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§2.303: Definitions

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

(1) Actively involved--Significant, ongoing, and supportive involvement with an individual by a person, as determined by the MRA, based on the person's:

(A) interactions with the individual;

(B) availability to the individual for assistance or support when needed; and

(C) knowledge of, sensitivity to, and advocacy for the individual's needs, preferences, values, and beliefs.

(2) Adaptive behavior--The effectiveness with or degree to which an individual meets the standards of personal independence and social responsibility expected of the individual's age and cultural group as assessed by a standardized measure.

(3) Behavioral emergency--A situation in which severely aggressive, destructive, violent, or self-injurious behavior exhibited by an individual:

(A) poses a substantial risk of imminent probable death of, or substantial bodily harm to, the individual or others;

(B) has not abated in response to attempted preventive de-escalatory or redirection techniques;

(C) is not addressed in a written behavioral support plan; and

(D) does not occur during a medical or dental procedure.

(4) Behavioral support--Specialized interventions that assist an individual with increasing 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.

(5) Capacity--A person's ability to:

(A) understand the information provided to the person regarding a proposed psychoactive medication or behavioral support plan as described in §2.313(d)(1) or (e)(3) of this subchapter (relating to Health, Safety, and Rights); and

(B) make a decision whether to take the proposed medication or accept the behavioral support plan.

(6) CARE--The Client Assignment and Registration System database.

(7) CRCG--Community resource coordination group. A local interagency group composed of public and private agencies, organizations, and families that develops a coordinated plan of services and supports for an individual with complex needs. The group's role and responsibilities are described in the Memorandum of Understanding on Coordinated Services to Persons Needing Services from More than One Agency, available at

(8) DADS--The Department of Aging and Disability Services.

(9) Designated MRA--The MRA assigned to an individual in CARE.

(10) Developmental period--Birth through 17 years of age.

(11) General revenue services--Non-residential mental retardation services funded by general revenue through the performance contract, including:

(A) eligibility determinations;

(B) service coordination not funded by Medicaid Targeted Case Management; and

(C) respite.

(12) HCS Program--The Home and Community-based Services Program. A program operated by DADS and approved by the Centers for Medicare and Medicaid Services in accordance with §1915(c) of the Social Security Act that provides community-based services and supports to eligible individuals who live in their own homes or family homes or other residences permitted under DADS rules related to the HCS Program.

(13) ICF/MR Program--The Intermediate Care Facility for Persons with Mental Retardation Program. A program operated by DADS in accordance with the Social Security Act that provides Medicaid-funded residential services to individuals with mental retardation or a related condition.

(14) Individual--A person seeking or receiving services and supports from an MRA.

(15) Informed consent--Consent given by an individual or the individual's LAR if the person giving the consent:

(A) is:

(i) 18 years of age or older; or

(ii) 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;

(B) has not been determined by a court to lack capacity to make decisions with regard to the matter for which consent is being sought;

(C) has been provided the information described in §2.313(d)(1) or (e)(3) of this subchapter;

(D) has the capacity to give consent, as determined by the prescribing physician or the professional who develops the behavioral support plan, as applicable; and

(E) gives the consent voluntarily, free from coercion or undue influence.

(16) 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 who may be a parent, guardian, or managing conservator of a minor, or the guardian of an adult.

(17) Local planning--A broad-based community participatory process that identifies community values, service needs, and service priorities for individuals in the mental retardation priority population within a local service area and which guides resource development and allocation and results in a local plan that identifies goals and establishes strategies for accomplishment.

(18) Local service area--A geographic area composed of one or more Texas counties as identified in the performance contract to be served by an MRA.

(19) Medication class--A group of medications with similar actions and indications for use.

(20) Mental retardation--Consistent with THSC, §591.003, significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period.

(21) MRA--mental retardation authority. As defined in THSC, §531.002, an entity designated in accordance with the THSC, §533.035(a), to which the Health and Human Services Commission executive commissioner delegates the state's authority and responsibility within a specified region for planning, policy development, coordination, including coordination with criminal justice entities, and resource development and allocation and for supervising and ensuring the provision of mental retardation services to persons with mental retardation in the most appropriate and available setting to meet individual needs in one or more local service areas.

(22) Mental retardation priority population--Those persons who meet one or more of the following descriptions:

(A) have mental retardation;

(B) have a pervasive developmental disorder;

(C) have a related condition, are eligible for, and are enrolling in the ICF/MR Program, the HCS Program, or the TxHmL Program;

(D) are nursing facility residents who are eligible for specialized services for mental retardation or a related condition pursuant to §1919(e)(7) of the Social Security Act; or

(E) are children eligible for early childhood intervention services provided in accordance with Chapter 108 of this title (relating to Division for Early Childhood Intervention Services).

(23) Performance contract--A written agreement between DADS and an MRA as required by THSC, §534.054, for the provision of one or more functions as described in THSC, §533.035(a), and for the provision of general revenue services. The performance contract allocates general revenue funds for the MRA to fulfill its role and responsibilities as an MRA.

(24) Permanency planning--A philosophy and planning process that focuses on the outcome of family support for an individual under 22 years of age by facilitating a permanent living arrangement in which the primary feature is an enduring and nurturing parental relationship.

(25) Person-directed planning--A process that empowers the individual (and the LAR on the individual's behalf) to direct the development of a plan for services and supports that meet the individual's outcomes. The process:

(A) identifies existing services and supports necessary to achieve the individual's outcomes;

(B) identifies natural supports available to the individual and negotiates needed service system supports;

(C) occurs with the support of a group of people chosen by the individual (and the LAR on the individual's behalf); and

(D) accommodates the individual's style of interaction and preferences regarding time and setting.

(26) Planning team--Persons convened by an individual's MRA to develop a plan of services and supports for an individual. The team includes:

(A) the individual;

(B) if applicable, the LAR or actively involved person:

(C) the staff member assigned to the individual by the MRA; and

(D) other persons chosen by the individual, LAR, or actively involved person.

(27) Psychoactive medication--A medication for which the primary intended therapeutic effect is to treat or ameliorate the signs or symptoms of mental disorder, or to modify mood, affect, perception, or behavior.

(28) Restraint--A manual method, except for physical guidance or prompting of brief duration, or a mechanical device to restrict:

(A) the free movement or normal functioning of all or a portion of an individual's body; or

(B) normal access by an individual to a portion of the individual's body.

(29) Rights protection officer--As referenced in §4.113 of this title (relating to Rights Protection Officer at a State MR Facility or MRA), the staff member of an MRA whose primary duty is to advocate for the rights of individuals served by that MRA and to assist LARs in advocating for the rights of individuals.

(30) Safety net functions--As referenced in THSC, §533.0355(a)(6), functions performed by an MRA with available resources to respond to an individual in the mental retardation priority population who has an intensive need or who is in crisis to protect the individual's health and safety.

(31) Service coordination--A service provided by an MRA as defined in §2.553 of this chapter (relating to Definitions) contained in Subchapter L (relating to Service Coordination for Individuals with Mental Retardation).

(32) Service coordinator--An MRA employee who:

(A) meets the qualifications and has received training set forth in §2.559 of this chapter (relating to Minimum Qualifications) and §2.560 of this chapter (relating to Staff Training) contained in Subchapter L (relating to Service Coordination for Individuals with Mental Retardation); and

(B) performs service coordination activities.

(33) Services and supports--General revenue services and other publicly funded mental retardation services.

(34) Staff member--Personnel of an MRA including a full-time and part-time employee and a contractor.

(35) State MR facility--A state school or a state center with a mental retardation residential component that is operated by DADS.

(36) Subaverage general intellectual functioning--Consistent with THSC, §591.003, measured intelligence on standardized general intelligence tests of two or more standard deviations (not including standard error of measurement adjustments) below the age-group mean for the tests used.

(37) THSC--The Texas Health and Safety Code.

(38) TxHmL Program--The Texas Home Living Program. A program operated by DADS and approved by the Centers for Medicare and Medicaid Services in accordance with §1915(c) of the Social Security Act, that provides community-based services and supports to eligible individuals who live in their own homes or in their family homes.


Source Note: The provisions of this §2.303 adopted to be effective December 1, 2008, 33 TexReg 9512