Utah Admin. Code R539-1-2 - Definitions
Terms used throughout Title R539 are defined as follows:
(1) "Agency action" means the
same as defined in Section
63G-4-102.
(2) "Applicant" means an individual applying
for a determination of eligibility.
(3) "Attendant care services" means
individually tailored assistance, skill building, supervision, and support for
a person to live as independently as possible in the person's own home or
family home.
(4) "Behavior
intervention" means a specific technique or procedure designed to:
(a) decrease the occurrence of unwanted
target behavior and increase desirable target behavior;
(b) ensure the safety of the person or any
other person;
(c) reduce
significant property damage; or
(d)
teach a skill.
(5)
"Behavior support plan" means a written plan of instruction designed to address
a person's specific unwanted target behavior and teach a wanted target
behavior.
(6) "Brain injury" means
the same as defined in Section
26B-6-401.
(7)
(a)
"Budget limit" means the maximum allowable budget for any self-administered
service and caregiver compensation service described in Rule R539-16.
(b) This budget limit is published on the
division website in the Rate Master document.
(8) "Caregiver" means a person's parent,
step-parent, legal guardian, or spouse who delivers supported living or
attendant care services to the person through the caregiver compensation
service delivery method.
(9)
"Caregiver compensation" means a service delivery method to provide supported
living or attendant care services that allows a caregiver to be paid to provide
extraordinary care to a person.
(10)
(a)
"Cash assets" includes any:
(i)
bond;
(ii) certified
deposit;
(iii) checking
account;
(iv) savings
account;
(v) stock; and
(vi) trust account.
(b) An exempt discretionary trust account as
described in Subsection
26B-6-412(6) is
not included.
(11)
"Department" means the Department of Health and Human Services.
(12) "Director" means the director of the
Division of Services for People with Disabilities as defined in Section
26B-6-401
(13) "Division" means the Division of
Services for People with Disabilities as defined in Section
26B-6-401.
(14) "Employee of the division" means a staff
member employed by the division.
(15) "Extraordinary care" means the same as
defined in Section R414-523-3.
(16) "Fiscal agent" means an individual or
entity contracted by the division to perform fiscal, legal, and management
duties.
(17) "Guardian" means:
(a) the parent of a minor child; or
(b) someone appointed by a court with the
legal authority to make decisions on behalf of an individual deemed incompetent
to make an informed decision in areas of the individual's life.
(18)
(a) "HCBS waiver" or "waiver" means home and
community-based services, which are long term services and support provided to
individuals in their homes or other community settings that satisfy the
requirements of 42 CFR
441.301(c)(4) (2024).
(b) An HCBS waiver includes the:
(i) Acquired Brain Injury Waiver;
(ii) Community Supports Waiver;
(iii) Community Transitions Waiver;
(iv) Limited Supports Waiver; and
(v) Physical Disabilities Waiver.
(19) "Hearing request"
means a written request for an administrative hearing.
(20) "ICF" means an intermediate care
facility for people with intellectual disabilities.
(21) "Person" means an eligible individual:
(a) receiving a division service;
or
(b) on the waiting
list.
(22)
(a) "Person-centered budget" means an annual
budget that reflects the person's assessed needs and preferences.
(b) The budget conforms to the services and
budget amounts set by the RFS Committee.
(23)
(a)
"Person-centered planning" or "PCP" means an individualized approach to
planning services and supports to help a person achieve the person's
goals.
(b) PCP incorporates the
principles of inclusion, informed choice, integration, person-centered
practice, person-centered thinking, and self-determination.
(24) "Person-centered support
plan" or "PCSP" means the support plan developed through the PCP process that
complies with 42 CFR 441-301(c)(2) (2024).
(25) "Provider" means an agency or business
contracted with the division to provide services.
(26) "Provider human rights committee" means
a group established and maintained by the provider that provides a
recommendation to the person's PCSP, regarding the person's human
rights.
(27) "Provider-based" means
a service delivery model for a person to receive a service included in the PCSP
from a provider.
(28) "Qualifying
acquired neurological brain injury" means an eligible diagnosis from the
International Classification of Diseases. Tenth Revision, Clinical Modification
(ICD-10-CM), incorporated by reference in this rule.
(29) "Related Conditions" means the same as
defined in 42 CFR
435.1010 (2024).
(30)
(a)
"Request for services" or "RFS" means a process integrated into Utah System for
Tracking Eligibility, Planning, and Services (USTEPS) that facilitates the
creation of a person-centered budget through an initial budget and any budget
adjustment by submitting:
(i) proposed service
codes, units, and rates;
(ii)
designated start and end dates; and
(iii) evidence of need to the Request for
Services Committee for review.
(31) "Resident" means the same as defined in
Section 26B-6-401.
(32) "SAS
employee agreement" means a binding agreement between the SAS employer and SAS
employee that establishes the terms and conditions of employment.
(33) "SAS employer agreement" means a binding
agreement between the division, the person, and the SAS employer that
establishes the required terms and conditions of participation in the
self-administered services program.
(34)
(a)
"Self-administered services" or "SAS" means a service delivery model where the
person or the person's designee is the employer.
(b) The employer is responsible to manage the
budget and hire employees to administer certain services to the
person.
(35)
"Self-administered services employee" or "SAS employee" means an individual
hired to provide services to a person through the SAS delivery model.
(36) "Self-administered services employer" or
"SAS employer" is either a person, or an individual designated by the person,
responsible for the administration of the person's SAS.
(37) "State match rate" means the state
funded portion of a person's assessed needs as determined through the
person-centered planning process.
(38) "State resident" means an applicant,
person, or guardian who voluntarily lives in the state with the intention of
making the state their place of residence as described in Rule
R414-302.
(39) "Substantial
functional limitation" means the same as defined in Subsection
26B-6-401(9)(a)(iii)
and further includes the following for determining eligibility for DSPD
services:
(a) "Capacity for independent
living" means:
(i) a minor applicant, at least
seven years of age, who cannot:
(A) cross a
street safely;
(B) locate and use a
telephone; or
(C) understand that
it is not safe to accept food, money, or transportation from a
stranger.
(ii) An adult
applicant who lacks basic skills in the areas of shopping, preparing food,
housekeeping, or paying a bill.
(b) "Economic self-sufficiency" means an
adult applicant who:
(i) cannot work more
than 20 hours a week or is paid less than minimum wage without employment
support; and
(ii) receives
disability benefits.
(c)
"Expressive and receptive language" means an applicant:
(i) cannot follow a two-step
instruction;
(ii) does not
demonstrate an understanding of requests;
(iii) lacks functional communication skills;
or
(iv) requires the use of an
assistive device to communicate.
(d) "Learning" means an applicant has a valid
diagnosis of intellectual disability based on the criteria found in the
Diagnostic and Statistical Manual of Mental Disorders, version 5 (2013),
incorporated by reference in this rule.
(e) "Mobility" means an applicant:
(i) cannot self-evacuate from a building
during an emergency without an assistive device; and
(ii) requires the use of an assistive device
for mobility.
(f)
"Self-care" means an applicant requires assistance, training, or supervision
with eating, dressing, grooming, bathing, or toileting.
(g) "Self-direction" means an applicant is:
(i) a minor, at least seven years of age,
significantly at risk in making an age-appropriate decision;
(ii) a significant danger to self or any
other individual without supervision;
(iii) declared legally incompetent;
or
(iv) unable to provide informed
consent for medical care, personal safety, legal matters, financial matters,
habilitative care, or residential matters.
(40) "Support" means required assistance for
any portion of a task that allows a person to:
(a) independently complete any other portion
of the task; or
(b) assume
increasingly greater responsibility for performing the task
independently.
(41)
"Support coordinator" means an employee of the division or an individual
contracted with the division who assists with:
(a) assessing the need of a person receiving
division funding;
(b) completing
written documentation of support;
(c) developing a service and support plan for
a person receiving division funding;
(d) monitoring the appropriate spending of a
person's annual budget;
(e)
monitoring the health and welfare of the person; and
(f) monitoring the quality of each service
used by a person receiving division funding.
(42) "Supported living services" means
one-on-one assistance, skills building, and supervision to a person for
maintaining the health and safety of the person and promoting an independent,
integrated, and self-determined life.
(43) "Team" means the person-centered support
team made up of team members.
(44)
(a) "Team member" means any member of the
person's circle of support who participates in the planning and delivery of any
service and support with the person.
(b) A team member may include:
(i) the person applying for or receiving a
service;
(ii) the parent;
(iii) the guardian;
(iv) the support coordinator;
(v) a friend of the person; and
(vi) any other professional and provider
staff working with the person.
Notes
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