SECTION 392.201. Definitions

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

(1) Adjusted gross income--The gross income of the family, as defined in this section, minus allowable deductions. Adjusted income is used to determine a family's monthly cost share.

(2) Allowable deductions--Expenses that are not reimbursed by other sources. Allowable deductions are limited to:

(A) the actual medical or dental expenses of the parent or dependent that are primarily related to alleviating or preventing a physical or mental defect or illness, were paid over the previous 12 months, are expected to continue during the eligibility period, and are limited to the cost of:

(i) diagnosis, cure, alleviation, treatment, or prevention of disease;

(ii) treatment of any affected body part or function;

(iii) legal medical services delivered by physicians, surgeons, dentists, and other medical practitioners;

(iv) medication, medical supplies, and diagnostic devices;

(v) premiums paid for insurance that covers the expenses of medical or dental care;

(vi) transportation to receive medical or dental care; and

(vii) medical or dental debt that is being paid on an established payment plan;

(B) child-care and respite expenses for a family member;

(C) costs and fees associated with the adoption of a dependent child; and

(D) court-ordered child support payments paid for a child who is not counted as a family member or dependent.

(3) Applied behavior analysis (ABA)--The process of using behavioral principles to evaluate and teach socially relevant behavior, teach new skills, and increase desirable behaviors.

(4) Autism spectrum disorders (ASD)--The disorders found in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) related to autism. An ASD diagnosis of autistic disorder, Asperger's disorder, or pervasive developmental disorder not otherwise specified, made under a previous DSM, is acceptable.

(5) BCaBA--A board certified assistant behavior analyst.

(6) BCBA--A board certified behavior analyst.

(7) BCBA-D--A board certified behavior analyst-doctoral.

(8) Child--A son, daughter, foster child, or stepchild who is under age 19 living in the home.

(9) Contractor--A service provider under contract with DARS to provide autism services.

(10) Cost share--The amount of monthly financial contribution required of a family for a child to participate in the DARS Autism Program.

(11) DARS--Texas Department of Assistive and Rehabilitative Services.

(12) DARS Combined ABA services--ABA services that are provided to children three through eight years of age by a DARS contractor that may include either or both comprehensive ABA and focused ABA services.

(13) DARS Comprehensive ABA services--ABA services that are provided to children three through five years of age by a DARS contractor to treat all areas of developmental and behavioral needs.

(14) DARS Focused ABA services--ABA services that are provided to children 3 through 15 years of age by a DARS contractor to treat one or more deficits or behaviors of excess rather than the full range of developmental domains.

(15) Dependent--A child age 19 or older, parent, stepparent, grandparent, brother, sister, stepbrother, stepsister, or in-law; whose gross income is less than $3,900 a year; and for whom more than half of the person's support is provided for by the parent(s) or guardian(s) during the calendar year.

(16) Family--The child's parent(s) or guardian(s), the child, other children under 19 years of age; and other dependents of the parent or guardian.

(17) Fiscal year--The state fiscal year. Begins on September 1 and ends on August 31 of the following year.

(18) Gross income--All income received by the family for determination of the family's cost share, from whatever source, that is considered income by the Internal Revenue Service before federal allowable deductions are applied.

(19) Individualized Education Program (IEP)--A written document that is developed for each public school child who is eligible for special education.

(20) Interest list--A list, maintained by the contractor, of families who have indicated an interest in receiving services, and who meet the eligibility criteria.

(21) LEA--Local educational agency.

(22) Qualified professional--An actively licensed physician or psychologist with training and background related to the diagnosis and treatment of neurodevelopmental disorders.

(23) Texas resident--A person who is in Texas and intends to remain in the state, either permanently or for an indefinite period.

(24) Third-party payer--A company, organization, insurer, or government agency other than DARS that makes payment for health care services received by an enrolled child.

(25) Transition plan--A plan that identifies and documents appropriate steps and transition services to support the child and family to smoothly and effectively transition from the DARS Autism Program to LEA special education services or other community activities, places, or programs the family would like the child to participate in after exiting the DARS Autism Program.

(26) Treatment plan--A written plan of care, including treatment goals, for providing ABA treatment services to an eligible child and the child's family to enhance the child's development. Intensity and length of services is determined by the treatment goals.

Source Note: The provisions of this §392.201 adopted to be effective June 17, 2015, 40 TexReg 3638