Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 191 - STATE PLAN FOR THE CHILDREN WITH SPECIAL HEALTH CARE NEEDS PROGRAM › Section 12VAC5-191-10 - Definitions

Current through Register Vol. 40, No. 24, July 15, 2024
The following words and terms when used in this regulation
				  shall have the following meanings unless the context clearly indicates
				  otherwise:
"Appeal" means the client's right to seek relief from an
				  unfavorable decision in obtaining services or assistance included in the
				  plan.
"Applicant" means an individual who applies for the services
				  under this regulation. An application may be filed for or on behalf of a minor
				  or person under a legal disability by a parent, legal guardian, and attorney in
				  fact, or an attorney at law.
"Bleeding disorders" means inherited problems in coagulation
				  caused by missing or poorly functioning proteins in the blood such as
				  hemophilia and von Willebrand Disease.
"Board" means the State Board of Health.
"Care coordination" means a process that links individuals
				  and their families to services and resources in a coordinated effort to
				  maximize their potential and provide them with optimal health care.
"Center" means a unit providing Care Connection for Children
				  services.
"CCC" means Care Connection for Children.
"Children and youth with special health care needs" means
				  individuals who are ages birth to their twenty-first birthday and have, or are
				  at increased risk for, a chronic physical, developmental, behavioral, or
				  emotional condition and who also require health and related services of a type
				  or amount beyond that required by children generally.
"Client" means an individual who meets all the eligibility
				  criteria for a program and has been accepted for services.
"Commissioner" means the Commissioner of Health.
"Community-based" means a framework within which a variety of
				  programs work together to meet the many, varied needs of children, youth, and
				  families in communities.
"CSHCN" means children with special health care needs.
"Culturally-competent" means the ability to provide services
				  to clients that honor different cultural beliefs, interpersonal styles,
				  attitudes and behaviors and the use of multicultural staff in the policy
				  development, administration, and provision of those services.
"Department" means the Virginia Department of Health and
				  includes the central office, regional offices, health districts, and local
				  health departments.
"Developmental disorder" means a delay(s) in maturation or
				  deviant maturation of physical, language, sensory, motor, cognitive, social,
				  learning or self-help capabilities to the extent that there is a negative
				  impact on a child's ability to adapt to or cope with the typical environmental
				  demands as expected for chronological age.
"Direct health care services" means medically necessary
				  services for the treatment and monitoring of a condition(s) covered by the
				  program. The services are generally delivered one-on-one between a health care
				  professional and a client in an office, home, clinic, outpatient department, or
				  hospital.
"Director" means the Director, Children with Special Health
				  Care Needs Program.
"Division" means the Division of Child and Family Health.
"Enabling services" means support services that allow or
				  provide for access to and the receipt of benefits from an array of basic health
				  care services.
"Family" means the client and other such household members
				  who together constitute one economic unit. An economic unit is one or more
				  individuals who generally reside together and share income.
"Family-centered care" means an approach to the planning,
				  delivery, and evaluation of health care whose cornerstone is active
				  participation between families and professionals. Family-centered care
				  recognizes that families are the ultimate decision makers for their children,
				  with children gradually taking on more and more of this decision-making
				  themselves.
"Family-to-family support" means the provision of information
				  and peer support among families having experience with family members having
				  special health care needs.
"Guardian" means a court-appointed guardian of the person.
"Information and referral services" means assisting clients
				  and their families to find available services, responding to inquiries from the
				  general public, and disseminating information for accessing specific
				  services.
"MCH" means maternal and child health.
"Medical home" means a concept in which the child has an
				  ongoing source of health care from a primary care physician who works together
				  with the family to ensure that the child has accessible, continuous,
				  comprehensive, family-centered, coordinated, compassionate, and culturally
				  effective medical care.
"Parent" means a biological or adoptive parent or a
				  stepparent.
"Plan" means the State Plan for the Children with Special
				  Health Care Needs Program prepared pursuant to Title V of the United States
				  Social Security Act, as amended.
"Pool of funds" means funds designated for payment of direct
				  health care services. Access to the pool is not an entitlement and is subject
				  to availability of funds and guidelines that govern its eligibility and
				  coverage of services.
"Population-based services" means preventive interventions
				  and personal health services developed and available for the entire MCH
				  population of the Commonwealth rather than for individuals in a one-on-one
				  situation.
"Program" means the Children with Special Health Care Needs
				  Program.
"Provider" means an individual or agency that provides a
				  service under an agreement between the individual or agency and the Children
				  with Special Health Care Needs Program or its contractors.
"Resident" means an individual who resides within the
				  geographical boundaries of the Commonwealth.
"Services" means those activities provided or arranged by the
				  various programs within the Children with Special Health Care Needs Program.
"Sickle cell disease" means any inherited hemoglobin pattern
				  with a predominance of hemoglobin (S) in absence of, or greater than normal
				  hemoglobin (A); or hemoglobin S with another hemoglobin variant such as C, D,
				  or E or beta thalassemia.
"Sickle Cell Program Manager" means an employee of the
				  Pediatric Comprehensive Sickle Cell Clinic Network who is designated to be
				  responsible for the administration of the statewide Pediatric Comprehensive
				  Sickle Cell Clinic Network.
"Transition services" means assisting the client and his
				  family in the process of making necessary changes from life as a youth with
				  special health care needs to life as an adult with special health care needs.
				  Aspects to be addressed include health and wellness; education, vocation, and
				  employment; mobility, transportation, and recreation; and legal, insurance,
				  disability benefits, and housing.
"Underinsured" means having medically necessary service needs
				  that exceed an individual's health insurance coverage limits.
"Uninsured" means having no private health insurance or state
				  or federal medical assistance coverage.
Statutory Authority: §§ 32.1-12 and 32.1-77 of
					 the Code of Virginia.