Current through Reg. 49, No. 38; September 20, 2024
The following words and terms when used in this subchapter
shall have the following meanings unless the context clearly indicates
otherwise.
(1) Behavior services
director--A person appointed by the head of the state MR facility to chair the
facility's behavior therapy committee and consult with program directors and
who:
(A) is knowledgeable in the specifics of
behavior therapy principles and theory;
(B) is qualified to evaluate published
behavior therapy research studies; and
(C) has applied experience with behavior
therapy techniques.
(2)
Behavior therapy--The application of applied behavior analysis principles,
cognitive therapies, and skills acquisition to clinical problems with the
intent of increasing adaptive behaviors and modifying or replacing targeted
behaviors with behaviors that are adaptive and socially acceptable.
(3) Behavior therapy committee--Persons
designated by a state MR facility who are knowledgeable about applied behavior
analysis and who:
(A) review, approve, and
monitor behavior therapy programs; and
(B) review, monitor, and make suggestions
concerning the state MR facility's policies and procedures concerning behavior
therapy.
(4) CFR (Code
of Federal Regulations)--The compilation of federal agency
regulations.
(5) Functional
analysis--An assessment of environmental and biological factors that may
influence inappropriate behavior exhibited by an individual.
(6) Head of the state MR facility--The
superintendent of a state school or the executive director of a state
center.
(7) Highly restrictive
procedures--
(A) Restraint--The use of manual
pressure, except for physical guidance or prompting of brief duration, or a
mechanical device to restrict:
(i) the free
movement or normal functioning of the whole or a portion of an individual's
body; or
(ii) normal access by the
individual to a portion of the individual's body.
(B) Use of timeout room--Placement of an
individual alone and under constant, direct staff supervision in an enclosed
area in which positive reinforcement is not available and from which egress is
denied by a closed door in accordance with Code of Federal Regulations (CFR),
Title 42, §483.450(c), concerning timeout rooms. The term does not include
circumstances in which staff remain in close proximity to an individual who has
been directed to an area that is removed from regular activities.
(C) Application of aversive
stimuli--Application of any stimulus that may be unpleasant or noxious,
startling, or painful such that its intended effect is the suppression of the
targeted behavior upon which it is immediately contingent. Such stimuli include
olfactory, auditory, gustatory, tactile, and other stimuli that may result in
physical discomfort or pain.
(D)
Effortful task--An activity requiring physical effort by an individual that is
directed or manually guided by staff. Examples of effortful tasks include, but
are not limited to:
(i) Required exercise--A
procedure whereby an individual performs and may be guided by staff to perform
a series of physical movements that are incompatible with the undesirable
response they systematically follow. An example would be the guided movement of
a self-injurious individual's arms through a series of positions away from the
body.
(ii) Negative practice--A
procedure whereby an individual is required to repeatedly engage in an
effortful task that is topographically similar to the undesirable response the
procedure systematically follows. An example is a program in which an
individual who strikes others is required to repeatedly hit a punching bag
following each occurrence of striking others.
(iii) Restitutional overcorrection--A
procedure whereby an individual is required to correct the consequences of a
disruptive response by performing a task that restores the environment to a
state even more improved than existed before the disruptive behavior. An
example would be the requirement that a disruptive individual polish all the
tables in the residence as a consequence of knocking over one of
them.
(iv) Positive practice
overcorrection--A procedure whereby an individual is required to repeatedly
engage in an appropriate behavior related to the function of the undesirable
response the procedure systematically follows. An example is a program in which
an individual is required to repeatedly practice an appropriate social behavior
contingent upon exhibition of a targeted behavior.
(8) Human Rights Committee
(HRC)--Persons designated by a state MR facility in accordance with
42 CFR
§483.440(f)(3),
concerning specially constituted committee, who review, approve and monitor
behavior therapy programs and review, monitor, and make suggestions about the
state MR facility's policies, procedures, and practices concerning behavior
therapy programs.
(9)
Interdisciplinary team (IDT)--Mental retardation professionals and
paraprofessionals and other concerned persons, as appropriate, who assess an
individual's treatment, training, and habilitation needs and make
recommendations for services.
(A) Team
membership always includes:
(i) the
individual;
(ii) the individual's
LAR, if any; and
(iii) persons
specified by a state MR facility who are professionally qualified and/or
certified or licensed with special training and experience in the diagnosis,
management, needs, and treatment of individuals with mental
retardation.
(B) Other
participants in IDT meetings may include:
(i)
other concerned persons whose inclusion is requested by the individual or the
LAR; and
(ii) at the discretion of
the state MR facility, persons who are directly involved in the delivery of
mental retardation services to the individual.
(10) Individual--A person with mental
retardation who resides in a state MR facility.
(11) LAR (legally authorized
representative)--A person authorized by law to act on behalf of an individual
with regard to a matter described in this subchapter, and may include a parent,
guardian, or managing conservator of a minor individual, or a guardian of an
adult individual.
(12) Legally
adequate consent--A term consistent with provisions of the Texas Health and
Safety Code (THSC), §591.006, which states, in essence, that consent
obtained from an individual with mental retardation is legally adequate when
each of the following conditions has been met:
(A) legal status: The individual giving the
consent:
(i) is 18 years of age or older, or
younger than 18 years of age and is or has been married or had the disabilities
of minority removed for general purposes by court order as described in the
Texas Family Code, Chapter 31; and
(ii) has not been determined by a court to
lack capacity to make decisions with regard to the matter for which consent is
being sought.
(B)
comprehension of information: The individual giving the consent has been
informed of and comprehends the nature, purpose, consequences, risks, and
benefits of and alternatives to the procedure, and the fact that withholding or
withdrawal of consent shall not prejudice the future provision of care and
services to the individual with mental retardation; and
(C) voluntariness: The consent has been given
voluntarily and free from coercion and undue influence.
(13) State MR (mental retardation)
facility--A state school or state center operated by the department that
provides residential services to individuals with mental retardation.
(14) Targeted behavior--An inappropriate
behavior exhibited by an individual that the IDT has identified for
modification or reduction.
