Section 17a-230-1 - Definitions(a) "Admission" means a private residential facility's acceptance of an individual into residence.(b) "Authorization" means the department of mental retardation's acceptance of responsibility for programmatic payment for an individual.(c) "Case review" means examination of referral materials, records of decision making process of regional eligibility teams or private providers, and additional information as needed for the purposes of determining whether or not a person subjected to the authorization process or selection process for residential placement in a private residential facility had been unreasonably denied fair consideration.(d) "Commissioner" means the commissioner of the department of mental retardation.(e) "Department" means the department of mental retardation.(f)"Emergency placement" means the admission of an individual into a private residential facility for reasons considered emergency by the provider (ex: an individual rendered homeless or where his or her principal caretaking person becomes unavailable).(g) "Existing facilities" means private residential facilities except community training homes, residential schools or habilitative nursing facilities, licensed under 19a-467 on or before September 30, 1983.(h) "Fair hearing" means the right of the mentally retarded person or private provider to request a hearing or review for the purposes of providing additional information and requesting a decision or justification of determinations made under the provisions of this statute and regulations.(i) "Grandfathered individual" means a person residing in a private residential facility licensed by the department and receiving state payment for the cost of such services prior to October 1, 1983 or any person who is admitted to a private residential facility for the mentally retarded after October 1, 1983, and not later than December 31, 1983, which private residential facility is licensed by the department after October 1, 1983 and who is receiving state payment for the cost of such services, if (1) not later than July 15, 1983, the applicant for licensure owns or has an interest in the private residential facility or land upon which the private residential facility shall be located, or concludes a closing transaction on any mortgage loan secured by mortgage on such private residential facility or land, (2) such private residential facility is licensed not later than December 31, 1983, and (3) the applicant for licensure presents evidence to the commissioner that commitments had been made by such applicant not later than July 15, 1983, for the placement of individuals in such private residential facility.(j) "Impartial individual" means a person who has had at least two years experience related to residential services to mentally retarded persons and has not participated in any decision on the clients' eligibility or level of care.(k) "Level of care" means that degree of supervision, programming and intervention necessary to meet the needs of a given population or individual.(l) "Mentally retarded person" means an individual with significant sub-average general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period. "Mental retardation" means the condition of a mentally retarded person as defined, includes borderline intelligence, and shall be determined by a psychologist licensed in the State of Connecticut.
(m) "Pre-authorization process" means the method of determination by a regional eligibility team of the clients' eligibility for authorization or payment according to his appropriate level of care for the purposes of providing information to private providers essential to the development of private residential facilities and client selection.(n) "Overall plan of care" means an individual written plan of programs and services developed, implemented, reviewed and modified according to the resident's needs and in accordance with the department's licensing regulations.(o) "Private residential facility" means any residence licensed by the department or proposed to be licensed by the department pursuant to Section 19a-467 CGS excluding community training homes, residential schools and habilitative nursing facilities.(p) "Private sector client" an individual who resides in his own home, family home, or home of friends, or is residing in a privately operated residential program.(q) "Provider" means an individual, partnership or corporation which owns or operates a private residential program.(r) "Public sector client" means an individual who lives in residential accommodations which are owned or operated by the department or who are mentally retarded, duly considered to be clients of the department through existing department practices, and reside in long term care facilities licensed by the department of health services.(s) "Ratios" means the prevailing relationship between public sector clients, urgent waiting list clients, and private sector clients for the purposes of selection of clients for placement in private residential facilities funded by the department under the provisions of this statute and regulations.(t) "Reauthorization process" means the determination by the department that a person, previously authorized for funding is either no longer eligible for funding or continues to be eligible for funding and, if still eligible for funding whether at the same level of care.(u) "Referral" means the written presentation of essential information regarding a public sector, urgent waiting list or private sector client to a regional eligibility team upon which determination shall be made of that client's eligibility for authorization in accordance with these regulations.(v) "Residential services" means the provision of intervention, support or training appropriate to a level of care available in a private residential facility to meet the needs of mentally retarded persons and include direct care, administrative and support staff as well as other resources specified in these regulations which are necessary to ensure the provisions of such services.(w) "Respite" means the temporary emergency or relief placement of a mentally retarded person into a private residential facility for the purposes of providing food, shelter and supervision to that person for a period not to exceed thirty days.(x) "Supplemental case review" means a formal examination by an impartial third party of case review materials for which additional information and testimony may be given for the purposes of determining whether or not the individual has been unreasonably denied fair consideration during the authorization or selection process.(y) "Transfer" means the process by which the department shall coordinate efforts to secure an appropriate alternative residential placement for an individual who is not reauthorized for funding or not reauthorized at his present level of care.(z) "Urgent waiting list client" means an individual who is considered to be a client of the department through existing department practices who has met the existing department criteria of urgent need for residential placement as determined clinically through interdisciplinary team review, and whose name is maintained by the department on waiting lists for residential placement.Conn. Agencies Regs. § 17a-230-1