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Glossary Of Terms

Glossary of Frequently Used Terms, Acronyms and Abbreviations

Within the service delivery system for people with developmental disabilities, the following acronyms and abbreviations may be used to describe services:

1151 Benefits:

VA awarded monthly compensation benefits for disability or death incurred as the result of VA hospital care, medical or surgical treatment or examination, but only if the disability or death was proximately caused by negligence or an unforeseen event.

ABLE:

The Stephen Beck, Jr. Achieving a Better Life Experience (ABLE) Act (P.L. 113-295) added Section 529A to the federal tax code to enable eligible individuals with disabilities to save money in a tax-exempt account that may be used for qualified disability expenses while still keeping their eligibility for federal public benefits.

For more information:  https://maryland529.com/MDABLE

Access:

Access is the veteran’s ability to obtain medical care at his/her desired location. The ease of access is determined by components, such as availability of health care services, location of health care facilities, transportation, hours of operation, and cost-effective delivery of health care. Efforts to improve access often focus on improving efficiency of health care delivery processes.

Adjunct Condition:

An adjunct condition, for medical treatment purposes, is a non-service connected condition that may be associated with and held to be aggravating an adjudicated service-connected condition. VA bills health insurance plans for treatment of an adjunct condition and as applicable, may charge a copay for treatment of the adjunct condition.

Adult Day Health Care:

Adult Day Health Care is a therapeutic day care program, provides medical and rehabilitation services to disabled veterans in a congregate setting.

Aid and Attendance (A&A):

A VA compensation or pension benefit awarded to a veteran determined to be in need of the regular aid and attendance of another person to perform basic functions of everyday life. A veteran may qualify for aid and attendance benefits if he or she:

  • Is blind or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or less; or
  • Is a patient in a nursing home because of mental or physical incapacity; or
  • Proves a need for aid and attendance under established criteria

Allowable Deductions:

Allowable deductions are those payments made by veterans for certain non-reimbursed medical expenses, funeral and burial expenses and educational expenses. Veterans are able to exclude allowable deductions from their total gross household income in determining their eligibility for VA health care benefits.

ALU:

A model of DDA’s residential support service, provided in a home of 3 or less people, with supervision.

Appeal:

A process used to request VA reconsider a previous authorization or claim decision.

Applicant:

A person who has submitted a formal request for VA health care benefits and/or for enrollment in the VA health care system.

Area Agency on Aging (AAA):

Area Agencies on Aging address the concerns of older Americans at the local level by identifying community and social service needs and assuring that social and nutritional supports are made available to older people in communities where they live.

Find your local AAA here:  http://www.aging.maryland.gov/Documents/AAADirectoryFeb2017.pdf

Asset:

Property or resource of an individual which includes: cash, stocks and bonds, individual retirement accounts, income producing property, etc.

Behavior Plan (BP):

Behavior Plan- A plan designed to reinforce and shape behaviors and to provide an approved means to safely intervene when behaviors that are dangerous to self and/or others are exhibited.  Strategies chosen are based upon each person’s needs, characteristics, and preferences from the results of a person-centered plan and comprehensive functional behavior assessment.

Learn more here:  https://dda.health.maryland.gov/Pages/Behavioral%20Support%20Services.aspx

Bereavement Counseling:

Bereavement counseling is assistance and support to people with emotional and psychological stress after the death of a loved one. Bereavement counseling includes a broad range of transition services, including outreach, counseling, and referral services to family members.

Case Management (CM):

Service that helps people identify their strengths and needs in order to coordinate and locate community specialized services. This may include helping people make plans regarding financial decisions, personal relationships, etc.  The DDA uses a Targeted Case Management model.

Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes.

Catastrophically Disabled:

A veteran who has a permanent, severely disabling injury, disorder, or disease that compromises the ability to carry out the activities of daily living to such a degree that he/she requires personal or mechanical assistance to leave home or bed, or requires constant supervision to avoid physical harm to self or others.

Centers for Medicare and Medicaid Services (CMS):

Federal agency which administers Medicare, Medicaid, and the Children’s Health Insurance Program, including the Money Follows the Person demonstration grants.  www.cms.gov

Chronic Care:

Long-term care of individuals with long-standing, persistent diseases or conditions. Chronic care includes care specific to the problem, as well as other measures to encourage self-care, promote health, and prevent loss of function.

Code of Maryland Annotated Regulations (COMAR):

A compilation of all the regulations issued by the agencies of the State of Maryland.  It provides definitions and the process for how service by state agencies, such as the DDA, are provided.

The regulations are available on-line at  http://www.dsd.state.md.us/

Combat Service:

A status applied for a veteran who served on active duty in a theater of combat operations during a period of war recognized by the VA.

Commonwealth Army Veterans:

The term “Commonwealth Army veterans” refers to persons who served before July 1, 1946, in the organized military forces of the Government of the Philippines. These Filipino forces were made a part of the U.S. Armed Forces by a military order of the President dated July 26, 1941. Finally these veterans were discharged or released from this period of service under conditions other than dishonorable.

Community Based Outpatient Clinic (CBOC):

Medical clinic which is a satellite facility of a nearby VA Hospital.

Community First Choice (CFC):

A program created by Section 2401 of the Patient Protection and Affordable Care Act that allows states the option to offer certain community-based services as a state plan benefit to individuals who meet an institutional level of care.

Maryland’s CFC program offers personal assistance, supports planning, nurse monitoring, personal emergency response systems, transition services, and items that substitute for human assistance such as technology and environmental adaptations. Services are provided in the eligible individual’s home or community residence

Learn more here:  https://mmcp.health.maryland.gov/longtermcare/Pages/Community-First-Choice.aspx

Community Options Waiver (CO):

This waiver became effective January 6, 2014 and serves adults aged 18 years and older. It provides assisted living, senior center plus, family training, behavioral consultation, and case management services.

Find more information here:  https://mmcp.health.maryland.gov/longtermcare/SiteAssets/SitePages/Community%20First%20Choice/HCBOW%20Fact%20Sheet%2011.17.15.pdf

Community Residential Care:

Community Residential Care provides health care supervision to eligible veterans not in need of hospital or nursing home care but who, because of medical and/or psychosocial health conditions as determined through a statement of needed care, are not able to live independently and have no suitable family or significant others to provide the needed supervision and supportive care. The veteran must be capable of self-preservation with minimal assistance and exhibit socially acceptable behavior.

Community Supported Living Arrangements (CSLA):

Residential supports that enhance a person’s opportunity for community participation and enables them to exercise choice and control over their lifestyles.

Community Veterans Engagement Board:

A local board and members of military supporters and providers that discuss veterans issues and  resource information to assist veterans.

Compensable Disabilities:

A VA rated service-connected disability for which monetary compensation is authorized for payment. You might even be entitled to compensation when your disabilities are rated 0% disabling.

Congressional Appropriation:

The funding allocated by Congress to VA for providing benefits and medical services to eligible VA beneficiaries.

Contract Provider:

Any hospital, skilled nursing facility, extended care facility, individual, organization, or agency that has a contractual agreement with VA for providing medical.

Coordination of Community Services (CCS):

Coordinator of Community Services (formerly known as Service Coordinator or Resource Coordinator) a case manager who supports people in learning about and connecting to resources in their community, planning for their future and assessing the need for services and supports.

Comprehensive Assessment (CA)

Formerly referred to as E&A (Eligibility and Access). The process by which an individual with a disability applies to the Developmental Disabilities Administration (DDA) for services.  Eligibility is based on definitions in Maryland State Law, Health – General, Title 7, and Developmental Disability Law.  These services are not an entitlement service. Individuals must apply and be determined eligible for DDA services.

Conflict of Interest:

Any real or perceived incompatibility between an agency or agency
employee’s private interests and the duties of this Solicitation.

Continuing Adult Education:

Non-credit class or classes designed to enhance personal growth and development.

Covered Benefit:

Medically necessary care and services included in the Medical Benefits Package as defined within 38 Code of Federal Regulation (CFR) 17.38.

Crisis Prevention (CP):

The second priority category for services funded by Developmental Disabilities Administration (DDA).  People in this category have been determined to have an urgent need for services, but do not qualify for Crisis Resolution. The person qualifies for this category by meeting one or more criteria as stated in the regulations.

Crisis Resolution (CR):

The top priority category for services funded by DDA. To qualify for this category, the person has to be in crisis by meeting one or more criteria as stated in the regulations.

Current Request (CU):

The third or lowest priority category for services funded by Developmental Disabilities Administration (DDA). To qualify for this category, the applicant shall indicate at least a current need for services.

Day Supports:

Services which provide structured daily activities for individuals with developmental disabilities. There are several options under these services:

  • Day Habilitation – teaches skills for employment and/or community living. The service is designed for each individual and his or her goals for employment. You will take part in activities in places other than you home for the majority of the day. Day habilitation services are intended to increase independence and develop and maintain motor skills, communication skills, and personal hygiene skills related to specific habilitation goals that lead to opportunities for integrated employment.
  • Supported Employment – designed to assist you with accessing and maintaining paid employment in the community.
  • Community Learning Services – activities, special assistance, support, and education to help individuals whose age, disability, or circumstances currently limits their ability to be employed and/or participate in activities in their communities. They assist you in developing the skills and social supports necessary to gain, retain, or advance in employment.
  • Employment Discovery and Customization – Employment discovery and customization services are designed to help access employment or explore the possibilities and impact of work. These are time-limited activities, which include assessment, discovery, customization, and training activities.

Developmental Disabilities Administration (DDA):

The agency that provides funding and services to eligible individuals. The agency is part of the Maryland Department of Health.

Find more information here:  https://dda.health.maryland.gov/Pages/home.aspx

DDA-funded Services:

Any services which are purchased with the use of state (and, in some instances, federal) money through the Developmental Disabilities Administration (DDA).

“DD” Eligible:

One of two DDA eligibility categories for in which a person needs to meet the following criteria: Have a physical or mental condition other than a sole diagnosis of mental illness.  The disability is considered severe and chronic in nature.  The disability was manifested before the age of 22.  The disability results in the person being unable to live independently.  The person needs assistance to plan and coordinate services.  “DD” eligibility is required for accessing the Community Pathways waiver and the full range of services funded by the DDA.

Division of Rehabilitation Services (DORS):

A state funded agency that provides leadership and support to enable individuals with disabilities to live independently.  ​DORS helps people with physical, emotional, intellectual, developmental, sensory and learning disabilities go to work and keep their jobs by providing services such as career assessment and counseling, assistive technology, job training, higher education and job

Disenrollment:

The discontinuation of a veteran’s enrolled status. Disenrollment may result because the veteran requests not to participate in VA enrollment, or when VA determines that certain priority groups will no longer be provided services. Requests to dis-enroll must be in writing.

Department of Social Services (DSS):

Social services are managed by local county/city governments. Throughout the State, the Family Investment Administration and the Social Services Administration of the Department of Human Services oversee social services programs such as adoption; foster care; protective services to children, adults, and families; public assistance; and services to families with children. The local department of social services, funded by State government, administers public assistance programs for low-income Marylanders and those suffering economic hardships. These include the Supplemental Nutrition Program (formerly Food Stamps); the Medical Assistance Program (Medicaid); the Maryland Energy Assistance Program; and the Temporary Cash Assistance Program. In addition, local departments of social services also offer child care subsidy; child support enforcement; emergency food provision; and housing and employment assistance. With local organizations, social services departments work to provide emergency shelter and transitional housing, drug and alcohol rehabilitation programs, and even general education development (GED) courses.

Find your local office here:  http://msa.maryland.gov/msa/mdmanual/01glance/html/social.html#local

Domiciliary:

A VA facility that provides care on an ambulatory self-care basis for veterans disabled by age or disease who are not in need of acute hospitalization and who do not need the skilled nursing services provided in a nursing home.

Eligibility & Access (E & A):

The process by which a person with a disability applies to the Developmental Disabilities Administration (DDA) for services.  Eligibility is based on definitions in Maryland State Law, Health – General, Title 7, and Developmental Disability Law.  These services are not an entitlement service. Individuals must apply and be determined eligible for DDA services.

Eligibility Determination Division (EDD):

Determines financial eligibility for Medicaid under the waiver. EDD will review assets, income, and medical expenses and apply special financial eligibility rules under the waiver. Individuals must apply to the waiver regardless of their income and assets.

Emergency Planning:

To ensure the individual’s health and safety needs are met in the community and in keeping with current SCI practice, the Case Manager will assist Veterans with disabilities in registering with local emergency services providers such as the local Fire Department when appropriate.

Enclave:

A group of individuals working at the same community-based site with direct supervision.

Enrollee:

A veteran who has applied for VA medical services under 38 United States Code (U.S.C.) 1710 and 38 CFR 17.36, has been accepted for such care, and who has received confirmation of enrollment in the VA health care system.

Enrollment:

The process for providing veterans access to VA health care benefits covered by the medical benefits package.

Enrollment Group Threshold (EGT):

The enrollment priority group level, as determined by the Secretary Veterans Affairs, at which veterans will be accepted for enrollment into the VA health care system.

Environmental Contaminants / Gulf War Illness:

Gulf War veterans were exposed to a wide variety of environmental hazards and potential harmful substances during their service in Southwest Asia. These include depleted uranium, pesticides, the anti-nerve gas pill pyridostigmine bromide, infectious diseases, chemical and biological warfare agents, and vaccinations (including anthrax and botulinum toxoid), and oil well free smoke and petroleum products. VA recognizes that there are other health risk factors encountered by Gulf War veterans. Veterans with service during the Gulf War are eligible to receive treatment for conditions related to this service.

Family Support Services (F/ISS):

The assistance provided to individuals under age 21 to enable participation in the community. They make use of resources available in the community while, building on existing support network. Supports may include: assistance locating and accessing education, recreational and social activities, and roommates of the individual’s choosing; providing training related to finances, including money management, banking, and tax preparation; training, facilitating opportunities and accompanying you to acquire self-advocacy and independent living skills.

Find more information here:  https://dda.health.maryland.gov/Pages/Developments/2015/Participant%20Guide%20to%20DDA%20Services_(4-18-2014)%20FINAL.pdf

Financial Assessment:

A means of collecting income and asset information used to determine a veteran’s eligibility for health care benefits.

Fiscal Intermediary:

An agency through which money from the Developmental Disabilities Administration (DDA) can be pass through for payment for services on your behalf.

Formulary:

A formulary is a list of medicines from which your VA provider can choose to treat your medical condition. This list of medicines has been looked at and approved by a group of highly trained VA physicians and clinical pharmacists. New medicines are usually added to the formulary based on a complete review of published medical studies as well as available patient safety data. Medicines are grouped by VA as Formulary, Formulary-Restricted or Non-Formulary. Formulary-Restricted medicines usually can be used only by those providers with specific experience in how these medicines are prescribed and monitored. For example, oncologists usually are the only VA providers who can prescribe medicines used to treat cancer. Non-Formulary medicines are prescribed for those patients who either have failed or could not tolerate any of the VA Formulary medicines.

Funding:

Money made available to agencies to provide services to individuals. Futures Planning (used interchangeably with Person-Centered Plan or Essential Lifestyle Plan) is the process of sharing and gathering information on the dreams, desires, wants and needs of people in order to develop an Individual Plan specifically tailored to their lives. A comprehensive plan may include personal, financial, and legal components. Generic Resources: Services that are available to everyone in the community, not specific to people with developmental disabilities.

Future Need Registry:

A database kept by the Developmental Disabilities Administration for individuals who have been determined eligible for services but do not have a current need for them.

Geographic Means Test (GMT) Threshold Copay Required<

A copay status assigned to a veteran whose household income is above the VA means test income threshold but below the GMT income threshold. GMT copay for inpatient care is reduced by 80%, all other copay amounts remain the same. GMT income thresholds are based upon established geographic income thresholds.

GMT – Below the Means Test Threshold

Veterans whose household income and net worth are below the VA National income threshold such that they are unable to defray the expenses of care; therefore, they are not subject to copay charges for hospital and outpatient medical services.

GMT – Above the Means Test and GMT Threshold:

Veterans whose household income and/or net worth are ABOVE the VA National income threshold and income ABOVE the geographically-based income threshold for their resident location who do not otherwise qualify for placement in a higher enrollment priority group. These veterans must agree to pay copays for hospital care and outpatient medical services.

GMT – Above the Means Test and Below the GMT Threshold :

Veterans with household income and/or net worth are ABOVE the VA National income threshold and income BELOW the geographically-based income threshold for their resident location who do not otherwise qualify for placement in a higher enrollment priority group. These veterans must also agree to pay copays for hospital care and outpatient medical services, but their inpatient medical care copays are reduced 80 percent.

Geriatric Evaluation:

Geriatric evaluation, which is part of the basic benefits package, is the comprehensive assessment of a veteran’s ability to care for him/herself, physical health, and social environment, which leads to a plan of care. The plan could include treatment, rehabilitation, health promotion, and social services.

Hardship:

A “hardship” exist when there is a significant change in your family income and net worth from the previous calendar year to the present year. You could have been working in the previous year and due to a recent disability are no longer able to work. Chances are this type of situation would create a significant change in your families income.

Health Insurance Portability and Accountability Act (HIPAA):

HIPAA is a federal law enacted in 1996. It was designated to improve availability and portability of health coverage and the efficiency of the health care system by standardizing the electronic exchange of health information and protecting the security and privacy of member-identifiable health information.

Home and Community-based Services (HCBS):

Provide opportunities for Medicaid beneficiaries to receive services in their own home or community rather than institutions or other isolated settings. These programs serve a variety of targeted populations groups, such as people with intellectual or developmental disabilities, physical disabilities, and/or mental illnesses. Maryland Home and Community Based Waiver Programs

Home Health Care:

Skilled nursing and other therapeutic services provided by VA or a home health care agency in a home setting as an alternative to confinement in a hospital or skilled nursing facility.

Homemaker/ Home Health Aide Services:

The Homemaker / Home Health Aide (H/HHA) Program provides services as an “alternative” to nursing home care. The H/HHA Coordinator along with the interdisciplinary team makes a clinical judgment that the veteran would, in the absence of H/HHA services, require nursing home equivalent care.

Hospice/Palliative Care:

Hospice/Palliative Care programs offer pain management, symptom control, and other medical services to terminally ill veterans or veterans in the late stages of the chronic disease process.

Hostilities:

“Hostilities” means any armed conflict in which the members pf the Armed Forces are subjected to combat conditions comparable to a period of war. The periods of armed conflict are determined by the Secretary of VA in consultation with the Secretary of Defense.

Housebound Benefit:

The VA’s Housebound benefit is an additional amount available to eligible veterans and dependents who are entitled to VA pension or VA compensation. The housebound allowance may be paid to veterans, dependent spouses, or surviving spouses who because of their physical limitations, are unable to walk or travel beyond their home and are reasonably certain the disabilities or confinement will continue throughout his or her lifetime. Certain restrictions apply.

HUD-VASH:

The Program combines the Department of Housing and Urban Development (HUD) Housing Choice Voucher (HCV) rental assistance for homeless veterans and their families with case management and clinical services provided by the Department of Veterans Affairs (VA)

Individualized Education Plan (IEP):

The IEP is meant to address each child’s unique learning needs and include specific educational goals. It is a legally binding document. The school must provide everything it promises in the IEP. IEPs include: student’s present level of performance (PLOP), annual educational goals, supports/services that the school will provide to help student reach their goals, modifications/accommodations, how the goals will be measured, and transition planning.

For more information:  http://archives.marylandpublicschools.org/MSDE/divisions/earlyinterv/docs/IEP/IEP-Parents-Guide_Condensed-IEP-RR-32015-revised.pdf

Increased Community Services (ICS):

Maryland’s Increased Community Services program allows eligible individuals in nursing facilities to return to the community and receive specific waiver services and certain Medicaid services to support them in their homes and communities.

Learn more here:  https://mmcp.health.maryland.gov/longtermcare/Resource%20Guide/03.%20Program%20Fact%20Sheets/Increased%20Community%20Services%20Fact%20Sheet%2011.3.15.pdf

Intensive Acute Case Management

As outlined in the VHA Handbook 1110.04, “intensive-acute case management is geared towards Veterans with the highest level of need. These Veterans may be hospitalized, or have had recent, extended, or repeat hospitalizations, or recurrent episodes of crisis.

Individual Budget:

The total cost of services per year for an individual to fund the supports needed or desired.  Also knows as a Service Funding Plan or SFP.

Individual Support Services (ISS):

Assistance provided to individuals over 21 and their families to enable greater participation in the community and enhance quality of life.  Supports may include assistance locating and accessing education, recreational and social activities, and roommates of the individual’s choosing; providing training related to finances, including money management, banking, and tax preparation; training, facilitating opportunities and accompanying you to acquire self-advocacy and independent living skills.

Individual Plan (IP):

The Individual Plan (IP) is the foundation and roadmap of an individual’s services and supports.  The IP shall be developed by utilizing a person centered planning methodology based on the preference of the individual. Individual plans should incorporate natural supports as well as addressing ways to assist the individual in developing various types of relationships which may increase their natural support system.  

IPE:

Individual Plan for Employment (division of rehabilitation services)

Informed Choice:

Having the information and understanding about a situation prior to making a decision.

ISP:

Individual Service Plan (individual support service provider)

Intensive Behavioral Management Program (IBMP):

The specialized program which helps people who have behavioral issues, their families, the school system and other agencies. IBMP does an extensive evaluation of the person in all their regular environments and makes recommendations. Sometimes they can also provide specialized training, extra staff and respite services, based on the evaluation.

Job Coach:

A person who provides job training for a worker in a competitive location.

Low-Income Threshold:

Veterans with gross household income under the “low income threshold” are eligible to receive certain health related benefits at no cost to the veteran. The low-income threshold is set by law and varies according to the veteran’s family size and benefit applied for.

Low Intensity Support Services (LISS):

LISS funding is designed to improve an individual or family’s quality of life, increase or maintain independence, and participate in their communities. The LISS program uses an automated system called the Random Selection Process (lottery)  to select individuals who may be eligible for funding, granting up to $2000 for services and items to address their needs.

For more information, including how to apply:  https://dda.health.maryland.gov/Pages/liss.aspx

Local Health Department (LHD):

LHDs administer and enforce State, county and municipal health laws, regulations, and programs in Maryland’s twenty-three counties and Baltimore City and are overseen by the Public Health Services of the Maryland Department of Health (MDH).

Find your local department here: http://msa.maryland.gov/msa/mdmanual/01glance/html/healloc.html

Local Time:

Time in the Eastern Time Zone as observed by the State of Maryland.

Maryland Access Point (MAP):

Maryland’s Aging and Disability Resource Centers are called MAP sites, Maryland’s single-point of entry to long term supports and services.  The were established as the single entry point for individuals seeking long term support services. Maryland’s 20 local MAP sites provide individual, person centered counseling to consumers seeking information, referral and program support for long term services.

The MAP program also provides an online, searchable resource directory to serve the public and professionals in identifying, connecting and accessing private and public resources: www. marylandaccesspoint.info. Individuals can use the website to directly find and contact service providers or they can find an appropriate agency in their local area to contact for counseling and assistance.

Find your local office here:  https://www.marylandaccesspoint.info/consumer/connect.php

Maryland Department of Aging (MDoA):

Maryland’s State Unit on Aging designated to manage, design and advocate for benefits, programs and services for the elderly and their families; administers the Older Americans Act and the Aging and Disability Resource Center initiative in partnership with the local Area Agencies on Aging.

For more information on programs and services:  http://www.aging.maryland.gov/Pages/ProgramsAndServices.aspx

Maryland Department of Disabilities (MDOD):

Authorized by Senate Bill 188 in 2004, the Maryland Department of Disabilities is charged with unifying and improving the delivery of services to people with disabilities by working collaboratively with all state government agencies; and develops and facilitates the implementation of the State Disabilities Plan, calling for collaborative partnerships with state agencies to improve services for people with disabilities.

Maryland Department of Health (MDH):

Formerly known and the Maryland Department of Health and Mental Hygiene (DHMH) the Maryland Department of Health serves to promote and improve the health and safety of all Marylanders through disease prevention, access to care, quality management, and community engagement.  MDH has four major divisions – Public Health Services, Behavioral Health, Developmental Disabilities, and Health Care Financing.

Means Test:

The formal financial assessment process used by VA to measure a veteran’s gross household income and assets. The means test determines veterans copay responsibilities and helps to determine enrollment priority.

Means Test Copay Exempt:

Veterans not required to make copays for medical care provided by VA.

Means Test Copay Required:

A copay status assigned to a veteran who is required to make medical care copay based on financial status relative the applicable means test income threshold.

Medicaid/Medical Assistance:

A program, funded by the federal and state governments, which pays for medical care for low-income individuals or families, as well as elderly or disabled individuals. To receive Medicaid, an individual must meet certain financial requirements and also must go through an application process.

To learn more about Maryland’s Medicaid Program and how to apply:  http://dhr.maryland.gov/weathering-tough-times/medical-assistance/

Medicaid State Plan:

A written agreement between a State and the Federal Government that outlines Medicaid eligibility standards, provider requirements, payment methods, and health benefit packages. A Medicaid State Plan is submitted by each State and approved by the Centers for Medicare and Medicaid Services.

Medical Benefits Package:

The term “Medical Benefits Package” refers to a group of health care services that are provided to all enrolled veterans.

Medical Day Care:

Provides monitoring and therapies in a structured setting for people who have a medical need. Therapies are provided based on the need of the person being served. In some cases, attending medical day care on a temporary basis can help someone regain skills after a serious medical incident.  These programs are not restricted to DDA funded agencies.  There are generic programs, usually run by the aging service community, which may be accessed by people with disabilities.

Learn more here:  https://mmcp.health.maryland.gov/longtermcare/Pages/Medical-Day-Care-Services.aspx

Medical Need:

The determination that care or service(s) are required to promote, preserve, or restore a veteran’s health as specified within 38 CFR 17.38(b). A treatment, procedure, supply, or service is considered medically necessary as determined by the patient’s care provider and in accordance with generally accepted standards of clinical practice.

Medicare:

A federal program that provides health care coverage for people aged 65 and older, as well as some younger individuals with specific health problems. Medicare Part A covers hospitalization, extended care and nursing home care; Medicare Part B covers outpatient services, and is subject to a monthly premium.

Military Sexual Trauma (MST):

Sexual trauma experienced while on active duty in the military. Sexual trauma is defined as sexual harassment, sexual assault, rape and other acts of violence. Sexual harassment is further defined as repeated unsolicited, verbal or physical contact of a sexual nature, which is threatening in nature. If the veteran is being treated for any condition during this episode of care that the provider believes is related to MST; the veteran does not have to pay a copay for the visit or the medication.

Money Follows the Individual (MFI):

The State’s Money Follows the Individual policy allows individuals, who reside in institutions and whose services are being funded by Medicaid, to apply for the waiver program regardless of budgetary caps.

Money Follows the Person (MFP):

Will help people transition from an institution, for example a nursing facility, to community living in an apartment, private home, or small group setting. MFP initiatives increase outreach to individuals in institutions and decrease barriers to transition. New efforts under MFP include peer mentoring, enhanced transition assistance, improved information technology, housing assistance, flexible transition funds, and the addition of waiver services to existing waivers.

Learn more here: https://mmcp.health.maryland.gov/longtermcare/Pages/Maryland-Money-Follows-the-Person.aspx

Natural Supports:

Connections that individuals depend on that are provided through personal relationships within the family, home environment, work place, and through participation in the community that enhance their quality of life and do not require compensation.  (Ex. Co-workers, parents/other family members, friends, partnerships through volunteer opportunities)

Net Worth:

Simply put, “net worth” means the market value of everything you own, minus what you owe. There are exclusions, not everything you own or owe is considered. VA has some very specific guidelines on how it computes net worth. The VA Means Test uses the same rules as VA pension to determine your net worth.

Non-DDA Service:

Services that are not funded by the Developmental Disabilities Administration. Section 8 housing and public education services are two examples of non-DDA services.

Noncompensable:

Noncompensable refers awards of service-connection which VA determines do not warrant the award of monetary compensation.

Nonservice-Connected Pension:

A monetary support benefit awarded to permanently and totally disabled, low-income veterans with 90 days or more of active military service, of which at least one day was during wartime. Veterans of a period of war who are age 65 or older and meet service and income requirements are also eligible to receive a pension, regardless of current physical condition. Payments are made to qualified veterans to bring their total income, including other retirement or social security income, to a level set by Congress.

Nonservice-Connected Veteran:

An eligible veteran who has been discharged from active military duty and does not have a VA adjudicated illness or injury incurred in or aggravated by military service.

Normal State Business Hours:

Normal State business hours are 8:00 a.m. – 5:00 p.m. Monday
through Friday except State Holidays, which can be found at: www.dbm.maryland.gov – keyword State Holidays.

Open Enrollment:

The process of accepting applications for enrollment at any time during the year.

Other than Dishonorable Conditions:

All veterans are potentially eligible for most veterans’ health care benefits are based solely on active military service in the Army, Navy, Air Force, Marines, or Coast Guard (or Merchant Marines during WWII), and discharged under other than dishonorable conditions

Outpatient Care:

Refers to health care a patient receives without being admitted to a hospital. Examples include office visits, x-rays, lab tests and some surgical procedures.

One-Time Only:

A small and limited amount of funding through the DDA to help an individual purchase a one-time service or product.

Other Funding Sources:

Funding may also be available from other sources such as:

  • Maryland Department of Health (MDH)
  • Medical Assistance, Medicare or individual’s private insurance.

Palliative Care – Care provided primarily to relieve symptoms of a disease or condition rather than for curative purposes.

Pension Benefit:

VA pension is a monetary award paid on a monthly basis to veterans with low income who are permanently and totally disabled, or are age 65 and older, may be eligible for monetary support if they have 90 days or more of active military service, at least one day of which was during a period or war. Payments are made to qualified veterans to bring their total income, including other retirement or social security income, to a level set by Congress annually. Veterans of a period of war who are age 65 or older and meet service and income requirements are also eligible to receive a pension, regardless of current physical condition.

Person Centered Planning and Monitoring:

Service Coordination, Inc. (SCI) developed and utilizes a Person Centered Planning Tool and Document to assist Case Managers to expand their knowledge of a person, to ensure they assist individuals to have choice and input in all aspects of their life, and to capture their input and preferences within their plan.

Personal Supports:

A DDA service that provides regular personal assistance and support that enhance a person’s opportunity for community participation and enables them to exercise choice and control over their lifestyles. Personal Supports can be provided in a person’s home, family home or in the community. Services may include: Bathing, Toileting, Eating and preparing meals, dressing and changing clothes, Light housework including laundry.
See DDA’s Guide to Services more details: https://dda.health.maryland.gov/Pages/Developments/2015/Participant%20Guide%20to%20DDA%20Services_(4-18-2014)%20FINAL.pdf

Preferred Facility

The veteran identified VA health care location where the veteran prefers to receive care. A preferred facility may be any VA health care location, for example, VA health care facility, independent clinic, or community based outpatient clinic. If VA is unable to provide your needed health care, that facility will make arrangements to refer you to another VA health care facility or to one of VA’s private sector affiliates to provide the required care.

Preventive Care

Health Care that emphasizes prevention, early detection, and treatment.

Primary Care Provider

The clinician who is responsible for the supervision, coordination, and provision of the veteran’s medical care. This clinician provides routine health services and is the veteran’s first point of contact when the veteran becomes sick. The primary care provider can easily refer patients to a specialist (such as a surgeon) should they require care outside the scope of his or her expertise.

Progressive Chronic case Management

As outlined in the VHA Handbook 1110.04, progressive chronic case management is geared to Veterans who are “clinically stable but still need ongoing intervention for psychosocial or other clinical issues to ensure continuous coordination of care and access to services.”

Project 112/SHAD:

Project SHAD, an acronym for Shipboard Hazard and Defense, was part of a larger effort called Project 112, which was conducted during the 1960s. Project SHAD encompassed tests designed to identify US warships’ vulnerabilities to attacks with chemical or biological warfare agents and to develop procedures to respond to such attacks while maintaining a war-fighting capability.

Prosthetic Devices:

A device which replaces all or a portion of a part of the human body. A prosthetic device can be used when a part of the body is permanently damaged, is absent, or is malfunctioning.

Provider Agency:

Term that refers to licensed DDA providers who provide a variety services.  For a list of licensed DDA providers here:  https://dda.health.maryland.gov/Pages/providers.aspx

Public Law (PL) 104-262:

The public law passed by Congress in October 1996, also known as the Veteran’s Health Care Eligibility Reform Act of 1996. This law established national standards of access and equitable health care services to veterans and required that most veterans be enrolled to receive care.

Public Law (PL) 107-135:

” Department of Veterans Affairs Health Care Programs Enhancement Act of 2001″ provides for chiropractic care and services for veterans through Department of Veterans Affairs medical centers and clinics.

Purple Heart:

A “Purple Heart” is a medal given by the military to a service person injured as a direct result of combat.

Quality Assurance:

A way to look at the quality of the services being delivered to a person with developmental disabilities who receives funding from Developmental Disabilities Administration (DDA).

Referral:

The process of referring a veteran from one practitioner to another for health care services.

Regular Filipino Scouts:

The Filipino Scouts were guerrilla forces considered part of the Commonwealth Army of the Philippines. They were organized under commanders appointed, designated, or later recognized by the U.S. Army.

Residential Support:

Services which offer supervision and assistance to individuals in their home. “Home” may also include a group home, alternative living unit (ALU) and Personal Supports.

Resource Coordination:

Used interchangeably with Service Coordination: also known as case management.

Respite Care:

Short-term care provided to a person for the purpose of providing relief for the parent or primary caregivers. Respite care can mean many things to a parent/caregiver: time to relax, time to spend alone, time to spend with other family members, or assistance when emergency care is needed.

Restore Health:

The process of improving a veteran’s quality of life or daily function level that has been lost due to illness or injury.

Secondary Condition:

A secondary condition, for medical treatment purposes, may be the result of an adjudicated service-connected condition. Veterans are encouraged to file compensation claims for non-rated secondary conditions. Non-rated secondary conditions are billable as a non service-connected condition. If awarded service-connection for the secondary condition, VA may reimburse all copays related to such service-connection retroactive to the date of the original claim filing.

Self-Advocate:

Those individuals who have chosen to assert their right to choose what is best for them.

Self-Determination:

Practicing self-determination means that the individual makes the decisions about his or her life, supports, and how his or her budgeted funds are spent.

Service-connected

Generally a service-connected disability is a disability that VA determines was incurred or aggravated while on active duty in the military and in the line of duty. A service-connected rating is an official ruling by VA that your illness/condition is directly related to your active military service. Service-connected ratings are established by VA Regional Offices located throughout the country.

Service-Connected Veteran:

A veteran who has an illness or injury incurred in or aggravated by military service as determined by VA.

Service Coordination:

Used interchangeably with Case Management, Resource Coordination, and Coordination of Community Services.

Service Coordination, Inc:

Service Coordination, Inc. is a private, nonprofit organization serving individuals with intellectual and developmental disabilities, those with mental health challenges, the elderly, transitioning youth, court-involved individuals throughout Maryland and veterans.

Sexual Trauma:

Sexual Harassment, Sexual Assault, Rape and other acts of violence. Repeated unsolicited, verbal or physical contact of a sexual nature, which is threatening in nature.

Social Security Administration – Supplemental Security Income (SSI):

The Supplemental Security Income (SSI) program pays benefits to disabled adults and children who have limited income and resources.  SSI benefits also are payable to people 65 and older without disabilities who meet the financial limits. Students may apply for SSI on their 18th birthday. They are considered a family of “one” and their income alone is taken into consideration.

Find more information here:  https://www.ssa.gov/disabilityssi/ssi.html

For other SSA benefits:  https://www.ssa.gov/disability/

Social Security Disability Insurance (SSDI)

Pays benefits to you and certain members of your family if you are “insured,” meaning that you worked long enough and paid Social Security taxes.

State Veterans Homes:

The eligibility for State Veterans Homes varies from state to state. But typically veterans and sometimes their spouse, can be admitted to a State Veterans Home. The costs of living in a State Veterans Home are usually paid by Medicaid, long term care insurance, and private funds. VA pays a modest share of the cost for each veteran living in a State Veterans Home. You can find information on the State Veterans Home(s) for your state by looking in the state government pages of the telephone book. VA social workers at the VA medical center where you’re being treated can also provide information about State Veterans Homes.

Support:

A term given for the different ways to meet peoples needs.  Supports are typically people, places, resources, and activities in our community.

Support Services for Veteran Families (SSVF):

is a housing first, supportive services outreach program operated by VOA Chesapeake, Inc. and the VA SSVF Program Office. The SSVFP is a community-based program which provides a range of supportive services to very low income Veteran families.

Support Staff:

Persons hired by individuals, families, or agencies to provide requested services.

Supported Employment:

Provides assistance for people who are working jobs in the community. The help can be in the form of job coaching, educating co-workers or negotiating with employers to help the person be as independent as his or her abilities allow.

Supportive Chronic Case Management:

As outlined in the VHA Handbook 1110.04, progressive chronic case management is geared to Veterans with stable clinical and psychosocial issues, but who require periodic monitoring of their care plan. Case Management services ensure the Veteran remains “well established in the system of care.”

Targeted Case Management (TCM):

Medicaid Targeted Case Management (TCM) is a service that manages multiple resources for Medicaid members. It is designed to help persons with intellectual disabilities, brain injury, or developmental disabilities gain access to appropriate and necessary medical services and interrelated social and education services. DDA TCM Provider Qualifications – Meets training, staffing qualification, and other state and federal requirements for case management/care coordination services – Meets federal criteria for conflict-free case management Role of Targeted Case Managers Targeted Case Managers facilitate the community-based assessment and planning process by working with individuals, families, service providers, and other agencies and individuals to create an individualized plan based on a comprehensive assessment of needs for each person. In addition, case managers assist individuals and/or parents or guardians in navigating the service system

Transitioning Youth:

Students transitioning from school to adult services are typically referred to as “Transitioning Youth.”  Students may be eligible for a funding source through the Developmental Disabilities Administration (DDA) to assist eligible individuals in the transition from school to work after the age of 21.

Learn more here:  https://dda.health.maryland.gov/Pages/TY.aspx

Urgent Care:

Services received for an unexpected illness or injury that is not life threatening but requires immediate outpatient medical care that cannot be postponed. An urgent situation requires prompt medical attention to avoid complications and unnecessary suffering or severe pain, such as a high fever.

VA Form 10-10EZ, Application for Health Benefits:

The VA form completed by veterans to apply for VA health care benefits. The form includes demographic, military, insurance and financial information

VA Form 10-10EZR, Health Benefits Renewal:

The VA Form used by veterans to submit their updated personal, insurance and financial information to VA.

Veteran:

The term ‘veteran’ means a person who served in the active military, naval, or air service, and who was discharged or released under conditions other than dishonorable

Veteran Support Network:

A group of veteran service providers to assist veterans with resources.

Waiver:

Another term for the Home and Community Based Services

Wrap Around Services:

Wraparound is intended to ensure that individuals  with complex needs (and multiple agency involvement) benefit from a coordinated care planning process that produces a single plan of care that cuts across all agencies and providers.