The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
Allowable cost- Expenses considered reasonable, necessary and related to the service provided.
Applicant-An entity that is in the process of enrolling in the Medical Assistance program as a provider of HCBS.
Base-funding- Reimbursement provided exclusively by a grant to a county under the Mental Health and Intellectual Disability Act of 1966 (50 P.S. §§ 4101-4704) or Article XIV-B of the Human Services Code (62 P.S. §§ 1401-B-1410-B).
Corrective action plan-A document that specifies the following:
Cost report- A data collection tool issued by the Department to collect expense and utilization information from a provider that may include supplemental schedules or addenda as requested by the Department.
Department-The Department of Human Services of the Commonwealth.
Designated managing entity-An entity that enters into an agreement with the Department to perform administrative functions delegated by the Department, as the Department's designee. For base-funding, this includes the county mental health and intellectual disability program.
Fixed asset-A major item, excluding real estate, which is expected to have a useful life of more than 1 year or that can be used repeatedly without materially changing or impairing its physical condition through normal repairs, maintenance or replacement of components.
HCBS-Home and community-based service- An activity, assistance or product provided to an individual that is funded through a Federally-approved waiver program or the State plan.
Health care practitioner-A person who is authorized to prescribe medications under a license, registration or certification by the Department of State.
Individual-A woman, man or child who receives a home and community-based service or base-funding service.
Individual plan- A coordinated and integrated description of person-centered activities, including services and supports for an individual.
Life sharer-An employee or a contracted person who shares a common home and daily life experience with an individual, providing service and support as needed in both the home and the community.
Provider- The person, entity or agency that is contracted or authorized to deliver the service to the individual.
Restraint-A physical, chemical or mechanical intervention used to control acute, episodic behavior that restricts the movement or function of the individual or a portion of the individual's body, including an intervention approved as part of the individual plan or used on an emergency basis.
SSI-Supplemental security income.
State plan-The Commonwealth's approved Title XIX State Plan.
Service-An activity, assistance or product provided to an individual and paid through a Federally-approved waiver program, the State plan or base-funding. A service includes an HCBS, support coordination, TSM, agency with choice, organized health care delivery system, and vendor goods and services, unless specifically exempted in this chapter.
Support-An unpaid activity or assistance provided to an individual that is not planned or arranged by a provider.
TSM-Targeted support management.
Vacancy factor-An adjustment to the full capacity rate to account for days when the residential service provider cannot bill due to an individual not receiving services.
Volunteer-A person who is an organized and scheduled component of the service system and who does not receive compensation, but who provides a service through the provider that recruits, plans and organizes duties and assignments.
55 Pa. Code § 6100.3
This section cited in 55 Pa. Code § 6100.43 (relating to regulatory waiver); 55 Pa. Code § 6100.801 (relating to agency with choice); 55 Pa. Code § 6100.804 (relating to base-funding); and 55 Pa. Code § 6100.805 (relating to vendor goods and services).