Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1439 - HOME AND COMMUNITY BASED SERVICES FOR THE DEVELOPMENTALLY DISABLED/MENTALLY RETARDED
Section 17-1439-2 - Definitions

As used in this chapter:

"Acuity level B" means the level of medical care and special services which are appropriately obtained from an ICF-MR.

"Adult day health services" means, the provision of coordinated health and developmental services to the recipient, as requied by the individual habilitation plan, All services are equivalent to "active treatment" in an ICF-MR institution and all program trainers are supervised by a QMRP.

"Applicant" means an individual whose written application for medical assistance has bete submitted to the department but who has not received final action.

"Assigned physician" means a medical doctor (M.D.) or a doctor of osteopathy (D.O.) who orders and directs the care needs of a medicaid recipient. The assigned physician may be a physician from a group practice who is designated as the primary physician or an alternate physician that has been delegated the role of the assigned physician by the client's initial assigned physician during the physician's absence.

"Case management" means services provided by an interdisciplinary team and QMRP to locate, coordinate, and monitor services prescribed for the client in the individual habilitation plan.

"Client" means an individual who meets the DD/MRH&CBS waiver program eligibility criteria anchas been admitted into the program.

"Contractor" means an agency or individual contractor providing home and community based services to a client under an agreement with the department.

"Environmental modifications" means the non recurring provision of change to dwelling units to enable non-ambulatory clients to reside in community homes which require adaptive and safety alterations such as the installation of sidewalks and ramps; widening of doorways and corridors; removal of other architectural barriers; and the enlargement of the bath 1439-2 facility to allow the movement of and ensure the safety of clients.

"Furnish", "furnishes", or "furnished" means items and services provided by or arranged for and which are under the direct supervision of a provider home and community-based services.

"HCFA" means the United States Department of Health and Human Services, Health Care Financing Administration.

"Habilitation services" means in home services prescribed by the interdisciplinary team in the individual habilitation plan which include activities related to developmental program objectives, community and social orientation, and the maintenance of appropriate and complete records. Persons providing services must be certified as passing the habilitation training curriculum.

"Home" means the client's own home or a home which meets all state licensure/certification requirements of a care, foster, or domiciliary home.

"ICF-MR" means an intermediate care facility for the mentally retarded or persons with related conditions, such as epilepsy, cerebral palsy, or other developmental disabilities as defined under part C of the developmental disabilities services and facilities construction act.

"Individual habilitation plan" (IHP) means a written plan based on the interdisciplinary team assessment that addresses identified client problems, indicates goals or outcomes, the specific type and frequency of service(s), and the provider(s) of services for each problem.

"Interdisciplinary team" means a team consisting of a licensed physician, a registered nurse, a social worker, and various specialized professionals and therapists (ie: psychologist, educator, and/or physical, occupational, speech, and/or hearing therapist) as needed. At least one member of the review team shall be a qualified mental retardation professional who has specialized training or at least one year of experience in treating or working with the mentally retarded.

"NF" means nursing facility.

"Personal care services" means the health oriented assistance to the client in activities of daily living, as specified in the individualized habilitation plan.

Personal care services include assistance in bathing, dressing, toileting, positioning, transfers, feeding, special incontinence care, supervisionof medications, special diet preparations, and/or other specialized treatments. Personal care services are supervised by a Hawaii licensed registered nurse and are provided by qualified personnel who have received training as designated by the department

"Qualified mental retardation professional" (QMRP) means an individual who has at least one year of experience working directly with persons with mental retardation or other developmental disabilities and who has graduated from an accredited university or is licensed/certified in a field related to developmental disabilities as stated in the waiver.

"Respite care" means care provided in a State licensed foster/care home or a certified ICF/MR facility on a limited basis for relief to the primary caretaker, client's medical recuperation or unmanageable behavior.

"Skilled nursing" means the provision of professional nursing services requiring substantial specialized knowledge of the biological, physical, behavioral, psychological and sociological sciences of nursing theory, as the basis for assessment, diagnosis, planning, intervention and evaluation in the promotion and maintenance of health and the restoration of optimum functioning. Skilled nursing services are prescribed by the Interdisciplinary teamand provided by a Hawaii licensed registered (R.N.) or practical nurse (L.P.N.).

"UR" means utilization review of home and community-based services provided to clients to determine whether continued stay is appropriate.