Abandonment
Leaving an individual with caregiving needs without arranging for adequate care and support while gone.
"A-B-C" Chart
A chart used in Applied Behavioral Analysis and Positive Behavior Support practices. This chart is way to record: 1) what happens directly before a behavior occurs (Antecedent), 2) the specific behavior, and 3) what happens after the behavior (Consequence). This information helps to clarify the function (or purpose) of the behavior. It can look similar to the Communication Chart used in the Learning Community. However, it serves a different purpose.
Ableism
Ableism is a set of societal practices and attitudes that devalues and limits the potential of people with disabilities. These beliefs assign less worth to people who have cognitive, developmental, emotional, physical, or psychiatric disabilities.
Accountable Care Organization (ACO)
Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health-care providers, who come together voluntarily to give coordinated high quality care to patients. The goal of coordinated care is to ensure that patients, especially people with chronic illnesses, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.
Active Listening
Mindfully listening to another person for the purpose of understanding them fully. This process includes both intent and action. The intent is to really listen for understanding. The listener must set aside judgment of the person's view. Actions that support this approach include aligning verbal and nonverbal communication. Listeners use body language to indicate open engagement. This includes facing the person, having an attentive but open pose, making good eye contact, and nodding. It also includes repeating what you heard the speaker say for the purpose of clarifying and staying on track. For example: "May I ask if, when you say … , you mean… ?" "I think you mean… . Do I have that right?"
Activities of Daily Living (ADL)
Commonly referred to as ADLs, these are the basic tasks of everyday life. They include such things as eating, bathing, dressing, toileting, and transferring.
Administration on Aging (AoA)
The Administration on Aging (AOA) is one of the many federal administrations housed within the Administration on Community Living (ACL) in the U.S Department of Health and Human Services. It is the principal agency designated to carry out the provisions of the Older Americans Act (OAA). The OAA promotes the well-being of older individuals and ensures provision of services and programs to help them live independently in their homes and communities.
Adoption
It's a process whereby a legally recognized, lifelong parental relationship is established between a child or adult (adoptee) and their adoptive parent (who is not the biological parent). Adoption is a permanent choice for biological parents of the adoptee.
Adult Protection Agency (Adult Protective Services)
An agency designated in a state to investigate reports of potential maltreatment to adults. Mandated reporters must know where to report. However, people who are not mandated to report may also contact these agencies.
Advocate 
A person who speaks up and is active in working toward equal rights,
opportunities, and respect for another person or groups of people. Advocates
can be paid or unpaid. Also see Arc National and Self-advocacy.
Advocacy
Speaking up for oneself or others to improve a situation and get what is wanted, needed, or fair.
Affordable Care Act (ACA)
The ACA was enacted to increase the quality and affordability of health insurance, lower the number of people who are uninsured, and reduce the costs of health care. The law made a number of significant changes that protect individuals. For instance, requiring mental health parity, allowing parent's insurance to cover emerging adults up to age 25, and requiring insurance companies to cover all applicants within new minimum standards and offer the same rates regardless of pre-existing conditions or sex.
Ageism
Ageism is the stereotyping and discrimination of a person or group of people because of age.
Aging and Disability Resource Center (ADRC)
ADRCs were established in many areas to provide accurate, unbiased information to support people with needs related to aging or living with a disability. They provide information on broad range of programs and services and support people in making decisions about options. ADRCs are key community resources in the development the No Wrong Door (NWD) system.
Alzheimer's Disease
Alzheimer's disease is the most common form of dementia among older
people. It involves the parts of the brain that control thought, memory, and
language. The disease usually begins after age 60, and risk goes up with age.
There is some indication that people with certain disabilities, Downs Syndrome
being one of them, are at increased risk for onset at an earlier age.
Alzheimer's disease is not a normal part of aging and currently there is no
cure.
Ambiguous loss
A person experiences a loss that is private or not easy to define. It is
the loss of dreams and hopes as much as the tangible loss that affects the
person. Some examples may include miscarriage, loss of an important
relationship, having to move from your home, or receiving a diagnosis of a
mental illness.
Ambivalence
Having two conflicting attitudes or feelings at the same time. For example, feeling both excitement and fear when considering an opportunity.
American Sign Language (ASL)
A language used to communicate in deaf communities. ASL is the predominant sign language used in the United States.
Americans with Disabilities Act (ADA)
A major civil rights law for people with disabilities signed by President George H.W. Bush in 1990. Section 504 of the 1973 Rehabilitation Act formed the basis for the ADA, which made it against the law to discriminate against people with disabilities in five major areas: employment, public and private transportation, government agencies, public accommodations, and telecommunications. As a result of this law, people with disabilities were recognized as members of a group that receives protections similar to laws prohibiting discrimination on the basis of race, color, sex, national origin, age, and religion.
Amyotrophic Lateral Sclerosis (ALS)
ALS is a progressive degenerative disease that affects nerve cells in the brain and the spinal cord.
Annuities
An annuity is an insurance product that pays out income after certain criteria are met.
Appeal
An appeal is a formal request to change a decision. For example, if someone is denied Medicaid, the person may appeal the decision.
Assessments
Assessments are tools or processes that one uses to identify a person's strengths and needs or to scan an environment based on particular criteria. There are a number of formal assessment tools available. Some may be required in certain situations (for example: as part of eligibility for programs or services). Many professionals also engage in informal assessments as part of supporting individuals.
Asset-Based Community Development (ABCD)
A way to assess a community for barriers and strengths in regard to people at risk of social isolation. Its purpose is to help communities identify and prioritize areas to reduce risk. (http://www.abcdinstitute.org/)
Assisted Living
Assisted living refers to an approach to supporting older people and people with disabilities. These facilities provide assistance with activities of daily living and other types of instrumental support such as transportation, housekeeping, or meals. Assisted living facilities may also help with coordinating services to ensure a person's health, safety, and well-being.
At Risk
Being in danger or likely to experience harm if something is not changed.
Attending Skills
Actions that demonstrate attention towards others. They may include leaning slightly forward or maintaining eye contact.
Augmentative and Alternative Communication (AAC)
Augmentative and Alternative Communication (AAC) includes strategies and devices that help people express themselves and communicate. Picture boards, tablets with touchscreens (such as an iPad), and voice output devices are typical AAC devices. AAC and other communication devices and aids are integral to fostering independence for people who need communication access.
Authority figures
People that have power over others and who others fear or revere.
Autonomy
Freedom from external control.
B
Barriers
Things that get in the way of a person doing or achieving something.
Behavioral Health Homes
Health homes are a way of coordinating care for individuals with complex or chronic health conditions. The model recognizes that coordination of health care is critical for good outcomes. It also recognizes that barriers to health may go beyond medical needs. For example, other pressures on the person or family may make treatment challenging, such as lack of stable housing, mental health issues, or a need for family education. In a health home model, a single entity ensures all care is coordinated. They also respond to other needs that impact health. Health homes often start in primary care clinics. When mental health clinics are designated as health homes, they are called behavioral health homes.
Bias
A preference towards or against something that is not objective or fair. Bias is a form of prejudice.
Blending and Braiding
Methods of approaching the use of funding streams to create more flexible or robust services for individuals. Blending is when funds are combined into a single pool from which they can be allocated to providers without recording their source, as specific requirements will allow. Braiding is when funds from various sources are used to pay for a service package, but tracking and accountability for each pot of money is maintained at the administrative level.
Board and Care
Board and care homes are small supportive housing facilities for people with non-medically related need for support.
Brain Injury
Brain Injury is any injury cause to the brain that damages parts of the brain. It is estimated that 5.3 million Americans are currently living with a BI-related disability. The effects from brain injury can be mild to severe but often causing changes in a person's personality and abilities. Short term memory is often affected.
Branching Conversations (Learning Community)
Branching conversations are an approach to learning what is most important to and for a person in a situation. They are purposeful discussions that are framed by open-ended questions. They support the person's comfort during assessment and discovery processes by creating an environment that is conversational and is guided by the person. (See Discovery.)
Burnout
When a professional or caregiver has lost interest in their work. These situations typically include high demands or expectations and a lack of control over outcomes.
C
Capitated
Capitation is a way that managed care organizations reimburse service providers. A capitated rate is the rate for each person in the potential pool of service users that will be given to the provider, whether each person in the pool uses the service or not.
Care Coordinator
Care coordination involves helping people organize care, be informed of options, and make decisions about care. Care coordinators typically are affiliated with one service or program and do not provide information about options beyond it. Care coordination with ACO may include both health care and social service needs.
Caregiver
A caregiver is a person – either paid or unpaid – who helps another person who cannot independently complete activities of daily living (ADLs) or instrumental activities of daily living (IADLs).
Care Transitions
The term "care transitions" refers to the person's movement between health-care practitioners and settings as their condition and care needs change. For example, in the event of a chronic illness, someone might receive care from a primary care physician or specialist in an outpatient setting. From there, they might transition to a hospital physician and nursing team during an inpatient admission, and then move on to yet another care team at a skilled nursing facility. Finally, the person might return home, where they would receive care from a visiting nurse. Each of these shifts from care providers and settings is defined as a care transition.
Caregiver gain
The benefits that people identify as part of their role as a caregiver.
Caregiving family
A group of people that work or function as a family and participate in caregiving roles. This group may be legal family or family of choice. They may receive pay for their caregiving roles but typically they are unpaid.
Case Management or Care Coordination
A person who helps others navigate a system. These professionals are often assigned as part of a service model. An example includes case management services through the home and community-based waiver programs. Another is the assignment of a care coordinator as part of managed care benefits. Occasionally, service users may hired a coordinator directly as a support. The professional's authority and responsibility will vary greatly. It depends on how services are paid for and regulated.
CAT
An acronym for remembering prompts related to change talk in motivational interviewing approaches. CAT stands for commitment, activation, and taking steps.
(See OARS, EARS, DARN.)
Center for Independent Living (also known as Independent Living Center)
A Center for Independent Living (CIL) is a consumer controlled, community-based, cross disability, non-residential private nonprofit agency that is designed and operated within a local community by individuals with disabilities. A CIL provides an array of independent living services including information and referral, independent living skills training, individual and systems advocacy, and peer counseling (Section 702 of the Rehabilitation Act of 1973, as amended).
Centers for Medicare and Medicaid Services (CMS)
The Centers for Medicare and Medicaid Services (CMS) is part of the US Department of Health and Human Services (HHS). This office administers Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and parts of the Affordable Care Act (ACA).
Cisgender
A person whose gender corresponds to their assigned sex.
Challenges
Difficulties or problems. Barriers to achieving something. Problems or issues when trying to get something done or when engaging with a person.
Cerebral palsy
Cerebral Palsy (CP) is a brain condition that results in difficulty with controlling body movements and posture. It is permanent but does not worsen with time. (Symptoms may increase in later years due to issues related to aging.) There are different ways in which CP may affect a person. The person may have hearing or vision impairments. Many people with CP have difficulties with speech. People with CP may also have intellectual disabilities.
Change Talk
Self-motivational statements that indicate a person is ready to make changes in their life.
Chemical Dependency
Chemical dependency is a term used to describe the physical craving for or the perceived need for drugs or alcohol.
Child Protective Services
The name of this agency may vary from state to state, but its purpose is to focus on the prevention, detection, and resolution of maltreatment of children.
Children's Health Insurance Program (CHIP)
CHIP provides low-cost health coverage to children in families in need that earn too much money to qualify for Medicaid but do not have other access to health care. In some states, CHIP covers parents and pregnant women.
Choice
The freedom to pick among several options. To make a decision when faced with one or more possibilities
(See Informed Choice and Supported Decision-Making.)
Coercion
Coercion is the practice of forcing another party to act in an involuntary manner by use of threats or force.
Cognitive Abilities
A person's abilities related to understanding and using information. They may include the ability to recognize and remember information. They can include the speed in which the person can respond to or organize information.
Colloquialisms
Informal and regional words and phrases used in everyday speech. These are not often understood by people outside the regional or cultural group.
Combined Waiver
States can apply to simultaneously implement two types of waivers – 1915(b) and 1915(c) – to provide a continuum of services to the elderly and people with disabilities, as long as all Federal requirements for both programs are met.
Communication
A process of sharing information. It requires both the sender and the receiver of a message to mutually agree on that message. Communication is not only speaking words and being heard, but also attending to body language, decoding meaning, explaining, questioning, and clarifying the information being exchanged.
Community elder
An older person whose perspective is respected and sought by members of a community.
Community First Choice 1915(k)
The "Community First Choice Option" allows states to provide home and community-based services and supports to eligible Medicaid enrollees under their State Plan.
Community Living
People living in and being part of their communities, regardless of a need for support or services.
Community Inclusion
A concept that reflects the practice of sharing in community life involving at least these four aspects (1) physical presence where the individual actually lives in a typical community setting (house, apartment etc.) vs. an isolated setting such as an institution or a nursing home, (2) cultural integration where the individual exhibits locally valued lifestyles and roles (e.g., farm hand in a rural community; condominium or home owner; church or association member), (3) connections to others who are not paid as supporters. These connections include a variety of reciprocal relationships like friend, coworker, neighbor, spouse, etc.) and (4) self-determination. (see community integration, self-determination).
Community Resources
Places, people, or organizations that provide services to anyone.
Compadre
Special friends not related by blood or marriage.
Competency
The ability to perform or complete tasks effectively (as in competency-based training). Also a legal definition (competence). This is a decision of the court based on the assessment of a person's capacity and ability to understand and use information effectively when making decisions. Those the court deems lacking in competence will be assigned a legal representative of some kind.
Conservator
A conservator is a court-appointed representative that assists an adult who has been deemed incompetent to manage their own care or finances.
Conservatorship
A voluntary proceeding in which a person asks to appoint a specific individual to manage his or her financial affairs. The Court must find the petitioner incapable of managing his or her financial affairs, but capable of making the decision to have a conservator appointed to do so.
Consolidated Omnibus Budget Reconciliation Act (COBRA)
COBRA is the federal law that provides many workers with the right to continue coverage in a group health plan. This federal law applies to most (not all) employers with 20 or more employees, including self-insured employers.
Consumer Directed Community Supports (CDCS)
Consumer Directed Community Supports (CDCS) is a choice for people who receive home and community-based waivered services. CDCS gives people more flexibility to plan for services and supports. It also gives more responsibility. This includes hiring and managing direct-care staff. CDCS may include services and items that provide specific, needed supports. CDCS may vary by state.
Control
Control is the ability to exercise authoritative influence on aspects of life that are important to the person. This can include any aspect of support and services and risk-taking.
Cognitive disabilities
Individuals scoring below 70-75% on IQ tests are said to have a cognitive disability. Cognitive disabilities may involve difficulties or deficits involving problem-solving, attention, memory, math comprehension, visual comprehension, reading, linguistic, and verbal comprehension.
Cost Calculator
A cost calculator is a tool that people can use to estimate the cost of services and supports. It helps with long-term planning.
Co-occurring disorders
A person is said to have co-occurring disorders if they have a mental health disorder and are also diagnosed with substance use disorders such as; alcohol or drug abuse, or dependence. People with mental health disorders are more likely than people without mental health disorders to experience an alcohol or substance use disorder.
Cost-sharing
The term "cost-sharing" refers to how health-plan costs are shared between employers and employees.
Crisis
A period, situation, or event where things are uncertain and traumatic. It is time where an issue reaches a critical point. Immediate action is required to prevent further damage, disaster, or injury.
Cultural
- Having to do with culture.
- A person being knowledgeable, appreciative, and sensitive to a group's
beliefs, values, traditions, expressions, ethnicity, culture, and
race.
Culturagram
A way of diagramming the unique cultural patterns of a family.
Cultural Competence
A never-ending process of learning that includes valuing diversity of all kinds. That includes, culture, ethnicity, language, race, religion, gender, economics, education, sexual orientation, etc. It also includes a willingness to learn about oneself as well as others. It is an exploration of how experiences influence views, values, and beliefs. It is the ability to appropriately change one's own behavior. It also includes the ability to find resources that are meaningful to people based on their backgrounds and views.
Cultural guides
A person from another culture who is willing to help you learn about their culture. They may also help you to learn about barriers to services due to culture. They recognize that within their own culture there are differences in views, beliefs, customs, celebrations, and rituals.
Cultural Humility
The practice of being open to constant self-evaluation of one's own biases and having the humility to learn from others and their experiences. Cultural humility also involves working to fix existing power imbalances and aspiring towards care and advocacy that extends beyond the individual to the community.
Cultural Reciprocity
The process of becoming aware and understanding the subtle, deep-seated values in our professional beliefs and practice so that we can explain them to families from culturally and linguistically diverse backgrounds who might not share these same values. It stems from a belief that neither culture is superior or inferior but rather simply different.
Culturally Eelevant
Research evidence demonstrates standard practices based on data for a majority population have uncertain relevance for specific cultural groups. Research evidence about intervention outcomes tends to focus on individual symptoms and behaviours and may not reflect culturally relevant outcomes.
Culturally responsive
Interacting with others in ways that are respectful and responsive to their unique cultural views.
Culture
A particular social group, nation, or people's way of life, including its shared knowledge, beliefs, values, attitudes, rules of behavior, language, skills, and worldview.
Custodial
If a child's parents are divorced or separated, the custodial parent is the parent who has custody of the child.
Customs
A practice, ritual, routine, or way of behaving that is traditional and is shared by a group.
Cultural Norms
Expectations and behaviors of the group including how to act, what to wear, rituals and routines, etc.
Culture Change
A period in which an established culture is giving way to new beliefs and patterns.
Cycle of Violence
This is a pattern whereby the intimate partner violence occurs repeatedly, through four stages. A full cycle may take varying lengths of time to complete: a few hours to a few months to a year or more. The four stages of the cycle of violence include the "incident" stage, where the abuse occurs. This is followed by the "tension building" stage, which is when the abuser starts to get angry and/or abusive, there is a breakdown in communication, and the tension grows. Next is the "making-up" stage where the abuser apologizes for the abuse, promises that it will never happen again, or even denies it ever happened. The last stage is the "calm" or the "honeymoon" stage. The is when the abuser acts as if the abuse never happened, there is no abuse taking place, and the person being abused hopes the abuse is over.
D
DARN
An acronym for remembering prompts related to eliciting change talk in motivational interviewing approaches. DARN stands for desire, ability, reason, need.
(See OARS, EARS, DARN.)
Decision Support
The process of helping the person/family clarify, sort through and prioritize the decisions to be made. It looks at which ones are truly pressing and which ones can wait a bit longer. It also looks at the values and beliefs of the person in sorting through options.
Dementia
A decline in a person's mental ability to the point that they cannot reliably care for themselves. Dementia is not a specific disease. It is a term that describes symptoms associated with a decline in cognitive ability, which decreases a person's ability to carry out daily activities. Cognitive abilities include learning, understanding, remembering, thinking, and planning. Dementia involves significant impairment in at least two of the following core abilities: memory, communication, attention, reasoning, and visual perception. Dementias include Alzheimer's disease, Lewy body disease, and frontotemporal and vascular dementia.
Demonstration Waivers
Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs. The purpose of these demonstrations, which give states additional flexibility to design and improve their programs, is to demonstrate and evaluate policy approaches. States apply for these in order to test and build systems that lead to desired outcomes for populations served.
Developmental Disabilities
A federally defined term to help identify who is eligible for funding or services, which is: A severe, chronic disability of an individual 5 years of age or older that: is attributable to a mental or physical impairment or combination of mental and physical impairments; is manifested before the individual attains age 22; is likely to continue indefinitely; and results in substantial functional limitation in three or more of the following areas of major life activity: 1) self-care; 2) receptive and expressive language; 3) learning; 4) mobility; 5) self-direction; 6) capacity for independent living; 7) economic self-sufficiency; and 8) reflects a need for a combination and sequence of supports and service that are likely to be lifelong in duration. When this term is applied to children 5 or under, it means the high probability that the person will meet this definition after 5 years of age.
Dignity of Risk
A fundamental belief that people grow and develop by making their own life decisions and learning from them (especially their mistakes). Self-determination is a fundamental right of human existence. Therefore it is critical that people be supported in these opportunities regardless of their need for support for physical or cognitive disabilities.
Direction
Direction is when the person determines the course of their days and lives. This includes which services and supports they will use. This includes what, where, how much, and/or how often. The person is not obligated to participate in any service or support including formal person-centered planning processes.
Disability
Disability is an official definition. It describes the impact of a condition. Conditions are only considered disabling under certain circumstances. They must limit a person's capacity to care for themselves in critical ways. They must also be expected to last indefinitely, if not forever, even with treatment or services. Criteria for disability are often embedded in public laws regarding access to services or supports. They may vary depending on age or setting. For example, a child may be "disabled" for the purposes of special education but not eligible for adult services or support.
Disability Property Tax
People with disabilities may be eligible for property tax exemptions. State laws may vary.
Discovery (Learning Community)
A purposeful engagement that supports gaining a well-balanced view of people who are seeking or using services and supports. Discovery helps to identify what is important to a person. It also identifies their strengths, preferences, and hopes and how they would like to address what is important for them. This is a foundational skill in the person-centered thinking approach.
Discovery Skills (Learning Community)
Ways of organizing discovery to arrive at what is important to a person. They also identify how a person would like to address what is important for them, as well as their strengths and preferences. These approaches are used in person-centered planning and thinking approaches. Tools and approaches used to support this include the relationship map, rituals and routines, good day/bad day, 2-minute drill, communication chart, and reputations.
Discrimination
Treating someone less favorably in a situation where the outcome can influence the person's rights or opportunities because of an attribute or trait that is not within the person's control and is unlikely to influence on the person's capacity to complete the task at hand in meaningful ways. For example, treating someone less favorably because of their age, skin color, sexual orientation, or gender. Some discrimination is against the law and is defined by state and federal laws.
Disenfranchised grief
When there are no easy, public way to express grief. Grief that cannot be
expressed and supported tends to linger and grow
Diversion Services
Any service designed to help people succeed in ways that are likely to prevent unnecessary institutionalization. For example, in a locked unit at a hospital or treatment facility, jail, or prison.
Diverse
A person's beliefs, norms, values and language affect how they perceive and experience mental health conditions.
Diversity
Differences among people in a group. They can include such things as age, race, culture, beliefs, background, and experiences.
Donut Sort (Learning Community)
A person-centered thinking tool. It help clarify roles, responsibilities, and boundaries.
Dual Eligibility
Dual eligibility is when a person qualifies for both Medicare and Medicaid. To qualify, an individual must meet the requirements for both Medicare and Medicaid. Some people qualify for Medicare and partial dual eligibility. That means that they have Medicare coverage and can also have Medicaid coverage if they pay a very small monthly premium for it. Others qualify for total dual eligibility, meaning that they can be covered by both Medicare and Medicaid and, because their income and assets are below a certain point, they do not have to pay any Medicare premiums.
E
Early and Periodic Screening Diagnosis and Treatment (EPSDT)
The EPSDT benefit provides comprehensive and preventive health-care services for children under age 21 who are enrolled in Medicaid. EPSDT is key to ensuring that children and adolescents receive appropriate preventive, dental, mental health, and developmental, and specialty services.
Early Intervention
A system of services that helps babies and toddlers with developmental delays or disabilities. Early intervention focuses on helping eligible babies and toddlers learn the basic and brand-new skills that typically develop during the first three years of life.
EARS
An acronym for remembering prompts related to encouraging change talk in motivational interviewing approaches. EARS stands for elaborating, affirming, reflecting, and summarizing. (See OARS, EARS, DARN.)
Ecomaps
A way of diagramming a family's relationships to outside systems.
Elder Law (Elder Law Attorneys)
Elder Law refers to areas of the law that impact older adults and people with disabilities. Elder law attorneys may help people with wills, trusts, special needs trusts, powers of attorney, Social Security, Medicare, Medicaid, and/or veterans benefits.
Emergency Preparedness
A continuous cycle of planning, organizing, training, equipping, exercising, evaluating, and taking corrective action in an effort to ensure effective coordination during incident response.
Emotional Support
A type of support when people are available to each other emotionally. That includes talking through decisions, making each other laugh, praying together, or listening to complaints or boasts.
End-Stage Renal Disease (ESRD)
ESRD, also called end-stage kidney disease, is the last stage of chronic kidney disease. This is when your kidneys can no longer support your body's needs. The kidneys remove waste and excess water from the body.
Ethnic
Of or relating to a sizable group of people sharing a common and
distinctive racial, national, religious, linguistic, or cultural heritage.
Estate Planning
Estate planning is developing a plan that describes what you would like to happen to the things you own when you die. Your estate may include your car, home, other real estate, checking and savings accounts, investments, life insurance, furniture, and personal possessions.
Estate Recovery
Estate recovery refers to when Medicaid recovers some of its costs by taking ownership of someone's property.
Equity
Fairness or evenness in mental health care supports and services. It is seen as the absence of avoidable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically.
Everyday Learning Skills (Learning Community)
Everyday Learning skills provide approaches to learning about a person's needs and the best ways to support them. Some everyday learning tools are the 4 + 1 questions and what's working/not working (also called "what makes sense/what doesn't make sense").
Exploitation
Exploitation is the misuse of a person's money, goods, or body for the benefit of someone else.
F
Facilitation Skills
Skills used to support group processes to achieve desired outcomes.
Faith leader
A person who is recognized formally or informally as a leader in a spiritual practice
Family
A group of two or more people related by birth, marriage, adoption, or choice. It includes legal or blood relatives and/or other significantly important people. Family often provides psychological, emotional, financial, and spiritual support for a person. Family is individually and culturally defined.
Family-centered
Family-centered planning is care planning that is strength-based and focuses on individual capacities, preferences, and goals.
Family-focused therapy
A complex system of care that operates under a carved-out insurance plan whose navigation requires the patient, the family, or both to become project managers with no formal training. This often results in emotional and financial stress.
Family of choice
People who serve as consistent and intimate companions to each other. They are committed and act in ways that are like family. However, the people are not necessarily legally or biologically related.
Family Medical Leave Act (FMLA)
The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health-insurance coverage under the same terms and conditions as if the employee had not taken leave.
Family Support Network
The family members who are actively engaged in a person’s life. Members of this support network may be family by birth, adoption, or choice. The size and focus of this group will vary depending on a person’s culture and life circumstances.
Fee-For-Service
Some Medicaid enrollees are served through a fee-for-service delivery system where health-care providers are paid for each service (like an office visit, test, or procedure) rather than a per-person rate for access to all benefits.
Financial Assessment
Financial assessments are an in-depth look at a person's financial situation. They are often required as part of eligibility processes for public funding.
Financial Exploitation
Financial exploitation occurs when a person misuses or takes the assets of another without their knowledge or consent and uses them for their own personal benefit. When this happens to a senior or disabled adult it may meet the definition of maltreatment in some states or regions.
Financial Management Services
Financial management services (FMS) must be available to assist individuals who receive self-directed services in exercising budget authority. Individuals can perform some or all of the FMS functions themselves.
Financial Neglect
This involves a designated or knowledgeable caregiver's disregard for a vulnerable person's financial obligations. Examples would be failing to support them in paying bills, rent, mortgage, or property taxes appropriately. In some states this may meet the local definition of maltreatment.
Foster families
Foster care means 24-hour substitute care for children placed away from their parents or guardians and for whom the State agency has placement and care responsibility. This includes, but is not limited to, placements in foster family homes, foster homes of relatives, group homes, emergency shelters, residential facilities, childcare institutions, and pre-adoptive homes.
Formal Programs
Formal programs are structured programs. Often they are government-funded or otherwise regulated programs for delivering treatment, services, or supports. Often there are eligibility requirements that need to be met before a person is able to use these.
4+1 Questions (Learning Community)
The 4+1 questions tool is an approach to problem-solving. It is a purposeful analysis of past actions to defined next steps. The approach helps ensure both helpful and less helpful actions are identified before deciding how to proceed. The four questions are: What have we tried? What have we learned? What are we pleased about? What are we concerned about? After those questions have been answered by everyone involved, the "plus one" question is: Given what we have learned, what should we try/do next?
Friends
Non-related people who like and trust each other but do not consider each other family. Friendship is a reciprocal and voluntary relationship. This means people both enjoy each other and are there for each other without legal or moral obligation outside of their own desire.
Functional Assessment
An evaluation that helps determine the function of a specific behavior.
Functional Eligibility
In order to qualify for many long-term services and supports, people must be able to demonstrate a need. Functional eligibility is based on a person's ability to complete activities of daily living or instrumental activities of daily living.
Functional Skills
The skills a person needs to do defined tasks. Functional skills may include such things as an ability to read, open a door without assistance, or cook a meal.
G
Gatekeeper
People or agencies that make decisions about access to resources.
Generational trauma
Trauma that is transferred from the first generation of trauma survivors to the second and further generations of offspring of the survivors.
Genograms
A way of diagramming that is used to describe and gain insight into relationships and roles within a family.
Goals
What a person or group wants to achieve.
God-parent
Traditionally, a godparent is a person who promises to help teach and guide a child (in some cases another adult) in religious matters as part of a Christian baptism ceremony. In today’s world, guardians may not be framed in terms of religion, but rather, agree to love and care for the child as their own.
Grievance
A grievance is a complaint. In long-term services and supports, a person may file a grievance if they feel they were unfairly treated or denied access to programs or funding for which they were eligible.
Group Home
A home in which two or more non-related people live together for the purpose of receiving services. These homes can range in size from two people to 15 people and can be publicly or privately owned and operated.
Guardian
A legal relationship with another, where one person (the guardian) is legally appointed to oversee the decisions of another, due to the other's inability to fully understand the risks and benefits of his or her decisions.
Guardianship
The condition that exists when an individual is legally appointed to assist a person who is incapable of understanding the risks and benefits of a situation, in making the most important decisions.
Guess/Ask/Write
A simple way to check assumptions. It ensures you understand a person's view before you write anything down. This is a foundational skill in discovery practices. It is part of the person-centered thinking approach.
H
Health-Care Directive
A health-care directive (also referred to as a living will, personal directive, advance directive, or advance decision) is a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves.
Health (Medical) Insurance
Health insurance is a type of insurance coverage that helps people cover the costs of medical and surgical expenses.
Health Insurance Marketplace
The Health Insurance Marketplace helps people find and enroll in an insurance plan. For people who do not have coverage through a job, Medicare, Medicaid, the Children's Health Insurance Program (CHIP), or another source, the marketplace is a place to obtain health insurance or compare costs.
Heritage
Features belonging to the culture of a particular society, such as traditions, languages, or buildings, which come from the past and are still important.
Heterosexual
A person who has sexual desire toward individuals of the opposite sex.
Home and Community-Based Services (HCBS)
Home and community-based services (HCBS) provide opportunities for Medicaid beneficiaries to receive services in their own home or community. These programs serve a variety of targeted population groups, such as older adults with support needs and people with mental illnesses, intellectual or developmental disabilities, and/or physical disabilities.
Home and Community-Based Waivers 1915(c)
The 1915(c) waivers are one of many options available to states to allow the provision of long-term services and supports in home and community based settings under the Medicaid Program. Standard services may include case management, homemaker, home health aide, personal care, adult day health services, habilitation, and respite care. States can also propose "other" types of services that may assist in diverting and/or transitioning individuals from institutional settings into their homes and community.
Home Equity
Home equity is the difference between a property's fair market value and the outstanding balance of all loans on it.
Homelessness
Having no reliable access to shelter.
Homestead
The primary home and the surrounding land where a person or family lives.
Hospice
An approach to end-of-life care that includes respecting the dying person and keeping them comfortable. A team works together. They provide unique, comfortable care in ways that are meaningful to the person.
Housing Choice Voucher
The housing choice voucher program is the federal government's major program for assisting very low-income families, older adults, and people with disabilities to afford decent, safe, and sanitary housing in the private market.
Huntingtons Disease
A genetic brain disorder that attacks the body's functioning and breaks
the body down, eventually resulting in death.
Human rights committee
A group of people who come together within an agency to review situations in which a person’s rights are being restricted and to ensure that all possible steps are being taken to remove and reduce restrictions.
I
Implicit Bias
Unconscious and involuntary attitudes and stereotypes that all people have.
Important to
Important to includes things that have meaning and value in a person's life. This can include routines and rituals, relationships, as well as possessions, opportunities, and goals.
Important for
Important for includes things that a person must attend to in order to stay healthy and safe and meet the social expectations of others in ways that allow for inclusion.
Inclusion (Please see #Community Inclusion)
Independent Living (IL)
Independent living is a movement, philosophy, and culture that is supported by funding and guidance for local programs by the federal government under Section 702 of the Rehabilitation Act of 1973 as amended. It is founded in the belief that people with disabilities have a common history and a shared culture and struggle. The independent living philosophy emphasizes consumer control and the belief that that each person with disability is the best expert on their own needs. That includes receiving supports and services while still maintaining control of one's own life and making one's own decisions. It includes the concept of the dignity of risk.
Individual Advocacy
Individual advocacy is speaking up for one's own rights or the rights of another person in a particular circumstance. Individual advocacy can help a person improve a situation. It can also help a person get what is wanted, needed, or fair.
Individualized Family Service Plan (IFSP)
An individualized plan for a family with a child who has service needs. The plan focuses on organizing and obtaining services that will help the family support the child and help the child receive effective individual intervention as needed.
Individuals with Disabilities Education Act (IDEA)
The Individuals with Disabilities Education Act (IDEA) is a federal law that ensures access to free and public education and essential early intervention services for children with disabilities. IDEA governs how states and public agencies provide early intervention, special education, and related services to more than 6.5 million eligible infants, toddlers, children, and youth with disabilities nationwide. Infants and toddlers with disabilities (Age 0 to 2) and their families receive early intervention services under IDEA Part C. Children and youth (age 3 to 21) receive special education and related services under IDEA Part B.
Information Management
Information management refers to an organized approach to gathering and using information.
Information and Referral
Information and Referral entities include any agency, organization, website, hotline or other entity that, as part of its normal business, comes into contact with people who may need help in accessing long term services and supports and is a critical referral source for a NWD System. In addition to formal information and referral/assistance programs, other sources may include faith-based and civic organizations, non-profit community organizations that serve older adults and/or people with disabilities, community health centers, homeless shelters, community health centers, Veteran Services Organizations, YM/WCAs, etc.
Informed Choice
A choice where a person has sufficient information (provided in ways that are meaningful to them) to understand the risks, benefits, and likely outcomes of the choice before making it.
In-home services
Services and supports provided in a person's home.
Institutional level of care
Assumes total care is need. This term may be used to demonstrate need when determining Medicaid eligibility.
Instrumental Activities of Daily Living (IADL)
These are the basic tasks of managing everyday life, such as cooking, managing finances, and running errands.
Instrumental Support
Instrumental support is when people do things for others, such as picking up groceries, providing a ride, or caring for another's pets, children, home, or yard.
Intellectual
The ability to understand new or complex information and to learn and apply new skills.
Interference
Get in the way of or impede; coercion - lure, trick, or manipulate someone to do something
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)
Intermediate care facilities for individuals with intellectual disabilities (ICF/IID) provide services as an optional Medicaid benefit.
Intersectionality
Is a social thought process which best describes the multiple levels of discrimination that an individual or group experiences when their identities overlap with that of other minority classes such as race, class, gender, sexuality and nationality, as they relate to a particular individual or group. Intersectionality can affect one’s mental health, specifically, anxiety and depression directly because of social inequalities.
J
Jargon
Words related to a certain field of interest. They are not meaningful to most people outside of that field.
K
L
Labels
Using words that identify people as things or categories rather than individuals. For example: “a bipolar or a schizophrenic.” Although common, this is a controversial and generally non-preferred approach. However, in some communities (for example the Autism self-advocacy community), a movement to “identify-first” language can seem similar to labeling language. For example, “As an autistic, I…”
Learned Helplessness
A belief that one cannot influence one's life outcomes. This is based on repeated or traumatic past experiences in which attempts were unsuccessful.
Legal family
People recognized by law as having a connection to each other. Common legal connections are birth, marriage, and adoption.
Legal Representative
A generic term that can be used for any kind of substitute or alternative decision-maker with legal powers, such as guardians, power of attorney.
LGBTQA
LGBTQA stands for lesbian, gay, bisexual, transgender, queer/questioning, asexual and/or ally
Life Insurance
Life insurance is a contract between a person and an insurance provider (insurer). The insurer promises to pay a designated amount of money upon the person's death. To maintain benefits, the person must pay an agreed upon amount of money at regular intervals (a premium).
Literacy
The ability to read.
Long-Term Care Annuity
A contract in which an individual gives an insurance company money that is later distributed back to the person over time. Annuity contracts traditionally provide a guaranteed distribution of income over time, until the death of the person or persons named in the contract or until a final date, whichever comes first.
Long-Term Care Insurance (LTCI)
LTCI is a type of insurance that covers care generally not covered by health insurance, Medicare, or Medicaid. LTCI can be used to prevent a major loss of assets at a time when long-term care is needed.
Long-Term Care Ombudsman
This is a mandated advocacy organization. It is for people who live in long-term care. People who feel their civil, legal, or resident rights have been violated can contact the ombudsman for support. Others who have concerns about quality of care in LTC facilities may also report to an ombudsman. Some states require that certain events must be reported to an ombudsman, such as death and serious injuries. In every state, long-term care ombudsman programs work to resolve problems with individuals receiving long-term services and supports with a person-centered approach. They also advocate at the local, state, and national levels for changes that will improve consumers' care, services, and quality of life. Under federal law, this program serves residents of nursing homes, board and care homes, assisted living facilities, and similar adult care facilities. In some states, they are authorized to also serve individuals receiving long-term services and supports in non-residential settings.
Long Term Services and Supports (LTSS)
Support or assistance for a lifelong or enduring condition that impairs a person's ability to care for themselves. Assistance excludes temporary treatment for injury or illness from which a person is expected to recover.
Low Income Home Energy Assistance Program (LIHEAP)
LIHEAP provides energy assistance to low-income households that meet eligibility criteria.
M
Maltreatment
Abuse, neglect, or exploitation of a vulnerable person. Maltreatment laws and definitions vary by state or regions. Many professionals are considered mandated reporters of maltreatment.
Managed Care/Managed Care Organization
Managed care is a health-care delivery system organized to manage cost, utilization, and quality. Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services, whether they use the services or not.
Managed Care Waivers 1915(b)
1915(b) Waivers are one of several options available to states that allow the use of managed care in the Medicaid Program.
Managed Long-Term Services and Supports (MLTSS)
MLTSS refers to the delivery of long-term services and supports through capitated Medicaid managed care programs. Increasing numbers of states are using MLTSS for home and community-based services
Marketplace
(See Health Insurance Marketplace.)
MDS Section Q
The Minimum Data Set (MDS) is part of the federally mandated process for assessing individuals receiving care in certified skilled nursing facilities. The process provides a comprehensive assessment of individuals' current health conditions, treatments, abilities, and plans for discharge. The MDS is administered to all people upon admission, quarterly, yearly, and whenever there is a significant change in an individual's condition. Section Q is the part of the MDS designed to explore meaningful opportunities for nursing facility residents to return to community settings.
Means
Financial resources or money
Mediation
Support for people resolving disputes. The mediator does not decide who is right or wrong. Unlike courts, they do not issue a decision. They use strategies to help the parties work out their own solutions to problems.
Medicaid
The federal funding stream for subsidized health-care plans for vulnerable populations in need. These vary greatly from state to state. Medicaid is also a primary way that states pay for publically funded long-term services and supports.
Medicaid Health Insurance
Free or low-cost health coverage funded by Medicaid for Americans in need, including some low-income people, families and children, pregnant women, older adults, and people with disabilities. Sometimes called Medical Assistance
Medical Assistance
(See Medicaid.)
Medicare
A federally subsidized entitlement health-care plan established by Congress in the 1960s to help provide health care for citizens 65 and over and certain disabled adults who have contributed to the system. Medicare provides about 40 percent of the cost of acute care for elderly patients. Benefits for Medicare patients are mandated by the federal government.
Medical Assistance for Employed Persons with Disabilities (MA-EPD)
Many people with disabilities fear that if they return to work and start earning more money, they'll lose their Medical Assistance (MA) coverage. By using MA-EPD, people can earn any level of income, build more assets, and keep their MA coverage. MA-EPD pays for the same services that standard MA covers, including visits to the doctor, hospital stays, medical equipment, home care services, and mental health services.
Medical Model of Disability
The medical model of disability is a framework that posits that people with disabilities have something wrong with them and that disability resides in and comes from the individual. In this model, disability is seen as purely a medical issue – an unacceptable disease or medical condition that must be treated, removed, or fixed. This model believes that doctors and medical treatments should try to cure or fix people with disabilities and make them "normal" again. Solutions address the medical nature of the disability and not the social and environmental factors that can influence disability.
Mental Illness
A disease of the mind or brain that seriously affects a person's thoughts,
emotions, personality, behavior and ability to function, and may include
extreme moods, such as excessive sadness or anxiety. Sometimes referred to as
mental disorders. People with known mental health needs caused by mental
illness are often stigmatized and excluded by other members of the community,
however, some mental health disorders like depression are extremely common and
often undiagnosed. With proper treatment and support, most people with mental
illnesses can lead productive and satisfactory lives. People who have mental
retardation and metal illness are sometimes labeled as having a "dual
diagnosis."
Mental Retardation
A disability that is present prior to the age 18, in which the person has
an IQ level below average for his or her same age peers, and in which there
are significant limitations in the person's ability to understand and process
information. People with mental retardation are each unique, with very
different needs and abilities, even if they have the same IQ. Many people with
mental retardation can live satisfactory lives with intermittent support from
others. Other people with mental retardation, need significant daily
assistance.
Microaggression
Ongoing, subtle, dismissive, stereotypical, or negative comments or messages directed towards and experienced by people of a particular group that is seen as "less than" others based on personal traits or experiences they cannot change. These groups can include people of different ages, races, abilities, genders, and sexual orientations or identifications, among others.
Money Follows the Person Program (MFP)
The MFP Rebalancing Demonstration Grant helps states rebalance their Medicaid long-term care systems. The goal is to help move people from care institutions back into their communities. The Affordable Care Act of 2010 strengthened and expanded the MFP program allowing more states to apply.
Motivation
This is that inner excitement, focus, and energy that drives people to do things.
Motivational Interviewing (Miller & Rollnick, 2009)
A collaborative, person-centered form of guiding through conversation. It is meant to elicit and strengthen motivation for change. The spirit of motivational interviewing is grounded in collaborating with the person and drawing out their ideas about change. It emphasizes autonomy.
Multidimensional
The concepts of health and wellness depend upon a variety of variables such as individual perception, cultural values, norms, and social class. When looking at treatment or the road to recovery, all dimensions are valued and considered.
Muscular Dystrophy
A group of diseases that cause progressive weakness and loss of muscle mass.
N
National Alliance on Mental Illness (NAMI)
NAMI is a national mental-health advocacy organization.
Natural Support
Unpaid and/or informal support that people get from others in their social networks, such as family, coworkers, neighbors, and community members.
Natural Support Caregivers
Refers to unpaid caregiving provided by a person’s family, friends, co-workers, peers, etc.
Natural Support Networks
The group of people in a person’s life who provide natural support.
Neglect
Any recent act or failure to act on the part of a parent or caretaker that results in death, serious physical or emotional harm, or sexual abuse or exploitation. Neglect can also be an act or failure to act that presents an imminent risk of serious harm. Neglect may be part of state definitions of maltreatment.
No Wrong Door (NWD) System
The formal "point of entry" into a state's long term services and supports system designed to be highly visible and trusted in communities as a way to get reliable information about long term services and support. The NWD system serves people of all ages, incomes, and abilities. It provides information and one-on-one person-centered counseling on a full range of long-term services and solutions. It is designed so that people can connect through typical community venues, such as medical or social service agencies, school, and community centers, as well as designated disability or aging resources.
Nursing Facility
Nursing facility services are provided by Medicaid certified nursing homes, which primarily provide three types of services: skilled nursing, rehabilitation, and long-term care. A nursing facility is one of many settings for long-term services and supports, provided by Medicaid or other state agencies.
Nursing Level of Care
A formal level of care designation commonly used to determine if a person is eligible for Medicaid-funded, nursing home care. It is also used to determine if someone is eligible to receive long-term care and support from Medicaid at home.
O
OARS
An acronym for remembering prompts related to eliciting change talk in motivational interviewing approaches. OARS stands for open-ended questions, affirmations, reflections, and summary statements.
(See DARN, CAT.)
Obsessive Compulsive Disorder (OCD)
OCD is characterized by uncontrollable repetitive thoughts and fears that are not grounded in reality and a compulsion to engage in repetitive behaviors to relieve the anxiety caused by those thoughts.
Older Americans Act (OAA)
The OAA law provides funding to states for community planning and social services, research and development projects, and personnel training in the field of aging. It also established the Administration on Aging (AoA) to administer the programs and to serve as the federal focal point on matters concerning older persons.
Olmstead Decision
The Olmstead Decision is a Supreme Court ruling that said it was a violation of the Americans with Disabilities Act and a form of segregation and discrimination if people with disabilities received needed services in a nursing home or institution when they and their teams wanted a more inclusive setting and had determined it would be effective. It ruled that people with disabilities had a right to get services in the most integrated setting of their choosing. This meant that if a person wanted, their services should be provided in a home or other community setting where there would also be people without disabilities.
Open-ended questions
Questions a person cannot answer with a simple "yes" or "no." Open-ended questions will begin with words like "how" "what" or 'tell me about…"
Options Counseling
Options counseling is a supportive, person-centered process of planning long-term services and supports. It aligns with a person's preferences, strengths, values, and needs. Approaches offer decision support and include ongoing follow-up.
Orders of commitment
An order made by the court that puts a person in custody such as a jail or mental institution. It can happen if the court sees that the person is dangerous to him/herself and needs to be detained.
Outcomes
Things that happen as a result of action.
P
Palliative Care
Care focused on relieving pain and providing comfort rather than treatment.
Paralysis
The loss of function in all or part of your body.
Payee
A person who receives a payment. This may be the person to whom the money is paid or a different person who manages the money for them. (Often called a "rep payee.")
Peer Support Group
People of approximately equal social status who have reciprocal
relationships; friends, colleagues or others who have common bonds.
People with support needs
People of any age who need assistance to complete developmentally expected activities necessary for independent living.
Personal Care Assistance
Personal care assistance is a service provided to people who need help with day-to-day activities in their own homes.
Person-Centered
An approach to supports and services that engages discovery for the purpose of understanding the person's correct "to/for balance." It also includes a person's unique strengths, preferences, needs, and goals.
Person-Centered Assessment
A person-centered assessment is a way to evaluate things that are important to a person as well as important for them for a specific purpose or need. It takes into account the person's interests, preferences, goals, values, and needs. It focuses on areas where the person is being reviewed for eligibility, diagnostics, or other purpose-driven criteria.
Person-Centered Content Expert (Learning Community)
The person or someone who knows them well.
Person-Centered Counseling
Person-centered counseling is a counseling process that ensures the person is an active participant from start to finish. It is a process that ensures the person's voice is heard and honored. It acknowledges what is both important to and for the person in a way that makes sense to the person. The values of choice, direction, and control are central to this process. The person remains in charge or control to the greatest extent possible and desired (with whatever support they need).
Person-Centered Counseling (PCC) Professional (PCC professional)
This is a professional in the No Wrong Door (NWD) system. Professionals who have direct contact with people in the NWD system should be trained and credentialed through the NWD PCC Training Program. This training will help PCC professionals gain additional skills and have shared language around critical skills in person-centered planning and approaches. People in this role will have other local training opportunities and often previous experience to draw from. Many may have additional formal roles or titles in the system such as options counselors or peer specialist. These roles are compatible with the PCC counseling role and will not change as a result of becoming credentialed. However, the person may also have additional roles related to NWD system functions.
Person-Centered Plan
A person-centered plan identifies a person's strengths, goals, preferences, needs (medical and HCBS), and desired outcomes. The best person-centered plans help people to live better lives, with support to do the things most important to them.
Person-Centered Planning
A planning process which looks at the person's strengths, needs, and desires. It uses purposeful discovery processes to gather information and listen to a person. Discovery helps identify what's important to a person and how they would like to address what is important for them. This planning process results in an action plan that is developed to help the person achieve personal goals.
Person-Centered Practices
Person-centered practices are tools, techniques, and approaches used to support people in a way that gives them maximum choice, direction, and control in their lives.
Person-Centered Process Expert (Learning Community)
A person who knows how to gather and organize information to use for person-centered counseling and planning.
Person-centered Professional
A mental health and social services professional whose work is guided by person-centered principles. A professional who views the people they support as equal partners in planning, developing, and supporting their unique preferences, choices, and interest.
Person-Centered Support
Support based on the correct "to/for balance" for a person and their preferences and strengths.
Person-Centered Thinking (Learning Community)
A set of value based skills and approaches. They support others seeing the person's strengths, preferences, and positive attributes. They provide ways of identifying what is important to a person and for the person. They help others act on what is learned in a way that is meaningful to the person. They help ensure choice, direction, and control in services and supports.
Positive Control
When people experience or reclaim choice, direction, and control in services and in their lives.
Postural orthostatic tachycardia syndrome (POTS)
When people experience or reclaim choice, direction, and control in services and in their lives.
Post-Traumatic Stress Disorder (PTSD)
PTSD is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares, disassociation, severe anxiety, as well as uncontrollable thoughts about the event.
Power of Attorney
The authority to sign legal documents and make legal decision on behalf of another. This power is given to a person voluntarily.
Power Over (Learning Community)
The practice of trying to "fix" people with support needs. Deciding for people how they need to solve their problems.
(See Power With.)
Power With (Learning Community)
The practice of shared responsibility and support for people with support needs. Providing options and decision support to individuals while respecting their right to self-determine and experience the dignity of risk.
(See Power Over.)
Preadmission Screening and Resident Review (PASRR)
PASRR is a federal requirement to help ensure that individuals are not inappropriately placed in nursing homes for long-term care. PASRR requires that all applicants for a Medicaid-certified nursing facility 1) be evaluated for mental illness and/or intellectual disability; 2) be offered the most appropriate setting for their needs in the community, a nursing facility, or acute care setting, and 3) receive the services they need in those settings.
Preference (s)
Things that one prefers or likes best.
Privacy
Being left alone or having certain procedures followed (such as covering body parts during an assisted bath) during activities that matter to a person. Privacy also refers to the person's right to control access to their personal information.
Private Funds
Personal assets used to pay for services that are not covered by public funding or insurance companies.
Private Insurance
Private insurance refers to health insurance that is paid for through personal or corporate funds (not tax-based or public funds).
Privilege
A special right, advantage, or immunity granted or available only to a particular person or group of people.
Protective Service Agency (Protective Services)
The agency that investigates reports of abuse, neglect, and injury to individuals that rely on others for care and are considered vulnerable.
Psychiatric Residential Treatment Facilities (PRTF)
A PRTF is any non-hospital facility with a provider agreement with a State Medicaid Agency to provide the inpatient services benefits to Medicaid-eligible individuals under the age of 21 (psych under 21 benefit).
Q
Qualified Medicare Beneficiaries (QMB)
QMB is a Medicare Savings Program that helps people who have some income pay for Medicare Part A, Medicare Part B, as well as deductibles, coinsurance, and copays.
Quality of Life
The degree of satisfaction someone has about their life or lifestyle.
R
Railroad Retirement Board
The RRB administers retirement/survivor and unemployment/sickness benefit programs for railroad workers and their families.
Relationship Map
A visual representation of a person's relationships and social network.
Relatives as Caregivers
Some programs will allow family members to be paid as caregivers. The availability and eligibility of these programs will vary.
Representative payee
An individual or organization appointed by the Social Security Administration to receive Social Security and/or SSI benefits for someone who cannot manage (or direct someone else to manage) his or her money.
Representative or Protective Payee
An individual or organization appointed by the Social Security Administration to receive Social Security and/or SSI benefits for someone who cannot manage (or direct someone else to manage) his or her money.
Reprisal
Take action against someone because of their behavior
Respite Services (Respite Care)
Temporary or limited services designed to give family or other caregivers a break from caregiving duties.
Restraint
Any method for restricting a person's movement or behavior. For more
information see medical restraints, mechanical restraints, and physical
restraints.
Retirement, Survivors, Disability Insurance (RSDI)
RSDI is a federally funded program designed to ensure the continuation of income for people who have disabilities, have reached retirement age, or are the surviving dependents of someone who qualified for Social Security Disability Insurance.
Reverse Mortgage
A reverse mortgage is a loan only available to homeowners age 62 years or older that allows them to convert part of the equity in their homes into monthly cash payments for a period of time. Not everyone will qualify.
Right(s)
A reverse mortgage is a loan only available to homeowners age 62 years or older that allows them to convert part of the equity in their homes into monthly cash payments for a period of time. Not everyone will qualify.
S
School-Based Services
School-based services are delivered in the school setting but go beyond required or mandated roles of the schools. They focus on partnerships that support student success especially for at-risk students. They may include mental health, nutritional, or other services.
Section 8 Program
This is a federal housing choice voucher program that provides assistance to very low-income families to afford decent, safe, and sanitary housing. Housing can include single-family homes, townhouses, or apartments and is not limited to units located in subsidized housing projects.
Segregated living
An environment where only people with a certain label or defining
characteristic work, live, or play.
Self-Determination
The person makes decisions independently, plans for his or her own future, and takes responsibility for making these decisions. If a person has a legal representative, the legal representative's decision-making authority is limited to the scope of authority granted by the court or allowed in the document authorizing the legal representative to act.
Self-Direction
Self-direction refers to people making their own choices and life decisions.
Self-Directed Personal Assistance Services 1915(j) (PAS)
PAS are personal care and related services provided under the Medicaid state plan and/or section 1915(c) waivers the state already has in place. People are able to recruit and train their own PAS providers and determine rate of pay.
Self-Directed Services
Self-directed Medicaid services means that people, or their representatives if applicable, have decision-making authority over certain services and take direct responsibility for managing their services with the assistance of a system of available supports. The self-directed service delivery model is an alternative to traditionally delivered and managed services, such as an agency delivery model. Self-direction of services allows people to have the responsibility for managing all aspects of service delivery in a person-centered planning process.
Service
A paid support or treatment to a person who needs it, such as transportation, homemaking, job assistance, or therapy.
Service Plan
An agreement or contract between a supported individual and a service provider. The plan outlines services that will be provided for the individual. These are based on their needs for safety and support. The service plan may be referred to by different names, depending support setting, such as individual educational, program, habilitation, or service plan (IEP/IPP/IHP/ISP).
Sign Language
Sign language is a form of communication used by people who are deaf. It's a way to communicate that uses gestures and signs with one's hands. There is no universal sign language and different cultures or regions will have distinct sign languages with their own rules, customs, and practices.
(See American Sign Language.)
Shared decision-making
A process in which caregivers, persons with support needs, and professionals work together to make decisions. The process takes into account all perspectives but recognizes the person’s fundamental rights to self-determine.
Slang
Informal words that have meaning to certain groups. The meaning of these words is not understood by people outside the group. Some are not real words. Others have a different formal meaning.
Social Capital
Social capital refers to the value a person obtains through connections with others in their social networks. For example, knowing and being known often means you have protection and support. Knowing and being known by people of higher influence or resources increases your social capital.
Social Model of Disability (also known as the Independent Living Model)
Unlike the medical model of disability, the social model of disability believes that people with disabilities don't need to be changed or fixed. Rather, disability is framed as just another individual characteristic (like having brown hair or green eyes). Any problems that need to be fixed aren't in the person, as the medical model suggests, but are present in society and the environment. The social model believes that society has to change and the environment has to become more accessible for people with disabilities. The concepts of disability culture, pride, and acceptance are also part of the social model of disability.
Social Security
A federal insurance program that provides benefits to people who are retired, unemployed, or have disabilities.
Social Security Act
An act that established a system of federal benefits to help states support older adults and other populations.
Social Security Disability Insurance (SSDI)
A federal entitlement program in the United States. It provides a monthly cash payment to people with disabilities. To be eligible a person (or their parent or spouse) must have paid into the Social Security system for a certain amount of time. They must also have a qualifying disability and be unable to meet substantial gainful activity (SGA). In 2009, a person earning below $980 a month was not meeting SGA. SSDI continues to provide cash payment until a person is able to reach SGA or their disability improves. In 2009, work that earned $1,640 a month was considered SGA for people with vision impairment. The amount of money a person receives depends on how much they (or their parents or spouse) have paid into the system.
State Health Insurance Assistance Program (SHIP)
A state program that gets funding from the federal government to provide free local health coverage counseling to people with Medicare.
Standard practices
Approaches that are approved, sanctioned, or general used in a profession.
State Health Insurance Benefits Advisor (SHIBA)
Professionals that help people with their health-care coverage and Medicare options.
State Medicaid Programs
Each state develops a plan for how they will use Medicaid dollars. Currently, many states are making significant changes to their Medicaid and Children's Health Insurance Programs (CHIP). Most states are expanding coverage for low-income adults. All states are modernizing their Medicaid/CHIP eligibility, enrollment, and renewal processes and systems, and taking advantage of many of the new flexibilities provided by the Affordable Care Act. Finally, states are coordinating the application and enrollment process with the messaging and policies for the Health Insurance Marketplace operating in their state to ensure that there is no wrong door to coverage.
State Survey Agencies
In each state, the State Survey Agency has regulatory and compliance responsibility over nursing homes, home health agencies, hospices, end-stage renal disease facilities and other facilities serving Medicare and Medicaid beneficiaries. They investigate and verify how well these facilities meet the licensure and certification requirements necessary for participation in CMS programs. They also investigate complaints and incidents that cause serious injury or harm, as well as other regulatory violations.
Statewide Independent Living Council (SILC)
Each State is required to maintain a SILC. The council cannot be established as an entity within a state agency, it must be a free-standing group. The purpose of the council is to create opportunities for independence for people with disabilities through research, education, and consultation.
Stereotype
A belief about a group of people based on how some people in that group look, dress, talk, or act. Stereotyping can limit or even block a person's ability to understand and appreciate others and their unique contributions and strengths or needs.
Strength-Based
Acknowledging and building off of the person's unique, specific strengths and positive traits.
Streamlining Access
Streamlining access means making the process easier for someone to find the services and supports they want. The NWD Streamlined Eligibility for Public Programs Function optimizes the state's ability to improve the efficiency and effectiveness of the eligibility determination processes associated with LTSS programs, while also creating a more expeditious and seamless process for individuals who are trying to access publicly-supported LTSS. The State uses its NWD System to continually improve the efficient and effective administration of its multiple LTSS eligibility processes and requirements to make them seamless for consumers. The State includes all eligibility processes and requirements for any state administered program that provides LTSS in this NWD System function.
Stigma
Refers to the social labels or markings that links a person or group to unfavourable or unpopular characteristics that form a stereotype. Stigmas can take many different forms. The most common are those related to race, illness and disease, gender, culture, obesity, etc.
Supplemental Nutrition Assistance Program (SNAP)
SNAP offers nutrition assistance to millions of eligible, low-income individuals and families and provides economic benefits to communities.
Supplemental Security Income (SSI)
A needs-based cash assistance program in the United States. It provides income to people with little income and few resources. SSI is a joint federal and state program. Some states choose to supplement the federal dollars to provide added income. In 2015, the federal SSI payment for an individual, which is a base for all states, was $773. This amount is affected by a person's monthly earned and unearned income.
Support
Assistance from others to maintain best health, stay connected to others, maintain employment, or otherwise participate in the activities of life. Supports can be formal or informal and paid or unpaid. Paid/formally structured supports are sometimes called "Services."
Supporters
The process of recovery is supported through relationships and social networks. Family members are often key supporters as well as peers and friends.
Supported Decision-Making
This is an emerging practice that contrast to "substitute" decision-making (such as guardianship). This practice is one in which the person is provided extra support for decision-making. They are not encouraged to legally defer decision-making entirely to another but to seek and organize help for informed decision-making. Increasing recognition of rights of people with intellectual disabilities is pushing this practice forward.
Support Network
Support networks are defined as family, friends, paid supporters, and other people who play a role in providing everyday support to an individual.
System-Centered Planning
Planning that is designed to meet the requirements of regulations. It usually is a list of interventions and goals. These are organized around a person's limitations. The goal is to improve functioning and achieve independence (or minimized dependence on other's support). The plan is achieved when the person builds their functional skills to the level identified on the plan.
Systems of care
Services and supports devoted to the treatment of mental illnesses and the improvement of mental health in people with mental health conditions.
Systems Advocacy
Systems advocacy is an effort to change the policies, practices, organizations, and rules that affect people. Rather than changing and helping an individual person, systems advocacy changes cultures, organizations, and entire systems.
Systematic discrimination
Systemic discrimination refers to patterns of behaviour, policies or practices that are part of the structures of an organization, and which create or perpetuate disadvantage for racialized persons. It has a broad impact on an industry, profession, company, or geographic area.
T
Therapeutic Approach
An approach that a skilled therapist is trained to use with the intention of supporting recovery or wellness.
The "to/for balance"
A short-hand description of what makes sense from the person's view regarding what is important to them and how they want to address what is important for them.
Transition Cliff
The period of time when youth with disabilities age out of youth systems and attempt to access adult services. Many youth systems end at age 18, and others end at 22, which means a youth could simultaneously be a youth in one system and an adult in another.
Transitional Care
The movement of a person from one setting of care (hospital, ambulatory primary care practice, ambulatory specialty care practice, long-term care, home health, rehabilitation facility) to another.
Transitional Services
Transitional services are any services and/or supports provided to someone who is going through a transition. For example, someone who is transitioning from school to work. It could also refer to a specific transition, such as moving from a nursing home to an apartment. The State uses its NWD System to facilitate the successful transition of individuals with LTSS needs from hospitals and other health care settings back to the community.
Trauma
A significant physical, emotional, or psychological experience that has long-term negative impact on a person. Trauma can come in a variety of forms. Often it is a result of violence, threats, or injury made to or witnessed by a person.
Trauma-Informed Care
Trauma-informed care is an approach based on several principles. The first being acknowledgement of the very high rates of trauma in people seeking services. Another being that trauma can create symptoms and behaviors that mimic or interact with those of other disorders. Another being that aspects of how services are delivered can increase trauma or support healing. With these principles in mind, trauma-informed care seeks to create service and treatment environments that respect people's histories and support healing. These efforts are applied universally. They are combined with specific outreach and clinical support to those with significant trauma needs.
Trauma-Informed Practices
(See Trauma-Informed Care.)
U
Universal Design
Universal design, also called inclusive design, refers to ideas meant to produce buildings, products and environments that are inherently accessible to older people, people without disabilities, and people with disabilities.
V
Valued social roles
Roles that are perceived as having social value by others, such as being able to contribute financially or in other ways to positive causes and betterment of community, family or organizations. Many people with disabilities are shut out of valued roles due to inaccessibility of accommodations, service barriers, and stigma.
Veteran-Directed Home and Community-Based Services (VD-HCBS) Program
VD-HCBS provides veterans the opportunity to self-direct their long-term supports and services that enable them to avoid institutionalization and continue to live independently at home. Veterans enrolled in VD-HCBS have the opportunity to manage their own flexible budgets, to decide for themselves what mix of goods and services best meet their needs, and to hire and supervise their own workers.
Veterans Affairs Benefits
Benefits for qualified veterans. May include health insurance and other products that help provide long-term services and supports.
Viatical or Life Settlement
A viatical is a transaction where a person who has a life insurance policy and a terminal illness sells the interest on the insurance to a viatical settlement company. The viatical life settlement company makes a cash payment to the person in exchange for ownership of the life insurance policy. When the person dies, the life settlement company receives a return on its investment in the form of the proceeds from the life insurance policy.
Vocational Rehabilitation (VR or Voc Rehab)
VR is a federally funded service that helps people with disabilities prepare for, find, and keep a job, and live as independently as possible.
Vulnerable
At risk for injury or harm. Unable to defend or care for oneself in an expected way.
W
Waivers/Waivered Services
Waivers are vehicles states can use to deliver and pay for health care and long-term services and supports in Medicaid and the Children's Health Insurance Program (CHIP). There are four primary types of waivers and demonstration projects: Section 1115 Research and Demonstration Projects, Section 1915(b) Managed Care Waivers, 1915(c) Home and Community-Based Services Waivers, and Concurrent Section 1915(b) and 1915(c) Waivers.
Ward
A person for whom a legal guardian or representative has been appointed.
Warm Hand-off
When professionals support a person more seamlessly by working together and making sure to share critical information, as appropriate, with one another and with the person. It ensures the hand-off process does not feel fragmented or disjointed.
Well-being
A personal assessment the overall state related to health, quality of life, or overall wellness.
Worldview
The overall perspective from which a person sees and interprets the world. Worldview is greatly affected by culture and life experiences.
Wrap Around Services
A community-based process of working with people with serious mental health challenges and their families by “wrapping a variety of services and supports” around the individual. These services and supports may include their family in their home, school, and community in an effort to help meet their basic needs.
Will
A legal declaration by which a person names one or more persons to manage their estate when they die.
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