Definitions 650-25-10

Access Assistance

(National Family Caregiver Support Program)

A service that assists caregivers in obtaining access to the available services and resources within their communities. A trained Caregiver Coordinator will assess caregiver needs, establish an option plan, and arrange for support services.

Activities of Daily Living (ADL)

Self-care activities performed daily without assistance, stand-by assistance, supervision or cues including eating, dressing, bathing, toileting, and transferring in and out of bed/chair and walking.

Aging & Disability Resource LINK (ADRL)

An initiative designed to streamline access to long-term care services and supports for consumers of all ages, incomes, and disabilities, and their families through better coordination and strengthened partnering of existing systems of information, assistance, and access. North Dakota will develop ‘no wrong door’ models at the community level that can assist individuals in making informed decisions about their service and support options.

Aging Services Division

The designated state agency in North Dakota to carry out the provisions of the Older Americans Act of 1965, as amended.

Advocacy

Actions taken on behalf of older individuals to secure their rights or benefits.

Alzheimer’s Disease and Related Disorders

Any form of dementia characterized by neurological or organic brain dysfunction.

Assistive Safety Device

An adaptive and preventive health aid that will assist individuals in their activities of safe daily living.

At Risk for Institutional Placement

With respect to an older individual, such individual is unable to perform at least 2 activities of daily living without substantial assistance (including verbal reminding, physical cuing, or supervision) and is determined by the State to be in need of placement in a long-term care facility.

Caregiver

(National Family Caregiver Support Program)

(See Family Caregiver)

Child

(National Family Caregiver Support Program)

An individual who is not more than 18 years of age or who is an individual with a disability.

Client

An individual who meets eligibility requirements to receive services under the Older Americans Act.

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.

Contract Entity

A legal entity that has entered into a contract with the Department of Human Services to receive funds under the Older Americans Act for service provision to eligible clients.

Cost Sharing

Process that allows clients to share in the cost of service provision through the use of a sliding fee scale and self-declaration of income.

Counseling

(National Family Caregiver Support Program)

Counseling to caregivers to assist them in making decisions and solving problems relating to their caregiver roles.  This includes counseling to individuals, support groups, and caregiver training (of individual caregivers and families).

Disability

A condition attributed to mental or physical impairment, or a combination of mental and physical impairments that results in substantial functional limitations in one or more of the following areas of major life activity: (1) self care, (2) receptive and expressive language, (3) learning, (4) mobility, (5) self direction, (6) capacity of independent living, (7) economic self sufficiency, (8) cognitive functioning, and (9) emotional adjustment.

Disease Prevention and Health Promotion

Services funded under Title III-D of the Older Americans Act including health risk assessments; routine health screening, which may include hypertension, glaucoma, cholesterol, cancer, vision, hearing, diabetes, bone density, and nutrition screening; nutritional counseling and educational services; evidence-based health promotion programs, including programs related to the prevention and mitigation of the effects of chronic disease (including osteoporosis, hypertension, obesity, diabetes, and cardiovascular disease), alcohol and substance abuse reduction, smoking cessation, weight loss and control, stress management, falls prevention, physical activity and improved nutrition; programs regarding physical fitness and group exercise; home injury control; screening for the prevention of depression and coordination of community mental health services; medication management services; information concerning diagnosis, prevention, treatment and rehabilitation of age-related diseases and chronic disabling conditions; and gerontological counseling. Service priority shall be given to areas of the state that are medically underserved and have a large number of older individuals who have the greatest economic need for such services.

Economic Need

(See Greatest Economic Need).

Eligible Client

(See Client).

Equipment

Tangible nonexpendable personal property, including exempt property, charged directly to a Contract having a useful life of more than one year and an acquisition cost of $5000 or more per unit.

Escort/Shopping Assistance

An allowable service activity under Outreach Services that consists of accompanying and personally assisting or arranging for someone to accompany and personally assist a client with physical or cognitive difficulties obtain a service outside the home environment. Shopping assistance may include purchasing items for homebound clients.

Exploitation

The fraudulent or otherwise illegal, unauthorized, or improper act or process of an individual, including a caregiver (an individual who has the responsibility for the care of an older individual, either voluntarily, by contract, by receipt of payment for care, or as a result of the operation of law and means a family member or other individual who provides, on behalf of such individual or of a public or private agency, organization, or institution, compensated or uncompensated care to an older individual) or fiduciary, that uses the resources of an older individual for monetary or personal benefit, profit, or gain, or that results in depriving an older individual of rightful access to, or use of, benefits, resources, belongings, or assets.

Family Caregiver

(National Family Caregiver Support Program)

An adult family member, or another individual, who is an informal provider of in-home and community care to an older individual or to an older individual with Alzheimer’s disease or a related disorder with neurological and organic brain dysfunction. “Informal” means that the care is not provided as a part of a public service program or payment is received through a private service program.

Fiduciary

A person or entity with the legal responsibility to make decisions on behalf of and for the benefit of another person and to act in good faith with fairness. This includes a trustee, a guardian, a conservator, an executor, an agent under a financial power of attorney or health care power of attorney, or a representative payee.

Focal Point

A facility established to encourage the maximum co-location and coordination of services for older individuals. The eight Regional Human Service Centers have been designated as focal points.

Functionally Impaired

A condition characterized by the inability of an individual to perform a number of activities of daily living (ADL) and/or instrumental activities of daily living (IADL) without assistance.

Governor’s Committee on Aging

A fourteen member committee appointed by the Governor that serves in an advisory capacity to the Governor and to Aging Services Division; provides local input, acts as an advocate for the service needs of older individuals, and sponsors Statehouse Conferences on Aging and/or Governor's Forums on Aging.

Grandparent or Older Individual Who is a Relative Caregiver

(National Family Caregiver Support Program)

A grandparent or step-grandparent of a child, or a relative of a child by blood or marriage, or adoption who is 55 years of age or older and (a) lives with the child; (b) is the primary caregiver of the child because the biological or adoptive parents are unable or unwilling to serve as the primary caregiver of the child; and (c) has a legal relationship to the child, such as legal custody or guardianship, or is raising the child informally.

Greatest Economic Need

The need resulting from an income level at or below the poverty line [as defined by the Office of Management and Budget, and adjusted by the Secretary in accordance with section 673(2) of the Community Services Block Grant Act (42 U.S.C. 9902(2)].

Greatest Social Need

The need caused by non-economic factors which include: (a) physical and mental disabilities; (b) language barriers; and (c) cultural, social, or geographic isolation, including isolation caused by racial or ethnic status, that (i) restricts the ability of an individual to perform normal daily tasks; or (ii) threatens the capacity of the individual to live independently.

Health Maintenance

A combination of services provided in an effort to determine and maintain the health and well being of clients, which includes monitoring and screening procedures for early detection of disease processes, health education, referral, and follow-up.

High Nutritional Risk

Any client determined through the use of the Nutrition Screening Checklist to be at high nutritional risk.  High nutritional risk is defined as a score of 6 or higher using the checklist.

Home and Community-Based Services

An array of services that are essential and appropriate to sustain individuals in their homes and communities, and to delay or prevent institutional care.

Homebound

Unable to leave a place of residence due to limited physical mobility; emotional or psychological impairments that prohibit participation at a meal site or health screening site; remote geographic location where no meal site or health maintenance site exists; or a geographic location is so remote that transporting a client to and from a site is prohibitive.

Home-Delivered Meals

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

Ineligible Participant

Individuals who do not meet Older Americans Act eligibility requirements. Ineligible participants are required to pay the full cost of a service.

In Home Services

Includes homemaker and home health aide; visiting and telephone reassurance; chore maintenance; in-home respite care and adult day care as a respite service for families; minor modification of homes; personal care services, and other in-home services as defined in by the State/Area Agency in the State Plan.

Information and Assistance

A one-on-one service for older individuals that (a) provides individuals with information on opportunities and services available within their communities, including information relating to assistive technology; (b) assesses problems and capabilities of the individuals; (c) links the individuals to the services and opportunities that are available; (d) to the maximum extent practicable, establish adequate follow-up procedures; and (e) serve the entire community of older individuals, particularly older individuals with greatest economic need, greatest social need, and older individuals at risk for institutional placement.

Information Services

(National Family Caregiver Support Program)

A service for caregivers that provides the public and individuals with information on resources and services available to the individuals within their communities.

Instrumental Activities of Daily Living (IADL)

Independent living tasks that typically require mental/cognitive (memory, judgment, intellect) and/or physical ability such as: preparing meals, shopping for personal items, medication management, managing money, using telephone, doing heavy housework, doing light housework, transportation ability.  Transportation ability refers to the individual’s ability to make use of available transportation.

Legal Assistance

Legal advice and representation provided by an attorney to older individuals with economic or social needs and includes (i) to the extent feasible, counseling or other appropriate assistance by a paralegal or law student under the direct supervision of an attorney; and (ii) counseling or representation by a nonlawyer where permitted by law.

Licensed Registered Dietitian

A person licensed to practice dietetics as provided in North Dakota Century Code Chapter 43-44.

Limited English Proficiency

An individual who is not fluent in the spoken English language.

Living Alone

A one-person household where the householder lives by his or herself in an owned or rented place of residence in a non-institutional setting.

Long-Term Care

Any service, care, or item (including an assistive device), including disease prevention and health promotion service, an in-home service, and a case management service (a) intended to assist individuals in coping with, and to the extent practicable compensate for, a functional impairment in carrying out activities of daily living; (b) furnished at home, in a community care setting , or in a long-term care facility; and (c) not furnished to prevent, diagnose, treat, or cure a medical disease or condition.

Long-Term Care Facility

A facility defined in North Dakota Century Code Chapter 50-10.1, as any assisted living facility, any skilled nursing facility, basic care facility, nursing home as defined in subsection 3 of the North Dakota Century Code section 43-34-01, or swing bed hospital approved to furnish long-term care services.

Long-Term Care Ombudsman

An individual 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/tenants.

Minority Elderly

Individuals 60 years of age or over who are confined to the following designations: American Indian or Alaskan Native; Asian; Black or African American, not of Hispanic origin; Hispanic or Latino; origin; American Indian or Alaskan Native, and Asian American/Pacific Islander and Native Hawaiian or other Pacific Islander.

Multipurpose Senior Center

A community facility for the organization and provision of a broad spectrum of services, which includes the provision of health (including mental health), social, nutritional, educational, and recreational activities.

National Aging Program Information System (NAPIS)

Annual performance reporting requirements established by the Administration on Aging for Older Americans Act programs. The system includes the State Program Report.

National Family Caregiver Support Program

Provides for a multifaceted system of support services for family caregivers and for grandparents or older individuals that are relative caregivers. Support services include information to caregivers about available services; assistance to caregivers in gaining access to the services; individual counseling, organization of support groups, and caregiver training to caregivers to assist the caregivers in making decisions and solving problems relating to their care giving roles; respite care to enable caregivers to be temporarily relieved from their care giving responsibilities and supplemental services, on a limited basis, to complement the care provided by the caregivers.  Priority for services shall be given to older individuals with greatest social and economic need (with particular attention to low-income older individuals) and older individuals providing care and support to older individuals with mental retardation and related developmental disabilities (as defined in 42 U.S.C. 6001). Services are funded under Title III-E of the Older Americans Act.  

Neglect

The failure of a caregiver or fiduciary to provide the goods or services that are necessary to maintain the health or safety of an older individual; or self neglect.

New Client

Any client who has never been previously registered as a client for the service, either in the current fiscal year or a prior fiscal year by a contract entity funded with Older Americans Act funds in the planning and service area.

Non-Minority

Any individual who is not considered a minority.

Nutrition Counseling

Provision of individualized advice and guidance to individuals, who are at nutritional risk, because of their health or nutritional history, dietary intake, medications use or chronic illnesses, about options and methods for improving their nutritional status, performed by a licensed registered dietitian in accordance with North Dakota Century Code Chapter 43-44.

Nutrition Education

The provision of scheduled learning experiences on topics related to the improvement of health and nutritional well being. A program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to participants, caregivers, or participants or caregivers in a group or individual setting overseen by a dietitian or individual with comparable expertise.

Nutrition Screening

Completion of a nutrition screening checklist by eligible clients to determine if they are at nutritional risk. Nutritional screening data is a federal collection requirement of the National Aging Program Information System (NAPIS), found in the Federal Register, Volume 59, No. 188, September 29, 1994.

Nutrition Services

Services funded under Title III-C of the Older Americans Act including congregate and home-delivered meals, nutrition counseling, nutrition screening, and nutrition education.

Nutrition Services Incentive Program (NSIP)

Receipt of cash and/or commodities as an incentive to encourage and reward effective performance in the efficient delivery of nutritious meals to older individuals.

Nutrition Services Incentive Program (NSIP) Meal

A meal served in compliance with all the requirements of the Older Americans Act (OAA), which means at a minimum that: 1) it has been served to a participant who is eligible under the OAA and has not been means-tested for participation (i.e. meals provided to individuals through means-tested programs such as Medicaid Title XIX waiver meals or other programs such as state-funded means-tested programs are excluded from the NSIP meals); 2) it is compliant with the nutrition requirements; 3) it is served by an eligible agency; and 4) it is served to an individual who has an opportunity to contribute.  NSIP Meals include all OAA eligible meals including those served to persons under age 60 where authorized by the OAA.

Older Individual (Person)

An individual who is 60 years of age or older.

Older Americans Act of 1965

Public Law 89-73, first enacted in 1965, amended 13 times between 1965 and 2006; directed to improving the lives of America's older individuals, particularly in relation to income, health, housing, employment, long-term care, retirement and community services.  The Act also established the Administration on Aging within the United States Department of Health and Human Services.

Person with Comparable Expertise

For Nutrition Services, includes the following: licensed nutritionist, dietary technician or certified dietary manager.

Poverty

An individual with an annual income at or below the Federally established poverty level.

Program Income

Income received as a service contribution from eligible clients and income from ineligible participants (must pay the full cost of a meal). Program income must be used towards the cost of the service to expand and/or enhance services.

Program Income Carryover

Program income that is not expended during the contract period.

Rapid Inspection

Nursing task accomplished by limited observation of a client to detect status of visible health conditions.

Respite Care

(National Family Caregiver Support Program)

Services that offer temporary, substitute supports or living arrangements for older persons in order to provide a brief period of relief or rest for caregivers. Respite Care includes: (1) In-home respite (personal care and other in-home respite); (2) respite provided by attendance of the care recipient at a senior center or other nonresidential program; and 3) institutional respite provided by placing the care recipient in an institutional setting such as a nursing home for a short period of time as a respite service to the caregiver.

Rural

Any area that is not defined as urban.  Urban areas comprise (1) urbanized areas (a central place and its adjacent densely settled territories with a combined minimum population of 50,000) and (2) an incorporated place or a census designated place with 20,000 or more inhabitants.

Self-Directed Care

An approach to providing services (including programs, benefits, supports, and technology) under the Older Americans Act intended to assist an individual with activities of daily living in which (a) such services (including the amount, duration, scope, provider, and location of such services) are planned, budgeted, and purchased under the direction and control of such individual; (b) such individual is provided with such information and assistance as are necessary to and appropriate to enable such individual to make informed decisions about the individual’s care options; (c) the needs, capabilities, and preferences of such individual with respect to such services, and such individual’s ability to direct and control the individual’s receipt of such services, are assessed by the State/Area Agency (or other agency designated by the State/Area Agency) involved; (d) based on the assessment made under subparagraph (c), the State/Area Agency develops together with such individual and the individual’s family, caregiver or legal representative, (i) a plan for services for such individual that specifies which services such individual will be responsible for directing; (ii) a determination of the role of family members (and others whose participation is sought by such individual) in providing services under such plan; and (e) the State/Area Agency provides for oversight of such individual’s self-directed receipt of services, including steps to ensure the quality of services provided and the appropriate use of funds under the Older Americans Act.

Self-Neglect

An adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care tasks including (a) obtaining essential food, clothing, shelter, and medical care; (b) obtaining goods and services necessary to maintain physical health, mental health, or general safety; or (c) managing one’s own financial affairs.

Senior Companion Services

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

Service Contribution

See Program Income.

Severe Disability

A severe, chronic condition attributable to mental or physical impairment, or a combination of mental and physical impairments that (a) is likely to continue indefinitely; and (b) results in substantial functional limitation in three or more of the following major life activities: self-care; receptive and expressive language; learning; mobility; self-direction; capacity for independent living; and economic self-sufficiency.

Shelf Stable Meal

A combination of pre-portioned foods that can be stored and consumed at room temperature. Shelf stable meals are distributed for use in emergency situations, such as when meals cannot be delivered due to severe weather. Each meal must provide one-third of the Recommended Dietary Allowances.

Social Need

(See Greatest Social Need).

State Plan on Aging

A planning and compliance document that is required by the Older Americans Act for the provision of services for older individuals.

Supportive Services

Services funded under Title III - B of the Older Americans Act, including but not limited to health maintenance, information and assistance, ADRL options counseling, assistive devices, senior companion services, tribal home visits, and legal services.

Supplemental Services

(National Family Caregiver Support Program)

Services provided on a limited basis to complement the care provided by caregivers.

Targeting  

A concentrated effort to provide services and programs to a specific group.

Transportation

A service that provides a method of travel from one specific location to another specific location. All transportation services will be provided through the Department of Transportation.

Unduplicated Client Count

For NAPIS purposes, the counting an eligible individual only one time during a federal fiscal year, regardless of the number of services the individual receives.

Vulnerable Adult

An adult who has a substantial functional or mental impairment. [(A) Substantial functional impairment is a significant limitation in the adult's ability to live independently or provide self-care.  This limitation is due to physical incapabilities that are determined through observation, diagnosis, evaluation or assessment. (B) Substantial mental impairment is a significant disorder of thought, mood, perception, orientation, or memory that grossly impairs judgment, behavior, or ability to live independently or provide self-care. It is determined through observation, diagnosis, evaluation or assessment.]

Vulnerable Adult Protective Services

Remedial social, legal, health, mental health, and referral services provided for prevention, correction, or discontinuation of abuse or neglect which are necessary and appropriate under the circumstances to protect an abused or neglected vulnerable adult, and ensures that the lease restrictive alternatives provided prevent further abuse or neglect, and promote self-care and independent living. (Reference: North Dakota Century Code Chapter 50-25)