Rhode Island Code of Regulations › Title 210 - Executive Office of Health and Human Services › Chapter 40 - Medicaid for Elders and Adults with Disabilities › Subchapter 15 - Disabled Working Adults › Part 1 - Medicaid Code of Administrative Rules, Section 1373 Medicaid for Working People with Disabilities Program › Section 210-RICR-40-15-1.3 - Definitions

Current through June 14, 2024
A. As used herein, the following terms are
				  defined as follows:
1. "Couple" means a person
				  seeking initial or continuing eligibility for Medicaid and his or her spouse,
				  regardless of whether the spouse is also an applicant or beneficiary unless
				  otherwise indicated.
2. "Executive
				  Office of Health and Human Services" or "EOHHS" means the State agency
				  established in 2006 under the provisions of R.I. Gen. Laws Chapter 42-7.2
				  within the executive branch of State government which serves as the principal
				  agency for managing the Departments of Children, Youth, and Families (DCYF);
				  Health (DOH); Human Services (DHS); and Behavioral Healthcare, Developmental
				  Disabilities, and Hospitals (BHDDH).
3. "Long-Term Services and Supports" or
				  "LTSS" means a spectrum of services covered by the Rhode Island Medicaid
				  Program for persons with clinical and functional impairments and/or chronic
				  illness that require the level of care typically provided in a health care
				  institution. Medicaid LTSS includes skilled or custodial nursing facility care,
				  therapeutic day services, and personal care as well as various home and
				  community-based services. Medicaid beneficiaries eligible for LTSS are also
				  provided with primary care essential benefits.
4. "Medicaid Affordable Care Coverage" or
				  "MACC" means eligibility category for individuals and families subject to the
				  Modified Adjusted Gross Income (MAGI) identified in Part 30-00-1 of this
				  Title.
5. "Medicaid health
				  coverage" means the full scope of essential health care services and supports
				  authorized under the State's Medicaid State Plan and/or Section 1115
				  demonstration waiver provided through an authorized Medicaid delivery
				  system.
6. "Primary care essential
				  benefits" means and includes non-LTSS Medicaid health coverage, and includes an
				  array of acute, subacute, and specialty essential benefits, as identified under
				  the Medicaid State Plan, provided by licensed health professionals and
				  providers. These essential benefits include, but are not limited to: health
				  promotion, disease prevention, health maintenance, counseling, patient
				  education, various specialty services and diagnosis and treatment of acute and
				  chronic medical and behavioral health illnesses and conditions in a variety of
				  health care settings (such as office visits, inpatient, home care, day
				  care).
7. "Work supports" means the
				  array of Medicaid services available to beneficiaries who have disabilities who
				  need support to obtain or maintain employment. Depending on whether an LTSS
				  level of care is required, these supports may include: pre-vocational services,
				  education and training opportunities that build on strengths and interests,
				  individually tailored and preference-based career planning, job development,
				  job training, and job support that recognizes each person's employability and
				  potential contributions to the labor market.