Rule 37.109.103 - DEFINITIONS(1) "Advisory group" means the nine member group appointed as provided in 50-4-810, MCA.(2) "Applicant" means the entity applying for the grant. An entity applying for a grant will be expected to apply for federal grants supporting Public Health Service Act (PHSA) (2007) Section 330 grantees when available.(3) "Bureau of Primary Health Care (BPHC)" means the bureau within the Health Resources and Services Administration (HRSA) of the United States Department of Health and Human Services that oversees the determination of Community Health Center (CHC) status and makes a recommendation regarding federally qualified health center (FQHC) and FQHC look-alike status. A health care center that wants Section 330 grant money from the PHA must apply to the BPHC as provided in 42 CFR 51 c (2007).(4) "Capital Expenditure Application" means an application for a one-time capital expenditure to an existing federally qualified health center to expand services by increasing medical, dental, or mental health capacity by purchasing equipment or renovating clinic facilities.(5) "Centers for Medicare and Medicaid Services (CMS)" is the division of the United States Department of Health and Human Services that confers FQHC and FQHC look-alike status and implements FQHC reimbursement policy.(6) "Community health center (CHC)" means a health care center that meets the requirements of 42 USC 254 b (2007) and 42 CFR 51 c (2007), and is receiving federal Section 330 grant money under the PHSA.(7) "Comprehensive primary health care services" means: (a) basic health services which, for the purposes of this subchapter, shall consist of: (i) health services related to family medicine, internal medicine, pediatrics, obstetrics, or gynecology that are furnished by physicians and where appropriate, physician assistants, nurse practitioners, and nurse midwives;(ii) diagnostic laboratory and radiologic services;(iii) preventive health services, including: (A) prenatal and perinatal services;(B) appropriate cancer screening;(D) immunizations against vaccine-preventable diseases;(E) screenings for elevated blood lead levels, communicable diseases, and cholesterol;(F) pediatric eye, ear, and dental screenings to determine the need for vision and hearing correction and dental care;(G) voluntary family planning services;(H) preventive dental services;(iv) emergency medical services; and(v) pharmaceutical services as may be appropriate for particular centers;(b) referrals to providers of medical services (including specialty referral when medically indicated) and other health-related services (including substance abuse and mental health services);(c) patient case management services (including counseling, referral, and follow-up services) and other services designed to assist health center patients in establishing eligibility for and gaining access to federal, state, and local programs that provide or financially support the provision of medical, social, housing, educational, or other related services;(d) services that enable individuals to use the services of the health center (including outreach and transportation services and, if a substantial number of the individuals in the population served by a center are of limited English-speaking ability, the services of appropriate personnel fluent in the language spoken by a predominant number of such individuals); and(e) education of patients and the general population served by the health center regarding the availability and proper use of health services.(8) "Department" means the Montana Department of Public Health and Human Services.(9) "Department committee" means employees of the department and other persons appointed by the department director to participate in the screening and grant awards determination in this rule.(10) "Expanded Medical Capacity Application" means an application to expand the medical services offered by existing federally qualified health centers or other facilities that have received federally qualified health center look-alike status.(11) "Federally qualified health center" means a facility that meets the definition of 42 USC 1396 d(I)(2)(B) (2007). A FQHC is entitled to receive enhanced Medicaid and Medicare reimbursement. Federally qualified community health centers, federally qualified health center look-alikes, and certain tribal and urban Indian entities are FQHCs.(12) "FQHC look-alike" means a FQHC that has been determined by the United States Department of Health and Human Services to meet the requirements to be a Section 330 grantee but has not received Section 330 grants. A FQHC look-alike is entitled to receive enhanced Medicaid and Medicare reimbursement.(13) "Medically underserved area or population (MUA/MUP)" means an area or population designated by the Secretary of the United States Department of Health and Human Services as having a shortage of primary health services. Designation information may be obtained from the primary care office within the United States Department of Health and Human Services.(14) "New Access Points Application" means an application to create and support a health center which will serve a significant portion of a population located in a medically underserved area (MUA), or designated as a medically underserved population (MUP). Successful applicants will be expected to apply for federally qualified health center look-alike status and federal community health center grants at the first available opportunity.(15) "New Satellite Access Application" means an application by an existing 330 grant funded federally qualified health center to establish a new access point to serve a new patient population that is outside the approved scope of project.(16) "Public Health Service Act (PHSA)" means the federal Public Health Service Act codified at 42 USC 201, et seq. (2007).(17) "Section 330 grantee" means a CHC that meets the requirements of 42 USC 254 b and 254c (2007) and has been awarded federal grant money under the PHSA.(18) "Service Expansion Application" means an application to expand the medical, mental health, or dental services offered by existing federally qualified health centers or other facilities that have received federally qualified health center look-alike status.Mont. Admin. r. 37.109.103
NEW, 2008 MAR p. 959, Eff. 5/9/08.50-4-804, MCA; IMP, 50-4-801, MCA;