Subsection 144-101-II-18.02 - DEFINITIONS18. 02-1 Abuse means the infliction of injury, unreasonable confinement, intimidation or cruel punishment that causes or is likely to cause physical harm or pain or mental anguish; sexual abuse or sexual exploitation; or the intentional, knowing or reckless deprivation of essential needs as defined in 22 MRSA §3472. 18. 02-2 Assessing Services Agency (ASA) is an Authorized Entity of the Department of Health and Human Services (DHHS) for Medical Eligibility Determinations that conducts face-to-face assessments, using the DHHS Medical Eligibility Determination form or other DHHS approved form. 18. 02-3 Authorized Entity is an organization authorized by the Department of Health and Human Services (DHHS) to perform specified functions pursuant to a signed contract or other approved signed agreement. 18. 02-4 Blocking is momentary deflection of an individual's movement, when that movement would otherwise be destructive or harmful. Blocking is a moderately intrusive intervention. 18. 02-5 Care Coordinator is a provider responsible for the development and ongoing support of the implementation of the Care Plan. This includes monitoring of the health, welfare and safety of the participant. 18. 02-6 Care Monitor is the Department of Health and Human Services (DHHS) professional who assists the member with the member's enrollment in the waiver services and monitors the services received to assure they are meeting the health and safety needs of the member. 18. 02-7 Care Plan is a comprehensive document that specifies the services a member will receive under this section and the manner in which those services will be provided. 18. 02-8 Contingent Reinforcement is using rewards based upon modification of inherent rights. Positive contingent reinforcement is a reward given contingent upon the occurrence of a target behavior. Negative contingent reinforcement is the removal of an unpleasant event contingent upon the occurrence of a target behavior. Both positive and negative contingent reinforcement result in a higher rate of the target behavior. A contingent reinforcement is a moderately intrusive intervention. 18. 02-9 Environmental alterationis the modification of a site, activity or schedule that appears to be triggering or contributing to a dangerous or maladaptive behavior. 18. 02-10 Exploitation means the illegal or improper use of an incapacitated or dependent member or that member's resources for another's profit or advantage as defined in 22 MRSA §3472. 18. 02-11 Extinctionis withdrawal of attention or planned ignoring of the target behavior that is in response to behavior that is disruptive but not harmful or destructive. This is a mildly intrusive behavioral intervention. 18. 02-12 Mayo Portland Adaptability Inventory(MPAI) is a clinical evaluation tool designed to assist in the clinical evaluation of people during the post-acute (post-hospital) period following acquired brain injury (ABI), and to assist in the evaluation of rehabilitation programs designed to serve these people. The MPAI is one of the tools used to establish eligibility and level of care for the waiver initially and on a yearly renewal basis. For more information see this website http://www. tbims. org/combi/mpai/index. html18. 02-13 Medical Eligibility Determination (MED) Tool means the form approved by DHHS to assess the medical service needs of the member. The information provided by the MED tool will be used in determining the eligibility for the waiver and authorizing services. 18. 02-14 Member is a person determined to be eligible for MaineCare benefits by the Office for Family Independence (OFI) in accordance with the eligibility standards published by the OFI in the MaineCare Eligibility Manual. Some members may have restrictions on the type and amount of services they are eligible to receive. 18. 02-15 Natural Supports include the relatives, friends, neighbors, and community resources that a member or family goes to for support. They may participate in the treatment team, but are not MaineCare reimbursable. 18. 02-16 Neglect means a threat to an member's health or welfare by physical or mental injury or impairment, deprivation of essential needs or lack of protection from these as defined in 22 MRSA §3472. 18. 02-17 Non-exclusionary Timeout is the voluntary withdrawal of an individual from a reinforcing activity or setting while remaining in the reinforcing environment. Coercion may not be used. This is a mildly intrusive behavioral intervention. 18. 02-18 Overcorrectionis activity done in excess of what would reasonably be required simply to restore a setting or situation to its original state. There are two forms of overcorrection. The first involves activity in excess of what is necessary or desired, such as mopping the entire room when milk is spilled onto the floor, rather than simply cleaning the spill. The second, also called positive practice overcorrection, consists of practicing an alternative more desirable behavior, such as spending ten minutes putting glasses into the dishwasher. This is a moderately intrusive intervention. 18. 02-19 Positive behavioral supports are supports that help people develop and engage in adaptive, socially desirable behaviors and overcome patterns of destructive and stigmatizing responding, but which do not entail any limitations upon the individual's rights. Positive behavioral support incorporates a comprehensive set of procedures and support strategies that are selectively employed based on an individual's needs, characteristics, and preferences. 18. 02-20 Prior Authorization(PA)is the process of obtaining prior approval as to the medical necessity and eligibility for a service. 18. 02-21 Redirection is the distraction or diversion of the attention of an individual from a maladaptive or dangerous behavior to a positive or neutral behavior; a suggestion, by word or gesture, that an individual try an alternate activity. No threats or coercion are involved. 18. 02-22 Target Behavior is a specific behavior of an individual that is operationally defined. This is the behavior identified in a behavioral intervention with the intention of purposefully increasing or decreasing the rate of the behavior. 18. 02-23 Token is an object used to positively reward target behavior with the understanding that multiple tokens or objects are exchanged for desired items. 18. 02-24 Token Economy is a system of positive reinforcement to reward target behavior whereas an individual earns a token for eliciting specific target behaviors. A token Economy is a moderately intrusive intervention. 18. 02-25 Utilization Review is a formal assessment of the medical necessity, efficiency and appropriateness of services and Care Plans on a prospective, concurrent or retrospective basis. The provider is required to notify DHHS or its Authorized Entity upon initiation of all services provided under Section 18 in order for the Authorized Entity to begin utilization review. 18. 02-26 Verbal reprimandis a matter-of-fact message, delivered against a background of a generally positive and supportive environment, to express disapproval of an individual's behavior. It must be conveyed without humiliating or threatening language. This is a mildly intrusive behavioral intervention. C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-18, subsec. 144-101-II-18.02