Cal. Code Regs. Tit. 22, § 51185 - Targeted Case Management Services Program Definitions
(a) "Encounter" means a face-to-face contact
or a significant telephone contact in lieu of a face-to-face contact when
environmental considerations preclude a face-to-face encounter, for the purpose
of rendering one or more targeted case management service components by a case
manager. For the target populations specified in Section
50262.7(a)(3)(B), (C) or
(D), the encounter may be with persons acting
on behalf of the Medi-Cal beneficiary.
(b) "High-risk persons" means those persons
who have failed to take advantage of necessary health care services, or do not
comply with their medical regimen or who need coordination of multiple medical,
social and other services due to the existence of an unstable medical condition
in need of stabilization, substance abuse or because they are victims of abuse,
neglect, or violence, including, but not limited to, the following individuals:
(1) Women, infants, children and young adults
to age 21.
(2) Pregnant
women.
(3) Persons with Human
Immunodeficiency Virus/Acquired Immune Deficiency Syndrome.
(4) Persons with reportable communicable
disease.
(5) Persons who are
technology dependent. Solely for the purposes of the Targeted Case Management
Services program, "technology dependent persons" means those persons who use a
medical technology, embodied in a medical device, that compensates for the loss
of normal use of a vital body function and require skilled nursing care to
avert death or further disability.
(6) Persons with multiple diagnoses who
require services from multiple health/social service providers.
(7) Persons who are medically fragile. Solely
for the purposes of the Targeted Case Management Services program, "medically
fragile persons" means those persons who require ongoing or intermittent
medical supervision without which their health status would deteriorate to an
acute episode.
(c) "Host
county" means the local governmental agency that has been designated by all
local governmental agencies participating in the targeted case management
program, to be the administrative and fiscal intermediary between the
department and all participating local governmental agencies.
(d) "Local Governmental Agency" means a
county or chartered city.
(e)
"Skilled Professional Medical Personnel" means a physician, dentist, or nurse,
or other specialized personnel who has completed a 2-year or longer program
leading to an academic degree or certification in a medically-related
profession and who performs duties and responsibilities requiring professional
medical knowledge and skills, and who is in an employer-employee relationship
with the local governmental agency.
(f) "Year", "current year" or "fiscal year"
means the period July 1 through June 30.
Notes
2. New section refiled 10-29-96 as an emergency; operative 10-29-96 (Register 96, No. 44). Submitted to OAL for printing only pursuant to Section 6, Chapter 305, Statutes of 1995. A Certificate of Compliance must be transmitted to OAL by 2-26-97 or emergency language will be repealed by operation of law on the following day.
3. Editorial correction of HISTORY 2 (Register 97, No. 15).
4. Repealed by operation of Government Code section 11346.1(g) (Register 97, No. 15).
5. New section filed 4-10-97; operative 4-10-97 pursuant to Government Code section 11343.4(d) (Register 97, No. 15).
Note: Authority cited: Sections 10725, 14105, 14124.5 and 14132.44, Welfare and Institutions Code. Reference: Section 14132.44, Welfare and Institutions Code.
2. New section refiled 10-29-96 as an emergency; operative 10-29-96 (Register 96, No. 44). Submitted to OAL for printing only pursuant to Section 6, Chapter 305, Statutes of 1995. A Certificate of Compliance must be transmitted to OAL by 2-26-97 or emergency language will be repealed by operation of law on the following day.
3. Editorial correction of History 2 (Register 97, No. 15).
4. Repealed by operation of Government Code section 11346.1(g) (Register 97, No. 15).
5. New section filed 4-10-97; operative 4-10-97 pursuant to Government Code section 11343.4(d) (Register 97, No. 15).
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