TITLE 59: MENTAL HEALTH
CHAPTER I: DEPARTMENT OF HUMAN SERVICES
PART 120 MEDICAID HOME AND COMMUNITY-BASED SERVICES WAIVER PROGRAM FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES
SECTION 120.10 DEFINITIONS


 

Section 120.10  Definitions

 

For the purposes of this Part, the following terms are defined:

 

            "Code."  The Mental Health and Development Disabilities Code [405 ILCS 5].

 

            "Community integrated living arrangement (CILA)."  A living arrangement provided by a licensed community developmental disabilities services agency where eight or fewer individuals with a developmental disability reside under the supervision of the agency. Individuals receive a customized array of flexible habilitation or personal care supports and services in the home, in day programs and in other community locations under the supervision of a community support team within the local agency.  [210 ILCS 135/3(d)]

 

            "Community living facility (CLF)."  A facility geared to assist the individual in preparing for independent living.  Emphasis is placed on teaching the individual adequate social and daily living skills. Individuals are involved in practical experiences in community living and are guided in planning for and using leisure time and developing the ability to function independently in the community.  Community living facilities are limited to no more than 20 individuals, age 18 or older (Community Living Facilities Licensing Act [210 ILCS 35]).

 

            "Community residential alternatives (CRA)."  A group home, as defined in the Community Residential Alternatives Licensing Act [210 ILCS 140], for eight or fewer adults with developmental disabilities who are unable to live independently but are capable of community living if provided with an appropriate level of supervision, assistance and support services.  A community residential alternative may provide training and guidance to individuals in the skills of daily living and shall provide opportunities for participation in community activities.  A community residential alternative shall not be a medical or nursing facility. [210 ILCS 140/3(4)]

 

            "Confidentiality Act."  The Mental Health and Developmental Disabilities Confidentiality Act [740 ILCS 110].

 

            "Days."  Unless otherwise indicated, means calendar days.

 

            "Department."  The Department of Human Services.

 

            "Developmental training."  A day program that focuses on the development and enhancement of daily living skills such as motor development, dressing, grooming, toileting, eating, language, reading and writing, quantitative skills, capacity for independent living, economic self-sufficiency and reduction of maladaptive behaviors.

 

            "Grant agreement."  When fully executed the obligating instrument providing the basis for Departmental financial participation in grant-in-aid programs and which formalizes the contractual relationship between the Department and the provider indicating the amount of Department funds which will be paid to the provider for the provision of services as described in the grant agreement and the agency plan.  Requirements for grant-in-aid funded providers are contained in the Department's rules at 59 Ill. Adm. Code 103.

 

            "Guardian."  A person appointed by the court as the plenary or limited guardian or conservator of the individual for an individual over age 18 so long as the limited guardian's duties encompass concerns related to service requirements or the natural or adoptive parent of a minor or a person acting as a parent of a minor.

 

            "Habilitation."  An effort directed toward the alleviation of a developmental disability or toward increasing the level of physical, mental, social or economic functioning of an individual with a developmental disability. Habilitation may include, but is not limited to diagnosis, evaluation, medical services, residential care, day care, special living arrangements, training, education, sheltered employment, supported employment, protective services, counseling and other services provided to individuals with developmental disabilities by developmental disabilities facilities. (Section 1-111 of the Code)

 

            "Home individual program (HIP)."  A program which provides support and training to one or two individuals with developmental disabilities in a home environment.

 

            "Individual."  A person with developmental disabilities who is requesting, is receiving or has received services under this Part.

 

            "Individual service/support plan."  A written plan of care, consistent with the individual's diagnosis and needs, which describes the habilitation goals and a projected timetable for their attainment and the services/support to be provided as defined in Section 4-309 of the Code.

 

            "Intermediate care facility for the mentally retarded (ICF/MR)." Medicaid-certified long-term care facility as defined by 42 CFR 440.150 (1996) serving individuals with developmental disabilities. ICF/MR includes community facilities licensed by the Department of Public Health for skilled/pediatric nursing (77 Ill. Adm. Code 390) (if certified as ICF/MR), intermediate care for the developmentally disabled (77 Ill. Adm. Code 350), intermediate care for the developmentally disabled with 16 beds and under (77 Ill. Adm. Code 350) and State-operated developmental centers.

 

            "Mental retardation." Significantly subaverage general intellectual functioning which exists concurrently with impairment in adaptive behavior and which originates before the age of 18 years. (Section 1-116 of the Code)

 

            "Nursing facility."  A Medicaid-certified long-term care facility. Nursing facilities include facilities licensed by the Department of Public Health for skilled/pediatric nursing (77 Ill. Adm. Code 390) (unless certified as ICF/MR), intermediate care and skilled nursing (77 Ill. Adm. Code 300).

 

            "Pre-admission screening and resident review (PASARR) agents."  Community agencies or units of local government selected by the Department to act as agents of the Department in carrying out certain federal and State requirements related to the assessment, determination of eligibility, and arrangements for Medicaid-funded services and supports for individuals with a developmental disability.

 

            "Program." The Medicaid Home and Community-Based Services Waiver Program implemented in this Part.

 

            "Provider."  Government, not-for-profit or private for-profit agency under contractual obligation with the Department to provide services to individuals with developmental disabilities.

 

            "Purchase of service contract."  When fully executed, the obligating instrument providing the basis for Departmental financial participation in purchase of service contract programs, and which formalizes the contractual relationship between the Department and the provider indicating the amount of Department funds which will be paid to the provider for the provision of services as described in the purchase of service contract.

 

            "Qualified mental retardation professional."  A person who meets the standards defined in the Department's rule at 59 Ill. Adm. Code 115.120, consistent with the federal standards at 42 CFR 442.400 (1996).

 

            "Respite."  The provision of temporary care and supportive services to allow an individual to remain in the community.

 

            "Secretary."  The Secretary of the Department of Human Services or his or her designee.

 

            "Service coordination."  The coordination and monitoring of supports to assist an individual in planning and evaluating necessary services to ensure a comprehensive array of supports and services to meet an individual's needs, personal goals and choices as defined in the individual service/support plan.

 

            "Special home placement (SHP)."  Foster home placement designed for individuals who can benefit from the interaction of family living.

 

            "State-operated developmental center."  A residential facility providing services and supports to individuals with developmental disabilities and operated by the State of Illinois, under the jurisdiction of the Department; also called a State-operated facility.

 

            "Supported employment (SEP)."  Paid work with ongoing support services in a variety of integrated work settings in which persons without disabilities are also employed.

 

(Source:  Amended at 20 Ill. Reg. 4762, effective March 8, 1996)