Special Needs Unit. A special dedicated unit within the PH-MCO and the EAP broker’s organizational structure established to deal with issues related to Members with Special Needs. Start Date — The first date on which the PH-MCO is operationally responsible and financially liable for the provision of Medically Necessary services to Members. Step Therapy — A type of Prior Authorization requirement, sometimes referred to as a fail first requirement, intended as a cost savings that begins drug therapy with the most cost-effective drug therapy, and progresses to other more costly therapies determined to be Medically Necessary. Stop-Loss Protection — Coverage designed to limit the amount of financial loss experienced by a Health Care Provider. Subcapitation — A fixed per capita amount that is paid by the PH-MCO to a Network Provider for each Member identified as being in their capitation group, whether or not the Member received medical services. Subcontract — A contract between the PH-MCO and an individual, business, university, governmental entity, or nonprofit organization to perform part or all of the PH-MCO’s responsibilities under this Agreement. Exempt from this definition are salaried employees, utility agreements and Provider Agreements, which are not considered Subcontracts for the purpose of this Agreement and, unless otherwise specified herein, are not subject to the provisions governing Subcontracts. Subcontractor — An individual or entity that has a contract a PH-MCO that relates directly or indirectly to the performance of the PH-MCO’s obligation under its contract with the Department. A network provider is not a Subcontractor by virtue of the network Provider Agreement with the MCO, PIHP, or PAHP. Sustained Improvement — Improvement in performance documented through continued measurement of quality indicators after the performance project, study, or quality initiative is complete.
Special Needs Unit i. The cells for persons with disabilities in the Special Needs Unit lack accessible toilets and lavatories. In each, provide a “standard” accessible toilet such that all of the toilet’s elements, including toe clearances, grab bars and controls, comply with the Standards. Also provide an accessible lavatory such that its elements comply with the Standards. Standards §§ 4.1.3(11), 4.1.6(1)(b), 4.22.4, 4.22.7, 4.13, 4.16, 4.17, 4.26, 4.27, Fig. 30, 4.19.2, 4.19.3, 4.19.4, 4.19.5, 4.27.4, Figs. 31, 32.
Special Needs Unit w. the Unit you are renting has been designated as Special Needs Housing. Special Needs Housing has been physically changed and/or has provincially-funded support services provided to you as a person with a disability to live independently. You agree that if you no longer need Special Needs Housing, you will notify us of this within 30 days of the change;
Special Needs Unit
