Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.09 - MEDICAID BASIC PLAN BENEFITS › COVERED SERVICES › SUB AREA: ESSENTIAL PROVIDERS › Section 16.03.09.850 - SCHOOL-BASED SERVICE: DEFINITIONS

Current through August 31, 2023
01.
Activities of Daily Living (ADL)
. The performance of basic
				  self-care activities in meeting a participant's needs for sustaining them in a
				  daily living environment, including, but not limited to, bathing, washing,
				  dressing, toileting, grooming, eating, communication, continence, mobility, and
				  associated tasks. (7-1-23)T
02.
Children's Habilitation Intervention Services (CHIS)
. CHIS are
				  medically necessary, evidence-informed or evidence-based therapeutic techniques
				  based on applied behavior analysis principles used to result in positive
				  outcomes. These intervention services are delivered directly to
				  Medicaid-eligible students with identified developmental limitations that
				  impact the student's functional skills and behaviors across an array of
				  developmental domains. CHIS include habilitative skill building, behavioral
				  intervention, behavioral consultation, crisis intervention, and
				  interdisciplinary training services. (7-1-23)T
03.
Educational Services
.
				  Services that are provided in buildings, rooms, or areas designated or used as
				  a school or an educational setting, which are provided during the specific
				  hours and time periods in which the educational instruction takes place in the
				  school day and period of time for these students, which are included in the
				  individual educational plan (IEP) for the student. (3-17-22)
04.
Evidence-Based
				  Interventions
. Interventions that have been scientifically researched
				  and reviewed in peer reviewed journals, replicated successfully by multiple
				  independent investigators, have been shown to produce measurable and
				  substantiated beneficial outcomes, and are delivered with fidelity by certified
				  or credentialed individuals trained in the evidence-based model.
				  (3-17-22)
05.
Evidence-Informed Interventions
. Interventions that use elements or
				  components of evidencebased techniques and are delivered by a qualified
				  individual who is not certified or credentialed in an evidence-based model.
				  (7-1-23)T
06.
Human Services
				  Field
. A diverse field that is focused on improving the quality of life
				  for participants. Areas of academic study include sociology, special education,
				  counseling, and psychology, or other areas of academic study referenced in the
				  Medicaid Provider Handbook. (7-1-23)T
07.
School-Based Services
.
				  School-based services are health-related and rehabilitative services provided
				  by Idaho public school districts and charter schools under the Individuals with
				  Disabilities Education Act (IDEA). (3-17-22)
08.
The Psychiatric Rehabilitation
				  Association (PRA)
. An association that works to improve and promote the
				  practice and outcomes of psychiatric rehabilitation and recovery. The PRA also
				  maintains a certification program to promote the use of qualified staff to work
				  with individuals with mental illness.
http://www.psychrehabassociation.org
.
				  (7-1-23)T
09.
Serious Mental
				  Illness (SMI)
. Under 42 CFR
				  483.102(b)(1), a person with
				  SMI: (7-1-23)T
a. Currently or at any time
				  during the year, must have had a diagnosable mental, behavioral, or emotional
				  disorder of sufficient duration to meet the diagnostic criteria specified in
				  the DSM-5-TR; and (7-1-23)T
b. Must
				  have a functional impairment that substantially interferes with or limits one
				  (1) or more major life activities. Functional impairment is defined as
				  difficulties that substantially interfere with or limit role functioning with
				  an individual's basic daily living skills, instrumental living skills, and
				  functioning in social, family, vocational, or educational contexts.
				  Instrumental living skills include maintaining a household, managing money,
				  getting around the community, and taking prescribed medication. An adult who
				  met the functional impairment criteria during the past year without the benefit
				  of treatment or other support services is considered to have a serious mental
				  illness. (7-1-23)T