Idaho Administrative Code
Title IDAPA 16 - Health and Welfare, Department of
Rule 16.07.01 - BEHAVIORAL HEALTH SLIDING FEE SCHEDULES
Section 16.07.01.010 - DEFINITIONS
Current through August 31, 2023
For the purposes of this chapter, the following definitions apply. (3-15-22)
01. Ability to Pay. The financial capacity that is available to pay for the program services after allowable deductions in relation to gross income and family size exclusive of any liability of third party payor sources. (3-15-22)
02. Adjusted Gross Income. Total family annual income less allowable annual deductions. (3-15-22)
03. Adult. An individual eighteen (18) years of age or older. (3-15-22)
04. Adult Mental Health Program. A program administered by the Idaho Department of Health and Welfare to serve seriously mentally ill and severely and persistently mentally ill adults. (3-15-22)
05. Allowable Annual Deductions. In determining the family's ability to pay for behavioral health services, the following are allowable annual deductions: (3-15-22)
06. Behavioral Health Services. Services offered by the Department to improve mental health and substance use disorders issues. (3-15-22)
07. Child. An individual who is under the age of eighteen (18) years. (3-15-22)
08. Children's Mental Health Program. A program as defined in IDAPA 16.07.37, "Children's Mental Health Services," administered by the Idaho Department of Health and Welfare. (3-15-22)
09. Court-Ordered Obligations. Financial payments which have been ordered by a court of law. (3-15-22)
10. Court-Ordered Recipient. A person receiving behavioral health services under Sections 19-2524, 20-520(i), and 20-511A, Idaho Code. (3-15-22)
11. Department. The Idaho Department of Health and Welfare. (3-15-22)
12. Dependent Support. An individual that is dependent on their family's income for over fifty percent (50%) of his financial support. (3-15-22)
13. Extraordinary Rehabilitative Expenses. Those payments incurred as a result of the disability needs of the person receiving services. They include annual costs for items including wheelchairs, adaptive equipment, medication, treatment, or therapy which were not included in the medical payments deduction and the annual estimate of the cost of services received. (3-15-22)
14. Family. A family is an adult, or married adults, or adult(s) with children, living in a common residence. (3-15-22)
15. Family Household. Persons in a family related by blood, marriage, or adoption. Adult siblings who are not claimed as dependents and individuals receiving Supplemental Security Income (SSI) or Supplemental Security Disability Income (SSDI) are excluded from consideration as a member of the household for income and counting purposes. Income from minor siblings is excluded from household income. The term "family household" is synonymous with the term "family unit." (3-15-22)
16. Federal Poverty Guidelines. Guidelines issued annually by the Federal Department of Health and Human Services establishing the poverty income limits. The federal poverty guidelines for the current year may be found online at http://aspe.hhs.gov/poverty. (3-15-22)
17. Management Service Contractor (MSC). An independent contractor with whom the Department contracts to manage a statewide network of Department-approved facilities and programs to deliver substance use disorders treatment and recovery support services. (3-15-22)
18. Parent. The person who, by birth or through adoption, is legally responsible for a child. (3-15-22)
19. Recipient. The person receiving services. The term "recipient" is synonymous with the terms: "patient," "participant," "resident," "consumer," or "client." (3-15-22)
20. Sliding Fee Scale. A scale used to determine an individual's financial obligation for services based on Federal Poverty Guidelines and the number of persons in the family household. (3-15-22)
21. Substance Use Disorders Program. A program administered by the Idaho Department of Health and Welfare to serve adolescents and adults with alcohol or substance use disorders. (3-15-22)
22. Third-Party Payor. A payor other than a person receiving services or a responsible party who is legally liable for all or part of the person's care. (3-15-22)
