SECTION 5.403. Definitions

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.

Source Note: The provisions of this §5.403 adopted to be effective June 23, 2004, 29 TexReg 5939; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841