Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part I - General Health › Chapter 4 - HEAD INJURY PROGRAM › Section 4.2 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this chapter,
				  have the following meanings, unless the context clearly indicates
				  otherwise:
Agency head
-The Secretary or a deputy
				  secretary designated by the Secretary.
Alternative financial resources
-
(i) All income subject to tax under section
				61 of the Internal Revenue Code (26 U.S.C.A. §
										61).
(ii) Funds which are available to the
				applicant or client by virtue of experiencing a TBI. These include, but are not
				limited to, court awards, insurance settlements and other financial settlements
				made as a result of the TBI and received by any person on behalf of or for the
				use of the applicant or client.
(iii) Funds which are available to the
				applicant or client through other State or Federal programs including, but not
				limited to, Medicaid, Medicare, Social Security Disability Insurance (Title
				II), Supplemental Security Income (Title XVI), veterans' benefits, workers'
				compensation insurance and unemployment compensation insurance.
Applicant
-An individual for whom a completed
				  application for enrollment in HIP has been submitted to the Department.
Authorized representative
-An individual who
				  is authorized by law to make a decision for, or enter into an agreement on
				  behalf of, an applicant or client. The term does not include an employee of the
				  provider unless the employee is appointed by a court to serve as the legal
				  guardian of the applicant or client.
Case management services
-Services to be
				  offered by the provider to a client during the enrollment period.
Case manager
-An individual who delivers case
				  management services to a client through a provider.
Client
-An individual enrolled in HIP.
Day services
-Nonresidential services
				  intended to improve the physical, cognitive, behavioral or functional abilities
				  of the client through therapeutic intervention and supervised activities which
				  are provided on an outpatient basis at a facility belonging to a
				  provider.
Department
-The Department of Health of the
				  Commonwealth.
Division
-The Division of Child and Adult
				  Health Services.
Enrollment period
-The period of time,
				  comprised of the rehabilitation period and the transition period, during which
				  a client is enrolled in HIP.
Fund
-The Catastrophic Medical and
				  Rehabilitation Fund.
HIP-Head Injury Program
-The traumatic brain
				  injury program of the Department.
HIP Peer Review Committee
-A committee,
				  composed of professionals and representatives of organizations offering
				  rehabilitation services in this Commonwealth to persons with traumatic brain
				  injury, whose members are appointed by the Department to review rehabilitation
				  plans and services offered to clients and to recommend actions to improve
				  services.
HIP services
-Rehabilitation and case
				  management services for which the Department authorizes payment through
				  HIP.
Home facilitation
-A formal rehabilitation
				  program which provides a community reentry specialist in the client's home to
				  continue therapy learned by the client and to assist the client in the practice
				  of techniques and strategies for living independently.
Immediate family
-A parent, spouse, child,
				  brother, sister, grandparent or grandchild and, when living in the family
				  household (or under a common roof), all other individuals related by blood or
				  marriage.
Peer review
-A review of services and
				  rehabilitation service plans for clients conducted by the HIP Peer Review
				  Committee for the purpose of advising the Department on best practices to be
				  followed in offering services to clients.
Provider
-An individual, organization or
				  facility that delivers rehabilitation and case management services to clients
				  under a contractual agreement with the Department.
Rehabilitation period
-The period of time
				  that a client receives rehabilitation services through HIP.
Rehabilitation service plan
-The written plan
				  developed by the provider, which states specific goals to be achieved and
				  expected time frames for achievement of each goal.
Rehabilitation services
-Services provided to
				  assist the client to recover from TBI, improve the client's health and welfare,
				  and realize the client's maximum physical, social, cognitive, psychological and
				  vocational potential for useful and productive activity. These services include
				  neuropsychological evaluation, physical therapy, occupational therapy, speech
				  or language therapy, behavior management, home facilitation, therapeutic
				  recreation, prevocational services, case management services and psychological
				  services which may include cognitive remediation.
Secretary
-The Secretary of the
				  Department.
TBI-traumatic brain injury
-An insult to the
				  brain, not of a degenerative or congenital nature, caused by an external
				  physical force that may produce a diminished or altered state of consciousness,
				  which results in impairment of cognitive abilities or physical functioning or
				  in the disturbance of behavioral or emotional functioning. These impairments
				  may be either temporary or permanent and cause partial or total functional
				  disability or psychosocial maladjustment.
Transition period
-The period of time
				  following the rehabilitation period during which a client receives case
				  management services through HIP to guide and assist the client to make the
				  transition out of HIP.