Utah Admin. Code R434-30-2 - Definitions

The definitions in Section 26-10b-101 apply. In addition:

(1) "Equipment" is defined as: capital equipment that:

(a) costs $5,000 or more, or is a group of items costing less than $5,000 each, when combined makes up one functional unit with a combined cost of $5,000 or greater;

(b) has a life span of three years or more;

(c) is non-expendable material; and

(d) is not consumed.

(2) "Office" means the Utah Department of Health, Division of Family Health and Preparedness, Bureau of Emergency Medical Services and Preparedness, Office of Primary Care and Rural Health.;

(3) "Children who are not eligible for Medicaid or CHIP" means individuals who are age 18 years and under and for whom at least one of the following apply:

(a) who have applied for Medicaid or CHIP coverage and have been denied;

(b)

who have been informed that they have lost Medicaid or CHIP coverage;

; or

(c) who receive a service not covered by CHIP, Medicaid, other public health care coverage, or private insurance.

(4) "Children who have insurance" means individuals who are age 18 years and under and who are eligible for CHIP, Medicaid, other public health care coverage, or private insurance, either on their own or through their parents' health care coverage.

(5) "Follow-up Patient Visit" means face-to-face contact after an initial patient visit between an eligible individual and the awarded agency's provider who exercises independent judgment in providing services to the eligible individual and where the services provided under the Primary Care Grant Program are rendered and recorded in the eligible individual's records.

(6) "Initial Patient Visit" means any person, or member of a family, served by the awarded agency for the first time within three years, who is considered medically underserved.

(7) "Innovative" means whether the aspects are new, different, or more efficient, while also providing significant benefit to the community and the underserved populations served by the project.

(8) "Low-income" means individuals at or below 200% of the Federal Poverty Level, as established and published annually by the U.S. Department of Health and Human Services.

(9) "Medically Underserved" means geographic areas or populations with limited access to primary healthcare services.

(10) "Referral to CHIP" means an individual who is age 18 years and under or parents of an individual 18 years and under who has been informed of the availability of CHIP and Medicaid and provided information to contact the Department, Bureau of Eligibility Services local office, outreach location, or telephone unit for determination of their eligibility for Medicaid or CHIP.

(11) "Sliding fee scale" means a system of patient co-payment or fee per clinical visit, which varies by income and other variables, such as family size.

(12) "Sustainable" means a project or service that can be continued without Primary Care Grant Program funds.

(13) "Underinsured" means individuals with public or private insurance that does not cover necessary health care services, resulting in out- of-pocket expenses that exceed their ability to pay; or individuals who are denied full coverage plans from work; have health insurance plans which only cover the worker and not the family or extended family; or have health insurance plans with high deductibles or co-insurance.

(14) "Uninsured" means individuals who lack public or private insurance and who are unable to afford health insurance or are denied paid health care through their employer;

Notes

Utah Admin. Code R434-30-2

Amended by Utah State Bulletin Number 2022-09, effective 4/22/2022