Glossary

Access Health CT: A health insurance marketplace developed by the State of Connecticut to satisfy the requirements of the federal Affordable Care Act. It offers Connecticut residents and employers a range of quality, affordable health and dental insurance options from several health insurance partners.

Accessibility: The process of creating products, Services & Supports that are usable by people with the widest range of abilities, regardless of a disability. Accessible technology enable people to live as independently as possible.

Activities of Daily Living (ADLs): Everyday tasks such as eating, bathing, dressing, using the bathroom and transferring (moving between surfaces such as bed, chair or wheelchair).

Adult Family Living: A unique housing model that allows older adults to live in a private home and still receive care. A caregiver who lives in the home or adjacent to it provides personal care.

Advance Care Planning: The process by which individuals can make decisions about their future health care when they are in a position where they cannot make or communicate their own health care choices.

Advance Directives: See Living Will / See Durable Power of Attorney.

Aging in Place: The ability for a person to live in the residence of their choice and in the community as they age.

Allied Community Resources: An organization that provides financial management services for several Medicaid Waivers and state funded programs.

Americans with Disabilities Act: A civil rights law that prohibits discrimination against individuals with disabilities in all areas of public life.

Assisted Living: A long-term care option for older adults who do not need the full array of nursing home services but who require some physical and medical support services, such as assistance with activities of daily living or memory care.

Behavioral Health: Describes the connection between behaviors, and the health and well-being of the body, mind and spirit; and the ability of the person to function in everyday life.

Care Coordinator: Someone who brings together a team of different specialists to provide a range of Services & Supports for an individual. The coordinator is also responsible for monitoring and evaluating the care delivered.

Care Plan: An action plan that outlines a person’s care needs, specifies the supports and services the person requires to meet those needs, the persons or organizations that will provide those services, and when.

Care Transitions: The coordination of providing medical and nonmedical Services & Supports during a person’s move from one setting to another.

Caregiver: Someone who provides assistance and support to someone with physical, psychological or developmental needs.

Care Manager: Someone who assesses, plans, facilitates and evaluates the Services & Supports to meet an individual’s comprehensive health needs.

Certified Nursing Assistant (CNA): Someone who assists persons with health care needs or in the performance of Activities of Daily Living. A CNA must have completed required training and competency testing in the skills required and work under the supervision of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN).

Chronic Disease: Long-lasting conditions that usually can be controlled but not cured. People living with chronic illnesses often must manage daily symptoms that affect their quality of life, and may experience acute health problems and complications that can shorten their life expectancy.

Community First Choice (CFC): Administered by the Department of Social Services (DSS), CFC is offered to active Medicaid members. This benefit allows individuals at institutional level of care to receive Services & Supports in their home .

Congregate Housing: A housing option for older adults who need minor assistance with daily activities. They reside in a semi-independent community living environment with shared dining areas, and some social and recreational activities.

Continuing Care Retirement Communities (CCRCs): Also called “Life Plan Communities,” these organizations provide a continuum of housing and health services for older adults from independent living to assisted living to nursing home care. Persons at a CCRC move between levels of care as needed.

Co-Payment: A form of cost sharing under many health insurance plans where a beneficiary must make a payment (either a fixed amount or a percentage of the cost) to supplement the amount paid by the insurer.

Cost of Living Adjustment or Allowance (COLA): A measured increase to a benefit such as Social Security benefits, made to counteract the effects of inflation.

Dementia: A term for a decrease in mental ability severe enough to interfere with daily life. Alzheimer’s Disease is the most common form of dementia.

Developmental Disabilities: Severe, long-term physical and/or mental conditions that arise at birth or during childhood and substantially restrict functioning in everyday living.

Discharge: The process of being released from a health facility.

Discharge Planner: Someone in a health facility who is responsible for ensuring that persons released from the facility go to the environment that can best care for the person with required support services in place.

Do Not Resuscitate Order (DNR Order): A type of Advance Directive in which a physician’s order written is placed in a patient’s medical record to reflect the person’s wishes that health care providers should not attempt resuscitation (often called “CPR”) if a person’s heart stops beating or the person stops breathing.

Dual Eligible: A person who is eligible for both Medicare and Medicaid benefits.

Durable Medical Equipment (DME): Equipment to provide therapeutic benefits to a person due to medical conditions or illness. Includes items such as hospital beds, wheelchairs, ventilator, oxygen system, home dialysis system and prostheses used at home for an extended period. DME may be covered by Medicaid and in part by Medicare or private insurance.

Durable Power of Attorney For Health Care: For health care is a document that names your health care proxy. Your proxy is someone you trust to make health decisions if you are unable to do so. It is also called a Health Care Power of Attorney or a Health Care Proxy.

Family Medical Leave Act: A federal law requiring employers with more than 50 employees to provide eligible workers up to 12 weeks of unpaid leave for birth, adoptions, foster care placement, and illnesses of employees and their families. Connecticut has a similar state law.

Federally Qualified Health Center (FQHC): Also called a community health center, provides primary medical, dental and behavioral health care to all people, regardless of ability to pay.

Fiscal Intermediary: An organization that assists people who receive funds from the Department of Social Services to pay for the Services & Supports they need.

For-Profit Organization: A business or other organization that aims to make a profit by developing products and services that are of value to its customers.

Geriatric Assessment: A holistic, comprehensive test designed to evaluate an older adult’s functional ability, physical health, cognition and mental health, and environment.

Home and Community Based Waivers: Also called Medicaid Waivers. A provision in federal Medicaid law allows states to “waive” rules that would normally apply to the Medicaid program. These waivers allow people to receive supports and services in their homes or communities instead of going to a nursing home.

Hospice: The process of providing care, comfort and support to individuals with life-limiting conditions as well as their families.

Individual Plan (IP): All individuals who receive ongoing Services & Supports funded by the Department of Developmental Services have an IP. An IP guides the provision of services to the individual and includes important information about where they live and work, the outcomes they want, and the steps they and their team need to take to get there.

Instrumental Activities of Daily Living (IADLs): IADLs are activities related to independent living and include preparing meals, managing money, shopping for groceries or personal items, performing housework, doing laundry and using a telephone.

Level of Care (LOC): Amount of assistance required by an individual which may determine their eligibility for programs and services.

Level of Need (LON): The Level of Need, determined by an assessment tool, correlates to an amount of funding that can be allocated to the individual for the purchase of Services & Supports.

Life Plan Communities: See Continuing Care Retirement Communities.

Life-Sustaining Treatment: Medical procedures that replace or support an essential bodily function. Life-sustaining treatments include CPR, mechanical ventilation, artificial nutrition and hydration, dialysis and certain other treatments.

Living Will: A legal document that defines medical interventions or life support measures you want or do not want at the end of life in the event that you are unable to make or communicate a health care decision.

Long-Term Care Insurance: Insurance policies that pay for long-term Services & Supports. Coverage may be denied based on health status or age. People who qualify can pay out of pocket for long-term care insurance. Benefits vary widely among policies, but most have some type of coverage for nursing home care, home care, personal care/assisted living and adult day programs.

Long-Term Care Ombudsman Program: Is responsible for investigating and resolving complaints and promoting and protecting the quality of life of residents of skilled nursing homes, residential care homes and assisted living. Also responsible for monitoring and informing federal and state policies that relate to long-term care facilities. The Long-Term Care Ombudsman Program is authorized by Title III of the Older Americans Act.

Long-Term Services & Supports (LTSS) / Long-Term Care (LTC): These terms are often used interchangeably. The general definition is the Services & Supports used by individuals of all ages with functional limitations or chronic illnesses who need assistance to perform routine daily activities such as bathing, dressing, preparing meals and administering medications. These Services & Supports can be provided in a variety of settings. Sometimes “long-term care” is used to refer to nursing home care or long-term care insurance.

Medicaid: Medicaid is a state health insurance program for low-income people. HUSKY Health encompasses Medicaid and the Children’s Health Insurance Program. In addition to providing for general and acute medical care, Medicaid can cover long-term Services & Supports in an individual’s home, as well as residential and institutional settings.

Medicaid Waivers: See Home and Community Based Waivers.

Medicare: Medicare is a federal health insurance program for people aged 65 and over and eligible people with disabilities. Medicare covers nursing home stays for not more than 100 days following a hospital stay of at least three days. Medicare coverage for home health care is limited.

Money Follows the Person (MFP): Is a federal demonstration program, administered by the Department of Social Services, that helps Medicaid eligible individuals currently living in long-term care facilities – such as nursing homes, hospitals and other qualified institutions – successfully transition back into the community.

My Place Partners: Specially trained professionals who provide local, in-person help that makes it easier for older adults, people with disabilities and their families to plan and find the Services & Supports they need to live independently.

No Wrong Door (NWD): A network built to streamline access for individuals seeking long-term Services & Supports regardless of age, income or disability. It assists individuals and their caregivers to find complete and accurate information about their options and to make informed decisions regardless of which “door,” or organization, they first contact for help.

Nonprofit Agencies: An organization dedicated to furthering a social cause or community benefit, whose profits cannot be distributed to owners but must be reinvested in the organization’s mission.

Nursing Homes: Also referred to as Institutions and Skilled Nursing Facilities.

Palliative Care: A holistic approach to the treatment of the pain, symptoms and stress of an illness for someone at any stage of an illness or disease.

Personal Care Attendant: Also called Personal Care Assistant. Trained professionals who help older adults and people with disabilities perform daily activities.

Personal Emergency Response System: A medical alarm device that allows the user to call for help in an emergency so that a provider may dispatch aid.

Person-centered Care: A way of thinking and doing things that sees the people using health and social services as equal partners in planning, developing and monitoring care to make sure it meets their unique needs and preferences.

PHR: Known as a personal health record, it is an electronic record of a patient’s health information.

Power of Attorney: A written authorization that allows you to appoint someone to make decisions for you and act on your behalf in legal or financial affairs.

Respite Care: Short-term relief for individuals and families serving as caregivers to older adults and people with disabilities.

Self Direction: Self-directed Medicaid services means that participants, or their representatives if applicable, have decision-making authority over certain services and have the responsibility to manage their services with the assistance of a system of available supports. The self-directed service delivery model is person-centered and serves as an alternative to traditionally delivered services, such as an agency delivery model.

Skilled Nursing Facility: A licensed institution that provides a higher level of medical care, including 24-hour assistance.

Social Security Disability Income: This program pays monthly cash benefits to you and certain family members if you become disabled or have worked a number of years and pay Social Security taxes.

Spend-down: A way for certain categories of applicants to qualify for Medicaid even though their income or assets are over the limit, by offsetting the excess with medical expenses.

Spousal Impoverishment Protections Under Medicaid: Rules that exist to protect married people who need Medicaid-covered long-term services from making the difficult choice of either going without services or leaving the spouse still living at home with little income or resources.

State Medicaid Agency: The Department of Social Services (DSS) has the primary responsibility of administering the Medicaid program.

Supplemental Security Income: This program pays monthly benefits to cover basic needs, such as food, clothing and shelter, based on the individual’s financial need, up to a maximum allowable amount.

Universal Assessment (UA): A tool to facilitate level-of-need determinations for long-term Services & Supports utilized across multiple programs and populations.

Warm Hand-Off: A “Warm Hand-Off” approach to information and referral simply means “good customer service”; i.e., going that extra mile, when necessary, to ensure that individuals get connected to a service provider who can provide what they want and need.