Section 278.23 - Definitions for the Transition to Life in the Community (TLC) ProgramThe 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.26 Tex. Admin. Code § 278.23
Transferred from 40 TAC § 48.2721 Texas Register, Volume 49, Number 23, June 7, 2024, TexReg 4061, eff. 6/28/2024