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1915(j) - A new subsection of the Social Security Act that allows States to amend their Medicaid State plans, giving individuals the ability to self-direct their home and community based services, hire and fire their own workers, and purchase appropriate goods and services to fulfill their plan of care.
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ACA - Affordable Care Act. Also known as the Patient Protection and Affordable Care Act (PPACA) and ACA, PL 111-148. The Affordable Care Act was passed by Congress and signed into law by the President in March 2010.
Accessibility of Service - The relative opportunity for people in need to obtain relevant services.
ACL - Administration for Community Living. Developed in 2012, this federal agency brings together the Administration on Aging, the Office on Disability and the Administration on Developmental Disabilities into a single agency that supports both cross-cutting initiatives and efforts focused on the unique needs of individual groups.
Activities of Daily Living ( ADL's) - Basic personal activities which include bathing, dressing, transferring from bed to chair, toilet assistance, mobility and eating. ADL’s are used to measure how dependent a person may be on requiring assistance in performing any or all of these activities.
ADA - Americans With Disabilities Act. The ADA prohibits discrimination on the basis of disability in employment, by state and local government entities and by places of public accommodation.
Adult Day Care - A daytime community-based program for functionally impaired adults that provides a variety of health, social, and related support services in a protective setting.
AFDC - Aid to Families with Dependent Children provided transitional financial assistance to needy families. Federal and state governments shared in its cost. It was replaced by TANF in 1997.
Agency with Choice (AwC) - Is a model of Financial Management Services wherein the Agency with Choice provides services under a co-employment arrangement with participants. In the Agency with Choice model the agency is the common law employer and the participant is a managing employer of workers who serve the participant.
AGI - Adjusted Gross Income
Aging and Disability Resource Center (ADRC) - The Aging and Disability Resource Center Grant Program, a cooperative effort of the Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS), was developed to assist states in their efforts to create a single, coordinated system of information and access for all persons seeking long term support to minimize confusion, enhance individual choice, and support informed decision-making.
ALF - Assisted Living Facility
ASPE - Assistant Secretary for Planning and Evaluation
Assisted Living - Residences that provide a “home with services” and that emphasize residents’ privacy and choice. Residents typically have private locking rooms (only shared by choice) and bathrooms. Personal care services are available on a 24-hour-a-day basis.
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Board and Care Home - A residence that offers housing and personal care services for a small number of residents (usually 3 to 16). Services (such as meals, supervision, and transportation) are usually provided by the owner or manager. May be single family home.
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Care management - Refers to programs that seek to help patients achieve an optimal level of wellness, improve coordination of care, and engage beneficiaries and their support systems in a collaborative process designed to manage medical, social, and mental health conditions more effectively.
Care Plan - A written document that outlines the types and frequency of the long-term care services that a consumer receives. It may include treatment goals for him or her for a specified time period.
Caregiver - A person who provides support and assistance with various activities to a family member, friend, or neighbor. May provide emotional or financial support, as well as hands-on help with different tasks. Caregiving may also be done from long distance.
Case management - Services that assist eligible enrollees to secure medical and other services necessary for appropriate health care treatment. Services include the assessment of an eligible individual to determine service needs, development of a specific care plan, referral and related activities to help an individual obtain needed services, and monitoring and follow-up activities.
Cash & Counseling Demonstration and Evaluation - An implementation and study of consumer-directed PAS programs offering cash allowances and information services. Consumers use the allowances to purchase services, assistive devices, and home modifications. The goal is to enable medicaid PAS consumers to exercise maximum consumer direction.
CD-PAS - Consumer Directed Personal Assistance Services
CDDO - Community Developmental Disabilities Organization
Certificate of Need (CON) - A certificate issued by a government body to a health care provider who is proposing to construct, modify, or expand facilities, or to offer new or different types of health services. CON is intended to prevent duplication of services and overbedding. The certificate signifies that change has been approved.
CMHSP - Community Mental Health Service Program
COLA - Cost of Living Adjustment
Community Health Center - An ambulatory health care program usually serving an area that has scarce or nonexistent health services or a population with special health needs. These centers attempt to coordinate federal, state, and local resources in a single organization capable of delivering both health and related social services to a defined population. While such a center may not directly provide all types of health care, it usually takes responsibility to arrange all medical services needed by its patient population.
Community Living Program Grants (CLP) - Part of the Administration on Aging’s (AoA) grant initiative, it is funding for states to enable the elderly, at risk of nursing home placement, to continue to live in their communities, with access to professional help to find community resources and supports that best fit their individual needs.
Community-Based Services - Services designed to help people remain independent and in their own homes; can include senior centers, transportation, delivered meals or congregate meals site, visiting nurses or home health aides, adult day care, and homemaker services.
Community-Integrated Personal Assistance Services and Supports (CPASS) - The goal of this project is to develop an infrastructure and create products that will promote the effective recruitment and retention of personal assistants, and ensure that people with disabilities have the knowledge, access and resources available to maximize choice and control in the use of Personal Assistance Services.
Congregate Housing - Individual apartments where residents may receive some services, such as a daily meal with other tenants. Other services may be included as well. Buildings usually have some common areas such as a dining room and lounge as well as additional safety measures such as emergency call buttons. May be rent subsidized (known as section 8 housing).
Consumer choice - Provided when there is a range of service options to meet the diverse needs of consumers. The degree to which consumers have choice must go beyond the range of service choices and include opportunities for consumers to decide when and where services will be provided, and how and by whom tasks will be performed.
Consumer Directed Model (CDM) - A public program where consumers have an employer/employee relationship with PAS workers.
Consumer direction (CD) - Describes programs and services where people are given maximum choice and control. Consumer direction may also be called "self-determination" or "independent living." When people say they want to be "independent" or they want "autonomy" or "self-direction," they are talking about consumer direction too. In consumer-directed programs, consumers can choose to select, manage and dismiss their workers.
Consumer-directed programs - Consumers can decide which services to use, which workers to hire, and what time of day they will come. They can decide whether to hire family members and whether to spend the available funds on things other than services (like appliances or home modifications). In some consumer-directed programs, consumers pay their workers themselves; in others, consumers choose to have a "intermediary service organization" handle payments.
Consumers - Any persons who use goods and services. Consumers of consumer-directed services are people with disabilities of all ages, including persons with: Cognitive needs which include autism, mental retardation, brain injury, dementia (including Alzheimer's Disease, AIDS-related dementa); Physical needs due to accidents, injuries, illnesses, age-related conditions, developmental conditions such as muscular dystrophy, and sensory impairments (including vision and hearing losses, deafness, blindness).
Continuing Care Retirement Community (CCRC) - Communities that offer multiple levels of care (independent living, assisted living, skilled nursing care) housed in different areas of the same community or campus and which give residents the opportunity to remain in the same community if their needs change. Provide residential services (meals, housekeeping, laundry), social and recreational services, health care services, personal care, and nursing care. Require payment of a monthly fee and possibly a large-sum entrance fee.
Continuum of Care - The entire spectrum of specialized health, rehabilitative, and residential services available to the frail and chronically ill. The services focus on the social, residential, rehabilitative and supportive needs of individuals, as well as needs that are essentially medical in nature.
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Deficit Reduction Act Of 2005 - Signed by the President in February 2006, this Act is expected to generate $39 billion in federal entitlement reductions over the 2006 to 2010 period and $99 billion over the 2006 to 2015 period. The DRA makes several major changes to long-term services policies in Medicaid. Key changes including: Asset Transfers, Long-Term Care Partnership Programs, Family Opportunity Act, Money Follows the Person Demonstration, State Option to Provide HCBS Services and Cash & Counseling Option.
Deinstitutionalization - A policy that calls for the provision of supportive care and treatment for medically and socially dependent individuals in the community rather than an institutional setting.
Delegation - Transfer of authority from a licensed professional health care provider to an individual not licensed to perform delegated tasks.
Developmental Disability - A disability that originates before age 18, can be expected to continue indefinitely, and constitutes a substantial handicap to the person’s ability to function normally.
Disability - “With respect to an individual (A) a physical or mental impairment that substantially limits one or more of the major life activities of such individual; (B) a record of such impairment; or (C) being regarded as having an impairment.” (ADA, 42 USC 12102) “The phrase physical impairment includes but is not limited to … orthopedic, visual, speech and hearing impairments, cerebral palsy, epilepsy, muscular dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, specific learning disabilities, HIV disease (whether symptomatic or asymptomatic), tuberculosis, drug addiction, and alcoholism… The phrase major life activities means functions such as caring for one’s self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning and working.” (ADA Handbook, pp.II-16 through II-19.)
DMR - Department of Mental Retardation
DSPD - Division of Services for People with Disabilities
Dual Eligibles - Individuals with certain combinations of needs who enroll in both the state-administered Medicaid program and the federally-administered Medicare program are referred to as dual eligibles. Currently, dual eligibles receive prescription drugs and most long-term care benefits from Medicaid, while they are covered by Medicare for acute benefits such as doctor’s visits and inpatient hospital care. (also referred to as Dual-Elibible or Duals)
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Escort Services (also called transportation services) - Provide transportation for people to services and appointments. May use bus, taxi, volunteer drivers, or van services that can accommodate wheelchairs and persons with other special needs.
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Fee-for-Service - The way traditional Medicare and health insurance work. Medical providers bill for whatever service they provide. Medicare and/or traditional insurance pay their share, and the patient pays the balance through co-payments and deductibles.
FFP - Federal Financial Participation
Financial Management Services (FMS) - A service/function that helps a participant directing family or participant to manage and distribute funds in the participant-directed budget. It’s also key in facilitating the employment of staff along with fiscal accounting and expenditure reports for the participant, family and state authorities.
Fiscal Intermediaries - Organizations that provide third party and fourth party financial services between recipient and providers of a benefit.
Fiscal/Employer Agent Services (F/EA Services) - An Agent serves on behalf of participants enrolled in public programs under Section 3504 of the Internal Revenue Code. An F/EA Employer Agent may be a government entity, a private non-profit or for-profit entity that’s been contracted to serve public program enrolled participants.
FMAP - Federal Medical Assistance Percentage
Formative Evaluation - Formative evaluation is a method of judging the worth of a program while the program activities are forming or happening.
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HCBS - Home and Community Based Services. Services or other supports to help people with disabilities of all ages to live in the community. Each state has a mix of programs and funding sources. The Medicaid program pays for many of these services in all states. There are also other federal, state and local dollars that fund home and community based services, including the Social Services Block Grant (SSBG), Older Americans Act (OAA), Education and Rehabilitation funds and State General funds.
HCFA - Health Care Financing Administration
HIPAA - Health Insurance Portability and Accountability Act of 1996. Title I protects health insurance coverage for workers and their families when they change or lose their jobs. The Administrative Simplification provisions (HIPAA, Title II) require the Department of Health and Human Services to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addresses the security and privacy of health data.
HMO - Health Maintenance Organization
Home and Community-Based Waivers - Section 2176 of the Omnibus Reconciliation Act of 1987 permits states to offer, under a waiver, a wide array of home and community-based services that an individual may need to avoid institutionalization. Regulations to implement the act list the following services as community and home-based services which may be offered under the waiver program: case management, homemaker, home health aide, personal care, adult day health care, habilitation, respite care and other services.
Home Health Agency - A public or private organization that provides home health services, supervised by a licensed health professional in the patient's home, either directly or through arrangements with other organizations.
Home Health Aide - A person who, under the supervision of a home health or social service agency, assists elderly, ill or disabled persons with household chores, bathing, personal care, and other daily living needs. Social service agency personnel are sometimes called personal care aides.
Home Health Care - Includes a wide range of health-related services such as assistance with medications, wound care, intravenous (IV) therapy, and help with basic needs such as bathing, dressing, mobility, etc., which are delivered at a person's home.
Home Medical Equipment (also called durable medical equipment) - Equipment such as hospital beds, wheelchairs, and prosthetics used at home. May be covered by Medicaid and in part by Medicare or private insurance.
Homemaker Services - In-home help with meal preparation, shopping, light housekeeping, money management, personal hygiene and grooming, and laundry.
Hospice - A program which provides palliative and supportive care for terminally ill patients and their families, either directly or on a consulting basis with the patient's physician or another community agency. The whole family is considered the unit of care, and care extends through their period of mourning.
Hospice Care - Services for the terminally ill provided in the home, a hospital, or a long-term care facility. Includes home health services, volunteer support, grief counseling, and pain management.
HUD - Housing and Urban Development
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ICF - Intermediate Care Facility
ICFs/MR - Intermediate Care Facilities for persons with Mental Retardation
IDEA - Individuals with Disabilities Education Act
IHSS - In-Home Supportive Services
IMD - Institution for Mental Disease
Independence Plus - These waiver templates give states tools to create programs that allow people with disabilities and their families to decide how best to plan, obtain and sustain community-based services, placing control into the hands of the people using the services.
Individual Budgets - Are the funds or resources available to participants to meet their needs. They may directly manage their services and expenditures or assign this task to a representative who can express the participants’ preferences. An individual budget is the key program element that increases choice and control.
Instrumental Activities of Daily Living (IADL’s) - Include housekeeping, cooking, shopping, laundry, medication management, money management, and communication.
Intermediary Service Organizations (ISOs) - May provide assistance to consumers who choose consumer direction. An ISO may also be called "fiscal intermediary" or "employer agent." ISOs may perform one or more of the following tasks to support consumers: Provide training on worker management issues. Assist consumers with managing their workers. Assist with paperwork required when consumers use vouchers or cash to pay their workers (such as filling out time sheets, completing tax forms, paying Social Security taxes).
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Long-Term Care (LTC) - Range of medical and/or social services designed to help people who have disabilities or chronic care needs. Services may be short- or long-term and may be provided in a person's home, in the community, or in residential facilities (e.g., nursing homes or assisted living facilities).
Long-Term Care Insurance - Insurance policies which pay for long-term care services (such as nursing home and home care) that Medicare and Medigap policies do not cover. Policies vary in terms of what they will cover, and may be expensive. Coverage may be denied based on health status or age.
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MCO - Managed Care Organization
MDS - Minimum Data Set
Medicaid (Title XIX) - Federal- and state-funded program of medical assistance to low-income individuals of all ages. There are income eligibility requirements for Medicaid.
Medicaid Infrastructure Grant (MIG) - This grant program supports people with disabilities in securing and sustaining competitive employment in an integrated setting. This is achieved by providing money to the states to develop and implement the core elements of the Ticket to Work and Work Incentives Improvement Act (TWWIIA) of 1999, so as to successfully modify their health care delivery systems to meet the needs of people with disabilities who want to work.
Medicaid managed long-term services and support (MLTSS) program - A plan in which a contractor is accountable for providing beneficiaries with a defined set of long-term care services and support in exchange for a prepaid capitation payment. MLTSS is present in a range of models. Some plans include just Medicaid benefits; others include Medicare and Medicaid benefits.
Medical Home - Model provide accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective medical care to patients, and are managed by a primary care physician in order to maximize patients’ health outcomes.
Medicare (Title XVIII) - Federal health insurance program for persons age 65 and over (and certain disabled persons under age 65). Consists of 2 parts: Part A (hospital insurance) and Part B (optional medical insurance which covers physicians' services and outpatient care in part and which requires beneficiaries to pay a monthly premium).
Medicare Supplement Insurance - (MedSupp) (also called Medigap) Insurance supplement to Medicare that is designed to fill in the "gaps" left by Medicare (such as co-payments). May pay for some limited long-term care expenses, depending on the benefits package purchased.
Medigap - Insurance supplement to Medicare that is designed to fill in the "gaps" left by Medicare (such as co-payments). May pay for some limited long-term care expenses, depending on the benefits package purchased. (also called Medicare supplement insurance)
Mental Health Services - Variety of services provided to people of all ages, including counseling, psychotherapy, psychiatric services, crisis intervention, and support groups. Issues addressed include depression, grief, anxiety, stress, as well as severe mental illnesses.
Money Follows the Person (MFP) - A federal initiative that allows people who are living in nursing homes or other institutions to have the money or funding go with them as they move out into the community onto community based services.
MR/DD - Mental Retardation and other Developmental Disabilities
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Nurse - An individual trained to care for the sick, aged, or injured. Can be defined as a professional qualified by education and authorized by law to practice nursing.
Nurse Practitioner (NP) - A registered nurse working in an expanded nursing role, usually with a focus on meeting primary health care needs. NPs conduct physical examinations, interpret laboratory results, select plans of treatment, identify medication requirements, and perform certain medical management activities for selected health conditions. Some NPs specialize in geriatric care.
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OHCDS - Organized Health Care Delivery Systems
Older Americans Act (OAA) - Federal legislation that specifically addresses the needs of older adults in the United States. Provides some funding for aging services (such as home-delivered meals, congregate meals, senior center, and employment programs). Creates the structure of federal, state, and local agencies that oversee aging services programs. (See also Title III services.)
Olmstead v. LC - The case of Olmstead v. L.C. involved two Georgia women who had dual diagnoses (mental illness and mental retardation) and who were residing in a state mental health facility. They were denied home care because of inadequate funding. In June of 1999, the Supreme Court found that unjustified isolation is properly regarded as discrimination under the Americans with Disabilities Act, and required that the women be served “in the most integrated setting appropriate to [their] needs.” (Olmstead v. L.C., June 1999, p.6) In the Olmstead decision, the Supreme Court established specific conditions when community based services were required for persons with disabilities: the State’s treatment professionals have determined that community placement is appropriate the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and the placement can be reasonably accommodated, taking into account the resources available to the state and the needs of others. (Olmstead v. L.C. , June 1999, p.1)
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Participant Direction - A service model that empowers public program participants and their families by expanding their degree of choice and control over the long-term services and supports they need to live at home. Many self-directing program participants share authority with or delegate authority to family or friends.
PERS - Personal Emergency Response System
Person Centered Planning - Person-centered planning is a process-oriented approach to empowering people with disability labels. It focuses on the people and their needs by putting them in charge of defining the direction for their lives, not on the systems that may or may not be available to serve them. This ultimately leads to greater inclusion as valued members of both community and society.
Personal Assistance Services (PAS) - Include many different kinds of assistance to people with disabilities who need help with Activities of Daily Living (ADL’s) or Instrumental Activities of Daily Living (IADL’s). The main payment methods are cash payments to consumers or their representatives, payments to vendors or vouchers.
Personal Care - Assistance with activities of daily living as well as with self-administration of medications and preparing special diets. (also called custodial care)
PHP - Prepaid Health Plan
Professional Management Model (PMM) - A program where PAS workers are employees of organizations that are defined and regulated by licensing, other laws, and contractual arrangements with public financing programs.
Psychiatric Disability - When mental illness significantly interferes with the performance of major life activities, such as learning, thinking, communicating, and sleeping, among others.
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RAP - Resident Assessment Protocol
RCF - Residential Care Facility
Real Choice Systems Change (RCSC) - Grants for Community Living that will help states and territories enable people with disabilities to reside in their homes and participate fully in community life. These grants are part of the New Freedom Initiative, a nationwide effort to remove barriers to community living for people of all ages with disabilities and long-term illnesses.
Registered Nurse (RN) - A nurse who has graduated from a formal program of nursing education and has been licensed by an appropriate state authority. RNs are the most highly educated of nurses with the widest scope of responsibility, including all aspects of nursing care. RNs can be graduated from one of three educational programs: two-year associate degree program, three-year hospital diploma program, or four-year baccalaureate program.
Rehabilitation Services - Services designed to improve/restore a person's functioning; includes physical therapy, occupational therapy, and/or speech therapy. May be provided at home or in long-term care facilities. May be covered in part by Medicare.
Reimbursement - The process by which health care providers receive payment for their services. Because of the nature of the health care environment, providers are often reimbursed by third parties that insure and represent patients.
Residential Care - The provision of room, board and personal care. Residential care falls between the nursing care delivered in skilled and intermediate care facilities and the assistance provided through social services. It can be broadly defined as the provision of 24-hour supervision of individuals who, because of old age or impairments, need assistance with the activities of daily living.
Respite Care - Service in which trained professionals or volunteers come into the home or facility to provide short-term care (from a few hours to a few days) for an older person to allow caregivers some time away from their caregiving role.
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SEP - Service Entry Point
Service Coordinators - Assist consumers to assess their need for services, arrange and coordinate the services, and monitor the services. Different programs use different terms, including "case managers," "care managers" and "service brokers." Case Manager is the term for "service coordinator" used by the Medicaid Program and some state HCBS programs. In addition to assessing the need for services, arranging and coordinating services, case managers may also approve or "authorize" payments for home and community based services.
Service Plan - Written document which outlines the types and frequency of the long-term care services that a consumer receives. It may include treatment goals for him or her for a specified time period. (also called care plan or treatment plan)
SGA - Substantial Gainful Activity
Single Point of Entry - Provides a one stop place to gather information on referral and advocacy, to find out about and apply for services, and to evaluate and provide recommendations about services.
SNF - Skilled Nursing Facility
Social Services Block Grant Services - Grants given to states under the Social Security Act which fund limited amounts of social services for people of all ages (including some in-home services, abuse prevention services, and more). (formerly known as Title XX services)
Spend-Down - Medicaid financial eligibility requirements are strict, and may require beneficiaries to spend down/use up assets or income until they reach the eligibility level.
SSA - Social Security Administration
SSP - State Supplemental Payment
SUA - State Unit on Aging
Supplemental Security Income (SSI) - A program of support for low-income aged, blind and disabled persons, established by Title XVI of the Social Security Act. SSI replaced state welfare programs for the aged, blind and disabled in 1972, with a federally administered program, paying a monthly basic benefit nationwide of $512 for an individual and $769 for a couple in January 2000. States may supplement this basic benefit amount.
Support Broker - The individual or agency who arranges for the specific services and supports a consumer and/or family needs. The broker acts on behalf of the consumer to arrange these services and supports. A key principle of self-determination is the shifting of control from the funding agency to the consumer.
Support Groups - Groups of people who share a common bond (e.g., caregivers) who come together on a regular basis to share problems and experiences. May be sponsored by social service agencies, senior centers, religious organizations, as well as organizations such as the Alzheimer's Association.
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Targeted case management - Refers to case management services provided only to specific Medicaid beneficiary groups, defined either by disease or medical condition (e.g., HIV/AIDS, tuberculosis, chronic physical or mental illness) or by geographic regions (e.g., county or city). Described in Social Security Act 1915(g).
TCM - Targeted Case Management
TEFRA - Tax Equity and Fiscal Responsibility Act
Ticket to Work and Work Incentives Improvement Act (TWWIIA) - This legislation was enacted to allow individuals with disabilities to work. Title I of the act provides access to employment training and placement services and Title II of the act provides health care supports for working individuals with disabilities.
Title III Services - Services provided to individuals age 60 and older which are funded under Title III of the Older Americans Act. Include: congregate and home-delivered meals, supportive services (e.g., transportation, information and referral, legal assistance, and more), in-home services (e.g., homemaker services, personal care, chore services, and more), and health promotion/disease prevention services (e.g., health screenings, exercise programs, and more). (See also Older Americans Act.)
Title XIX (Medicaid) - Federal- and state-funded program of medical assistance to low-income individuals of all ages. There are income eligibility requirements for Medicaid.
Title XVIII (Medicare) - Federal health insurance program for persons age 65 and over (and certain disabled persons under age 65). Consists of 2 parts: Part A (hospital insurance) and Part B (optional medical insurance which covers physicians' services and outpatient care in part and which requires beneficiaries to pay a monthly premium).
Title XX Services - Grants given to states under the Social Security Act which fund limited amounts of social services for people of all ages (including some in-home services, abuse prevention services, and more). (now known as Social Services Block Grant services)
Treatment Plan - Written document which outlines the types and frequency of the long-term care services that a consumer receives. It may include treatment goals for him or her for a specified time period. (also called care plan or service plan)
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Visiting Nurse Association (VNA) - A voluntary health agency that provides nursing and other services in the home. Basic services include health supervision, education and counseling; bedside care; and the carrying out of physicians' orders. Personnel include nurses and home health aides who are trained for specific tasks of personal bedside care. These agencies had their origin in the visiting or district nursing provided to sick poor in their homes by voluntary agencies.
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Glossary/Acronyms
1
1915 (c) waiver - Medicaid home and community-based services waivers that allow states to request waivers of certain federal requirements to allow development of HCBS treatment alternatives to institutional care so long as these alternatives cost no more than it would to provide the same care in an institutional setting.1915(j) - A new subsection of the Social Security Act that allows States to amend their Medicaid State plans, giving individuals the ability to self-direct their home and community based services, hire and fire their own workers, and purchase appropriate goods and services to fulfill their plan of care.
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A
AAA - Area Agencies on AgingACA - Affordable Care Act. Also known as the Patient Protection and Affordable Care Act (PPACA) and ACA, PL 111-148. The Affordable Care Act was passed by Congress and signed into law by the President in March 2010.
Accessibility of Service - The relative opportunity for people in need to obtain relevant services.
ACL - Administration for Community Living. Developed in 2012, this federal agency brings together the Administration on Aging, the Office on Disability and the Administration on Developmental Disabilities into a single agency that supports both cross-cutting initiatives and efforts focused on the unique needs of individual groups.
Activities of Daily Living ( ADL's) - Basic personal activities which include bathing, dressing, transferring from bed to chair, toilet assistance, mobility and eating. ADL’s are used to measure how dependent a person may be on requiring assistance in performing any or all of these activities.
ADA - Americans With Disabilities Act. The ADA prohibits discrimination on the basis of disability in employment, by state and local government entities and by places of public accommodation.
Adult Day Care - A daytime community-based program for functionally impaired adults that provides a variety of health, social, and related support services in a protective setting.
AFDC - Aid to Families with Dependent Children provided transitional financial assistance to needy families. Federal and state governments shared in its cost. It was replaced by TANF in 1997.
Agency with Choice (AwC) - Is a model of Financial Management Services wherein the Agency with Choice provides services under a co-employment arrangement with participants. In the Agency with Choice model the agency is the common law employer and the participant is a managing employer of workers who serve the participant.
AGI - Adjusted Gross Income
Aging and Disability Resource Center (ADRC) - The Aging and Disability Resource Center Grant Program, a cooperative effort of the Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS), was developed to assist states in their efforts to create a single, coordinated system of information and access for all persons seeking long term support to minimize confusion, enhance individual choice, and support informed decision-making.
ALF - Assisted Living Facility
ASPE - Assistant Secretary for Planning and Evaluation
Assisted Living - Residences that provide a “home with services” and that emphasize residents’ privacy and choice. Residents typically have private locking rooms (only shared by choice) and bathrooms. Personal care services are available on a 24-hour-a-day basis.
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B
BBA - Balanced Budget ActBoard and Care Home - A residence that offers housing and personal care services for a small number of residents (usually 3 to 16). Services (such as meals, supervision, and transportation) are usually provided by the owner or manager. May be single family home.
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C
Care Coordination - Program target high-risk beneficiaries to improve coordination of both medical and social supports provided by different organizations and providers.Care management - Refers to programs that seek to help patients achieve an optimal level of wellness, improve coordination of care, and engage beneficiaries and their support systems in a collaborative process designed to manage medical, social, and mental health conditions more effectively.
Care Plan - A written document that outlines the types and frequency of the long-term care services that a consumer receives. It may include treatment goals for him or her for a specified time period.
Caregiver - A person who provides support and assistance with various activities to a family member, friend, or neighbor. May provide emotional or financial support, as well as hands-on help with different tasks. Caregiving may also be done from long distance.
Case management - Services that assist eligible enrollees to secure medical and other services necessary for appropriate health care treatment. Services include the assessment of an eligible individual to determine service needs, development of a specific care plan, referral and related activities to help an individual obtain needed services, and monitoring and follow-up activities.
Cash & Counseling Demonstration and Evaluation - An implementation and study of consumer-directed PAS programs offering cash allowances and information services. Consumers use the allowances to purchase services, assistive devices, and home modifications. The goal is to enable medicaid PAS consumers to exercise maximum consumer direction.
CD-PAS - Consumer Directed Personal Assistance Services
CDDO - Community Developmental Disabilities Organization
Certificate of Need (CON) - A certificate issued by a government body to a health care provider who is proposing to construct, modify, or expand facilities, or to offer new or different types of health services. CON is intended to prevent duplication of services and overbedding. The certificate signifies that change has been approved.
CMHSP - Community Mental Health Service Program
COLA - Cost of Living Adjustment
Community Health Center - An ambulatory health care program usually serving an area that has scarce or nonexistent health services or a population with special health needs. These centers attempt to coordinate federal, state, and local resources in a single organization capable of delivering both health and related social services to a defined population. While such a center may not directly provide all types of health care, it usually takes responsibility to arrange all medical services needed by its patient population.
Community Living Program Grants (CLP) - Part of the Administration on Aging’s (AoA) grant initiative, it is funding for states to enable the elderly, at risk of nursing home placement, to continue to live in their communities, with access to professional help to find community resources and supports that best fit their individual needs.
Community-Based Services - Services designed to help people remain independent and in their own homes; can include senior centers, transportation, delivered meals or congregate meals site, visiting nurses or home health aides, adult day care, and homemaker services.
Community-Integrated Personal Assistance Services and Supports (CPASS) - The goal of this project is to develop an infrastructure and create products that will promote the effective recruitment and retention of personal assistants, and ensure that people with disabilities have the knowledge, access and resources available to maximize choice and control in the use of Personal Assistance Services.
Congregate Housing - Individual apartments where residents may receive some services, such as a daily meal with other tenants. Other services may be included as well. Buildings usually have some common areas such as a dining room and lounge as well as additional safety measures such as emergency call buttons. May be rent subsidized (known as section 8 housing).
Consumer choice - Provided when there is a range of service options to meet the diverse needs of consumers. The degree to which consumers have choice must go beyond the range of service choices and include opportunities for consumers to decide when and where services will be provided, and how and by whom tasks will be performed.
Consumer Directed Model (CDM) - A public program where consumers have an employer/employee relationship with PAS workers.
Consumer direction (CD) - Describes programs and services where people are given maximum choice and control. Consumer direction may also be called "self-determination" or "independent living." When people say they want to be "independent" or they want "autonomy" or "self-direction," they are talking about consumer direction too. In consumer-directed programs, consumers can choose to select, manage and dismiss their workers.
Consumer-directed programs - Consumers can decide which services to use, which workers to hire, and what time of day they will come. They can decide whether to hire family members and whether to spend the available funds on things other than services (like appliances or home modifications). In some consumer-directed programs, consumers pay their workers themselves; in others, consumers choose to have a "intermediary service organization" handle payments.
Consumers - Any persons who use goods and services. Consumers of consumer-directed services are people with disabilities of all ages, including persons with: Cognitive needs which include autism, mental retardation, brain injury, dementia (including Alzheimer's Disease, AIDS-related dementa); Physical needs due to accidents, injuries, illnesses, age-related conditions, developmental conditions such as muscular dystrophy, and sensory impairments (including vision and hearing losses, deafness, blindness).
Continuing Care Retirement Community (CCRC) - Communities that offer multiple levels of care (independent living, assisted living, skilled nursing care) housed in different areas of the same community or campus and which give residents the opportunity to remain in the same community if their needs change. Provide residential services (meals, housekeeping, laundry), social and recreational services, health care services, personal care, and nursing care. Require payment of a monthly fee and possibly a large-sum entrance fee.
Continuum of Care - The entire spectrum of specialized health, rehabilitative, and residential services available to the frail and chronically ill. The services focus on the social, residential, rehabilitative and supportive needs of individuals, as well as needs that are essentially medical in nature.
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D
DDP - Developmental Disabilities Profile- The DDP is a four page instrument designed to record important characteristics of individuals with developmental disabilities. It was developed by New York’s Office of Mental Retardation over a two year period finalized in 1990. The information collected via the DDP includes a broad range of adaptive functioning skills as well as behavioral challenges and health factors.Deficit Reduction Act Of 2005 - Signed by the President in February 2006, this Act is expected to generate $39 billion in federal entitlement reductions over the 2006 to 2010 period and $99 billion over the 2006 to 2015 period. The DRA makes several major changes to long-term services policies in Medicaid. Key changes including: Asset Transfers, Long-Term Care Partnership Programs, Family Opportunity Act, Money Follows the Person Demonstration, State Option to Provide HCBS Services and Cash & Counseling Option.
Deinstitutionalization - A policy that calls for the provision of supportive care and treatment for medically and socially dependent individuals in the community rather than an institutional setting.
Delegation - Transfer of authority from a licensed professional health care provider to an individual not licensed to perform delegated tasks.
Developmental Disability - A disability that originates before age 18, can be expected to continue indefinitely, and constitutes a substantial handicap to the person’s ability to function normally.
Disability - “With respect to an individual (A) a physical or mental impairment that substantially limits one or more of the major life activities of such individual; (B) a record of such impairment; or (C) being regarded as having an impairment.” (ADA, 42 USC 12102) “The phrase physical impairment includes but is not limited to … orthopedic, visual, speech and hearing impairments, cerebral palsy, epilepsy, muscular dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, specific learning disabilities, HIV disease (whether symptomatic or asymptomatic), tuberculosis, drug addiction, and alcoholism… The phrase major life activities means functions such as caring for one’s self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning and working.” (ADA Handbook, pp.II-16 through II-19.)
DMR - Department of Mental Retardation
DSPD - Division of Services for People with Disabilities
Dual Eligibles - Individuals with certain combinations of needs who enroll in both the state-administered Medicaid program and the federally-administered Medicare program are referred to as dual eligibles. Currently, dual eligibles receive prescription drugs and most long-term care benefits from Medicaid, while they are covered by Medicare for acute benefits such as doctor’s visits and inpatient hospital care. (also referred to as Dual-Elibible or Duals)
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Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) - A program mandated by law as part of the Medicaid program. The law requires that all states have in effect a program for eligible children under age 21 to ascertain their physical or mental defects and to provide such health care treatments and other measures to correct or ameliorate defects and chronic conditions discovered. The state programs also have active outreach components to inform eligible persons of the benefits available to them, to provide screening, and if necessary, to assist in obtaining appropriate treatment.Escort Services (also called transportation services) - Provide transportation for people to services and appointments. May use bus, taxi, volunteer drivers, or van services that can accommodate wheelchairs and persons with other special needs.
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Family2Family - Family-to-Family Information and Education Centers provide, in a single, community-level location, access to information and assistance for families with children with special health care needs. These centers are funded through the New Freedom Initiative.Fee-for-Service - The way traditional Medicare and health insurance work. Medical providers bill for whatever service they provide. Medicare and/or traditional insurance pay their share, and the patient pays the balance through co-payments and deductibles.
FFP - Federal Financial Participation
Financial Management Services (FMS) - A service/function that helps a participant directing family or participant to manage and distribute funds in the participant-directed budget. It’s also key in facilitating the employment of staff along with fiscal accounting and expenditure reports for the participant, family and state authorities.
Fiscal Intermediaries - Organizations that provide third party and fourth party financial services between recipient and providers of a benefit.
Fiscal/Employer Agent Services (F/EA Services) - An Agent serves on behalf of participants enrolled in public programs under Section 3504 of the Internal Revenue Code. An F/EA Employer Agent may be a government entity, a private non-profit or for-profit entity that’s been contracted to serve public program enrolled participants.
FMAP - Federal Medical Assistance Percentage
Formative Evaluation - Formative evaluation is a method of judging the worth of a program while the program activities are forming or happening.
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Group Home - (also called board and care home) - Residence which offers housing and personal care services to a small number of residents (usually 3 to 16). Services (such as meals, supervision, and transportation) are usually provided by the owner or manager. May be single family home.back to top
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Handicapped - As defined by Section 504 of the Rehabilitation Act of 1973, any person who has a physical or mental impairment that substantially limits one or more major life activity, has a record of such impairment, or is regarded as having such impairment.HCBS - Home and Community Based Services. Services or other supports to help people with disabilities of all ages to live in the community. Each state has a mix of programs and funding sources. The Medicaid program pays for many of these services in all states. There are also other federal, state and local dollars that fund home and community based services, including the Social Services Block Grant (SSBG), Older Americans Act (OAA), Education and Rehabilitation funds and State General funds.
HCFA - Health Care Financing Administration
HIPAA - Health Insurance Portability and Accountability Act of 1996. Title I protects health insurance coverage for workers and their families when they change or lose their jobs. The Administrative Simplification provisions (HIPAA, Title II) require the Department of Health and Human Services to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addresses the security and privacy of health data.
HMO - Health Maintenance Organization
Home and Community-Based Waivers - Section 2176 of the Omnibus Reconciliation Act of 1987 permits states to offer, under a waiver, a wide array of home and community-based services that an individual may need to avoid institutionalization. Regulations to implement the act list the following services as community and home-based services which may be offered under the waiver program: case management, homemaker, home health aide, personal care, adult day health care, habilitation, respite care and other services.
Home Health Agency - A public or private organization that provides home health services, supervised by a licensed health professional in the patient's home, either directly or through arrangements with other organizations.
Home Health Aide - A person who, under the supervision of a home health or social service agency, assists elderly, ill or disabled persons with household chores, bathing, personal care, and other daily living needs. Social service agency personnel are sometimes called personal care aides.
Home Health Care - Includes a wide range of health-related services such as assistance with medications, wound care, intravenous (IV) therapy, and help with basic needs such as bathing, dressing, mobility, etc., which are delivered at a person's home.
Home Medical Equipment (also called durable medical equipment) - Equipment such as hospital beds, wheelchairs, and prosthetics used at home. May be covered by Medicaid and in part by Medicare or private insurance.
Homemaker Services - In-home help with meal preparation, shopping, light housekeeping, money management, personal hygiene and grooming, and laundry.
Hospice - A program which provides palliative and supportive care for terminally ill patients and their families, either directly or on a consulting basis with the patient's physician or another community agency. The whole family is considered the unit of care, and care extends through their period of mourning.
Hospice Care - Services for the terminally ill provided in the home, a hospital, or a long-term care facility. Includes home health services, volunteer support, grief counseling, and pain management.
HUD - Housing and Urban Development
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ICAP - Inventory for Client and Agency PlanningICF - Intermediate Care Facility
ICFs/MR - Intermediate Care Facilities for persons with Mental Retardation
IDEA - Individuals with Disabilities Education Act
IHSS - In-Home Supportive Services
IMD - Institution for Mental Disease
Independence Plus - These waiver templates give states tools to create programs that allow people with disabilities and their families to decide how best to plan, obtain and sustain community-based services, placing control into the hands of the people using the services.
Individual Budgets - Are the funds or resources available to participants to meet their needs. They may directly manage their services and expenditures or assign this task to a representative who can express the participants’ preferences. An individual budget is the key program element that increases choice and control.
Instrumental Activities of Daily Living (IADL’s) - Include housekeeping, cooking, shopping, laundry, medication management, money management, and communication.
Intermediary Service Organizations (ISOs) - May provide assistance to consumers who choose consumer direction. An ISO may also be called "fiscal intermediary" or "employer agent." ISOs may perform one or more of the following tasks to support consumers: Provide training on worker management issues. Assist consumers with managing their workers. Assist with paperwork required when consumers use vouchers or cash to pay their workers (such as filling out time sheets, completing tax forms, paying Social Security taxes).
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Level of Care (LOC) - Amount of assistance required by consumers which may determine their eligibility for programs and services. Levels include: protective, intermediate, and skilled.Long-Term Care (LTC) - Range of medical and/or social services designed to help people who have disabilities or chronic care needs. Services may be short- or long-term and may be provided in a person's home, in the community, or in residential facilities (e.g., nursing homes or assisted living facilities).
Long-Term Care Insurance - Insurance policies which pay for long-term care services (such as nursing home and home care) that Medicare and Medigap policies do not cover. Policies vary in terms of what they will cover, and may be expensive. Coverage may be denied based on health status or age.
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Maternal and Child Health - Health and healthcare information pertaining to mothers and children.MCO - Managed Care Organization
MDS - Minimum Data Set
Medicaid (Title XIX) - Federal- and state-funded program of medical assistance to low-income individuals of all ages. There are income eligibility requirements for Medicaid.
Medicaid Infrastructure Grant (MIG) - This grant program supports people with disabilities in securing and sustaining competitive employment in an integrated setting. This is achieved by providing money to the states to develop and implement the core elements of the Ticket to Work and Work Incentives Improvement Act (TWWIIA) of 1999, so as to successfully modify their health care delivery systems to meet the needs of people with disabilities who want to work.
Medicaid managed long-term services and support (MLTSS) program - A plan in which a contractor is accountable for providing beneficiaries with a defined set of long-term care services and support in exchange for a prepaid capitation payment. MLTSS is present in a range of models. Some plans include just Medicaid benefits; others include Medicare and Medicaid benefits.
Medical Home - Model provide accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective medical care to patients, and are managed by a primary care physician in order to maximize patients’ health outcomes.
Medicare (Title XVIII) - Federal health insurance program for persons age 65 and over (and certain disabled persons under age 65). Consists of 2 parts: Part A (hospital insurance) and Part B (optional medical insurance which covers physicians' services and outpatient care in part and which requires beneficiaries to pay a monthly premium).
Medicare Supplement Insurance - (MedSupp) (also called Medigap) Insurance supplement to Medicare that is designed to fill in the "gaps" left by Medicare (such as co-payments). May pay for some limited long-term care expenses, depending on the benefits package purchased.
Medigap - Insurance supplement to Medicare that is designed to fill in the "gaps" left by Medicare (such as co-payments). May pay for some limited long-term care expenses, depending on the benefits package purchased. (also called Medicare supplement insurance)
Mental Health Services - Variety of services provided to people of all ages, including counseling, psychotherapy, psychiatric services, crisis intervention, and support groups. Issues addressed include depression, grief, anxiety, stress, as well as severe mental illnesses.
Money Follows the Person (MFP) - A federal initiative that allows people who are living in nursing homes or other institutions to have the money or funding go with them as they move out into the community onto community based services.
MR/DD - Mental Retardation and other Developmental Disabilities
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Neighborhood Health Center - An ambulatory health care program usually serving a catchment area which has scarce or nonexistent health services or a population with special health needs. These centers attempt to coordinate federal, state, and local resources in a single organization capable of delivering both health and related social services to a defined population. While such a center may not directly provide all types of health care, it usually takes responsibility to arrange all medical services needed by its patient population. (also called community health center)Nurse - An individual trained to care for the sick, aged, or injured. Can be defined as a professional qualified by education and authorized by law to practice nursing.
Nurse Practitioner (NP) - A registered nurse working in an expanded nursing role, usually with a focus on meeting primary health care needs. NPs conduct physical examinations, interpret laboratory results, select plans of treatment, identify medication requirements, and perform certain medical management activities for selected health conditions. Some NPs specialize in geriatric care.
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OBRA - Omnibus Budget Reconciliation ActOHCDS - Organized Health Care Delivery Systems
Older Americans Act (OAA) - Federal legislation that specifically addresses the needs of older adults in the United States. Provides some funding for aging services (such as home-delivered meals, congregate meals, senior center, and employment programs). Creates the structure of federal, state, and local agencies that oversee aging services programs. (See also Title III services.)
Olmstead v. LC - The case of Olmstead v. L.C. involved two Georgia women who had dual diagnoses (mental illness and mental retardation) and who were residing in a state mental health facility. They were denied home care because of inadequate funding. In June of 1999, the Supreme Court found that unjustified isolation is properly regarded as discrimination under the Americans with Disabilities Act, and required that the women be served “in the most integrated setting appropriate to [their] needs.” (Olmstead v. L.C., June 1999, p.6) In the Olmstead decision, the Supreme Court established specific conditions when community based services were required for persons with disabilities: the State’s treatment professionals have determined that community placement is appropriate the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and the placement can be reasonably accommodated, taking into account the resources available to the state and the needs of others. (Olmstead v. L.C. , June 1999, p.1)
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PACE - Program of All-inclusive Care for the ElderlyParticipant Direction - A service model that empowers public program participants and their families by expanding their degree of choice and control over the long-term services and supports they need to live at home. Many self-directing program participants share authority with or delegate authority to family or friends.
PERS - Personal Emergency Response System
Person Centered Planning - Person-centered planning is a process-oriented approach to empowering people with disability labels. It focuses on the people and their needs by putting them in charge of defining the direction for their lives, not on the systems that may or may not be available to serve them. This ultimately leads to greater inclusion as valued members of both community and society.
Personal Assistance Services (PAS) - Include many different kinds of assistance to people with disabilities who need help with Activities of Daily Living (ADL’s) or Instrumental Activities of Daily Living (IADL’s). The main payment methods are cash payments to consumers or their representatives, payments to vendors or vouchers.
Personal Care - Assistance with activities of daily living as well as with self-administration of medications and preparing special diets. (also called custodial care)
PHP - Prepaid Health Plan
Professional Management Model (PMM) - A program where PAS workers are employees of organizations that are defined and regulated by licensing, other laws, and contractual arrangements with public financing programs.
Psychiatric Disability - When mental illness significantly interferes with the performance of major life activities, such as learning, thinking, communicating, and sleeping, among others.
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Quality - The degree to which services and supports for individuals and populations increase the likelihood for desired health and quality of life measurable outcomes and are consistent with current professional knowledge. The goal of quality services and supports is to maximize the quality of life, functional independence, health and well being of the population.back to top
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RAI - Resident Assessment InstrumentRAP - Resident Assessment Protocol
RCF - Residential Care Facility
Real Choice Systems Change (RCSC) - Grants for Community Living that will help states and territories enable people with disabilities to reside in their homes and participate fully in community life. These grants are part of the New Freedom Initiative, a nationwide effort to remove barriers to community living for people of all ages with disabilities and long-term illnesses.
Registered Nurse (RN) - A nurse who has graduated from a formal program of nursing education and has been licensed by an appropriate state authority. RNs are the most highly educated of nurses with the widest scope of responsibility, including all aspects of nursing care. RNs can be graduated from one of three educational programs: two-year associate degree program, three-year hospital diploma program, or four-year baccalaureate program.
Rehabilitation Services - Services designed to improve/restore a person's functioning; includes physical therapy, occupational therapy, and/or speech therapy. May be provided at home or in long-term care facilities. May be covered in part by Medicare.
Reimbursement - The process by which health care providers receive payment for their services. Because of the nature of the health care environment, providers are often reimbursed by third parties that insure and represent patients.
Residential Care - The provision of room, board and personal care. Residential care falls between the nursing care delivered in skilled and intermediate care facilities and the assistance provided through social services. It can be broadly defined as the provision of 24-hour supervision of individuals who, because of old age or impairments, need assistance with the activities of daily living.
Respite Care - Service in which trained professionals or volunteers come into the home or facility to provide short-term care (from a few hours to a few days) for an older person to allow caregivers some time away from their caregiving role.
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Senior Center - Provides a variety of on-site programs for older adults including recreation, socialization, congregate meals, and some health services. Usually a good source of information about area programs and services.SEP - Service Entry Point
Service Coordinators - Assist consumers to assess their need for services, arrange and coordinate the services, and monitor the services. Different programs use different terms, including "case managers," "care managers" and "service brokers." Case Manager is the term for "service coordinator" used by the Medicaid Program and some state HCBS programs. In addition to assessing the need for services, arranging and coordinating services, case managers may also approve or "authorize" payments for home and community based services.
Service Plan - Written document which outlines the types and frequency of the long-term care services that a consumer receives. It may include treatment goals for him or her for a specified time period. (also called care plan or treatment plan)
SGA - Substantial Gainful Activity
Single Point of Entry - Provides a one stop place to gather information on referral and advocacy, to find out about and apply for services, and to evaluate and provide recommendations about services.
SNF - Skilled Nursing Facility
Social Services Block Grant Services - Grants given to states under the Social Security Act which fund limited amounts of social services for people of all ages (including some in-home services, abuse prevention services, and more). (formerly known as Title XX services)
Spend-Down - Medicaid financial eligibility requirements are strict, and may require beneficiaries to spend down/use up assets or income until they reach the eligibility level.
SSA - Social Security Administration
SSP - State Supplemental Payment
SUA - State Unit on Aging
Supplemental Security Income (SSI) - A program of support for low-income aged, blind and disabled persons, established by Title XVI of the Social Security Act. SSI replaced state welfare programs for the aged, blind and disabled in 1972, with a federally administered program, paying a monthly basic benefit nationwide of $512 for an individual and $769 for a couple in January 2000. States may supplement this basic benefit amount.
Support Broker - The individual or agency who arranges for the specific services and supports a consumer and/or family needs. The broker acts on behalf of the consumer to arrange these services and supports. A key principle of self-determination is the shifting of control from the funding agency to the consumer.
Support Groups - Groups of people who share a common bond (e.g., caregivers) who come together on a regular basis to share problems and experiences. May be sponsored by social service agencies, senior centers, religious organizations, as well as organizations such as the Alzheimer's Association.
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TANF - Temporary Assistance for Needy Families-TANF provides assistance and work opportunities to needy families by granting states the federal funds and flexibility to develop and implement their own welfare programs.Targeted case management - Refers to case management services provided only to specific Medicaid beneficiary groups, defined either by disease or medical condition (e.g., HIV/AIDS, tuberculosis, chronic physical or mental illness) or by geographic regions (e.g., county or city). Described in Social Security Act 1915(g).
TCM - Targeted Case Management
TEFRA - Tax Equity and Fiscal Responsibility Act
Ticket to Work and Work Incentives Improvement Act (TWWIIA) - This legislation was enacted to allow individuals with disabilities to work. Title I of the act provides access to employment training and placement services and Title II of the act provides health care supports for working individuals with disabilities.
Title III Services - Services provided to individuals age 60 and older which are funded under Title III of the Older Americans Act. Include: congregate and home-delivered meals, supportive services (e.g., transportation, information and referral, legal assistance, and more), in-home services (e.g., homemaker services, personal care, chore services, and more), and health promotion/disease prevention services (e.g., health screenings, exercise programs, and more). (See also Older Americans Act.)
Title XIX (Medicaid) - Federal- and state-funded program of medical assistance to low-income individuals of all ages. There are income eligibility requirements for Medicaid.
Title XVIII (Medicare) - Federal health insurance program for persons age 65 and over (and certain disabled persons under age 65). Consists of 2 parts: Part A (hospital insurance) and Part B (optional medical insurance which covers physicians' services and outpatient care in part and which requires beneficiaries to pay a monthly premium).
Title XX Services - Grants given to states under the Social Security Act which fund limited amounts of social services for people of all ages (including some in-home services, abuse prevention services, and more). (now known as Social Services Block Grant services)
Treatment Plan - Written document which outlines the types and frequency of the long-term care services that a consumer receives. It may include treatment goals for him or her for a specified time period. (also called care plan or service plan)
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VD-HCBS - These programs serve veterans of any age who are at risk of nursing home placement and their family caregivers. They provide veterans the opportunity to receive home and community based services that enable them to avoid institutionalization and continue to live in their homes and communities.Visiting Nurse Association (VNA) - A voluntary health agency that provides nursing and other services in the home. Basic services include health supervision, education and counseling; bedside care; and the carrying out of physicians' orders. Personnel include nurses and home health aides who are trained for specific tasks of personal bedside care. These agencies had their origin in the visiting or district nursing provided to sick poor in their homes by voluntary agencies.
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Waiver - This is when the Federal Government allows or grants States permission to waive certain Federal requirements in order to operate a specific kind of program. They are often used to authorize managed care, or alternative delivery or reimbursement systems (Example: 1915c waiver).back to top
HCBS / Clearinghouse for the Community Living Exchange Collaborative / (http://www.hcbs.org)