Section 1200.20 Definitions

Section 1200.20

Definitions

"Act"

means the Specialized Care for Children Act [110 ILCS 345].

"Applicant

Child" means the individual seeking DSCC Program benefits.

"Associated Health Impairment" means a

health impairment that, in isolation, would not be considered a medically

eligible condition, but the treatment of which is medically necessary to

successfully treat a medically eligible condition, excluding malignancy and chronic

vegetative states.

"Care Coordination Services" means services

paid for or provided by DSCC to promote the effective and efficient

organization and utilization of resources to assure access to necessary

comprehensive services for children eligible under this Part and their

families.

"Chronic" means a condition that is expected

to be long lasting or to be lifelong.

"Covered Supports and Services" means those

benefits for which financial assistance is available under Section 1200.120.

"DSCC"

or "Division" means the Division of Specialized Care for Children.

"DSCC Program" or "Program" means

the program of care coordination services and financial assistance, a component

of which is diagnostic services, for children with physical disabilities or who

suffer from conditions that may lead to physical disabilities who meet

eligibility criteria as set forth in this Part.

"Day" means calendar day, except when an

action to be taken is scheduled to occur on a Saturday, Sunday or a State of

Illinois holiday, in which case the legally responsible adult, designated representative,

or DSCC has until the end of the next State business day to take the action.

"Designated Representative" means a person

authorized by the LRA to act on his or her behalf.

"Diagnostic Services" means services

provided or paid for by DSCC without regard to eligibility for financial assistance

that are medically necessary to determine whether an applicant or recipient child

meets the medical eligibility criteria of Section 1200.110

t State business day to take the action.

"Designated Representative" means a person

authorized by the LRA to act on his or her behalf.

"Diagnostic Services" means services

provided or paid for by DSCC without regard to eligibility for financial assistance

that are medically necessary to determine whether an applicant or recipient child

meets the medical eligibility criteria of Section 1200.110. Diagnostic services

are a component of care coordination services and financial assistance and no

separate application is required. Diagnostic services are further described in

Section 1200.90.

"Director" means the Executive Director of

DSCC.

"Financial Assistance" means DSCC payment to

a provider or other eligible persons for covered supports and services rendered

to an applicant or recipient child.

"Good Cause Shown" means a sufficient

justification determined in the sole discretion of the Director or designee for

failure to meet a requirement of this Part.  The availability of good cause shown

is limited as further specified in this Part.  Good cause shown includes, but

is not limited to, family emergencies, family death, demonstrated delays caused

by the U.S. Postal Service, demonstrated delays or failures in electronic

systems, or failure of a third party (e.g., medical provider) to submit

necessary information to determine whether a child meets medical eligibility

criteria.

"Legally Responsible Adult" or "LRA"

means:

if the applicant or recipient child is

non-emancipated, a person with legal authority to act on behalf of and legally

required to financially provide for the applicant or recipient child; or

an applicant or recipient child who is emancipated

under State law to act on his or her own behalf.

"Medically Eligible Condition" means a

medical condition that serves as one of the criteria that renders the applicant

or recipient child eligible for DSCC Program benefits as detailed in Section

1200.110

lf of and legally

required to financially provide for the applicant or recipient child; or

an applicant or recipient child who is emancipated

under State law to act on his or her own behalf.

"Medically Eligible Condition" means a

medical condition that serves as one of the criteria that renders the applicant

or recipient child eligible for DSCC Program benefits as detailed in Section

1200.110.

"Provider" means a person, firm,

corporation, association, agency, institution or other legal entity that

provides covered supports and services to an applicant or recipient child and

meets the requirements of Section 1200.150.

"Recipient Child" means the individual who

has been determined eligible to receive DSCC Program benefits.

"Receipt by DSCC" means the date DSCC

acknowledges taking possession of information or forms (e.g., completed application)

by means of an electronic or manual stamp.

"Receipt by an LRA" means the date the LRA

acknowledges taking possession of information or forms (e.g., Notice of

Determination) or 10 days after the date of the information or forms, whichever

is later.