Revision 17-1; Effective June 1, 2017

 

 

Consumer Directed Services (CDS) – The member or his legally authorized representative or guardian is the employer of, and retains control over, the hiring, management and termination of an individual providing certain services.

CDS Employer – An individual or LAR, parent, or court appointed guardian who chooses to participate in the CDS option and therefore is responsible for hiring and retaining service providers to deliver program services.

Designated Representative (DR) – A willing adult appointed by the CDS employer to assist with or perform the employer's required responsibilities to the extent approved by the employer. A DR, usually a family member, is not a paid service provider and is at least 18 years of age.

Employee (a.k.a. service provider) – An individual who is hired, trained and managed by the employer to provide services authorized by the MCO.

Financial Management Services Agency (FMSA) – An agency contracting with the MCO that provides financial management services for an employer who participates in the CDS option.

Legally Authorized Representative (LAR) – The member’s representative defined by state or federal law, including Texas Occupations Code §151.002(6), Texas Health and Safety Code §166.164, and Texas Estates Code Chapter 752.

Managed care organization (MCO) – An insurer licensed by the Texas Department of Insurance that coordinates health care for Medicaid members in exchange for a monthly premium.

Service Coordinator – The person with primary responsibility for providing service coordination and care management to STAR+PLUS members.

Service Plan – A plan of care developed by the MCO service coordinator authorizing tasks to be performed by the service provider (e.g., Individual Service Plan).