As used in this part 7, unless the context otherwise
requires:
(1)Adult day care means health and social services furnished two or more
hours per day on a regularly scheduled basis for one or more days per week in an
outpatient setting and for the purpose of ensuring the optimal functioning of the
member.
(2)Behavioral programming means an individualized plan that sets forth
strategies to decrease a member's maladaptive behaviors that interfere with the
member's ability to remain in the community. Behavioral programming includes a
complete assessment of maladaptive behaviors of the member, the development
and implementation of a structured behavioral intervention plan, continuous
training and supervision of caregivers and behavioral aides, and periodic
reassessment of the ind
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As used in this part 7, unless the context otherwise
requires:
(1) Adult day care means health and social services furnished two or more
hours per day on a regularly scheduled basis for one or more days per week in an
outpatient setting and for the purpose of ensuring the optimal functioning of the
member.
(2) Behavioral programming means an individualized plan that sets forth
strategies to decrease a member's maladaptive behaviors that interfere with the
member's ability to remain in the community. Behavioral programming includes a
complete assessment of maladaptive behaviors of the member, the development
and implementation of a structured behavioral intervention plan, continuous
training and supervision of caregivers and behavioral aides, and periodic
reassessment of the individualized plan.
(3) Brain injury means an injury to the brain arising from external forces
including, but not limited to, toxic chemical reactions, anoxia, near drownings,
closed or open head injuries, and focal brain injuries.
(4) Eligible person means a person:
(a) Who has a diagnosis of brain injury, as such term is defined in subsection
(3) of this section;
(b) Who is in need of the level of care available in a hospital, rehabilitation
hospital, hospital in lieu of a nursing facility, or is in need of specialized care
provided in a nursing facility in lieu of a hospital;
(c) Who is categorically eligible for medical assistance, or has a gross
income that does not exceed three hundred percent of the current federal
supplemental security income benefit level and resources that do not exceed the
limit established for individuals receiving a mandatory minimum state
supplementation of supplemental security income benefits or, in the case of a
person who is married, do not exceed the amount authorized in section 25.5-6-101;
and
(d) For whom the cost of services would not exceed the average cost of
hospital care.
(5) Independent living skills training means skills and therapies that are
directed at the development and maintenance of community living skills and
community integration. Independent living skills include supervision or training with
respect to or assistance with self-care, communication skills, socialization, sensory
and motor development, reducing maladaptive behavior, community living and
mobility, and therapeutic recreation.
(6) Repealed.
(7) Structured day treatment means structured, nonresidential therapeutic
treatment services that are directed at the development and maintenance of
community living skills and are provided two or more hours per day on a regularly
scheduled basis for one or more days per week. Day treatment services include
supervision and specific training that allows a member to function at the member's
maximum potential. The services include, but are not limited to, social skills training
that allows for reintegration into the community, sensory and motor development
services, and services aimed at reducing maladaptive behavior.
(8) Supported living means assistance or support designed to maximize or
maintain independence and self-direction on a supportive care campus. Supported
living services consist of structured interventions designed to provide:
(a) Protective oversight and supervision;
(b) Behavioral management and cognitive supports;
(c) Interpersonal and social skills development;
(d) Improved household management skills to support independence and
community integration; and
(e) Medical management.
(9) Supportive care campus means a residential campus that provides
supported living services.
(10) Transitional living means a nonmedical residential program that
provides training and twenty-four-hour supervision to a member that will enhance
the member's ability to live more independently.