Connecticut Administrative Code › Title 17a - Social and Human Services and Resources › 230 - Funding Program for Privately Operated Community Residences for Mentally Retarded Persons › Section 17a-230-1 - Definitions

Current through July 10, 2024
(a) "
Admission
" means a private
			 residential facility's acceptance of an individual into residence.
(b) "
Authorization
" means the
			 department of mental retardation's acceptance of responsibility for
			 programmatic payment for an individual.
(c) "
Case review
" means
			 examination of referral materials, records of decision making process of
			 regional eligibility teams or private providers, and additional information as
			 needed for the purposes of determining whether or not a person subjected to the
			 authorization process or selection process for residential placement in a
			 private residential facility had been unreasonably denied fair
			 consideration.
(d)
			 "
Commissioner
" means the commissioner of the department of mental
			 retardation.
(e)
			 "
Department
" means the department of mental retardation.
(f)
"Emergency placement"
means
			 the admission of an individual into a private residential facility for reasons
			 considered emergency by the provider (ex: an individual rendered homeless or
			 where his or her principal caretaking person becomes unavailable).
(g) "
Existing facilities
" means
			 private residential facilities except community training homes, residential
			 schools or habilitative nursing facilities, licensed under 19a-467 on or before
			 September 30, 1983.
(h) "
Fair
			 hearing
" means the right of the mentally retarded person or private
			 provider to request a hearing or review for the purposes of providing
			 additional information and requesting a decision or justification of
			 determinations made under the provisions of this statute and
			 regulations.
(i)
			 "
Grandfathered individual
" means a person residing in a private
			 residential facility licensed by the department and receiving state payment for
			 the cost of such services prior to October 1, 1983 or any person who is
			 admitted to a private residential facility for the mentally retarded after
			 October 1, 1983, and not later than December 31, 1983, which private
			 residential facility is licensed by the department after October 1, 1983 and
			 who is receiving state payment for the cost of such services, if (1) not later
			 than July 15, 1983, the applicant for licensure owns or has an interest in the
			 private residential facility or land upon which the private residential
			 facility shall be located, or concludes a closing transaction on any mortgage
			 loan secured by mortgage on such private residential facility or land, (2) such
			 private residential facility is licensed not later than December 31, 1983, and
			 (3) the applicant for licensure presents evidence to the commissioner that
			 commitments had been made by such applicant not later than July 15, 1983, for
			 the placement of individuals in such private residential facility.
(j) "
Impartial individual
" means
			 a person who has had at least two years experience related to residential
			 services to mentally retarded persons and has not participated in any decision
			 on the clients' eligibility or level of care.
(k) "
Level of care
" means that
			 degree of supervision, programming and intervention necessary to meet the needs
			 of a given population or individual.
(l) "
Mentally retarded person
"
			 means an individual with significant sub-average general intellectual
			 functioning existing concurrently with deficits in adaptive behavior and
			 manifested during the developmental period.
"Mental retardation" means the condition of a mentally retarded
				person as defined, includes borderline intelligence, and shall be determined by
				a psychologist licensed in the State of Connecticut.
(m) "
Pre-authorization process
"
			 means the method of determination by a regional eligibility team of the
			 clients' eligibility for authorization or payment according to his appropriate
			 level of care for the purposes of providing information to private providers
			 essential to the development of private residential facilities and client
			 selection.
(n) "
Overall plan
			 of care
" means an individual written plan of programs and services
			 developed, implemented, reviewed and modified according to the resident's needs
			 and in accordance with the department's licensing regulations.
(o) "
Private residential
			 facility
" means any residence licensed by the department or proposed to
			 be licensed by the department pursuant to Section 19a-467 CGS excluding
			 community training homes, residential schools and habilitative nursing
			 facilities.
(p) "
Private
			 sector client
" an individual who resides in his own home, family home,
			 or home of friends, or is residing in a privately operated residential
			 program.
(q)
			 "
Provider
" means an individual, partnership or corporation which
			 owns or operates a private residential program.
(r) "
Public sector client
" means
			 an individual who lives in residential accommodations which are owned or
			 operated by the department or who are mentally retarded, duly considered to be
			 clients of the department through existing department practices, and reside in
			 long term care facilities licensed by the department of health
			 services.
(s) "
Ratios
"
			 means the prevailing relationship between public sector clients, urgent waiting
			 list clients, and private sector clients for the purposes of selection of
			 clients for placement in private residential facilities funded by the
			 department under the provisions of this statute and regulations.
(t) "
Reauthorization process
"
			 means the determination by the department that a person, previously authorized
			 for funding is either no longer eligible for funding or continues to be
			 eligible for funding and, if still eligible for funding whether at the same
			 level of care.
(u)
			 "
Referral
" means the written presentation of essential information
			 regarding a public sector, urgent waiting list or private sector client to a
			 regional eligibility team upon which determination shall be made of that
			 client's eligibility for authorization in accordance with these
			 regulations.
(v) "
Residential
			 services
" means the provision of intervention, support or training
			 appropriate to a level of care available in a private residential facility to
			 meet the needs of mentally retarded persons and include direct care,
			 administrative and support staff as well as other resources specified in these
			 regulations which are necessary to ensure the provisions of such
			 services.
(w)
			 "
Respite
" means the temporary emergency or relief placement of a
			 mentally retarded person into a private residential facility for the purposes
			 of providing food, shelter and supervision to that person for a period not to
			 exceed thirty days.
(x)
			 "
Supplemental case review
" means a formal examination by an
			 impartial third party of case review materials for which additional information
			 and testimony may be given for the purposes of determining whether or not the
			 individual has been unreasonably denied fair consideration during the
			 authorization or selection process.
(y) "
Transfer
" means the process
			 by which the department shall coordinate efforts to secure an appropriate
			 alternative residential placement for an individual who is not reauthorized for
			 funding or not reauthorized at his present level of care.
(z) "
Urgent waiting list client
"
			 means an individual who is considered to be a client of the department through
			 existing department practices who has met the existing department criteria of
			 urgent need for residential placement as determined clinically through
			 interdisciplinary team review, and whose name is maintained by the department
			 on waiting lists for residential placement.