Medically fragile means the condition of a child who requires the availability of twenty-four-hour skilled care from a health care professional or specially trained staff or volunteers in a group care setting. These conditions may be present all the time or frequently occurring. If the technology, support and services being received by the medically fragile children are interrupted or denied, the child may, without immediate health care intervention, experience death.
Vulnerable means a condition in which an adult is unable to protect himself or herself from abuse, neglect, or exploitation because of a mental or physical impairment or because of advanced age.
Medically Necessary Services means those covered services that are, under the terms and conditions of the contract, determined through contractor utilization management to be:
Medically Necessary means a service which is appropriate and consistent with the treatment of the condition in accordance with accepted standards of community practice.
Medically incapacitated means a person who is incapacitated as a result of prescribed sedatives, anesthesia, or other medication.