39-5602. DEFINITIONS. As used in this chapter, the following terms shall have the following meanings:

(1) "Department" means the department of health and welfare of the state of Idaho.

(2) "Director" means the director of the department of health and welfare.

(3) "Eligible participant" or "participant" means an individual determined eligible by the department for Idaho medicaid services, as authorized by title XIX, of the social security act, as amended.

(4) "Fiscal intermediary agency" means an entity that provides services that allow the participant receiving personal assistance services, or his designee or legal representative, to choose the level of control he will assume in recruiting, selecting, managing, training and dismissing his personal assistant and over the manner in which services are delivered.

(5) "Individual service plan" means a document which outlines all services including, but not limited to, personal assistance services and IADLs, required to maintain the individual in his or her home and community.

(6) "Instrumental activities of daily living (IADL)" means those activities performed in supporting the activities of daily living for an adult, including, but not limited to: managing money, preparing meals, shopping, light housekeeping, using the telephone, or getting around in the community.

(7) "PCS family alternate care provider" means an individual licensed by the department to provide personal care services to one (1) or two (2) children who are unable to reside in their own home and require assistance with medically oriented tasks related to the child’s physical or functional needs.

(8) "Personal assistance agency" means an entity that recruits, hires, fires, trains, supervises, schedules, oversees quality of work, takes responsibility for services provided, provides payroll and benefits for personal assistants working for them, is the employer of record and in fact.

(9) "Personal assistance services" includes both attendant care services and personal care services and means services that involve personal and medically oriented tasks dealing with the functional needs of the participant and accommodating the participant’s needs for long-term maintenance, supportive care or IADLs. These services may include, but are not limited to, personal assistance and medical tasks that can be done by unlicensed persons or delegated to unlicensed persons by a health care professional or participant. Services shall be based on the participant’s abilities and limitations, medical diagnosis or other category of disability.

(10) "Personal assistant" means an individual who directly provides personal assistance services.

(11) "Personal care services (PCS)" means a range of medically oriented care services related to a participant’s physical or functional requirements. These services are provided in the participant’s home or personal residence but do not include housekeeping or skilled nursing care.

(12) "Provider" means a personal assistance agency, a fiscal intermediary agency or a PCS family alternate care provider.

(13) "Representative" means an employee of the department of health and welfare.

(14) "Service coordination" means a case management activity that assists individuals eligible for medicaid in gaining and coordinating access to necessary care and services appropriate to the needs of the individual. Service coordination is a brokerage model of case management.

(15) "Voucher service option" means a method of service provision whereby the participant receives vouchers to pay for personal assistance services.

History:

[(39-5602) 39-A4702, added 1981, ch. 65, sec. 1, p. 93; am. & redesig. 1990, ch. 326, sec. 2, p. 889; am. 1997, ch. 316, sec. 1, p. 933; am. 1998, ch. 224, sec. 1, p. 770; am. 2000, ch. 274, sec. 123, p. 859; am. 2007, ch. 222, sec. 2, p. 665; am. 2010, ch. 347, sec. 2, p. 905.]