Ariz. Admin. Code § R6-6-2101 - Definitions

Current through Register Vol. 27, No. 52, December 24, 2021

The following definitions apply to this Article:

1. "Agreement file" means the public, documented record of procurement transactions that is maintained by and available at the Division contracts management office.

2. "AHCCCS" means the Arizona Health Care Cost Containment System as established by A.R.S. § 36-2901 et seq.

3. "Application" means the Qualified Vendor application, including any amendments, supplements, or updates submitted by the applicant.

4. "Assistant Director" means the Assistant Director of the Department of Economic Security, Division of Developmental Disabilities.

5. "Authorization" means the approval by the Division or its designee identifying the type and number of units of service a Qualified Vendor is authorized to provide to a specific consumer.

6. "Community developmental disability services" means any service or support the Division is authorized to purchase under A.R.S. § 36-557 on behalf of individuals with developmental disabilities and their families or guardians.

7. "Conflict of interest" means that a Qualified Vendor applicant, a Qualified Vendor, or an officer or employee of a Qualified Vendor applicant or Qualified Vendor has a relative as defined in A.R.S. § 38-502 who is an employee of the Division with direct or indirect responsibility for purchasing, authorizing, monitoring or evaluating community developmental disability services or vendors.

8. "Consumer" means an individual authorized to receive community developmental disability services from the Division.

9. "Consumer and family choice" means the consumer's or consumer's representative's expressed preference to receive services from a specific provider.

10. "Contract list" means a roster of agencies, organizations, and professional independent providers who, on January 1, 2003 have a valid contract or agreement with the Division to provide community developmental disability services.

11. "Day" means calendar day unless otherwise specified.

12. "Department" means the Arizona Department of Economic Security.

13. "Department procurement officer" means the person, or his or her designee, authorized by the Department to make written determinations with respect to purchasing processes or agreements authorized under A.R.S. § 36-557.

14. "Division" means the Division of Developmental Disabilities of the Department of Economic Security.

15. "Division web site" means the Division of Developmental Disabilities internet web site.

16. "Emergency need" means a situation that requires an immediate change in services, in service providers, or in both services and service providers, and is necessary for the health or safety of the consumer.

17. "Independent assessment" means a review by a third party of an authorization decision.

18. "Independent rate model" means a methodology for rate development that includes the definition of the cost components and assumptions used in the development of a reimbursement rate.

19. "Individual Independent Provider" means a person who is qualified to provide service, has a provider identification number and an individual service agreement or a qualified vendor agreement with the Division to provide community developmental disability services.

20. "Individual service agreement" means the legally binding contract between the Division and an individual independent provider to provide community developmental disability services.

21. "Individual support plan" or "ISP" means a written statement of services to be provided to an individual with developmental disabilities including habilitation goals and objectives and a listing of the services, if any, the consumer is authorized to receive. The ISP incorporates and replaces the Individual Program Plan, the placement evaluation, the individualized service program plan and the service program plan used in A.R.S. § 36-557, and for the purposes of these rules incorporates the Individual Family Service Plan (IFSP) as defined in Section 809.1 of the Division of Developmental Disabilities Policy and Procedures Manual.

22. "Individual support plan team" or "ISP Team" means a group of persons including the consumer, the consumer's representative, and other persons selected by the consumer, assembled by the Division and coordinated by the consumer's support coordinator in compliance with A.R.S. §§ 36-551 and 36-560 to develop the consumer's individual support plan.

23. "Itemized service budget" means a description of the cost of services and includes documentation that results in a defined unit rate.

24. "List serv" means an electronic mailing list maintained by the Division for purposes of sending information via electronic mail to a predefined directory of intended recipients.

25. "Negotiated rate" means the amount per unit of service a provider will be paid for services rendered based on successful negotiation of a price with the Division.

26. "Network development plan" means the annual plan developed by the Division that identifies the services and supports anticipated to be needed by consumers throughout the state.

27. "Non-identifying information" means a description that does not provide information that could lead the recipient of the information to recognize a consumer.

28. "Notice of Protest" means a written document signed by the protester and submitted to the Department procurement officer to protest a procurement process or decision under this Article.

29. "Open and continuous process" means that responses to a Request for Qualified Vendor Applications may be submitted by an applicant to the Division at any time during the time period the Request is posted to the Division web site and identified as being open.

30. "Personal financial statement" means documentation of the applicant's financial status for the past three years as represented by copies of federal income tax statements, an accountant's statement of assets and liabilities or other similar documentation of financial status.

31. "Professional Independent Provider" means a person who is licensed or certified under Title 32, Arizona Revised Statutes, who provides services for consumers as a Qualified Vendor and is not an employee or subcontractor of a provider agency.

32. "Program plan" means a response to a requirement specified in the Qualified Vendor application that identifies the services to be provided and the service specific methodology to be followed by the applicant.

33. "Provider" means a Qualified Vendor or an Individual Independent Provider.

34. "Provider organization" means a corporation, professional corporation, partnership, limited liability company, or joint venture that is or applies to be a Qualified Vendor.

35. "Published rate" means the payment amount per unit of service established by the Division for the purchase of a community developmental disability service.

36. "Qualified Vendor" means a provider of community developmental disability services that has applied for Qualified Vendor status, meets the criteria for Qualified Vendor status, and has entered into a Qualified Vendor Agreement with the Division.

37. "Qualified Vendor Agreement" means the legal, binding document between the Division and a Qualified Vendor describing the services the Qualified Vendor is qualified to provide and the terms and conditions governing the relationship between the Division and the Qualified Vendor including any amendments, attachments, schedules, or exhibits.

38. "Qualified vendor list" means the roster of vendors who have entered into Qualified Vendor Agreements with the Division.

39. "Quality management plan" means the procedures used to monitor service and system performance and to define and implement actions that will result in service and system improvements.

40. "Request for Problem Solving" means a written document, signed by the protester and submitted to the Division to protest a procurement process or decision under this Article that requests informal problem solving actions be taken by the Division.

41. "Request for Qualified Vendor Applications" means a notice issued by the Division requesting vendors to apply to be Qualified Vendors for the delivery of community developmental disability services.

42. "Vendor Call for Services" means a notice from the Division inviting Qualified Vendors and individual independent providers to submit a response indicating their availability to provide services for a specific consumer or specific group of consumers, based on the requirements defined in the consumer's ISP.

43. "Vendor Call Response" means a response to a Vendor Call for Services that indicates the provider's availability to provide the requested service or services and describes how the provider proposes to meet the special accommodations needed for a specific consumer or specific group of consumers, based on the consumer's ISP.

44. "Title XIX" means that section of the federal Social Security Act that authorizes the provision of Medicaid services including acute care and long-term care services.

Notes

Ariz. Admin. Code § R6-6-2101
New Section made by exempt rulemaking at 9 A.A.R. 170, effective February 1, 2003 (Supp. 03-1). Amended by exempt rulemaking at 9 A.A.R. 4656, effective October 9, 2003 (Supp. 03-4).

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