Ariz. Admin. Code § 9-6-401

Current through Register Vol. 30, No. 50, December 13, 2024

Section R9-6-401 - Definitions

In this Article, unless otherwise specified:

1. "ADAP" means the AIDS Drug Assistance Program.

2. "Adult" means an individual who is:

a. Eighteen or more years old;

b. Married; or

c. Emancipated, as specified in A.R.S. Title 12, Chapter 15.

3. "AHCCCS" means the Arizona Health Care Cost Containment System.

4. "Annual household income" means the adjusted gross income of all adult individuals within a household, as would be reported on the federal income tax return for an individual in the household, modified to include:

a. Federal taxable wages,

b. Tips,

c. Unemployment compensation,

d. Social security income,

e. Self-employment income,

f. Social security disability income,

g. Retirement or pension income,

h. Capital gains,

i. Investment income,

j. Rental and royalty income,

k. Excluded (untaxed) foreign income, and

l. Alimony.

5. "Applicant" means an individual for whom a request for initial enrollment in ADAP is submitted to the Department, as specified in R9-6-404.

6. "Applying for a low-income subsidy" means submitting forms and supporting documentation to the Social Security Administration for determining eligibility for receiving a low-income subsidy.

7. "Calendar day" means any day of the week, including a Saturday, Sunday, or legal holiday.

8. "Case manager" means an individual who:

a. Assesses the needs of a person living with HIV for:

i. Medical services, nursing services, or health-related services, as defined in A.R.S. § 36-401;

ii. Services not related to the treatment of HIV infection, intended to maintain or improve the physical, mental, or psy-chosocial capabilities of a person living with HIV or an individual in the person living with HIV's household;

iii. Housing; or

iv. Financial assistance;

b. If applicable, assists the person living with HIV with obtaining housing, financial assistance, or the services specified in subsection (8)(a)(i) and (ii);

c. Coordinates the interaction of the person living with HIV with individuals providing the services specified in subsection (8)(a)(i) and (ii); and

d. Monitors the interaction of the person living with HIV with individuals providing the services specified in subsection (8)(a)(i) and (ii) to:

i. Determine the effects of the activities of individuals providing the services specified in subsection (8)(a)(i) and (ii) on the needs of the person living with HIV, and

ii. Develop strategies to reduce unmet needs.

9. "CD4-T-lymphocyte count" means the number of a specific type of white blood cell in a cubic millimeter of blood.

10. "Contract pharmacy" means an entity that has a legally binding agreement with the Department to dispense drugs through ADAP to enrolled individuals.

11. "Current" means within the six months before the date on which an:

a. Individual submits the documents specified in R9-6-404 to the Department as an application for initial enrollment in ADAP, or

b. Enrolled individual submits to the Department the documents required in R9-6-407 for continuing enrollment.

12. "Date of application" means the month, day, and year that the Department receives the documents specified in R9-6-404 for enrollment in ADAP.

13. "Drug" means a chemical substance or a compound made by or derived from a plant or animal source that:

a. Has been determined by the U.S. Food and Drug Administration to be useful in the treatment of individuals with HIV infection, and

b. Is available through a prescription order.

14. "Formulary" means a list of drugs that are available to an individual through the individual's health insurance or ADAP.

:

:

.

15. "Health insurance enrollment period" means an interval of time during which an individual may apply for health insurance coverage, including:

a. An annual interval of time, and

b. Any additional intervals of time due to a change in the individual's situation or circumstances.

, as

16. "HIV infection" means the same as in A.R.S. § 36-661.

17. "HIV-care provider" means the physician, registered nurse practitioner, or physician assistant who is treating an applicant or enrolled individual for HIV infection.

18. "Household" means an applicant or enrolled individual and any of the following individuals, as applicable, residing with the applicant or enrolled individual:

a. The applicant's or enrolled individual's spouse;

b. A dependent parent;

c. A parent of a child who is:

i. The applicant or enrolled individual, and

ii. Claimed as a dependent by the parent;

d. A dependent sibling or other relative;

e. A dependent child of the applicant or enrolled individual, regardless of age and including an adopted child or a foster child;

f. A non-dependent child or other relative if claimed or could be claimed as a dependent on the applicant's or enrolled individual's taxes; and

g. A child who is a part of a shared custody agreement of the applicant or enrolled individual, in years for which the child is claimed or could be claimed as a dependent on the applicant's or enrolled individual's taxes.

19. "Job" means a position in which an individual is employed.

20. "Low-income subsidy" means Medicare-provided assistance that may partially or fully cover the costs of drugs and is based on the annual household income for an individual

21. "Medicare" means a federal health insurance program established under Title XVIII of the Social Security Act.

22. "Medicare drug plan" means insurance approved by Medicare to cover some of the costs of drugs for individuals enrolled in Medicare.

23. "Non-permanent housing" means a situation in which an individual is:

a. Living in a place that is not designed to be a sleeping place for human beings or ordinarily used as a primary nighttime sleeping place for human beings, or

b. Living in a shelter or other temporary living arrangement.

.

24. "Person living with HIV" means an individual who is HIV-infected.

25. "Physician" means an individual licensed as a:

a. Doctor of allopathic medicine under A.R.S. Title 32, Chapter 13, or through a similar licensing board in another state; or

b. Doctor of osteopathic medicine under A.R.S. Title 32, Chapter 17, or through a similar licensing board in another state.

26. "Physician assistant" means an individual licensed under A.R.S. Title 32, Chapter 25, or through a similar licensing board in another state.

27. "Poverty level" means the annual household income for a household of a particular size, as specified in the poverty guidelines updated annually in the Federal Register by the U.S. Department of Health and Human Services.

28. "Pre-approved enrollment status" means that an applicant may receive drugs or other services through ADAP on a temporary basis.

29. "Prescription order" means the same as in A.R.S. § 32-1901.

30. "Registered nurse practitioner" means an individual who meets the definition of registered nurse practitioner in A.R.S. § 32-1601 and is licensed under A.R.S. Title 32, Chapter 15, or through a similar licensing board in another state.

31. "Regular" means recurring at fixed intervals.

32. "Representative" means the:

a. Guardian of an individual;

b. Parent of an individual who is not an adult; or

c. Person designated as an agent for an individual through a power of attorney, as specified in A.R.S. Title 14, Chapter 5, Article 5.

33. "Resident" means an individual who has a place of habitation in Arizona and is living in Arizona .

34. "Self-employed" means receiving money as a direct result of the work performed by an individual rather than from wages or a salary paid to the individual.

.

35. "Valid" means still in effect or having legal force.

36. "Viral load" means the amount of HIV circulating in the body of an individual.

Ariz. Admin. Code § R9-6-401

Adopted as an emergency effective January 12, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-1). Emergency expired. Readopted without change as an emergency effective May 9, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-2). Amended and readopted as an emergency effective August 8, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-3). Emergency expired. Readopted without change as an emergency effective November 16, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-4). Emergency expired. Adopted without change as a permanent rule effective May 22, 1989. Amended as an emergency effective June 26, 1989, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 89-2). Emergency expired. Emergency amendment readopted without change effective October 17, 1989 (Supp. 89-4). Amended effective September 19, 1990 (Supp. 90-3). Renumbered from R9-6-801 effective October 19, 1993 (Supp. 93-4). Former Section R9-6-401 renumbered to R9-6-402; new Section R9-6-401made by final rulemaking at 8 A.A.R. 1953, effective April 3, 2002 (Supp. 02-2). Amended by final rulemaking at 13 A.A.R. 3329, effective November 10, 2007 (Supp. 07-3). Amended by final rulemaking at 25 A.A.R. 3614, effective 12/3/2019.