Section 4305.4. Definitions

The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:

Base service unit—The functional unit responsible for assessing and evaluating client needs, planning comprehensive treatment programs and making available the necessary services on a continuing basis.

County administrator—The administrator of the county mental health and mental retardation program, or a designee.

Liability—The maximum, monthly amount the liable person is charged toward the cost of service for the client. The term does not include the cost of the client’s room or board.

Liable person—The person responsible for payment of the liability. The term includes the following persons:

(i) If the client is 18 years of age or older, the client is not married and the client does not have a legal guardian of estate or a representative payee, the client is the liable person.

(ii) If the client is married, and the client does not have a legal guardian of estate or a representative payee, the client and the client’s spouse are the liable persons.

(iii) If the client is under 18 years of age, the client is not married, the client is not an emancipated minor and the client does not have a legal guardian of estate or a representative payee, both of the client’s parents are the liable persons.

(iv) If the client is under 18 years of age, the client is not married, the client is an emancipated minor and the client does not have a legal guardian of estate or a representative payee, the client is the liable person.

(v) If the client has a legal guardian of estate or a representative payee, the legal guardian of estate or the representative payee is the liable person.

Mental health client fee schedule—A list of the provider’s usual and customary charges to the general public for a unit of service.

Mental health professional—An individual practicing in a generally recognized clinical discipline including, but not limited to, psychiatry, social work, psychology, nursing, rehabilitation or activity therapies, who has a graduate degree and clinical experience.

Mental retardation professional—A case manager or an individual who is responsible for the clinical treatment program for the client.

Net charge—The amount the provider bills for services provided.

Outpatient unit of service—One-half hour of treatment in a licensed mental health outpatient clinic/program.

Parent—A biological or adoptive mother or father of the client.

Partial hospitalization unit of service—Three hours per day of treatment in a licensed mental health partial hospitalization program.

Representative payee—A person or an organization selected by a benefit issuing agency to receive and manage benefits on behalf of a beneficiary.

Notation

Cross References

This section cited in 55 Pa. Code § 4300.117 (relating to computation of reimbursement).