Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 403 - MEDICAID HOME AND COMMUNITY-BASED WAIVER SERVICES (HCBS) FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES › Chapter 1 - ADMINISTRATION AND DEFINITIONS › Section 403-1-003 - DEFINITIONS

Current through June 17, 2024
The following definitions apply to this Title:
003.01
ACTIVITIES OF DAILY LIVING
				(ADLs).
Basic, personal everyday activities, such as eating,
				dressing, and bathing.
003.02
ADULT DAY SERVICE.
A non-habilitative service
				consisting of meaningful day activities which take place in the
				community.
003.03
APPLICANT.
An individual seeking services through
				submission of an application.
003.04
APPLICATION
				DATE.
The date on which the Department receives a completed
				application for services which contains all information necessary to determine
				eligibility.
003.05
ASSESSMENT.
The process of evaluating and identifying
				the preferences, skills, and needs of a participant and what services,
				interventions, and supports would facilitate the health, safety, and welfare of
				that participant.
003.06
ASSISTIVE TECHNOLOGY.
Equipment or a product system
				necessary for a participant's health, welfare, and safety, that is used to
				increase, maintain, or improve functional capabilities of a
				participant.
003.07
AUTHORIZED REPRESENTATIVE.
A person authorized to
				represent the applicant or participant in any matter with the
				Department.
003.08
BEHAVIOR SUPPORT PLAN (BSP).
A written strategy, based
				on person-centered planning and a Functional Behavioral Assessment (FBA), which
				contains specific instructions for a provider designed to reduce the frequency
				and intensity of challenging behaviors of a participant and to adjust
				environment and teach new skills.
003.09
CENTER FOR THE
				DEVELOPMENTALLY DISABLED (CDD).
A residential setting for
				individuals with developmental disabilities in which services are provided for
				a period of more than twenty-four consecutive hours to four or more
				individuals.
003.10
CERTIFIED PROVIDER.
An agency, organization,
				association, or other entity that the Department has certified as meeting
				certification and accreditation requirements under applicable state statutes
				and regulations.
003.11
COMMUNITY INTEGRATION .
The opportunity for an
				individual with a developmental disability to live and interact in community
				settings where individuals without disabilities are present and a habilitative
				service that offers training and staff supports for the acquisition, retention,
				or improvement in self-help; and behavioral, socialization, and adaptive skills
				that take place in the community in a non-residential setting, separate from
				the participant's private residence or other residential living arrangement; or
				any setting outlined and approved in the participant's Individual Support Plan
				(ISP).
003.12
COMPETITIVE INTEGRATED EMPLOYMENT.
Being gainfully
				employed in a job that takes place in an integrated community setting where the
				participant receives a competitive wage for his or her job. Work is performed
				on a full-time or part-time basis (including self-employment) in accordance
				with 34 C.F.R. §
										361.5 (9).
003.13
CONSULTATIVE ASSESSMENT
				SERVICE.
The development, modification, evaluation, or
				implementation of a behavior support plan to assist in maintaining the living
				environment of a participant.
003.14
CUSTOMIZED
				EMPLOYMENT.
Competitive integrated employment for an individual
				with a significant disability in accordance with
				34 C.F.R. §
										361.5(11).
003.15
DAY SUPPORT.
Regularly scheduled activities that take place in a provider-operated or
				controlled non-residential setting, separate from the participant's private
				residence or other residential living arrangement. This service includes the
				provision of personal care, health maintenance, and supervision.
003.16
ELECTRONIC VISIT
				VERIFICATION (EVV).
A tracking system that requires electronic
				verification of when a person receives Medicaid-funded personal care or home
				health services.
003.17
ELIGIBILITY DETERMINATION.
The assessment of an
				individual to determine eligibility for Waiver services.
003.18
ELIGIBILITY
				REDETERMINATION.
The assessment of an individual to determine
				continued eligibility for Waiver services.
003.19
EMERGENCY SAFETY
				INTERVENTION (ESI).
When a provider must physically intervene to
				prevent or reduce the risk of serious harm to the participant or
				others.
003.20
ENVIRONMENTAL MODIFICATION ASSESSMENT.
A functional
				evaluation conducted with a participant to determine whether environmental
				modifications or assistive technology are necessary to enable the participant
				to integrate more fully into the community; provide greater access to the
				participant's home or ensure the health, welfare, and safety of the
				participant.
003.21
FUNDING.
The money used to pay for a participant's
				Waiver services.
003.22
HABILITATION.
The assisting of an individual with
				improving and achieving developmental skills when impairments have caused
				delaying or blocking of initial acquisition of the skills.
003.23
HEALTH AND SAFETY
				PLAN.
A written strategy that outlines supports for a
				participant's specific health and safety needs, based on person-centered
				planning and the individual's health risk factors.
003.24
HOMEMAKER
				SERVICE.
The performance of general household activities, such as
				meal preparation, laundry services, errands, and routine household care. This
				service does not include direct care or supervision of the
				participant.
003.25
HOME MODIFICATIONS.
Physical alterations to a
				participant's residence that are necessary to ensure the health, welfare, and
				safety of the participant or enable the participant to function with greater
				independence.
003.26
INDEPENDENT PROVIDER.
A provider who has not been
				certified by the Department as a Certified Agency Provider.
003.27
INDIVIDUAL BUDGET AMOUNT
				(IBA).
The amount of funds authorized to fund a participant's
				Individual Support Plan, based on the participant's assessed needs.
003.28
INDIVIDUAL EDUCATION
				PROGRAM (IEP).
A written plan of instructional goals and
				objectives developed by a team including the student, parent or legal
				representative, and representatives of the school district, administered though
				the school district.
003.29
INDIVIDUAL FAMILY MEETING (IFM).
A meeting, with the
				participant's Individual Support Planning team at which the participant is
				informed of the program services that are available, the first of which occurs
				prior to the initial Individual Support Plan development, and annually
				thereafter. The team consists of the participant, the participant's legal
				guardian, Service Coordination staff, service providers, other professionals,
				and anyone the participant invites to participate.
003.30
INDIVIDUAL SUPPORT PLAN
				(ISP).
A document which identifies the supports, activities, and
				resources required for a participant to achieve and maintain personal goals and
				health and safety.
003.31
INSTITUTION.
A residential facility within Nebraska
				that assumes total care of individuals admitted. These facilities include, but
				are not limited to, in-patient hospitals, nursing facilities, Intermediate Care
				Facilities for Individuals with Developmental Disabilities (ICF/DD), and
				Institutions for Mental Disease.
003.32
INTEGRATION.
The full participation of all people in their community life which encompasses
				the self-determination, independence, empowerment, and inclusion of children
				and adults with disabilities in all parts of society.
003.33
INTERMEDIATE CARE
				FACILITIES FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES
				(ICF/IID).
An institution that:
(A) Is primarily for the diagnosis,
				treatment, or rehabilitation of the intellectually disabled or individuals with
				related conditions; and
(B)
				Provides, in a protected residential setting, ongoing evaluation, planning,
				24-hour supervision, coordination, and integration of health or rehabilitative
				services to help each individual function at the individual's greatest
				ability.