Haw. Code R. § 11-88.1-2
"As used in this chapter:
"Adaptive behavior" is the collection of conceptual, social, and practical skills that have been learned by people in order to function in their everyday lives.
"Activities of daily living" (ADL) means activities related to personal care including, but not limited to, bathing, dressing, toileting, transferring and eating.
"Adult day health services (ADH)" means services offered to a participant in a non-institutional community-based setting encompassing health and social services needed for optimal functioning of the participant.
"Adverse event" means any incident or event that may have quality of care implications for participants, including but not limited to:
(1) Changes in the participant's condition requiring medical treatment;
(2) Hospitalization of the participant;
(3) Death of the participant;
(4) All bodily injuries sustained by the participant for which medical treatment (i.e., treatment rendered by a physician, nurse practitioner, ambulance or emergency medical personnel, or emergency room medical staff) that may or may not require necessary follow-up regardless of cause or severity;
(5) Injuries of unknown cause;
(6) All reports of abuse and neglect made to the Department of Human Services Adult Protective and Community Services Branch (APCS) or the Department of Human Services Child Welfare Services Branch (CWS);
(7) All medication errors and unexpected reactions to drugs or treatment;
(8) Situations where participant's whereabouts are unknown; or situations where participant's behavior requires a plan of action or intervention.
"Applicant" means a person whose written application has been submitted to the division but who has not received final action on their application.
"Application" means the documentation needed to determine eligibility for services from the division. An application must be complete to be considered.
"Assessment" means the process of gathering a broad range of information through indirect and direct means such as interviewing, record reviews, and direct observations. Assessment information assists in identifying what is important to the person, how any issue of health or safety may be addressed, and what needs to happen to support the person in the person's desired life.
"Assistive technology" means a device such as an item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain or improve the functional capabilities of a participant or a service that directly assists the participant in the selection, acquisition or use of an assistive device. Assistive technology does not include devices and services available under the State Plan and EPSDT.
"Case management services" means services defined in HRS § 333F-1.
"Centers for Medicare & Medicaid Services (CMS)" means the United States Department of Health and Human Services, Center for Medicare & Medicaid services.
"Chore services" means services needed to maintain the home in a clean, sanitary and safe environment.
"Clinical Interdisciplinary Team (CIT)" means the established committee that uses available clinical evidence-based and current prevailing practices in the field of intellectual and other disabilities to assist in the determination of eligibility and to provide consultation to the case managers.
"Conservator" means a person who is appointed by a court to manage the estate of a protected person pursuant to section 560:5-409, HRS. The term includes a limited conservator.
"Consumer directed services" means services where the provider is directly employed by the participant or designated representative and meets the developmental disabilities division's criteria to deliver non-Medicaid services and Medicaid waiver services.
"Cost share" means the amount identified by the department of human services as an individual's excess income available for meeting a portion of the individual's own Medicaid health care cost.
"Department" means department of health, State of Hawaii.
"Department of Health (DOH)" means department of health, State of Hawaii.
"Department of Human Services (DHS)" means the department of human services, State of Hawaii, which administers Title XIX, section 1915(c) of the Social Security Act (Hawaii Medicaid program).
"Developmental disabilities" means a severe chronic disability of a person which:
(1) Is attributable to a mental or physical impairment or combination of mental and physical impairments;
(2) Is manifested before the person attains age twenty-two (22);
(3) Is likely to continue indefinitely;
(4) Results in substantial functional limitations in three (3) or more of the following areas of major life activity:
self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic sufficiency; and
(5) Reflects the person's need for a combination and sequence of special care, interdisciplinary care, or generic care, treatment or other services which are of lifelong or extended duration and are individually planned and coordinated.
"Developmental Disabilities Division (DDD) " means developmental disabilities division, department of health, State of Hawaii.
"Director" means director of the department of health, State of Hawaii.
"Division" means the developmental disabilities division, department of health, State of Hawaii.
"Division chief" means the chief of the developmental disabilities division, department of health, State of Hawaii.
"Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)" means Medicaid's comprehensive and preventive child health program for individuals under the age of twenty-one (21) years.
"Emergency outreach" means services that are immediate and short-term, on-site or telephonic, support for situations in which a participant's presence in home or program is at risk due to the participant's display of challenging behavior that occurs with intensity, duration and frequency so as to endanger the participant's safety or the safety of others or results in the destruction of property.
"Emergency respite services" means emergency short-term out-of-home placement for a participant with potential for danger to self or others, challenging behavior, or the participant's significant support system is compromised such as the death of a primary caregiver.
"Emergency shelter services" means emergency short-term out-of-home placement of a participant in need of intensive intervention in order to avoid institutionalization or more restrictive placement and for return to the current or a new living situation once stable.
"Employment services" means pre-vocational, or on-going individual employment support or group employment support to assist a participant to prepare for, obtain, and sustain paid employment at or above the State's minimum wage or to engage in self-employment.
"Environmental accessibility adaptations (EAA)" means those physical adaptations to a participant's home that are necessary for the health, welfare and safety of the participant and that enable the participant to function with greater independence in the home. Such adaptations include the installation of ramps and grab-bars, widening of doorways, modification of bathroom facilities or the installation of specialized electric and plumbing systems that are necessary to accommodate the medical equipment and supplies that are necessary for the welfare of the participant.
"Guardian" means a court appointed legal guardian of the person pursuant to sections 560:5-204 and 560:5-304, Hawaii Revised Statutes.
"Home and community-based services (HCBS) waiver program" means services provided under the Title XIX, section 1915(c) waiver of the Social Security Act. The HCBS program permits a state to furnish an array of home and community-based services that assist Medicaid beneficiaries to live in the community and avoid institutionalization.
"Individualized service plan (ISP)" means the written plan required by section 333F-6 that is developed by the individual, with the input of family, friends, and other persons identified by the individual as being important to the planning process. The plan shall be a written description of what is important to the individual, how any issue of health or safety shall be addressed, and what needs to happen to support the individual in the individual's desired life.
"Instrumental activities of daily living" (IADL) means activities such as light housework, laundry, meal preparation, transportation, grocery shopping, using the telephone, managing one's medication and money management.
"Intellectual disability (ID)" means significantly sub-average general intellectual functioning resulting in or associated with concurrent moderate, severe, or profound impairments in adaptive behavior and manifested during the developmental period.
"Intermediate care facility for individuals with intellectual disabilities (ICF/ID)" means an ICF/ID that provides intermediate care facility/mental retardation (ICF/MR) services as defined in 42 CFR 440.150. (Note: ICF/MR is the abbreviation currently used in all Federal requirements; however, CMS prefers to use the accepted term "individuals with intellectual disability" (ID) instead of "mental retardation").
"Intermediate Care Facility for Persons with Intellectual Disabilities level of care (ICF/ID LOC)" is a level of care determination for an individual applying for Medicaid waiver services. An individual that meets ICF/ID LOC shall have a diagnosis of either developmental or intellectual disability, adaptive functioning with at least moderate deficiency or below, and will benefit from waiver services.
"Medicaid waiver" or "waiver services" or "waiver" or "home and community-based services" program means the Title XIX, section 1915(c) waiver program approved by the Centers for Medicare & Medicaid Services (CMS) for which institutional requirements are waived for an individual with a developmental or intellectual disability, who requires services and support similar to those provided in an institution, to remain in the community.
"Monitor" means to conduct a systematic, coordinated, objective, qualitative review of services provided by any person, agency or organization.
"Natural Support" means unpaid support that is available to the participant within the family, and community.
"Non-medical transportation" means services offered to enable a waiver participant to gain access to waiver and other community services, activities and resources. These services are offered in addition to medical transportation required by federal Medicaid regulations and transportation services under the State Plan.
"Participant" means a person who meets the eligibility criteria and voluntarily elects to receive services from the division.
"Person" means any individual, and the individual's guardians or legal representatives.
"Personal assistance/habilitation (PAB) services" means a range of assistance or training in activities of daily living (ADL) and instrumental activities of daily living (IADL).
"Personal emergency response system (PERS) " means an emergency response system in which an electronic device that enables a waiver participant to secure help in an emergency is connected to a response center.
"Person-centered planning" means a process, directed by the individual or the family with long term care needs, intended to identify the strengths, capacities, preferences, needs, and desired outcomes of the individual.
"Provider" means an agency or individual who provides Medicaid waiver services and meets the developmental disabilities division's criteria to deliver the services to participants.
"Purchase of service (POS) provider" means an agency or individual who meets the division's criteria to deliver non-Medicaid waiver services.
"Representative" means any person who can advise and advocate for a person with a developmental or intellectual disability and who shall serve at the request and pleasure of that person; provided that should the person with a developmental or intellectual disability be a minor, is legally incapacitated, or has not requested a representative, the parent or guardian of the person may request a representative to assist on behalf of the person with a developmental or intellectual disability.
"Respite" means services that are furnished on a short-term basis because of the absence or need for relief of those individuals normally providing care for the participant.
"Services" means appropriate assistance provided to a person with a developmental or intellectual disability living in the community. These services include case management, residential alternatives, respite services, counseling, program for single-entry access, informational and educational services to the public, provision of individually appropriate services, and support which are not provided under other federal, state, or county laws and regulations.
"Severe, chronic disability" means a documented consistent pattern of disability over the lifetime of a person that is progressive or expected to be lifelong or unchanged.
"Skilled nursing (SN)" means services within the scope of chapter 457, HRS, and other skilled nursing functions required by federal law and the State Plan. Services are supervised by or provided by a registered professional nurse licensed to practice in the State of Hawaii.
"Specialized medical equipment and supplies (SMES)" means devices, controls or appliances which enable a participant to increase abilities to perform activities of daily living or to perceive, control or communicate with the environment in which the participant lives. Items necessary for life support, ancillary supplies and equipment necessary to the proper functioning of such items, and durable and nondurable medical equipment not available under the Medicaid State Plan are included.
"State matching funds" means the portion of Medicaid costs that the State pays to finance its Medicaid program. The state match is determined by the federal medical assistance percentage (FMAP).
"State Plan" means Hawaii Medicaid State Plan.
"Support" means both government funded and nongovernment funded services which assist a person with a developmental or intellectual disability to live in the community.
"Title XIX" means the Medicaid program defined in the Title XIX of the Social Security Act, 42 Code of Federal Regulations, Chapter 42, Public Health Service, department of health and human services.
"Training and consultation" means services for an individual who provides support, training, or supervision to a participant. These services include instruction about treatment regimens and other services included in the ISP, the use of equipment specified in the service plan, and updates as necessary to safely maintain the participant at home.
"Utilization Review Committee (URC)" means the committee that reviews services for the authorization of services above or below the service limitations or conditions to ensure that participants' needs are met.
"Vehicular modifications" means adaptations to an automobile or van to accommodate the special needs of a participant to integrate more fully into the community and to ensure the health, welfare and safety of the participant. This does not include adaptations or improvements to the automobile or van that are of general utility and are not of direct medical or remedial benefit to the participant; purchase or lease of an automobile or van; and regularly scheduled upkeep and maintenance of the automobile or van.
"Ward" means a person for whom a guardian has been appointed.
"Waitlist" means a list, maintained by the department, of persons waiting for home and community-based services.
Haw. Code R. § 11-88.1-2