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Specialty Care Glossary

November 1, 2020


Assisted living

Helps older adults and people with disabilities maintain as much independence as possible by providing apartment-like units and individualized support services, which accommodate individual needs and abilities.1

Access services

Services, such as transportation, escort/shopping assistance, outreach, and information and assistance, which help people to identify, obtain and use existing services. 1

Acquired brain injury (ABI)

An acquired brain injury (ABI) is damage to the brain, which may be caused traumatically (e.g., from an external force such as a collision, fall, or assault) or through a medical problem or disease process which causes damage to the brain (e.g., anoxia, nonprogressive tumour, aneurysm, infection, stroke with diffuse cognitive deficits). An ABI occurs after birth and is not related to a congenital disorder or developmental disability (e.g., cerebral palsy, muscular dystrophy, autism, spina bifida with hydrocephalus) or a process which progressively damages the brain (e.g., dementing processes, multiple sclerosis, Alzheimer’s Disease, Parkinson’s Disease). 2

Activities of daily living (ADL)

Daily activities one must perform to fundamentally care for oneself and be independent. Ability or inability to perform ADLs are used as a way of measuring an individual’s functional status. May be divided into BADLs (basic ADLs) and IADLs (Instrumental Activities of Daily Living). 3


Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases. 4

Addiction psychiatrist

An addiction psychiatrist is a medical professional who is well-versed in the field of psychiatry, diagnosis of mental and behavioral disorders, evaluation and substance abuse. Addiction therapists primarily treat people with mental health issues using medications such as antipsychotics and antidepressants to address underlying issues. 5

Administrative assessment

Process of documenting reports of suspected child abuse or neglect that do not meet the criteria for a Child Protection Services Assessment. 1

Administrative referral

Process of documenting the referral of reports of suspected child abuse or neglect that fall outside the jurisdiction of the county where the report is received. 1

Adult day care

A program of nonresidential activities provided on a regularly scheduled basis one or more days per week and encompassing both the health and social services needed to ensure the optimal functioning of the individual. 1

Adult foster care

Provision of 24-hour care within a home environment to adults who are unable to function independently or who may benefit from a home environment. Care is provided in a licensed facility. 1

Adult residential care home or facility (ARF)

A public or privately operated (24-hour) residence that provides personal assistance, lodging and meals for compensation to two or more adults who are unrelated to the residence licensee, owner or director. 6

Affordable Care Act (ACA)

Also known as Patient Protection and Affordable Care Act. Federal legislation signed into law in March 2010 that included a provision for states to expand the Medicaid program along with implementing other health-related provisions. 1

American Society of Addiction Medicine patient placement criteria (ASAM)

These are the clinical guidelines used for matching clients to the appropriate level of care for the treatment of substance-related disorders. 1

Americans with Disabilities Act (ADA)

The Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities in several areas, including employment, transportation, public accommodations, communications and access to state and local government programs and services. 7


Past-due, unpaid child support owed by the obligor. Also referred to as arrears. 1

Asperger’s syndrome

Asperger’s syndrome may still be used as a descriptive term to identify those on the higher end of the autism spectrum. 8

Assertive community treatment (ACT)

A team-based, best-practice treatment model that provides multidisciplinary, flexible treatment and support to individuals with mental illness. 1

Assistive technology (AT) device

Any item or piece of equipment used to maintain or improve the functional capabilities of individuals with disabilities. 1

Assistive technology (AT) service

Any service that directly assists an individual with a disability in selecting, acquiring, or using an assistive technology device. AT services may include: evaluation, purchasing, designing, leasing, training for individuals, family members, and professionals; and coordinating therapies. It also includes services that expand access to electronic and information technology for people with functional impairments. 1

At-home care

This refers to medical care provided to seniors in their place of residence rather than in a senior living facility. 9

Attendant care service (ACS)

Hands-on care, of both a supportive and medical nature, specific to a client who is ventilator-dependent for a minimum of 20 hours per day, and which includes nursing activities that have been delegated by the Nurse Manager to the ACS provider. ACS is an all-inclusive service that provides direct care to ventilator-dependent individuals to meet their care needs. 1

Attendant care service (ACS) provider

Is a Qualified Service Provider (QSP). The attendant care service is provided under the direction of a licensed nurse who is enrolled with the Department of Human Services as a QSP to provide Nurse Management. 1


Autism spectrum disorder (ASD) is not a mental illness, but a neurologically based developmental disability that significantly impairs the ability to communicate and to interact in a socially appropriate manner. 10


Behavioral health (BH)

Behavioral health is a state of mental/emotional being and/or choices and actions that affect wellness. Behavioral health illnesses are common, recurrent and often serious, but they are treatable, and people recover.1


A specific measurement as it relates to progress toward meeting a standard or goal1

Best practice

Practices that incorporate the best objective information currently available from recognized experts regarding effectiveness and acceptability. 1


Care coordinator

Describes a case manager in a child and family case involving severe emotional disturbance. 1

Case management

A service by which needs are assessed; services are arranged, coordinated and monitored; and client preferences are advocated for within the context of a clinical treatment plan. 11

Center for Substance Abuse Prevention (CSAP)

Center for Substance Abuse Prevention is the sole federal organization with responsibility for improving accessibility and quality of substance abuse prevention services. 1

Center for Substance Abuse Treatment (CSAT)

Center for Substance Abuse Treatment is a component of the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (DHHS) that works to expand the availability of effective treatment and recovery services for alcohol and drug problems. 1

Centers for Independent Living (CIL)

Nonprofit agency that is run by individuals with disabilities (over 50% of staff and Board of Directors) and provides independent living services. 12

Centers for Medicare and Medicaid Services (CMS)

The federal agency which oversees Medicare, Medicaid and the Children’s Health Insurance Program. Note: Medicare is administered by the federal government. 1

Certified Nursing Assistant (CNA)

A CNA, working under the direction of a registered or a practical nurse, fulfills many basic needs regarding direct patient care, including feeding, dressing, assisting with matters of hygiene, taking vital signs, collecting specimens, accompanying to and from appointments or while taking exercise and often providing emotional support. 13

Child abuse and neglect (CA/N)

Any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm. 14

Child and Family Services review (CFSR)

Periodic reviews of state child welfare systems, to achieve three goals: ensure conformity with federal child welfare requirements, determine what is actually happening to children and families as they are engaged in child welfare services, and assist states in helping children and families achieve positive outcomes. 15

Child Care and Development Block Grant Act (CCDBG)

The Child Care and Development Block Grant (CCDBG) is the primary federal grant program that provides child care assistance for families and funds child care quality initiatives. CCDBG is administered to states in formula block grants. States use the grants to subsidize child care for low-income working families. CCDBG also funds Child Care Resource and Referral services and quality projects for infants and toddlers. 16

Child Care and Development Fund

The Child Care and Development Fund (CCDF) is administered by states, territories and tribes. States use CCDF to provide financial assistance to low-income families to access child care so they can work or attend a job training or educational program. States can also use CCDF dollars to invest in improving quality through teacher workforce, supporting child care programs to achieve higher standards, and providing consumer education to help parents select child care that meets their families’ needs. 16

Child Care Assistance Program (CCAP)

Child Care Assistance Program provides partial payment for child care services provided to children from qualifying low-income families. 1

Child care centers

Child care centers often group children by age and are generally operated out of nonresidential, commercial buildings. Centers are larger and enroll more children; they usually have a dedicated director and numerous staff members. 17

Child care provider

A person, group of persons or agency that is responsible for the education and supervision of the child/children in their care in exchange for money, goods or services. 1

Child Fatality Review Panel

A multi-professional group that meets to review the deaths of all minors in the state and identifies trends or patterns in the deaths of minors. 1

Child Protective Services (CPS)

Child Protective Services protect the health and welfare of children by encouraging the reporting of children known to be or suspected of being abused or neglected and provide services for the protection and treatment of abused and neglected children to safeguard them from further harm. 1

Child welfare

The child welfare system includes public and private services that are focused on ensuring that all children live in safe, permanent and stable environments that support their well-being. Child welfare services may interact with entire families, or they may be focused on direct intervention with children. Child welfare work typically includes foster care, child protection services, in-home preservation services and adoption. 1

Children with special health care needs (CSHCN)

As defined at the federal level, this population of children has or is at increased risk for chronic physical, developmental, behavioral, or emotional conditions requiring health and related services of a type or amount beyond that required by children generally. 1

Children’s Health Act

Reauthorizes SAMHSA programs that work to improve mental health and substance abuse services for children and adolescents. It also provides SAMHSA the authority to implement proposals that give U.S. states more flexibility in how they use block grant funds, with accountability based on performance. 18

Chore service

These tasks enable a client to remain in the home. Tasks include heavy housework, periodic cleaning, professional extermination and snow removal, and the task must be the responsibility of the client and not the responsibility of the landlord. Emergency response systems (ERS), such as electronic devices enabling the client to secure help in an emergency by activating the “help” button, are also available under this service. 1

Client Assistance Program (CAP)

Designed to inform and advise all Vocational Rehabilitation clients and applicants about the benefits available under the Federal Rehabilitation Act of 1973, as amended by the Workforce Innovation and Opportunity Act, and to assist clients in securing those services. 1

Commission on Accreditation of Rehabilitation Facilities (CARF)

CARF International, a group of companies that includes CARF Canada and CARF Europe, is an independent, nonprofit accreditor of health and human services. Through accreditation, CARF assists service providers in improving the quality of their services, demonstrating value and meeting internationally recognized organizational and program standards. 19

Community Mental Health Services (CMHS) Block Grant

The Community Mental Health Services Block Grant (MHBG) program makes funds available to all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands and 6 Pacific jurisdictions to provide community mental health services. 20

Congregate care

A placement setting that consists of 24-hour supervision for children in highly structured settings, such as licensed group homes, child care institutions, residential treatment facilities or maternity homes. 1

Congregate meals

A service that provides meals that assure a minimum of one-third of the recommended dietary allowances for a client who will be eating in a group setting. 1

Continuing care retirement community (CCRC)

Continuing care retirement communities, also known as CCRCs or life plan communities, are a long-term care option for older people who want to stay in the same place through different phases of the aging process. The chief benefit of CCRCs is that they provide a wide range of care, services and activities in one place, offering residents a sense of stability and familiarity as their abilities or health conditions change. 21

Continuum of care

A functional philosophy that seeks to ensure clients receive the right service in the right place at the right time. 1

Co-occurring disorders (COD)

The combination of one or more mental disorder and one or more substance-related disorder. 1

Corporate guardianship

A service purchased on behalf of individuals eligible for developmental disabilities program management services when a district court has determined the individual requires a guardian and no one else is available to serve as guardian. 1

Crisis residential units (CRU)

Crisis residential units provide generally short-term stabilization and support to individuals diagnosed with mental illness and/or chemical dependence who are experiencing crisis as a result of exacerbation of symptoms. 1

Custodial parent

The parent who has primary residential responsibility for a child. 1


Day habilitation (day supports)

This type of support is available through the Traditional IID/DD HCBS Waiver to qualifying individuals. Day habilitation services are provided in a nonresidential setting and include scheduled activities, formalized training and staff support that promote community participation, development of self-help skills and improved sensory-motor, cognitive, communication and social interaction skills. 1

Day treatment

A substance use disorder treatment program of clinically intensive programming with direct access to psychiatric, medical and laboratory services. Also known as partial hospitalization. 1

Dementia care services program

A program that provides care consultation and training to caregivers, medical personnel, law enforcement and the general public to address the unique and individual needs that arise throughout various stages of dementia. 1

Developmental Disabilities Assistance and Bill of Rights Act

In every state and territory, programs authorized by the Developmental Disabilities Assistance and Bill of Rights Act (DD Act) empower individuals with developmental disabilities and their families to help shape policies that impact them. 22

Developmental disability

Refers to a severe chronic disability of an individual which is caused by a mental or physical impairment or a combination of mental and physical impairments, including Down syndrome; is displayed before an individual reaches age twenty-two; is likely to continue indefinitely; and results in substantial functional limitations in three or more of major life activity areas. 23

Disability Determination Services (DDS)

Disability Determination Services makes eligibility decisions for Social Security Disability Insurance and Supplemental Security Income so that eligible individuals can receive disability benefits. This is part of the Department of Human Services. 1


A program that provides families with short-term emergency benefits and services during a “specific crisis or episode of need” for up to four months who would otherwise qualify for Temporary Assistance for Needy Families (TANF). 1

Down syndrome

Down syndrome is a genetic disorder caused when abnormal cell division results in an extra full or partial copy of chromosome 21. This extra genetic material causes the developmental changes and physical features of Down syndrome. 1

Drug court

Judicial court for nonviolent substance abuse offenders that includes specialized community partnerships to help the offender restore in recovery. 1

Drug Utilization Review Board (DUR Board)

Drug Utilization Review Board is a volunteer board whose makeup and duties appear in Code of Federal Regulations and subsequently in state statute. Comprised of pharmacists and physicians, the Board advises the Medicaid program on prior authorization and other pharmacy cost control and utilization matters. 1

Dual diagnosis

Diagnosed with two disorders, such as those individuals diagnosed with mental illness and chemical dependence or individuals diagnosed with mental illness and developmental disabilities. 1

Dual Diagnosis Capability in Addiction Treatment (DDCAT)

A tool for measuring the quality of treatment services for individuals with co-occurring disorders, it offers practical tools for rapid service improvement. 1

Dually eligible beneficiaries

Individuals who qualify for both Medicaid (state and federally funded health coverage for low-income persons) and Medicare (federal health coverage program for persons age 65 and older and other qualifying individuals with disabilities). 1


Early childhood education

Early childhood education consists of activities and/or experiences that are intended to effect developmental changes in children prior to their entry into elementary school. Early childhood education (ECE) programs include any type of educational program that serves children in the preschool years and is designed to improve later school performance. 24

Early Head Start

A federally funded program that serves income-eligible infants, toddlers and expectant parents. Early Head Start provides services that include prenatal development/healthy pregnancy, child development, health, nutrition, parent education/family development and parent leadership opportunities. Early Head Start reserves 10 percent of its enrollment for children with special needs. 1

Early Intervention Program for Infants and Toddlers with Disabilities

Awards formula grants to the 50 states, District of Columbia, Puerto Rico, the Department of the Interior and Outlying Areas to assist them in implementing statewide systems of coordinated, comprehensive, multidisciplinary, interagency programs and making early intervention services available to children with disabilities, newborns through age 2, and their families. Under the program, states are responsible for ensuring that appropriate early intervention services are made available to all eligible birth-through-2-year-olds with disabilities and their families, including Indian children and families who reside on reservations geographically located in the State. 25

Early Intervention Services (EIS)

Refers to a statewide program offered in the developmental disabilities system for infants and toddlers who range from newborn to three years of age who have a developmental delay, disability, or a condition that could result in substantial limitations if intervention is not provided. Intervention services are designed to help address the physical and developmental needs of children, and to augment the capacity of their families to meet their special needs. 1

Early Learning Guidelines

These voluntary guidelines are intended as a resource for parents, child care providers, pre-kindergarten and Head Start teachers, and others. They outline the skills, knowledge, and dispositions young children need prior to entering first grade. 1

Elder abuse

A single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, in which one causes harm or distress to an older person. 26

Elderly nutrition services

Services provided under the Older Americans Act that includes congregate meals (served in a group setting), home-delivered meals, nutrition counseling, nutrition screening and nutrition education. 1

Electronic Benefit Transfer (EBT) Card

Debit card used by Supplemental Nutrition Assistance Program (SNAP) participants to buy food products at grocers, farmers markets and other USDA-approved vendors. 1

Electronic health record (EHR)

Designed to reach out beyond the health organization that originally collects and compiles the information (EMRs). They are built to share information with other health care providers, such as laboratories and specialists, so they contain information from all the clinicians involved in the patient’s care. An EHR is usually not the complete EMR or medical record from each clinician involved in the patient’s care, but a snapshot or care document compiling the most recent and critical information a clinician needs at the point of care to treat the patient when he/she presents to the clinician. 1

Electronic medical record (EMR)

Digital version of a medical record or chart. Complete medical and treatment record of a patient kept by a provider in electronic format. EMRs are patient records in one practice or in various practices that all are associated with one organization. 1

Employment support

Ongoing supports to assist clients in maintaining paid employment in an integrated setting. Services are designed for clients who need intensive ongoing support to perform in a work setting. Service includes on-the-job or off-the-job employment-related support for clients needing intervention to assist them in maintaining employment, including job development. Employment support includes individual and small group employment support. 1

English language learners (ELL)

People who are learning English. Another related term commonly used is English as a Second Language (ESL). 1

Environmental modification

Physical adaptions to the home necessary to ensure the health, welfare and safety of a client or that enable a client to function with greater independence in his/her home. 1

Evidence-based program

Disease prevention and health promotion programs and activities funded under the Older Americans Act, which have demonstrated through evaluation to be effective for improving the health and well-being or reducing disease, disability and/or injury among older adults. 1

Extended personal care

Includes hands-on care of a medical nature that is specific to the needs of an eligible individual and will enable an individual to live at home. This service is provided by a Qualified Service Provider (QSP), and to the extent permitted by state law, is care that would otherwise be provided by a nurse. A nurse licensed to practice in the state will provide training to a QSP who is approved by the Department to provide the required care and will provide, at a minimum, a review of the client’s needs every six months to determine if additional training is required. Activities of daily living (ADL) and instrumental activities of daily living (IADL) are not a part of this service. 1


Family Caregiver Support Program

Federally funded under the Older Americans Act, this Aging Services program offers help to informal (unpaid) caregivers providing 24-hour care for an adult age 60 and older, or an individual with Alzheimer’s disease or a related dementia, regardless of the age of the person with dementia, or caregivers age 55 or older and caring for a grandchild or relative child who is age 18 or younger or for an adult child with a disability who is between 19 and 59 years of age. Services include information and referral, assistance from a Human Services trained caregiver coordinator to help caregivers assess needs and access support services, individual and family counseling, support groups, training and respite care to allow caregivers temporary relief from providing 24-hour care. 1

Family home care

The purpose of family home care is to assist individuals to remain with their family members and in their own communities. It provides an option for an individual who is experiencing functional impairments, which contribute to their inability to accomplish activities of daily living. 1

Family personal care

This helps individuals remain with their family members and provides extraordinary care payments to the legal spouse of a recipient for the provision of personal care or similar services. 1

Family subsidy

A program that may reimburse a family for excess expenses related to their child’s disability. This offers support to enable families to keep their children in their homes when lack of financial support would make it very difficult for families to care for their children at home. A child may be eligible for this program through age 21. 1

Family support services

Family Support helps families access a broad array of supports and services, including formal supports (such as paid respite care) and informal supports (such as parent-to-parent connections) and a community system of services that promote the well-being of families and their children with special needs. 27

Family support services – in-home support

Refers to services that are provided for qualifying individuals with developmental disabilities to enable them to remain in appropriate home environments. Services are based on the primary caregiver’s need for support in meeting the health, safety, developmental and personal care needs of their family member. Personal care needs include activities of daily living such as eating, bathing, dressing and personal hygiene. 1

Federal Child and Dependent Care Tax Credit (CDCTC)

The Federal CDCTC helps families meet their child and dependent care expenses. Families can use any type of child care (such as a center, family child care [FCC home or a neighbor or relative’s house). The care must have been provided for one or more qualifying persons (dependent child age 12 or younger when the care was provided). 28

Federal Medical Assistance Percentage (FMAP)

Federal Medical Assistance Percentage is the federal matching rate for the Medicaid program. FMAP is evaluated annually on October 1 and is based upon the three-year average of North Dakota’s per capita personal income as compared to the three-year average of the national per capita personal income. 1

Federal Regulation 42 Code of Federal Regulations Part 8

Provides for accreditation and certification-based system for opioid treatment programs. 18


This is the degree of adherence to essential elements in the implementation of evidence-based clinical practice. Programs with high fidelity are expected to have greater effectiveness in achieving desired client outcomes. 1

First-episode psychosis

First-episode psychosis is the first time someone experiences psychotic symptoms or a psychotic episode. 1

Food and Nutrition Service (FNS)

A federal agency of the United States Department of Agriculture that, among other duties, administers the Supplemental Nutrition Assistance Program. 1

Foster care group homes

A licensed or approved residence in which foster care is regularly provided for unrelated children. Foster care group homes are licensed by the Children and Family Services Division. 1


Good Start, Grow Smart

The federal initiative that encouraged states to develop early learning guidelines, professional development systems and quality rating systems and required Head Start programs to demonstrate progress in children’s learning. 1


Head Start

This is a federally funded program for families with preschool-age children who meet income eligibility guidelines. Head Start is family-focused and provides early literacy, education, child development, child health services (dental, physical, social-emotional, nutrition), parent education and support services. 1

Health Information Technology for Economic and Clinical Health Act (HITECH)

Enacted as part of the American Recovery and Reinvestment Act of 2009, the HITECH Act promotes the adoption and meaningful use of health information technology. 1

Health Insurance Portability and Accountability Act (HIPAA)

Health Insurance Portability and Accountability Act of 1996 [Pub. L. 104-191; 110 Stat. 1936; 42 U.S.C. 1301 et seq. that, among other things, standardizes the format of certain health care information that is transmitted electronically and regulates the release of health care information. HIPAA impacts entities (and their computer systems) that handle individual health care information and provides penalties for its wrongful disclosure. HIPAA also establishes several fraud and abuse control programs and makes revisions to the current sanctions and criminal law. 1

Home- and community-based services (HCBS)

Home and community-based services refers to the array of services that are essential and appropriate to sustain individuals in their homes and communities and to delay or prevent institutional care. 1

Home- and community-based services waiver

Within broad Federal guidelines, States can develop home- and community-based services waivers (HCBS Waivers) to meet the needs of people who prefer to get long-term care services and supports in their home or community, rather than in an institutional setting. States can offer a variety of unlimited services under an HCBS Waiver program. Programs can provide a combination of standard medical and nonmedical services. Standard services include but are not limited to case management (e.g., supports and service coordination), homemaker, home health aide, personal care, adult day health services, habilitation (both day and residential) and respite care. 29

Home-delivered meal

A service that provides meals that assures a minimum of one third of the recommended dietary allowances for an individual who is homebound. 1

Homemaker service

This service allows an individual to maintain or develop the independence needed to remain in the home. Tasks include housekeeping, laundry and shopping. 1


Illness management and recovery (IMR)

An evidence-based curriculum that assists individuals with psychiatric symptoms to develop personalized strategies for managing their illness and moving forward in their lives. 1

Inclusion support program

A support program that offers technical assistance and consultation for child care and preschool providers who care for children with special needs, as well as grants to support the staffing and environmental needs specific to the individual needs of children with developmental delays or disabilities in care. 1

Independent living

Independent living is for seniors who are able to live on their own in an apartment or house, but who want the conveniences of living within a community that provides services and amenities such as housekeeping, social activities, dining, transportation, security or the option of assistance with daily tasks or medical care if they need it later on.30

Independent living services

Services that eliminate barriers and provide assistance to individuals with disabilities so they can live and work more independently in their homes and communities. 1

Indian Health Service

An agency within the U.S. Department of Health and Human Services that is responsible for providing federal health services to Native Americans and Alaska Natives. The provision of health services to members of federally-recognized tribes grew out of the special government-to-government relationship between the federal government and Indian tribes. 1

Individualized Plan for Employment (IPE)

Individualized Plan for Employment. It describes the nature and scope of rehabilitation, employment and training services provided to an individual with a disability to help that individual reach his or her employment goal. A vocational rehabilitation counselor helps the client write the IPE. 1

Individuals with Disabilities Act Part C (now listed as simply “Part C”)

A section within the federal law of the Individuals with Disabilities Education Act (IDEA) [Pub. L. 94-142; 84 Stat. 175; 20 U.S.C. � 1400 et seq. that entitles a child under the age of three years and their family to certain supports, services and rights. Part C provides federal financial assistance to states to develop and implement a collaborative statewide system of services for these children and their families. 1

Individuals with Disabilities Education Act (IDEA)

A law that makes available an appropriate public education to eligible children with disabilities at no cost. 1

Infant development

Home-based, family focused services that provide supports to families of eligible infants and toddlers with or at high risk for developmental delays or disabilities. An Individual Family Service Plan is developed to identify services and learning opportunities that support the family in meeting the needs of their child, enhance their child’s development and increase the child’s and family’s participation in everyday routines and activities within the home and community. An eligible child may receive infant development services until he or she is three years of age. 1

Institutional child abuse or neglect

Situations of known or suspected child abuse or neglect in which the institution responsible for the child’s welfare is a residential child care facility, a treatment or care center for the intellectually disabled, a public or private residential educational facility, a maternity home or any residential facility owned or managed by the state or a political subdivision of the state. 1

Instrumental activities of daily living (IADL)

Complex life activities routinely performed by an individual, such as meal preparation, shopping, managing money, doing housework, laundry, taking medicine, using the telephone and mobility outside the home. 1

Integrated dual disorder treatment (IDDT)

Integrated dual disorder treatment is an evidence-based practice that improves the quality of life of people with co-occurring mental and substance use disorders by promoting consumer and family involvement in service delivery, stable housing as a necessary condition of recovery, and employment as an expectation for many. The IDDT model integrates mental health and substance abuse services utilizing treatment that combines pharmacological, psychological, educational and social interventions to address the needs of consumers and their families and other support system members. The implementation of IDDT promotes systemic, organizational and clinical change. 1

Integrated treatment

The skills and techniques used by treatment providers to comprehensively address both mental health and substance abuse issues in people with co-occurring disorders. 1

Intellectual disability

Is a condition diagnosed by age 18 and characterized both by a significantly below-average score on a test of mental ability or intelligence and by limitations in the ability to function in areas of daily life such as communication, self-care and getting along in social situations and school activities. 31

Intensive in-home family therapy services

Services provided at some of the Department’s human service centers and under contract with a private agency to families who have at least one child at risk of out-of-home placement. The program’s purpose is to preserve the family, prevent foster care and assist with family reunification of children who are placed in foster care. 1

Intensive outpatient program (IOP)

A level of substance use disorder treatment that provides a combination of individual and group therapy. 1

Intensive supported living arrangement (ISLA)

Staffed supported living arrangements for people who need maximum support service. 32

Intermediate care facility (ICF)

Intermediate care facility for individuals with intellectual disabilities is a residential facility operated pursuant to federal regulations and serving people with developmental disabilities and related conditions. The programming provided is for individuals with extensive needs. Each client must receive a continuous active treatment program, which includes an aggressive and consistent program of training, health services and related services so that the client acquires the ability to function with as much self-determination and independence as possible. 1

Interstate Compact on Adoption and Medical Assistance (ICAMA)

Interstate Compact on the Placement of Children relates to the placement of foster children across state lines. 1

Interstate Compact on the Placement of Children (ICPC)

Job Opportunities and Basic Skills program provides vocational training and employment for eligible individuals through TANF for the purpose of entering or reentering the job market. The Department of Human Services program contracts with Job Service North Dakota, Community Options and Turtle Mountain Tribal Employment and Training to provide JOBS program services. 1


Job Opportunities and Basic Skills

Job Opportunities and Basic Skills program provides vocational training and employment for eligible individuals through TANF for the purpose of entering or reentering the job market. The Department of Human Services program contracts with Job Service North Dakota, Community Options and Turtle Mountain Tribal Employment and Training to provide JOBS program services. 1

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

The mission of The Joint Commission is to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. 34

Just-in-time scheduling

A scheduling management tool used to ensure new clients have access to psychiatric medication appointments by eliminating overbooking and missed appointments. 1


Kinship care

A Temporary Assistance for Needy Families (TANF) program that allows relatives, with supportive services, to provide care and protection to children who are under the care, custody and control of county social services and who would otherwise be in foster care. 35


Licensed child care center

Care for 19 or more children in a facility, depending on usable space and staff-to-child ratio. Children are often grouped by age. 1

Licensed child care providers

Are required to maintain at least minimum standards related to physical size of the facility, safety features, cleanliness, staff qualifications and staff-to-child ratios. See the definitions of the licensed child care provider categories: licensed family child care, licensed group child care, licensed child center, licensed preschools, licensed school-age programs and multiple license facility. (Unlicensed child care provider categories include self-declared providers, formerly called “self-certified,” approved relative providers and registered in-home providers.) 1

Long-term care facility

A skilled nursing facility/nursing home, basic care facility, assisted living facility or swing bed hospital unit. Common usage generally equates it to a nursing facility. 1

Long-term care ombudsman

A person who identifies, investigates and resolves complaints made by or on behalf of residents of long-term care facilities and tenants of assisted living facilities. The ombudsman also works in other ways to protect the health, safety, welfare and rights of residents. 1

Long-term services and supports (LTSS)

Millions of Americans, including children, adults and seniors, need long-term care services because of disabling conditions and chronic illnesses. Medicaid is the primary payer across the nation for long-term care services. Medicaid allows for the coverage of these services through several vehicles and over a continuum of settings, ranging from institutional care to community-based long-term services and supports (LTSS). 36


Managed care

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. 37


Medical Assistance, commonly referred to as “Medicaid,” provides medical assistance to certain specified groups of needy low-income individuals as defined by federal law. 1

Medicaid expansion

Authorized by the Affordable Care Act and approved by the North Dakota Legislature in 2013, the Medicaid Expansion program provides health coverage to individuals between the ages of 19 and 64, with incomes below 138% below the FPL, regardless of disability, assets and other factors that are usually taken into account in Medicaid eligibility decisions. 1

Medicaid Waiver for Home- and Community-Based Services

A program authorized by federal law that funds in-home and community-based services to individuals who meet Medicaid eligibility standards and require the level of care provided in a nursing facility. This waiver combines the previously separate waivers for aged and disabled and traumatic brain injury populations. The waiver’s goal is to adequately and appropriately sustain individuals in their own homes and communities and to delay or divert institutional care. The waiver provides service options for a continuum of home and community-based services in the least restrictive environment. 1

Medical Assistance

Medical Assistance, commonly referred to as “Medicaid,” provides medical assistance to certain specified groups of needy low-income individuals as defined by federal law. 1

Medicare Prescription Drug Program (Medicare Part D)

The federal Medicare Prescription Drug Program that provides Medicare beneficiaries with access to prescription drug coverage from a choice of private plans. 1

Medicare Savings Programs

Medicaid coverage that pays all or part of the Medicare premiums, deductibles and co-insurance for qualified Medicare beneficiaries, specified low-income Medicare beneficiaries and qualifying individuals. 1

Medication-assisted treatment

The proper term for describing treatment medications rather than “opioid replacement” or “methadone maintenance”. 38

Memory care

Memory care is a distinct form of long-term skilled nursing that specifically caters to patients with Alzheimer’s disease, dementia and other types of memory problems. Also called special care units (SCUs), memory care units usually provide 24-hour supervised care within a separate wing or floor of a residential facility. 39

Mental health conditions

A mental illness is a condition that affects a person’s thinking, feeling or mood. Such conditions may affect someone’s ability to relate to others and function each day. 40

Mental Health Parity and Addiction Equity Act (MHPAEA)

A federal law that generally prevents group health plans and health insurance issuers that provide mental health and substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical coverage. 41

Modified adjusted gross income (MAGI)

MAGI is a methodology used to calculate eligibility for Medicaid (including Medicaid Expansion) and the Children’s Health Insurance Program (CHIP). MAGI methodology was part of the Affordable Care Act, intended to have a consistent eligibility methodology across health care coverage, including Medicaid, CHIP and the federal marketplace. 1

Money Follows the Person (MFP)

Money Follows the Person is a federal grant that supports the transition of qualifying Medicaid-eligible individuals from institutional settings to home- and community-based long-term services. 1


National Core Indicators (NCI)


National Medical Support Notice (NMSN)

National Core Indicators (NCI) is used across states to assess the quality and outcomes of Developmental Disability (DD) services provided to individuals with IDD and their families. NCI offers valid, reliable, person-centered measures that states use to demonstrate how publicly funded supports are impacting people’s lives and to determine where they can improve the quality of those supports. 1

National Survey on Drug Use and Health (NSDUH)

Federally-mandated form used by the Child Support Division to enforce a medical support order when employer-sponsored health insurance is available to the obligor. Upon receipt of the NMSN, the employer has requirements to enroll the child and withhold premiums. 43

National Youth in Transition Database (NYTD)



Conducted by the U.S. Department of Health and Human Services, the NSDUH is an annual survey conducted in all fifty states that provides data on tobacco, alcohol and drug use in the United States. 1

Nonmedical transportation

Transportation that enables individuals to access essential community services, such as grocery stores, pharmacies, banking, post office, laundromat, utility company, social services and the Social Security office, in order to maintain themselves in their home. Nonmedical transportation escort is solely accompanying the client for the purpose of assisting in boarding and exiting, as well as during transport, in order that the client may complete the activity for which (nonmedical) transportation is authorized. 1

Nursing facility level of care determination

Nursing facility level of care determination is an assessment based on established criteria of an individual’s medical needs. A determination must be completed before an individual can receive Medicaid funded nursing facility services or home and community-based services through the Medicaid Waiver for Home and Community Based-Services. 1



The person to whom a child support obligation is owed. It may also be an entity to which a child support obligation is owed. 1


The person who is obliged to play child support. 1

Occupational therapy (OT)

Occupational therapy involves the assessment of an individual’s physical state and capabilities. The goal is to maintain the patient’s maximum degree of independence, given that person’s current limitations. Following a thorough assessment of the patient and that patient’s surroundings in the home (whether it’s their own or a facility of some kind), the occupational therapist will recommend, if need be, specialized equipment (e.g., a wheelchair, cane, walker) or training (such as driver rehabilitation) that will benefit patient. 13

Older Americans Act (OAA)

The Older Americans Act as amended 2016 provides federal funding for services to older persons, especially those who are low-income, socially needy, frail or minority persons. Among the services offered are caregiver services, elderly nutrition services, supportive services, Long-Term Care Ombudsman program, Vulnerable Adults Protective Services and the Aging and Disability Resource LINK. 1

Olmstead Decision

1999 legal decision that held that unjustified institutionalization or segregation of disabled individuals is discrimination and a violation of the ADA. 45

Open access

A clinic management model that offers assessments without appointments and immediate treatment for individuals with the greatest need. This results in quicker access for the client and reduces client “no shows” for assessments. Open access is being rolled out across the Department’s human service centers in North Dakota. 1


Any drug with the natural derivative of opium or synthetic psychoactive substance that relieves pain and has the capability to create physical dependence. Examples of these categories include morphine, codeine (natural); hydrocodone, oxycodone, the illicit drug heroin (semi-synthetic), fentanyl and methadone (synthetic). In addition to euphoric effects, which may lead to recreational use and addiction, these substances can also cause respiratory depression resulting in death by overdose. 1

Opioid treatment program (OTP)

A substance abuse treatment program that specializes in treating individuals addicted to opioids. These highly regulated programs provide counseling and dispense medications approved for the treatment of opioid addiction. 1

Options counseling

Under the Aging and Disability Resource LINK (ADRL), a service that provides a person-centered, interactive, decision-support process whereby consumers, family members and/or significant others are supported in determining appropriate long-term care choices based on the consumer’s needs, preferences, values and individual circumstances. 1

Outpatient treatment

Outpatient rehabs are part-time programs, allowing the recovering user to keep going to work or school during the day. Outpatient recovery programs usually require 10 to 12 hours a week spent visiting a local treatment center. These sessions focus on drug abuse education, individual and group counseling and teaching addicted people how to cope without their drug. Outpatient drug rehab can be a good standalone option for someone with a mild addiction, or it can be part of a long-term treatment program. 46


Parent aides

Individuals who, through training and support, work with parents who are at risk of abusing or neglecting their children. The Department’s human service centers and county social service boards employ the aides. 1

Parent who does not have primary residential responsibility

Formerly known as noncustodial parent (NCP). For child support purposes, this is the parent who does not have primary care, custody and control of the child(ren) or, if a court has made a custody determination, the parent who does not have legal custody of the child(ren). If child support is ordered, this parent may also be referred to as an obligor. 1

Participant-directed service (self-directed services)

Sometimes called self-directed supports, this option gives the individual the most control over his or her services and supports and also the most responsibility. 1

Patient Protection and Affordable Care Act (PPACA; Affordable Care Act; ACA; Obamacare)

Also known as Affordable Care Act. Federal legislation signed into law in March 2010, which included a provision for states to expand the Medicaid program along with implementing other health-related provisions. 1

Payment Error Rate Measurement (PERM)

Payment Error Rate Measurement is an examination of selected Medicaid and CHIP provider claims and recipient eligibility requirements to determine if a service is required and the beneficiary is eligible. 1

Peer support services

Services provided by an individual with lived experience. 1

Peer support specialist

An occupational title for a person with lived experience providing services. 1

Personal care service

A service that provides assistance with bathing, dressing, toileting, continence, transferring, mobility in the home, eating, personal hygiene, passive range of motion exercises and simple bandage changes. When specified within the plan of care, this service may also include cueing or prompting and/or housekeeping tasks, such as bed-making, dusting and vacuuming, which are incidental to the care furnished or which are essential to the health and welfare of the individual, rather than the individual’s family. 1

Preadmission screening and resident review (PASRR)

Preadmission screening and resident review is a federal requirement that every person who seeks admission to a nursing facility be screened by the state for evidence of intellectual disability or mental illness. If either exists, the screening is intended to determine if nursing facility care is necessary, and if so, to determine if specialized services are needed. 1

Pre-employment transition services

Services that support students with disabilities as they transition from high school to adult life. The services give students an introduction to work in a vocation of their choosing, help them develop positive work habits and obtain work experience that will make them ready to accept employment after high school graduation. 1

Preschool programs

Preschool is an early childhood program in which children combine learning with play in a program run by professionally trained adults. Children are most commonly enrolled in preschool between the ages of three and five, though those as young as two can attend some schools. Preschools are different from traditional day care in that their emphasis is learning and development rather than enabling parents to work or pursue other activities. 47

Prevention activities

Activities with goals of eliminating or reducing the factors that cause or predispose individuals to increased risk, disease, problems or disabilities. 1

Prevocational services

Formalized training, experiences and staff supports designed to prepare clients for paid employment in integrated community settings. Services are structured to develop general abilities and skills that support employability in a work setting. Services are not directed at teaching job-specific skills, but at specific habilitative goals outlined in the client’s person-centered service plan. 1

Prime-time child care

A prevention program designed to provide temporary child care to families at risk of neglecting or abusing their children. 1

Program of All-Inclusive Care for the Elderly (PACE)

Program of All-inclusive Care for the Elderly is a managed care program providing patient-centered, coordinated care to frail elderly individuals who are eligible for Medicare and Medicaid. The goal is to meet individual health needs through a care team so participants can remain living independently in the community. 1

Psychiatric residential treatment facility (PRTF)

A facility or a distinct part of a facility that provides children and adolescents with a 24-hour, therapeutic environment integrating group living, educational services and a clinical program based upon a comprehensive, interdisciplinary clinical assessment and an individualized treatment plan that meets the needs of the child and family. 1


Qualified Medicare beneficiaries (QMB)

Qualified Medicare beneficiaries are persons for whom Medicaid pays the Medicare premiums, deductibles and co-insurance. Income cannot exceed 100 percent of the poverty level. 1

Qualified rating and improvement system

A method to assess (initially and ongoing), improve and communicate the level of quality in early childhood care and education settings. 1

Qualified service provider (QSP)

An agency or independent contractor that agrees to meet standards for services and operations established by the Department of Human Services to provide home and community-based long-term care services. Home and community-based services are provided to older adults and individuals with physical or intellectual disabilities. 1

Qualifying individual (QI)

Qualifying Individuals are individuals for whom Medicaid pays their Medicare Part B premium. Income must be between 120 percent and 135 percent of poverty level. They cannot be otherwise covered by Medicaid to receive benefits. 1


Recovery Audit Contractor (RAC)

The Medicare Fee for Service (FFS) Recovery Audit Program’s mission is to identify and correct Medicare improper payments through the efficient detection and collection of overpayments made on claims of health care services provided to Medicare beneficiaries, and the identification of underpayments to providers so that the CMS can implement actions that will prevent future improper payments in all 50 states. 48

Recovery management (RM)

The philosophical framework for organizing substance use disorder treatment services to provide prerecovery identification and engagement, recovery initiation and stabilization; long-term recovery maintenance; and quality of life enhancement for individuals and families affected by severe substance use disorders. RM has several cornerstone beliefs that distinguish the recovery management model from acute-care models of addiction treatment that address the disease of addiction as a chronic primary illness, requiring long-term recovery approaches. The belief is that recovery begins with hope, not abstinence. 1

Refugee Cash Assistance

A benefit program available for the first eight months that qualifying refugees are living in the United States. 1

Refugee Medical Assistance

Refugee Medical Assistance provides up to eight months of medical assistance for qualifying newly arriving refugees. The program is 100 percent federally funded. 1

Rehabilitation Services Administration (RSA)

The federal oversight agency responsible for the Rehabilitation Act (Vocational Rehabilitation services). 1

Report of suspected child abuse or neglect

Information received by Child Protective Services concerning the suspected maltreatment of a child. 1

Reserved Waiver Capacity

The state may reserve a portion of the participant capacity for specified purposes, such as community transition of institutionalized persons or for individuals who may experience a crisis. 1

Residential care

Services provided in a facility in which at least five unrelated adults reside, and in which personal care, therapeutic, social and recreational programming are provided in conjunction with shelter. This service includes 24-hour on-site response staff to meet scheduled and unpredictable needs and to provide supervision, safety and security. 49

Residential child care facility (RCCF)

Children’s residential facilities (CRF) provide temporary care or treatment to children in a group setting when not living with a parent or guardian. Services include supervision, food, lodging, training, education or treatment. 50

Respite care

Temporary relief to a primary caregiver for a specified period of time. The caregiver is relieved of the stress and demands associated with continuous daily care. 1

Rett syndrome

Rett syndrome is a rare noninherited genetic neurological disorder that affects 1 in 10,000 females (and even fewer males) and begins to display itself in missed milestones or regression at 6 to 18 months. Rett syndrome leads to severe impairments, affecting nearly every aspect of life: ability to speak, walk, eat and breathe easily. The hallmark of Rett syndrome is near constant repetitive hand movements while awake. 51



People with intellectual and/or developmental disabilities must have the right to – and be supported to – act as self-advocates. Self-advocates exercise their rights as citizens by communicating for and representing themselves, with supports in doing so, as necessary. This means they have a say in decision-making in all areas of their daily lives and in public policy decisions that affect them. 52

Senior Community Services Employment Program

Funded under the Older Americans Act, this program provides career counseling, training and community service work experience to help low-income persons age 55 and older to secure meaningful employment. 1

Senior companion services

A service that offers periodic companionship and nonmedical support by volunteers (who receive a stipend) to adults with special needs. 1

Serious emotional disability (SED)

A child with a serious emotional disability shall have emotional or social functioning which prevents the child from receiving reasonable educational benefit from general education. 53

Serious mental illness (SMI)

Serious mental illness (SMI) is defined as a mental, behavioral or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI. 54

Skilled nursing facility

By definition, a skilled nursing facility is a health care institution that has at least one full-time registered nurse (many facilities have much more than this on staff at any given time) as well as a doctor, provides nursing care 24 hours a day and has a place to store and dispense medication. The staff at skilled nursing facilities also help with meals and personal hygiene. Many times, patients go to a skilled nursing facility after being released from the hospital so that they can recover or heal from an injury, illness or surgery. They remain at skilled nursing facilities until they are well enough to go home. Skilled nursing facilities frequently meet the criteria for Medicare. 55

Social Security Administration (SSA)

The Social Security Administration (SSA) is a U.S. government agency that administers social programs covering disability, retirement and survivors’ benefits. 56

Social Security Disability Insurance (SSDI)

Social Security Disability Insurance 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. 57

Social Services Block Grant (SSBG)

The Social Services Block Grant (SSBG) is a flexible funding source that allows states and territories to tailor social service programming to their population’s needs. Through the SSBG, states provide essential social services that help achieve a myriad of goals to reduce dependency and promote self-sufficiency; protect children and adults from neglect, abuse and exploitation; and help individuals who are unable to take care of themselves to stay in their homes or to find the best institutional arrangements. 58

Special needs

Refers to the needs of children who have, or are at risk of developing, a developmental, emotional, behavioral, learning or physical condition that requires attention, services and/or program modifications beyond what is generally needed by other children. 1

Specialized equipment and supplies

Includes devices, controls or appliances specified in the plan of care, which enable recipients to increase their abilities to perform activities of daily living or to perceive, control or communicate with the environment in which they live. 1

Special-needs adoption

Adoption of children who have special needs. Children’s requirements to qualify for Federal Adoption Assistance vary by state. 59

Specified Low-Income Medicare Beneficiaries (SLMB)

Specified Low-Income Medicare Beneficiaries are persons for whom Medicaid pays the Medicare Part B premium. Income must be between 100 percent and 120 percent of the poverty level. 1


Also referred to as detoxification or, informally, “detox.” This refers to the process of removing toxic substances from the human body. 60

State child protection team (interdisciplinary team; case consultation team)

A multidisciplinary team of staff members from public and private agencies (determined by law) that makes the determination whether child abuse or neglect is indicated in cases of suspected institutional child abuse or neglect. 1

State Opioid Treatment Authority

The Department of Human Services regulates the establishment and ongoing operation of opioid treatment programs statewide. 1

Strategic Prevention Framework – Partnerships for Success Grant (SPF-PFS)

A SAMHSA five-year federal discretionary grant designed to address the prevention priority of underage drinking among persons ages 12 to 20. The program is based on the premise that changes at the community level will, over time, lead to measurable changes at the state level. 1

Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS)

Structured Psychotherapy for Adolescents Responding to Chronic Stress is a group intervention specifically designed to address the needs of chronically traumatized adolescents who may still be living with ongoing stress and are experiencing problems in several areas of functioning. These include difficulties with regulation and impulsivity, self-perception, relationships, dissociation, numbing, avoidance, and struggles with their own purpose and meaning in life, as well as world views that make it difficult for them to see a future for themselves. Program goals include helping teens cope more effectively, enhance self-sufficiency, connect with others and establish supportive relationships, cultivate awareness and create meaning. 1

Substance Abuse and Mental Health Services Administration (SAMHSA)

Substance Abuse and Mental Health Services Administration is an agency of the U.S. Department of Health and Human Services (DHHS) that focuses on programs and provides funding to improve the lives of people with or at risk for mental and substance abuse disorders. 1

Substance abuse counselor

The substance abuse counselor is a mental health counselor specializing in treating patients who have a chemical dependency on drugs or alcohol. Whether counseling addicts or those who fear they will become addicts, a substance abuse counselor works with their client to help overcome dependencies and become self-sufficient. The substance abuse counselor may also work closely with the family of the client as substance abuse inevitably affects the loved ones of the chemically dependent person. Substance abuse counselors are not able to prescribe medicine or give medical or psychological therapy. Rather, they work with the client in an advocacy and mentoring capacity. 61

Substance abuse prevention and treatment funds (SAPT)

The Substance Abuse Prevention and Treatment Block Grant (SABG) program provides funds to all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, 6 Pacific jurisdictions and 1 tribal entity to prevent and treat substance abuse. 62

Substance use disorder (SUD)

Substance use disorder is a complex brain disease and includes such diseases as alcoholism and drug addiction. Substance use disorders occur when a person has a dependence on alcohol and or other drugs that is accompanied by intense and sometimes uncontrollable cravings and compulsive behaviors to obtain the substance. 1

Supervised group housing

Trained staff members are present 24/7 to provide care and assistance with things such as medication, daily living skills, meals, paying bills, transportation and treatment management. These group homes provide their residents with their own bed, dresser and closet space and shared bathrooms and common areas. This may be the best type of housing for people experiencing a serious mental illness which may affect their ability to perform their daily tasks. 63

Supplemental Nutrition Assistance Program (SNAP)

Supplemental Nutrition Assistance Program. This federally funded USDA program is intended to raise levels of nutrition among low-income households by supplementing their food purchasing power with monthly benefits distributed through an electronic benefit card. Formerly called the Food Stamp program. 1

Supplemental Security Income (SSI)

SSI stands for Supplemental Security Income. Social Security administers this program. Monthly benefits are paid to people with limited income and resources who are disabled, blind or age 65 or older. Blind or disabled children may also get SSI. SSI is financed by general funds of the U.S. Treasury – personal income taxes and corporate and other taxes. 64

Supported employment

Provides training for individuals with significant disabilities who, because of the severity of their physical or mental impairments, have never been employed or have a history of sporadic employment. Individuals served by this program need ongoing intervention on or off the job in order to maintain employment. 1

Supported living arrangement (SLA)

Supported living arrangement is a residential service that provides support to people living in their own homes or apartments. Supportive services include help with budgeting, shopping, laundry, etc., and are provided on an intermittent basis, usually fewer than 20 hours per month. There is a fixed staff-to-client ratio. People receiving this service generally need less support than people receiving individualized supported living arrangement services (ISLA). 1

Swing bed

A licensed hospital bed in a rural hospital that is used to provide nursing facility level of care services to an individual who is not in need of acute care services. 1


Temporary Assistance for Needy Families (TANF)

Temporary Assistance for Needy Families is a federal block grant program established under Title IV-A of the Social Security Act. It provides temporary cash assistance to needy families primarily to facilitate the return to or preparation for work; provides supported employment for obligors not paying child support; and assists teen parents while obtaining a high school diploma or GED. It meets some of the costs of foster care such as wraparound case management, parent aid, intensive in-home services, child abuse and neglect investigations, and foster care. 1

The Council for Quality and Leadership (CQL)

Often referred to as “The Council” or “CQL,” this entity accredits providers of services for intellectually/developmentally disabled people. 1

Third-party liability (TPL)

Third-party liability describes potential resources that may be available to offset claims for Medicaid program services. TPL includes health insurance, accident insurance, court settlements and decrees stemming from accidents of various kinds. 1

Title I preschool

Many school districts support preschool programs with their Title I (Education for the Disadvantaged) funds. More than 50,000 public schools across the country use Title I funds to provide additional academic support and learning opportunities to help low-achieving children master challenging curricula and meet state standards in core academic subjects. 28

Transition services

Services provided to assist students with disabilities as they move from school to adult services and/or employment. 1

Transitional assistance

Provides up to six months of monthly job retention, transportation allowance and child care assistance for families that become ineligible for TANF due to earnings. 1

Transitional child care (TCC)

Transitional child care provides partial payment of child care to families who lose TANF assistance eligibility. 1

Transitional community living facility (TCLF)

Transitional community living facility is a community waiver group home that provides training for individuals in community integration, social, leisure and daily living skills in a group living environment. 1

Transitional living

Transitional housing takes the form of furnished, fully equipped living accommodations. These apartments provide a safe and stable space where people in recovery can transition from rehab to independent daily life. Although the environment of transitional housing is less structured than that of a typical treatment center, there are strict rules regarding behavior and responsibilities. 65

Transitional living service

Services that train people to live with greater independence in their own homes. This includes training, supervision or assistance to the individual with self-care, communication skills, socialization, sensory/motor development, reduction/elimination of maladaptive behavior, community living and mobility. 1

Transitional Medicaid benefits

Provides up to 12 months of Medicaid coverage for families who lose eligibility under the Family Coverage group due to earnings. 1

Transitional memory care

Transitional care services provide progressive assistance and a gradual transition for those with mild or early stage memory loss from assisted living to memory care. 66

Traumatic brain injury (TBI)

Traumatic brain injury usually results from a violent blow or jolt to the head or body. These injuries can result in long-term complications or death. 67

Tribal Contract Health Centers (Tribal 638)

Tribal Contract or Compact Health Centers (also called a 638 contract or compact) are operated by tribes or tribal organizations and Urban Indian Health Centers and are outpatient health care programs and facilities that specialize in caring for Native Americans and Alaska natives. 1

Tribal Native Employment Works (Tribal NEW)

Tribal Native Employment Works program is the tribal equivalent of the Job Opportunities and Basic Skills (JOBS) program. The job placement and education program is available to American Indian TANF recipients. 1

Tribal Temporary Assistance for Needy Families (Tribal TANF)

Tribal governments have the option of direct administration of TANF programs. 1


Unaccompanied refugee minor (URM)

Unaccompanied refugee minor is a child between the ages of birth and 18 who enters the United States with refugee immigration status and whose parents are deceased or their whereabouts are unknown, and the child is without a family connection. URM youth enter a foster care program specifically administered for their care through a voluntary agency with coordination of the Department. URM foster care meets state licensing requirements. 1

Uniform Interstate Family Support Act (UIFSA)

Laws enacted at the state level to provide mechanisms for establishing and enforcing child support obligations in intergovernmental cases. 1

Uniform Parentage Act

The Uniform Parentage Act refers to laws, based on model legislation drafted by the National Conference of Commissioners on Uniform State Laws (NCCUSL), enacted at the state level to provide mechanisms for establishing paternity. 1

Unreimbursed public assistance

Unreimbursed public assistance refers to money paid in the form of public assistance (for example, Temporary Assistance for Needy Families expenditures), which has not been recovered by retaining assigned child support. 1

Upper payment limit (UPL)

Upper payment limit is a limit placed on Medicaid spending for particular services, most notably hospitals and nursing homes. Medicaid payments to institutional providers cannot exceed what Medicare would pay for the same care. This is calculated yearly for private, state-government-owned, and non-state-government-owned facilities. There are different UPLs for different services (hospitals – inpatient and outpatient, nursing homes, psychiatric residential treatment facilities, clinics and intermediate care facilities). 1


Vocational deployment

A program of vocational preparation prior to competitive or extended employment. 1

Vocational rehabilitation services (VR, VRA)

Vocational rehabilitation provides training and employment services to individuals with disabilities so they can become and/or remain employed. Services are designed to assist business owners and employers in developing short- and long-term strategies regarding disability-related issues, including staffing; education; tapping into financial incentives associated with hiring an individual who has a permanent injury, illness or impairment; or ensuring accessibility to goods or services. 1

Voluntary Paternity Acknowledgment (VPA)

A simple civil process that may be used, by completion and filing of an Acknowledgment of Paternity, to legally establish paternity without court involvement. 1

Vulnerable adult protective services

Addresses the safety of vulnerable adults who are at risk of harm due to the presence or threat of abuse, neglect or exploitation. 1


Wraparound practice model

This is a strength-based philosophy of care utilizing a definable process of partnering with children and families to ensure their safety, permanency and well-being. The application of the Wraparound Practice Model results in a unique set of community services and supports individualized for each child and family. This process is team driven, focuses on least restrictive methods of care, and uses the family’s strengths, preferences and choices in the process whenever possible. It is a continuum of intensity, which is driven by family needs, complexity, and level of risk. All child welfare and children’s mental health programs, including contracted providers, adhere to the requirements of this model. 1