Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 40 - Division of Maternal, Child and Family Health › Chapter 1 - Crippled Children's Service (CCS) › Section 19 CSR 40-1.010 - Definitions Relating to the Crippled Children's Service (CCS)

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule defines terminology used
				  throughout this chapter.
(1)
				Administrator means the administrator of CCS as designated in section
				201.050,
				RSMo (1986).
(2) Advisory committee
				means the general advisory committee, as defined in section 201.110, RSMo 1986.
				This committee shall be comprised of a majority of physicians, as licensed
				under Chapter 334, RSMo 1986, and the remainder of consumers, other health care
				personnel and interested parties. It shall meet at least once a year and shall
				select a chairperson among its members to voice the committee's collective
				advice.
(3) Care means specialized
				treatment services and does not include general medical care, which remains the
				responsibility of the client or the client's family and the referring health
				provider. Care does not include education or domiciliary care.
(4) Case finding means a method of locating
				children who can benefit from CCS. This shall be accomplished through close
				cooperation of local physicians, hospitals, other health providers, schools,
				official and voluntary agencies, parents and other interested
				individuals.
(5) Case management
				means management of resources across agency and professional lines to develop
				and attain the client's care plan with optimal participation of the client or
				the client's family or both.
(6)
				Central office means that portion of the CCS which has the responsibility and
				authority to administer the statewide program.
(7) Diagnostic services means services which
				include, but are not limited to, medical, social, psychological and other
				services necessary to identify the presence of a handicapping disability, its
				cause and complications and to determine the extent to which the disability
				limits or is likely to limit an individual's daily living and work
				activities.
(8) District and
				subdistrict office means that portion of CCS which includes case managers and
				personnel who interact directly with individual clients and providers of
				care.
(9) Financial eligibility
				means eligibility for those health services offered by CCS, based on the
				financial status of the client or the client's family or the client's
				guardians. Categories of financial eligibility have been established by CCS in
				19 CSR
				40-1.040.
(10) Habilitation means the continuous
				development of skills and abilities.
(11) Individual care plan (ICP) means a
				written statement developed by a provider of care, interdisciplinary team, case
				manager, parents or guardians and the child, if possible, which analyzes the
				child's achievement level, lists short-range and annual goals, describes
				specific services needed to meet those goals and develops a schedule for
				monitoring progress.
(12)
				Interdisciplinary team means a team of professionals representing a variety of
				disciplines which provides services to persons with physical
				handicaps.
(13) Services means
				services in hospitals, convalescent homes and clinics by physicians,
				chiropractors, dentists, nurses, medical social workers, nutritionists,
				dietitians, physical therapists, occupational therapists, speech pathologists
				and audiologists, technicians and other personnel whose services are needed in
				the CCS programs.
(14) Medical
				eligibility means eligibility for those health services offered by CCS as based
				on medical condition. Categories of medical conditions acceptable for services
				have been established in
				19 CSR
				40-1.030.
(15) Crippled Children's Service or CCS is
				the agency of the Department of Health for facilitating the early
				identification of physically handicapped children and of individuals who have
				the potential of producing physically handicapped children; the provision of
				preventive, diagnostic and treatment services, including case management
				services, for the restoration of optimum health for physically handicapped
				children; the development, strengthening and improvement of standards and
				techniques relating to the provision of those services; the training of
				personnel engaged in the provision of those services or the strengthening and
				improvement of services; and the necessary administration to provide services
				to physically handicapped children and individuals at risk of having physically
				handicapped children.
(16)
				Physically handicapped child means an individual below the age of twenty-one
				(21) years who has a disease, defect or condition which may hinder the
				achievement of normal physical growth and development.
(17) Pre-authorization means written
				permission obtained from CCS in advance of an action which would result in
				either the obligation or expenditure of funds or the performance of an
				activity.
(18) Program
				administrator means the person responsible for planning, developing,
				implementing and monitoring the program of special health services on a
				statewide basis for handicapped children.
(19) Program coordinator means the person
				responsible for coordinating a segment of the CCS and the duties assigned to
				that segment.
(20) Provider of care
				means an individual who is regulated under Chapters 331, 332, 334-338 and
				344-346, RSMo Supp. 1988; or an organization licensed under Chapter 197, RSMo
				Supp. 1988 or approved by the Joint Commission on Accreditation of Hospitals or
				the American Osteopathic Association.
(21) Rehabilitation means the process of
				improving or reestablishing an individual's skill or level of adjustment by
				increasing the ability to maintain an optimum level of independent
				functioning.
(22) Third-party payer
				means any person, corporation, trust, association, the state of Missouri, any
				governmental subdivision or agency or any other legal entity which pays
				directly or indirectly for health care services provided to another person or
				reimburses or pays a benefit to or on behalf of another person for health care
				services in conformance to a contract, plan, employee benefit or member
				benefit.
*Original authority: 192.005, RSMo 1985 and 201.060, RSMo
					 1959.