Section 508.1 - Definitions.

508.1 Definitions. As used in this Part:

(a) Child/Teen Health Plan (C/THP), formerly known as the Child Health Assurance Program (CHAP), means a program established and administered by local social services districts which is directed toward assisting eligible persons to receive ongoing primary and preventive health care in order to discover any physical and mental problems and to provide treatment to correct or ameliorate such problems or chronic conditions through the provision of the following services:

(1) early and periodic screening and diagnosis of eligible persons are regularly scheduled examinations and evaluations of the general physical and mental health, growth development and nutritional status of infants, children and youth. At a minimum, early and periodic screening and diagnosis must include, but is not limited to, the development of a comprehensive health and developmental history, a comprehensive unclothed physical examination, an appropriate vision and hearing test, appropriate laboratory tests and dental screening services furnished by direct referral to a dentist for children beginning at three years of age, as described in section 508.8 of this Part;

(2) inter-periodic screens; and

(3) treatment or referral for treatment for conditions including, but not limited to, defects in vision and hearing, including eyeglasses and hearing aids, dental care needed for the relief of pain and infections, restoration of teeth and maintenance of dental health, and appropriate immunizations, as described in section 508.8 of this Part.

(b) A continuing care provider for the purposes of the C/THP means a provider who has a written agreement with the department or a local social services district to provide at least the services described in section 508.12 of this Part to persons eligible for C/THP services formally enrolled with the provider.

(c) Date eligibility as determined means the certification date for medical assistance eligibility entered by the local social services district on the applicant's record, i.e., the date the supervisor signed the authorization. This date may be prospective or retroactive from the effective date of eligibility.

(d) The department means the New York State Department of Social Services.

(e) Oral informing means information provided to persons eligible or potentially eligible for C/THP services, including face-to-face conversation by local social services district workers, health aides and providers, as well as other forms of communication such as public service announcements, community awareness campaigns, audio-visual films, filmstrips and video tapes.

(f) Periodicity schedule means a schedule of comprehensive child health examinations.

(g) Persons eligible for C/THP services means persons under 21 years of age who are in receipt of medical assistance.

(h) Referral means the process of (1) directing an eligible person to a provider for a needed service after it has been confirmed that the provider is accessible and can provide the needed service to that person without undue delay, and (2) conducting a follow-up in a timely manner to determine whether the service was obtained and to provide an alternative referral if necessary.

 

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