Ariz. Admin. Code § 6-6-101

Current through Register Vol. 30, No. 45, November 8, 2024
Section R6-6-101 - Definitions

In addition to the definitions found in A.R.S. §§ 36-551 and 36-596.51, the following definitions apply to this Chapter, unless otherwise provided in a specific Article of this Chapter:

1. "Administrative Review" means a mechanism of informal review for decisions made by the Division of Developmental Disabilities.

2. "Adult" means a person aged 18 years or above.

3. "Agency" means any organization, funded by the Division, which provides services to individuals with developmental disabilities.

4. "Agency administrator" means the Chief Executive Officer or designee of an agency.

5. "AHCCCS" means the Arizona Health Care Cost Containment System.

6. "ALTCS" means the Arizona Long-term Care System.

7. "ALTCS service provider" means those service providers through whom health care services are delivered to DD/ALTCS clients.

8. "Appeals Board" means the Department of Economic Security Appeals Board.

9. "Appellant" means any person or the Department who appeals an action under R6-6-1801 et seq.

10. "Appellate Services Administration/Long-term Care" means the Appellate Services Administration/Long-term Care within the Department of Economic Security.

11. "Applicant" means the responsible person as defined in A.R.S. § 36-551 who has applied for Division services.

12. "Assignment of benefits" means the insurer is entitled to deal with the assignee as the owner or pledgee of the policy in accordance with the terms of the assignment.

13. "Behavior management" means procedures designed to increase a client's appropriate behaviors and decrease inappropriate behaviors which are a problem to the client or others.

14. "Behavior-modifying medications" means drugs which are prescribed, administered, and directed for the purpose of reducing or eliminating certain behaviors.

15. "Benefits" means, for the purpose of determining cost of care portion under Article 12, monies received from SSI, SSA, or other governmental funds which may be subject to a cost of care portion for residential and other services provided by the Division.

16. "Case plan" means a written document used by child welfare staff which is a separate and distinct part of the case record. It identifies the case plan goal and target date, objectives, tasks, time-frames, responsible parties, consequences, and barriers. The child welfare care manager is responsible for the development and implementation of the case plan in consultation with the family and service team.

17. "Child" means a person under the age of 18 years.

18. "Community residential setting resident" or "resident" means any person placed for care in a community residential setting whether or not the person is a client of the Department.

19. "Cost of care" means the dollar value of services listed in R6-6-1201(B) provided to a client through the Division.

20. "Cost of care portion" means the percentage of a client's cost of care that a parent, client, or responsible person may be required to pay to the Division to help offset the cost of the client's care.

21. "DD/ALTCS client" means an individual with developmental disabilities who has met the eligibility criteria of both the Division of Development Disabilities and the Arizona Long-term Care System (ALTCS).

22. "DD/non-ALTCS client" means an individual who has met the eligibility criteria of the Division but who does not meet the eligibility criteria of ALTCS.

23. "Direct care staff" means a person who is employed or contracted to provide direct services to clients by either a community residential setting licensee or license applicant, or by an agency applying for or certified to provide Home and Community-based Services.

24. "District Program Manager" or "DPM" means the Division of Developmental Disabilities' administrator or designee in each of the Department's six planning districts.

25. "Emergency measures" means physical management techniques used in an emergency to manage a sudden, intense, or out-of-control behavior.

26. "Evacuation device" means equipment used to facilitate the evacuation of a community residential setting in the event of an emergency.

27. "Exclusion time-out" means a time-out procedure in which an individual is removed from a reinforcing environment to an environment which is less reinforcing or in which there is less opportunity to earn reinforcement.

28. "Family support services" means those services and supports provided by the division and are designed to strengthen the family's role as a primary care giver, prevent inappropriate out-of-home placement, maintain family unity, and reunite families with members who have been placed out of the home."

29. "Family support voucher" means a written authorization provided to a client or responsible person to purchase family support services.

30. "Fee for service" means the costs that are assessed pursuant to R6-6-1201 et seq. for services received from or through the Division.

31. "Fire Risk Profile" means an instrument prescribed by the Division that yields a score for a facility based on the ability of the resident to evacuate the community residential setting.

32. "Forced Compliance" means a procedure in which an individual is physically forced to follow a direction or command.

33. "Grievant" means any person who is aggrieved by a decision of the Department.

34. "Health insurance payments" means the assignment of rights to medical support or other third-party payments for medical care.

35. "Health Plan" means a service provider of health-related services.

36. "Hearing Officer" means any person selected to hear and render a decision in an appeal under Article 22 of this Chapter.

37. "Human Rights Committee" or "HRC" means a committee established by the Director to provide independent oversight and review as described in R6-6-1701 et seq.

38. "IEP" or "Individualized Education Plan" means a written statement for providing special education services to a child with a disability that includes the pupil's present levels of educational performance, the annual goals, and the short-term measurable objectives for evaluating progress toward those goals and the specific special education and related services to be provided.

39. "Income" means, as used in Article 12, net taxable income as reported on the person's last tax return.

40. "Individual service and program plan" or "ISPP" means a written statement of services to be provided to an individual with developmental disabilities including habilitation goals and objectives and determinations as to which services, if any, the client may be assigned. The ISPP incorporates and replaces the Individual Program Plan and the placement evaluation, both as defined in A.R.S. § 36-551, and the service plan as defined in A.R.S. § 36-2938.

41. "Individual service and program plan team" or "ISPP team" means a group of persons assembled by the Division and coordinated by the client's case manager in compliance with A.R.S. §§ 36-551 and 36-560 to develop an ISPP for each client.

42. "Insured" means the party to an insurance arrangement to whom, or on behalf of whom, the insurance company agrees to indemnify for losses, provide benefits, or render services.

43. "Insurer" means the insurance company assuming risk and agreeing to pay claims or provide services.

44. "Least intrusive" or "least obtrusive" means the level of intervention necessary, reasonable, and humanely appropriate to the client's needs, which is provided in the least disruptive or invasive manner possible.

45. "License applicant" means a person or business entity which submits an application to the Division for an initial or a renewal license to operate a community residential setting.

46. "Licensee" means a person or entity licensed as a community residential setting, or a person designated by such person or entity to be responsible for carrying out the requirements under these rules.

47. "Lives independently" means a client who lives in a primary residence in which the Division does not fund, in whole or in part, daily habilitation or room and board and for which the client secures the residence and is the principle signatory on the lease or rental agreement; makes decisions regarding roommates, furnishings, and arrangements for on-site services; makes the payments relating to the residence; and makes decisions to terminate such arrangements or lease or rental agreement.

48. "Main provider record" means a record maintained by a service provider which contains all pertinent information concerning the evaluations of, and the services provided to, a client, and which is located in a designated place.

49. "Mechanical restraint" means any mechanical device used to restrict the movement or normal function of a portion of the client's body, excluding only those devices necessary to provide support for the achievement of functional body position or proper balance.

50. "Medically necessary services" means those covered services provided by a physician or other licensed practitioner of the healing arts within the scope of their practice under state law to prevent disease, disability, and other adverse health conditions or their progression or to prolong life.

51. "Medication error" means that one or more of the following has occurred: a client is given the wrong medication or the wrong dosage, the medication is given at the wrong time or not given at all, or the medication is given via the wrong route or to the wrong person.

52. "Monitoring" means the process of reviewing licensed adult and child developmental homes and community residential settings for compliance with licensing, contractual, or programmatic requirements.

53. "Office of Appeals" means the Office of Appeals of the Department of Economic Security.

54. "Overcorrection" means a group of procedures designed to reduce inappropriate behavior, in specifically:

a. Requiring a client to restore the environment to a state vastly improved from that which existed prior to the inappropriate behavior; or

b. Requiring a client to repeatedly practice a behavior.

55. "Party" means any person appealing an action under R6-6-1801 et seq. or the Department.

56. "Physical restraint" means a procedure whereby one or more persons restrict a client's freedom of movement for the purpose of managing the client's behavior.

57. "Policy" in Article 13 means the written contract effecting insurance or the certificate thereof by whatever name called, and papers attached thereto and made a part thereof.

58. "Program contractor" means the Division of Developmental Disabilities in its position as program contractor to AHCCCS.

59. "Program Review Committee" or "PRC" means a group of persons designated by the District Program manager to review and approve or disapprove all behavior management programs before such programs may be implemented or sent to the Human Rights Committee.

60. "Program Unit" means a location where services are provided.

61. "Protective device" means an appliance used to prevent a client from engaging in self-injurious behavior, used by a medical practitioner to restrain an individual while a treatment or procedure is being performed, or authorized by a medical practitioner for use in response to a medical condition.

62. "Residential service" means a residential living arrangement operated by the Division or by providers funded by the Division, in which clients live with varied degrees of appropriate supervision.

63. "Reinforcer" means any consequence that maintains or increases the future probability of the response it follows.

64. "Response cost" means a procedure designed to decrease inappropriate behaviors by removing earned reinforcers or possessions as a consequence of an inappropriate behavior.

65. "Responsible party" means a client or a person or entity that is obligated or liable to pay the cost of care for a client, including the parent of a minor client, representative payee, guardian, or conservator, and the personal representative of an estate, or the trustee of a trust of which the client is a beneficiary.

66. "Seclusion" or "locked time-out room" means the placement of a client in a room or other area from which the client cannot leave.

67. "Service provider" means an agency or individual operating under a contract or service agreement with the Department to provide services to Division clients.

68. "Services" means developmental disability programs and activities consistent with family support philosophy and operated by or contracted for the Department directly or indirectly, including residential services, family and child services, family and adult services, and case management and resource services.

69. "Standards" means Arizona Revised Statutes, administrative rules, the Code of Federal Regulations, interagency and intergovernmental agreements, and contract provisions that apply to licensing and monitoring community residential settings.

70. "Tardive Dyskinesia" means a slow, rhythmic, automatic stereotyped movement which occasionally occurs, either generalized or in single muscle groups, as an undesired side effect of therapy with certain psychotropic drugs.

71. "Third-party liability" means the resources available from a person or entity that is or may be, by agreement, circumstances, or otherwise, liable to pay all or part of the medical expenses incurred by a Division client.

72. "Third-party payor" means any individual, entity, or program that is or may be liable to pay all or part of the medical cost of injury, disease, or disability of a Division client.

73. "Time-out device" means a secured room or area used to enforce a "time-out procedure."

74. "Time-out procedure" means a procedure in which the client's access to sources of various forms of reinforcement is removed for the purpose of decreasing a client's inappropriate behavior.

75. "Vulnerable adult" means an individual who is 18 years of age or older and who is unable to protect himself from abuse, neglect, or exploitation by others because of a mental or physical impairment according to A.R.S. § 13-3623.

Ariz. Admin. Code § R6-6-101

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Amended paragraph (19) and adopted as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-101 renumbered to R6-6-201, new Section R6-6-101 adopted effective June 7, 1993, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 93-2). Amended effective September 30, 1993, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 93-3). Amended effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Amended effective February 1, 1996; filed in the Office of the Secretary of State December 26, 1995 (Supp. 95-4). Amended under an exemption from A.R.S. Title 41, Chapter 6, effective December 1, 1996; filed in the Office of the Secretary of State November 22, 1996 (Supp. 96-4). Amended by exempt rulemaking at 10 A.A.R. 205, effective January 1, 2004 (Supp. 03-4). R6-6-101(36) reference to Article 20 corrected to Article 22 at request of the Department, Office File No. M10-461, filed December 6, 2010 (Supp. 10-1).