Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Title XIX Rates for Community Health Centers › Section 17-134d-82 - Requirements for payment of case management services

Current through July 10, 2024
(a)
Scope
These regulations set forth the requirements for payment of
				  Case Management Services provided by the State of Connecticut Department of
				  Mental Retardation to persons determined eligible to receive services under
				  Connecticut's Medical Assistance Program pursuant to Section 17-134d of the
				  General Statutes of Connecticut.
(b)
Definitions
For the purposes of Regulation Section 17-134d-82, the
				  following definitions shall apply:
(1)
				"Case manager" means the person responsible for assisting an eligible person to
				gain access to needed services, managing the development of a plan of services,
				securing and coordinating needed services, monitoring an eligible person's
				progress, maintaining family contact, collecting or disseminating data and
				information.
(2) "Case management
				services" means a continuum of supportive activities systematically carried out
				by an individual case manager that are available to assist and enable an
				eligible person to gain access to needed medical, social, educational, or other
				services.
(3) "Calendar quarter"
				means the periods of time in any state fiscal year inclusive of July 1 through
				September 30; October 1 through December 31; January 1 through March 30; and
				April 1 through June 30.
(4)
				"Department" means the State of Connecticut Department of Income
				Maintenance.
(5) "Eligible person"
				means a person who qualifies to receive services under the Connecticut Medical
				Assistance Program pursuant to Section 17-134b of the General Statutes of
				Connecticut, as amended from time to time, and regulations promulgated pursuant
				to Section 17-134d of the General Statutes of Connecticut.
(6) "Needed services" means any medical,
				social, educational, or other services identified as required by an eligible
				person in a plan of services.
(7)
				"Plan of services" means a written document which is developed by a team on an
				annual basis that identifies an eligible person's unique characteristics,
				needs, needed services, and public agencies or private entities that will
				provide or may provide the needed services.
(8) "Representative" means any person,
				organization, or entity authorized to act on the behalf of an eligible person
				through an agreement, or a family member, or a court appointed delegate of the
				eligible person pursuant to provisions in the General Statutes of Connecticut,
				as amended from time to time.
(9)
				"Target group" means those eligible persons specified by the Department to
				receive case management services by age, type or degree of disability, illness
				or condition, or any other identifiable characteristics, or geographic areas or
				political subdivisions, or combination thereof.
(10) "Team" means a group of persons which
				consists of the case manager and shall include one or more of the following:
				the eligible person or his representative; actual or potential providers of
				needed services; pertinent professionals from various disciplines; and any
				other persons whose participation is relevant who convene to develop or review
				a plan of services.