Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 351.00 - Rates for Certain Adult Foster Care Services › Section 351.02 - Definitions

Current through Register 1525, July 5, 2024
As used in
				101 CMR
				351.00, unless the context requires otherwise, terms
				have the meanings in
				101
				CMR 351.02.
Activities of Daily Living (ADLs)
.
				Fundamental personal care tasks as defined in
				130
				CMR 408.402:
Activities of Daily
				Living (ADLs)
performed as part of an individual's routine of
				self-care. ADLs include, but are not limited to, eating, toileting, dressing,
				bathing, transferring, and ambulation.
Adult Foster Care (AFC)
. Services as
				defined in
				130
				CMR 408.402:
Adult Foster
				Care
.
Adult Foster Care (AFC) Caregiver
. A
				person selected, supervised, and paid by the provider for the provision of
				direct care in accordance with
				130
				CMR 408.415(A):
Direct Care
.
AFC Level I
. A level of payment for
				adult foster care services provided to a member who meets the clinical criteria
				of 130 CMR
				408.419(D)(1):
AFC
				Level I Service Payment
.
AFC Level II
. A level of payment for
				adult foster care services provided to a member who meets the clinical criteria
				of 130 CMR
				408.419(D)(2):
AFC
				Level II Service Payment
.
Alternative Caregiver Days
. A
				short-term placement during which a member receives adult foster care from an
				alternative care provider when the AFC caregiver is temporarily unavailable or
				unable to provide care.
EOHHS.
The Executive Office of Health
				and Human Services established under M.G.L. c. 6A.
Governmental Unit
. The Commonwealth,
				any board, commission, department, division, or agency of the Commonwealth, and
				any political subdivision of the Commonwealth.
Group Adult Foster Care (GAFC)
.
				Services as defined in
				130
				CMR 408.402:
Adult Foster
				Care
.
Intake and Assessment Services
.
				Services as defined in
				130
				CMR 408.402:
AFC Intake and
				Assessment Services
and outlined in
				130
				CMR 408.431(A):
Preadmission Procedures
provided to a MassHealth member
				referred to a provider for AFC services.
MassHealth
. A program of medical care
				and assistance that includes, but is not limited to, payment for certain health
				care services to eligible residents of the Commonwealth established under
				M.G.L. c. 118E and administered by the Executive Office of Health and Human
				Services through its Office of Medicaid.
Medical Leave of Absence (MLOA)
. A
				short-term absence during which a member does not receive AFC from the AFC
				caregiver because the member is temporarily admitted to a hospital or nursing
				facility. Member. A MassHealth eligible member who has received clinical
				authorization by either MassHealth or its designated screening agent for
				payment of adult foster care.
Member
. A MassHealth eligible member
				who has received clinical authorization by either MassHealth or its designated
				screening agent for payment of adult foster care.
Nonmedical Leave of Absence (NMLOA)
. A
				short-term absence during which a member does not receive AFC from the AFC
				caregiver because the member is away from the AFC-qualified setting for
				nonmedical reasons.
Procedure Code
. The service code from
				the Healthcare Common Procedure Coding System (HCPCS).
Provider
. An organization that meets
				the requirements of
				130 CMR
				408.000:
Adult Foster Care
and that
				contracts with MassHealth to provide adult foster care or group adult foster
				care to eligible MassHealth members.
Publicly Aided Individual
. A person
				who receives health care and other services for which a governmental unit is in
				whole or in part liable under a statutory program of public assistance.