator of a minor; a guardian of an adult; an agent appointed under a power of attorney; or a representative payee appointed by the Social Security Administration. An LAR, such as an agent appointed under a power of attorney or representative payee appointed by the Social Security Administration, may have limited authority to act on behalf of a person.

(21) LOC--Level of care. A determination given to an applicant or individual as part of the eligibility determination process based on data submitted on the ID/RC Assessment.

(22) LON--Level of need. An assignment given by HHSC to an individual upon which reimbursement for certain services is based.

(23) Medicaid HCBS--Medicaid home and community-based services. Medicaid services provided to an individual in an individual's home and community, rather than in a facility.

(24) Nursing facility--A facility licensed in accordance with THSC Chapter 242.

(25) PDP--Person-directed plan. A plan developed using an HHSC form that describes the supports and services necessary to achieve the desired outcomes identified by the applicant or individual and LAR and to ensure the applicant's or individual's health and safety.

(26) Program provider--A person, as defined in 40 TAC § 49.102(relating to Definitions), that has a contract with HHSC to provide HCS Program services, excluding a financial management services agency.

(27) Renewal IPC--An IPC developed for an individual in accordance with the rules governing the HCS Program.

(28) Revised IPC--An initial IPC or a renewal IPC that is revised during an IPC year in accordance with the rules governing the HCS Program to add a new HCS Program service or CFC service or change the amount of an existing service.

(29) Service coordinator--An employee of a local intellectual and developmental disability authority who provides service coordination to an individual.

(30) Service provider--A person who directly provides an HCS Program service or CFC service to an individual.

(31) TAC--Texas Administrative Code. A compilation of state agency rules published by the Texas Secretary of State in accordance with Texas Government Code, Chapter 2002, Subchapter C.

Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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