Common use of Activities of Daily Living Clause in Contracts

Activities of Daily Living. ADM — Alcohol, Drug Abuse & Mental Health Office of the Florida Department of Children & Families (aka SAMH — listed below) XXX — Assisted Living Facility APD — Agency for People with Disabilities BBA — Balanced Budget Act of 1997 CAP — Corrective Action Plan CARES — Comprehensive Assessment & Review for Long-Term Care Services CDC — Centers for Disease Control CHD — County Health Department CMS — Centers for Medicare & Medicaid Services CFR — Code of Federal Regulations CHCUP — Child Health Check-Up Program CPT — Physicians’ Current Procedural Terminology DCF — Department of Children & Families DFS – Department of Financial Services DHHS — United States Department of Health & Human Services DOH — Department of Health DJJ — Department of Juvenile Justice DEA — Drug Enforcement Administration DME — Durable Medical Equipment EDI — Electronic Data Interchange EDT – Eastern Daylight Time EPSDT — Early and Periodic Screening, Diagnosis & Treatment Program EQR — External Quality Review EQRO — External Quality Review Organization EST — Eastern Standard Time FAC — Florida Administrative Code FFS — Fee-for-Service FQHC — Federally Qualified Health Center FTE — Full Time Equivalent Position HIPAA — Health Insurance Portability & Accountability Act HMO — Health Maintenance Organization IBNR – Incurred but not reported LEIE — List of Excluded Individuals & Entities MBHO — Managed Behavioral Health Organization ODBC — Open Database Connectivity PCCB – Per capita capitation benchmark PCP — Primary Care Physician QI – Quality Improvement QIP — Quality Improvement Program RBI – Request for Benefit Information RFP — Request for Proposal RHC — Rural Health Clinic SAMH — Alcohol, Drug Abuse & Mental Health Office of the Florida Department of Children & Families (aka ADM — listed above) SFTP — Secure File Transfer Protocol SOBRA — Sixth Omnibus Budget Reconciliation Act SSI — Supplemental Security Income SQL — Structured Query Language UM — Utilization Management WIC — Special Supplemental Nutrition Program for Women, Infants & Children

Activities of Daily Living. ADM — Alcohol, Drug Abuse & Mental Health Office of the Florida Department of Children & Families (aka SAMH — listed below) XXX ALF — Assisted Living Facility APD — Agency for People with Disabilities BBA — Balanced Budget Act of 1997 CAP — Corrective Action Plan CARES — Comprehensive Assessment & Review for Long-Term Care Services CDC — Centers for Disease Control CHD — County Health Department CMS — Centers for Medicare & Medicaid Services CFR — Code of Federal Regulations CHCUP — Child Health Check-Up Program CPT — Physicians’ Current Procedural Terminology DCF — Department of Children & Families DFS – Department of Financial Services DHHS — United States Department of Health & Human Services DOH — Department of Health DJJ — Department of Juvenile Justice DEA — Drug Enforcement Administration DME — Durable Medical Equipment EDI — Electronic Data Interchange EDT – Eastern Daylight Time EPSDT — Early and Periodic Screening, Diagnosis & Treatment Program EQR — External Quality Review EQRO — External Quality Review Organization EST — Eastern Standard Time FAC — Florida Administrative Code FFS — Fee-for-Service FQHC — Federally Qualified Health Center FTE — Full Time Equivalent Position HIPAA — Health Insurance Portability & Accountability Act HMO — Health Maintenance Organization IBNR – Incurred but not reported LEIE — List of Excluded Individuals & Entities MBHO — Managed Behavioral Health Organization ODBC — Open Database Connectivity PCCB – Per capita capitation benchmark PCP — Primary Care Physician QI – Quality Improvement QIP — Quality Improvement Program RBI – Request for Benefit Information RFP — Request for Proposal RHC — Rural Health Clinic SAMH — Alcohol, Drug Abuse & Mental Health Office of the Florida Department of Children & Families (aka ADM — listed above) SFTP — Secure File Transfer Protocol SOBRA — Sixth Omnibus Budget Reconciliation Act SQL — Structured Query Language SSI — Supplemental Security Income SQL — Structured Query Language UM — Utilization Management WIC — Special Supplemental Nutrition Program for Women, Infants & Children

Activities of Daily Living. ADM — Alcohol, Drug Abuse & Mental Health Office of the Florida Department of Children & Families (aka SAMH — listed below) XXX — Assisted Living Facility APD — Agency for People with Disabilities BBA — Balanced Budget Act of 1997 CAP — Corrective Action Plan CARES — Comprehensive Assessment & Review for Long-Term Care Services CDC — Centers for Disease Control CHD — County Health Department CMS — Centers for Medicare & Medicaid Services CFR — Code of Federal Regulations CHCUP — Child Health Check-Up Program CPT — Physicians’ ‘ Current Procedural Terminology DCF — Department of Children & Families DFS – Department of Financial Services DHHS — United States Department of Health & Human Services DOH — Department of Health DJJ — Department of Juvenile Justice DEA — Drug Enforcement Administration DME — Durable Medical Equipment EDI — Electronic Data Interchange EDT – Eastern Daylight Time EPSDT — Early and Periodic Screening, Diagnosis & Treatment Program EQR — External Quality Review EQRO — External Quality Review Organization EST — Eastern Standard Time FAC — Florida Administrative Code FFS — Fee-for-Service FQHC — Federally Qualified Health Center FTE — Full Time Equivalent Position HIPAA — Health Insurance Portability & Accountability Act HMO — Health Maintenance Organization IBNR – Incurred but not reported LEIE — List of Excluded Individuals & Entities MBHO — Managed Behavioral Health Organization ODBC — Open Database Connectivity PCCB – Per capita capitation benchmark PCP — Primary Care Physician QI – Quality Improvement QIP — Quality Improvement Program RBI – Request for Benefit Information RFP — Request for Proposal RHC — Rural Health Clinic SAMH — Alcohol, Drug Abuse & Mental Health Office of the Florida Department of Children & Families (aka ADM — listed above) SFTP — Secure File Transfer Protocol SOBRA — Sixth Omnibus Budget Reconciliation Act SSI — Supplemental Security Income SQL — Structured Query Language UM — Utilization Management WIC — Special Supplemental Nutrition Program for Women, Infants & Children

Activities of Daily Living. ADM — Alcohol, Drug Abuse & Mental Health Office of the Florida Department of Children & Families (aka SAMH — listed below) XXX — Assisted Living Facility APD — AHRQ—Agency for People with Disabilities BBA Healthcare Quality and Research ALTSD—New Mexico Aging & Long-Term Services Department API—Application Programming Interface ARRA—American Recovery and Reinvestment Act ARTC—Accredited Residential Treatment Center BAA—Business Associate Agreement BCBA— Balanced Budget Board-Certified Behavior Analyst BC-DR—Business Continuity and Disaster Recovery BHPC—Behavioral Health Planning Council BHS—Behavioral Health Services Division of CYFD BMS—Behavioral Management Service BP—Blood Pressure CAHPS—Consumer Assessment of Healthcare Providers and Systems CANS—Child and Adolescent Needs and Strengths CARA—Comprehensive Addiction and Recovery Act of 1997 CAP — CAT—New Mexico Crisis Screening Tool CBMA—Community Benefits Member Agreement CBSQ—Community Benefits Services Questionnaire CISC—Children in State Custody CNA—Comprehensive Needs Assessment CAP—Corrective Action Plan CARES — CAS—Claims Adjustment Code identifying the detailed reason the adjustment was made CCC—Children with Chronic Conditions CCL—Care Coordination Level CCP—Comprehensive Assessment Care Plan CCSC—Consolidated Consumer Service Center CCSS—Comprehensive Community Support Services CDD—Center for Development & Review Disability CEO—Chief Executive Officer CFDA—Catalog of Federal Domestic Assistance CFO—Chief Financial Officer C.F.R.—Code of Federal Regulations CHW—Community Health Worker CHP—Cultural Humility Plan CHR—Community Health Representative CIO—Chief Information Officer CLIA—Clinical Laboratory Improvement Amendments CLNM—CareLink NM (New Mexico’s Health Home) CMHC—Community Mental Health Center CMMI—Center for Long-Term Care Services CDC — Centers for Disease Control CHD — County Health Department CMS — Medicare and Medicaid Innovation CMO—Chief Medical Officer CMS—Centers for Medicare & Medicaid Services CFR — Code CNP—Certified Nurse Practitioner CNS—Clinical Nurse Specialist COBA—Coordination of Federal Regulations CHCUP — Child Health Check-Up Program CPT — Physicians’ Benefits Agreement XXX—Category of Eligibility CPT—Current Procedural Terminology DCF CSA—Core Service Agencies CY—Calendar Year CYFD—New Mexico Children, Youth and Families Department DCAP—Directed Corrective Action Plan DD—Developmental Disability DHHS— Department of Children & Families DFS – Department of Financial Services DHHS — United States US Department of Health & and Human Services DOH — DM—Disease Management DME—Durable Medical Equipment DMZ—Demilitarized Zone DOH—New Mexico Department of Health DJJ — DSM—Diagnostic and Statistical Manual of Mental Disorders D-SNP—Dual Eligible Special Needs Plans DSIPT—Delivery System Improvement Performance Target DUR—Drug Utilization Review DWI—Driving While Intoxicated ECECD—New Mexico Early Childhood Education and Care Department of Juvenile Justice DEA — Drug Enforcement Administration DME — Durable Medical Equipment EDI — ECHO—Extension for Community Healthcare Outcomes EDI—Electronic Data Interchange EDT – Eastern Daylight Time EPSDT — EEO—Equal Employment Opportunity EHR—Electronic Health Record ENT—Ear, Nose, Throat EOR—Employer of Record EPSDT—Early and Periodic Screening, Diagnosis & Diagnostic and Treatment Program EQR — EQR—External Quality Review EQRO — EQRO—External Quality Review Organization EST — Eastern Standard Time FAC — Florida Administrative Code FFS — ER—Emergency Room FAQ—Frequently Asked Question FDA—U.S. Food and Drug Administration FDIC—Federal Deposit Insurance Corporation FEIN—Federal Employer Identification Number FEMA—Federal Emergency Management Agency FFS—Fee-for-Service FQHC — FICA—Federal Insurance Contributions Act FMA—Fiscal Management Agency FQHC—Federally Qualified Health Center FTE FTE—Full-time Equivalent FTP—File Transfer Protocol FUTA—Federal Unemployment Tax Act GH—Group Home GRT— Full Time Equivalent Position HIPAA Gross Receipts Tax HBRHC—Hospital Based Rural Health Clinic HCAC—Health Care Acquired Condition HCBS—Home- and Community-Based Service HCPCS—Healthcare Common Procedure Coding System HCRP— High Cost Member Risk Pool HEDIS—Healthcare Effectiveness Data and Information Set HIE—Health Information Exchange HIPAA—Health Insurance Portability & and Accountability Act HMO HITECH Act—Health Information Technology for Economic and Clinical Health Act HIT—Health Information Technology HFW—High-Fidelity Wraparound HIV—Human Immunodeficiency Virus XXX—Health Insurance Exchange HRA—Health Risk Assessment HSD—New Mexico Human Services Department I/T/U—Indian Health Service, Tribal health provider and Urban Indian provider IADL—Instrumental Activities of Daily Living ICD-10—International Classification of Diseases, Tenth Edition ICD-9—International Classification of Diseases, Ninth Edition ICWA—Indian Child Welfare Act ID—Identification IHS—Indian Health Service IOP—Intensive Outpatient Program IPF—Inpatient Psychiatric Facility/Unit IPRA—Inspection of Public Records Act IRS—Internal Revenue Service IT—Information Technology IV—Intravenous JJS—Juvenile Justice Services JUST Health—Justice-Involved Utilization of State Transitioned Healthcare LARC— Long-Acting Reversible Contraceptives LEP—Limited English Proficiency LGBTQ+—Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, and Others LISW—Licensed Independent Social Worker LMFT—Licensed Marriage and Family Therapist LPCC—Licensed Professional Clinical Counselor LTC—Long-Term Care LTSS—Long-Term Services and Supports MAD—Medical Assistance Division MAT— Medication Assisted Treatment MCO—Managed Care Organization MD—Doctor of Medicine MDS—Minimum Data Set MFEAD—New Mexico Medicaid Fraud & Elder Abuse Division MHSIP—Mental Health Maintenance Organization IBNR – Incurred but not reported LEIE — List Statistics Improvement Project MHV—Medicaid Home Visiting MIC—Medicaid Integrity Contractor MIS—Management Information System MITA—Medicaid Information Technology Architecture MLR—Medical Loss Ratio MMIS—Medicaid Management Information System MMIS-R—Medicaid Management Information System Replacement MST—Multi-Systematic Therapy XXXX—Native American Advisory Board NCPDP—National Council of Excluded Individuals & Entities MBHO — Managed Behavioral Prescription Drug Programs NCQA—National Committee for Quality Assurance NF—Nursing Facility NF LOC—Nursing Facility Level of Care NMAC—New Mexico Administrative Code NMHIC—New Mexico Health Organization ODBC — Open Database Connectivity PCCB – Per capita capitation benchmark PCP — Information Collaborative NMMIP—New Mexico Medical Insurance Pool NMSA—New Mexico Statute Annotated NOME—Not Otherwise Medicaid Eligible NPI—National Provider Identifier NQMC—National Quality Measures Clearinghouse NQTLs—Non-Quantitative Treatment Limitations OB/GYN—Obstetrics and Gynecology OIG—Office of Inspector General OMB—Office of Management and Budget OPPC—Other Provider Preventable Condition PACDR—Post-Adjudicated Claims Data Reporting PASRR—Pre-Admission Screening and Resident Review PCMH—Patient-Centered Medical Home PCP—Primary Care Physician QI – Physician/ Primary Care Provider PCS—Personal Care Service PDL—Preferred Drug List PHI—Protected Health Information PIP—Performance Improvement Project PL—Public Law PM—Performance Measure PMPM—Per Member Per Month PPACA—Patient Protection and Affordable Care Act PPC—Provider Preventable Condition PPS—Prospective Payment System PPW—Permanency Planning Worker PS—Protective Services PSC—Professional Services Contract PSR—Psychosocial Rehabilitation Q1—First Quarter Q2—Second Quarter Q3—Third Quarter Q4—Fourth Quarter QM/QI—Quality Management/ Quality Improvement QIP — Quality Improvement Program RBI – Request for Benefit Information RFP — QTLs—Quantitative Treatment Limitations RAC—Medicaid Recovery Audit Contractor RFP—Request for Proposal RHC — RHC—Rural Health Clinic SAMH — Alcohol, Drug RN—Registered Nurse RTC—Residential Treatment Center SAMHSA—Substance Abuse & and Mental Health Office Services Administration SB—Support Broker SBHC—School-Based Health Center SDCB—Self-Directed Community Benefit SDOH—Social Determinants of Health SED—Serious Emotional Disturbance SFY—State Fiscal Year SMI—Serious Mental Illness SNP—Special Needs Plan SOC – Setting of Care SOE—Summary of Evidence SSN—Social Security Number STMII—Short Term Medicaid for Incarcerated Individuals SUD—Substance Use Disorder TBD—To Be Determined TCN—Transaction Control Number TDD—Text Telephone TFC—Treatment for Xxxxxx Care TM—Tracking Measure TPL—Third Party Liability TTY—Telecommunication Device for the Florida Department of Children & Families (aka ADM — listed above) SFTP — Secure File Transfer Protocol SOBRA — Sixth Omnibus Budget Reconciliation Act SSI — Supplemental Security Income SQL — Structured Query Language UM — Deaf UM—Utilization Management WIC — Special UNM/CDD—University of New Mexico Center for Development and Disability UNM—University of New Mexico USC—United States Code USCDI—U.S. Core Data for Interoperability VBP—Value-Based Purchasing VPN—Virtual Private Network WIC—Supplemental Nutrition Food Program for Women, Infants & Childrenand Children YTD—Year-to-Date 3 CONTRACTOR’s Administrative Requirements

Activities of Daily Living. ADM — Alcohol, Drug Abuse & Mental Health Office of the Florida Department of Children & Families (aka SAMH — listed below) XXX — Assisted Living Facility APD — AHRQ—Agency for People with Disabilities BBA Healthcare Quality and Research ALTSD—New Mexico Aging & Long-Term Services Department API—Application Programming Interface ARRA—American Recovery and Reinvestment Act ARTC—Accredited Residential Treatment Center BAA—Business Associate Agreement BCBA— Balanced Budget Board-Certified Behavior Analyst BC-DR—Business Continuity and Disaster Recovery BHPC—Behavioral Health Planning Council BHS—Behavioral Health Services Division of CYFD BMS—Behavioral Management Service BP—Blood Pressure CAHPS—Consumer Assessment of Healthcare Providers and Systems CANS—Child and Adolescent Needs and Strengths CARA—Comprehensive Addiction and Recovery Act of 1997 CAP — CAT—New Mexico Crisis Screening Tool CBMA—Community Benefits Member Agreement CBSQ—Community Benefits Services Questionnaire CISC—Children in State Custody CNA—Comprehensive Needs Assessment CAP—Corrective Action Plan CARES — CAS—Claims Adjustment Code identifying the detailed reason the adjustment was made CCC—Children with Chronic Conditions CCL—Care Coordination Level CCP—Comprehensive Assessment Care Plan CCSC—Consolidated Consumer Service Center CCSS—Comprehensive Community Support Services CDD—Center for Development & Review Disability CEO—Chief Executive Officer CFDA—Catalog of Federal Domestic Assistance CFO—Chief Financial Officer C.F.R.—Code of Federal Regulations CHW—Community Health Worker CHP—Cultural Humility Plan CHR—Community Health Representative CIO—Chief Information Officer CLIA—Clinical Laboratory Improvement Amendments CLNM—CareLink NM (New Mexico’s Health Home) CMHC—Community Mental Health Center CMMI—Center for Long-Term Care Services CDC — Centers for Disease Control CHD — County Health Department CMS — Medicare and Medicaid Innovation CMO—Chief Medical Officer CMS—Centers for Medicare & Medicaid Services CFR — Code CNP—Certified Nurse Practitioner CNS—Clinical Nurse Specialist COBA—Coordination of Federal Regulations CHCUP — Child Health Check-Up Program CPT — Physicians’ Benefits Agreement XXX—Category of Eligibility CPT—Current Procedural Terminology DCF CSA—Core Service Agencies CY—Calendar Year CYFD—New Mexico Children, Youth and Families Department DCAP—Directed Corrective Action Plan DD—Developmental Disability DHHS— Department of Children & Families DFS – Department of Financial Services DHHS — United States US Department of Health & and Human Services DOH — DM—Disease Management DME—Durable Medical Equipment DMZ—Demilitarized Zone DOH—New Mexico Department of Health DJJ — DSM—Diagnostic and Statistical Manual of Mental Disorders D-SNP—Dual Eligible Special Needs Plans DSIPT—Delivery System Improvement Performance Target DUR—Drug Utilization Review DWI—Driving While Intoxicated ECECD—New Mexico Early Childhood Education and Care Department of Juvenile Justice DEA — Drug Enforcement Administration DME — Durable Medical Equipment EDI — ECHO—Extension for Community Healthcare Outcomes EDI—Electronic Data Interchange EDT – Eastern Daylight Time EPSDT — EEO—Equal Employment Opportunity EHR—Electronic Health Record ENT—Ear, Nose, Throat EOR—Employer of Record EPSDT—Early and Periodic Screening, Diagnosis & Diagnostic and Treatment Program EQR — EQR—External Quality Review EQRO — EQRO—External Quality Review Organization EST — Eastern Standard Time FAC — Florida Administrative Code FFS — ER—Emergency Room FAQ—Frequently Asked Question FDA—U.S. Food and Drug Administration FDIC—Federal Deposit Insurance Corporation FEIN—Federal Employer Identification Number FEMA—Federal Emergency Management Agency FFS—Fee-for-Service FQHC — FICA—Federal Insurance Contributions Act FMA—Fiscal Management Agency FQHC—Federally Qualified Health Center FTE FTE—Full-time Equivalent FTP—File Transfer Protocol FUTA—Federal Unemployment Tax Act GH—Group Home GRT— Full Time Equivalent Position HIPAA Gross Receipts Tax HBRHC—Hospital Based Rural Health Clinic HCAC—Health Care Acquired Condition HCBS—Home- and Community-Based Service HCPCS—Healthcare Common Procedure Coding System HCRP— High Cost Member Risk Pool HEDIS—Healthcare Effectiveness Data and Information Set HIE—Health Information Exchange HIPAA—Health Insurance Portability & and Accountability Act HMO HITECH Act—Health Information Technology for Economic and Clinical Health Act HIT—Health Information Technology HFW—High-Fidelity Wraparound HIV—Human Immunodeficiency Virus XXX—Health Insurance Exchange HRA—Health Risk Assessment HSD—New Mexico Human Services Department I/T/U—Indian Health Service, Tribal health provider and Urban Indian provider IADL—Instrumental Activities of Daily Living ICD-10—International Classification of Diseases, Tenth Edition ICD-9—International Classification of Diseases, Ninth Edition ICWA—Indian Child Welfare Act ID—Identification IHS—Indian Health Service IOP—Intensive Outpatient Program IPF—Inpatient Psychiatric Facility/Unit IPRA—Inspection of Public Records Act IRS—Internal Revenue Service IT—Information Technology JJS—Juvenile Justice Services JUST Health—Justice-Involved Utilization of State Transitioned Healthcare LARC— Health Maintenance Long-Acting Reversible Contraceptives LEP—Limited English Proficiency LGBTQ+—Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, and Others LISW—Licensed Independent Social Worker LMFT—Licensed Marriage and Family Therapist LPCC—Licensed Professional Clinical Counselor LTC—Long-Term Care LTSS—Long-Term Services and Supports MAD—Medical Assistance Division MAT— Medication Assisted Treatment MCO—Managed Care Organization IBNR – Incurred but not reported LEIE — List MD—Doctor of Excluded Individuals Medicine MDS—Minimum Data Set MFEAD—New Mexico Medicaid Fraud & Entities MBHO — Managed Behavioral Health Organization ODBC — Open Database Connectivity PCCB – Per capita capitation benchmark PCP — Primary Care Physician QI – Quality Improvement QIP — Quality Improvement Program RBI – Request for Benefit Information RFP — Request for Proposal RHC — Rural Health Clinic SAMH — Alcohol, Drug Elder Abuse & Division MHSIP—Mental Health Office of the Florida Department of Children & Families (aka ADM — listed above) SFTP — Secure File Transfer Protocol SOBRA — Sixth Omnibus Budget Reconciliation Act SSI — Supplemental Security Income SQL — Structured Query Language UM — Utilization Statistics Improvement Project MHV—Medicaid Home Visiting MIC—Medicaid Integrity Contractor MIS—Management WIC — Special Supplemental Nutrition Program for Women, Infants & ChildrenInformation System XXXX—Medicaid Information Technology Architecture