Frequently Used Terms

Advance Directives – A signed document indicating an individual’s preferences for medical treatment.

Advocate – A person who assists an individual in expressing and achieving their wants and needs.
Age of Beginner – Eligible age for kindergarten.

Americans with Disabilities Act
(ADA) – Federal statute that guarantees rights and access to people with disabilities.

Center for Medicare and Medicaid Services (CMS) (Formerly HCFA) – The federal agency that administers the Federal Medicaid Programs including the Medicaid Waiver.

Core Indicators Survey – Part of a national initiative among states to capture common quality management metrics so that information can be shared between the participating states.

Department of Public Welfare (DPW) – The Office of Mental Retardation is a program office within DPW.

Everyday Lives – Having a life which is typical of the general population and includes: being part of the community; living among family and friends but having the option of living alone; feeling safe and secure; having choice in life decisions; having control over one’s life; having dignity and status; and being recognized for abilities and gifts.

Health Care Quality Units (HCQU) – A group of healthcare and management professionals who help county mental retardation programs monitor and improve the overall health status of individuals receiving services in the county programs. There are 8 HCQUs in Pennsylvania.

Health Risk Profile (HRP) – An instrument utilized by HCSIS and designed to screen the overall health of individuals that receive MR services.

Home & Community Services Information System (HCSIS) – HCSIS is a web enabled information system and will serve as the information system for all DPW program offices that support the Home and Community-Based Services Waivers.

Independent Living – A living situation in which there is no supervision and resident lives independently.

Independent Monitoring for Quality (IM4Q) – Part of the larger Monitoring for Quality (M4Q) initiative; the IM4Q application will allow data capture and reporting for two quality management measures in OMR: the Core Indicators Survey and the Independent Monitoring survey.

Independent Monitoring Team – Team of individuals chosen to complete IM4Q monitoring survey. They are contracted by the county but are not county employees.

Intermediate Care Facilities for People with Mental Retardation (ICF/MR) – Intermediate Care Facility for the Mentally Retarded is a facility which can be operated by the State of privately and is licensed by the Department of Health. Most ICFs/MR are large facilities serving 40-400 individuals, however, there are also some ICF/MR that are homes of 4-8 people in the community.

Individual Service Plan (ISP) – A plan for each individual developed with the person and the people they choose, which will include specific services and supports, their frequency and duration. The Individual Service Plan will be the foundation for the individual budget.

Medical Assistance for Workers with Disabilities – A program that allows Pennsylvanians with disabilities to take a fulfilling job, earn more money and still keep their full medical coverage. Consumers can keep Medicaid while they work, even if their earnings increase above the limits for other Medicaid programs.

Medical Assistance or Medicaid (MA) – A federal program (Title XIX of the Social Security Act) that pays for medical services and behavioral health services for people who qualify. It also provides funding for ICF/MR and most home and community based services provided by county MH/MR programs.

MH/MR Act of 1966
– The Pennsylvania Law that created County-administered Mental Health and Mental Retardation Program which mandated the creation and provision of community Mental Health/Mental Retardation services.

Developmental Disabilities Supports:
  1. Natural Supports – Unpaid assistance to an individual. These supports can be provided by family and friends to move, go to the grocery store, carpool to work, or budget and pay bills.
  2. Community Supports – Services or organizations available within the individual’s community. Examples: YMCA, membership organizations, transportation services, job training services, advocacy groups, religious organizations, senior services, or adult education services.
Office of Developmental Disabilities – A state program office within DPW, which sets policy, allocates funds and administers services for persons with mental retardation.

Prioritization of Urgency of Need ( PUNS) – Current process for categorizing a person’s need for services.

PUNS Categories:
  1. Emergency Need – Means a person needs services immediately. An example of this is when there is a death in the family and there is no other family member available to provide support.
  2. Critical Need – Means a person needs service within one year. Some examples are when a person has an aging or ill caregiver who soon will be unable to continue providing support; there has been a death in the family or some other family crisis reducing the capacity of the caregiver to provide care; or a person has a single caregiver who would be unable to work if services are not provided.
  3. Planning for Need – When a person’s need for service is more than a year away. Examples of this are when a person is eligible for services, is not currently in need of services, but will need service if something happens; or the person or the family has expressed a desire to move; the person is living in a large setting and needs community services; or the person or caregiver wants increased supports.
Representative Payee – A person approved by the Social Security Office who voluntarily manages a person’s finances.

Respite Care
– A service that provides temporary relief to the person(s) normally responsible for the care and supervision of individuals with mental retardation. This service is limited to individuals residing in the homes of family, friends, companions, foster homes, or domiciliary homes. Service can be “overnight”, which is over 24 hours, or “temporary”, which is under 24 hours. Now known as “Respite Services”.

Risk Management
– A function within an organization that oversees and evaluates potential dangers to consumers.

– A movement which gives persons receiving services more control and responsibility in choosing how they want to live their lives.

Services and Supports Directory
– A web-based listing of providers and their services in the Home and Community Services Information System.

Social Security Disability Income
(SSDI) – Federal cash benefits and Medicare coverage to people unable to work for a year or more because of disability.

Spenddown – Medicaid regulation requiring an individual to reduce income and assets in order to be eligible for services under the various Medicaid programs.

Stakeholders – People with a vested interest.

Strong Preferences – A section of the Essential Lifestyle Plan that lists the individuals’ desires for services and supports.

Supplemental Security Income
(SSI) – Monthly federal cash benefits to people who have a substantial disability and who don’t own much or don’t have a lot of income. Individuals that receive SSI get Medicaid and may also be eligible to get food stamps.

Supported Employment – Employment of an individual who needs intensive ongoing support to perform work in a community employment setting.

Supports Coordinator
– Formerly known as Case Managers. An individual that facilitates, advocates, coordinates and monitors services for individuals with mental retardation.

Targeted Service Management – Billing of Medical Assistance funds for Supports Coordination management for persons with mental retardation.

Team - A group of people working together on behalf of an individual.

Ticket to Work
– Social Security initiative to assist individuals in obtaining gainful employment.

Vendor – An entity that provides general goods or services. Distinguishing characteristics:
  • Providing the goods/services within normal business operations.
  • Providing similar goods/services to many different purchasers.
  • Operating in a competitive environment.
  • Program compliance requirements do not pertain to the goods or services provided.