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Public Policy Clearinghouse Glossary
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
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.
AAA - Area Agencies on Aging
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.
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.
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.
Cash and 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.
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-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.
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.
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.
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.
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)
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.
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.
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.
Instrumental Activities of Daily Living (IADL) - 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).
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.
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 - 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.
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 - 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.
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)
PACE - Program of All-inclusive Care for the Elderly
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.
Real Choice Systems Change - 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.
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.
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)
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.
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)
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)
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.
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).
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