The following words and terms, when used in this subchapter shall have the following meanings, unless the context clearly indicates otherwise.
  (1) Act--The Texas Primary Health Care Services Act, Health and Safety Code, Chapter 31.
  (2) Applicant--An individual and/or family applying to receive primary health care services.
  (3) Commission--The Texas Health and Human Services Commission.
  (4) Commissioner--The Commissioner of Health.
  (5) Department--The Department of State Health Services.
  (6) Eligible individual--An eligible recipient of primary health care services under the Act.
  (7) Other benefit--A benefit, other than a benefit provided under the Act, to which an individual is entitled for payment of the costs of primary health care services, including:
    (A) benefits available from:
      (i) an insurance policy, group health plan, or prepaid medical care plan;
      (ii) Title XVIII or Title XIX of the Social Security Act;
      (iii) the Veterans Administration;
      (iv) the Civilian Health and Medical Program of the Uniformed Services; and
      (v) workers compensation or any other compulsory employer's insurance program.
    (B) a public program created by federal or state law, or by an ordinance or rule of a municipality or political subdivision of the state, except those benefits created by the establishment of a city or county hospital, a joint city-county hospital, a county hospital authority, a hospital district, or by the facilities of a publicly supported medical school; or
    (C) benefits resulting from a cause of action for medical, facility, or medical transportation expenses, or a settlement or judgment based on the cause of action, if the expenses are related to the need for services provided by the Act.
  (8) Primary Health Care Services--May include the following:
    (A) diagnosis and treatment;
    (B) emergency medical services;
    (C) family planning services;
    (D) preventive health services;
    (E) health education;
    (F) laboratory, x-ray, nuclear medicine, or other appropriate diagnostic services;
    (G) nutrition services;
    (H) health screening;
    (I) home health care;
    (J) dental care;
    (K) transportation;
    (L) prescription drugs and devices and durable supplies;
    (M) environmental health services;
    (N) podiatry services; and
    (O) social services.
  (9) Program--The primary health care services program created by the Act.
  (10) Provider--An entity that, through a grant or a contract with the department, delivers primary health care services that are purchased by the department for the purposes of the Act.
  (11) Recipient--An individual receiving primary health care services under the Act.
  (12) Request for proposal--A solicitation providing guidance and instructions issued by the department to entities interested in submitting applications to provide primary health care services under the Act.
  (13) Services--Primary health care services.
  (14) Texas resident--An individual who is physically present within the geographic boundaries of the state, and who:
    (A) intends to remain within the state, whether permanently or for an indefinite period;
    (B) does not claim residency in any other state or country;
    (C) is under 18 years of age, and at least one of his/her parents, managing conservator, or guardian is a bona fide resident of Texas;
    (D) is a person residing in Texas and his/her legally dependent spouse is a bona fide resident of Texas; or
    (E) is an adult residing in Texas whose legal guardian is a bona fide resident of Texas.

Source Note: The provisions of this §364.3 adopted to be effective May 28, 2006, 31 TexReg 4218; amended to be effective February 14, 2013, 38 TexReg 645; amended to be effective September 1, 2013, 38 TexReg 5505; transferred effective March 1, 2022, as published in the Texas Register February 11, 2022, 47 TexReg 674