Definitions 650-25-10

(Revised 5/10/21 ML #3621)

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Definitions in this manual include descriptors of Older Americans Act programs/services that must be used in the completion of required Federal reporting.

 

Access Assistance (Family Caregiver Support Program)- A service that assists caregivers in obtaining access to the available services and resources within their communities. Trained staff 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) - See Service Chapter 650-25-40

 

Benefits Counseling- The provision of information designed to help individuals learn about public and private benefits with referral to appropriate entities for access to needed benefits. Benefits Counseling is considered a part of the Options Counseling service.

 

Futures Planning- The process of assisting individuals in planning for their future long-term care needs with referral to appropriate entities for retirement planning, long-term care insurance, etc. Futures Planning is considered a part of the Options Counseling service.

 

Aging & Disability Resource-LINK Information and Assistance (ADRL I & A)- A one-on-one service that:

  1. provides consumers with information on opportunities and services available within their communities;
  2. assesses problems and capabilities of the individuals;
  3. links the consumers to the services and opportunities that are available; and
  4. to the maximum extent practicable, establishes adequate follow-up procedures.

 

Aging & Disability Resource LINK (ADRL) Operating- Day-to-day activities necessary to implement and maintain an ADRL.

 

Options Counseling- 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 individual’s needs, preferences, values, and individual circumstances.

 

Aging Services Division - The designated state agency in North Dakota to carry out the provisions of the Older Americans Act (OAA) 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 two 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 (Family Caregiver Support Program)- See Service Chapter 650-25-45

 

Child (Family Caregiver Support Program)- An individual who is not more than 18 years of age.

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

 

Committee on Aging- See Service Chapter 650-25-25

 

Congregate Meals- A meal that is eaten 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 using a sliding fee scale and self-declaration of income.

 

Counseling (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).

 

Dietary Reference Intakes (DRIs)- See Service Chapter 650-25-60-05

 

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 but not limited to health risk, routine health screening, nutritional counseling and education, evidence-based health promotion programs, etc. Please refer to the OAA more information.

 

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.

 

Evidenced-Based Program- A research-based program that demonstrates that a specific practice(s) increases the likelihood of a positive outcome(s). The Administration for Community Living has outlined a three-tiered evidence-based criterion for Title III-D programs and services under the Older Americans Act.

 

Family Caregiver (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.

 

Grandparent (Family Caregiver Support Program)- See Older Relative Caregiver.

 

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 USC 9902(2))].

 

Greatest Social Need- The need caused by non-economic factors which include:

  1. physical and mental disabilities;
  2. language barriers; and
  3. cultural, social, or geographic isolation, including isolation caused by racial or ethnic status, that
  1. restricts the ability of an individual to perform normal daily tasks; or
  2. threatens the capacity of the individual to live independently.

 

Health Maintenance- See Service Chapter 650-25-50.

 

High Nutritional Risk- Any client determined using 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 meal that is provided to the home of an eligible individual.

 

Individual with a Disability (Family Caregiver Support Program)- An individual with a disability, as defined in section 3 of the Americans with Disabilities Act of 1990 (42 USC 12101), who is not less than age 18 and not more than 59.

 

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

 

Informal Supports (Family Caregiver Support Program)- An adult residing in the home of a primary caregiver/care recipient who provides relief from direct care and/or supervision of a care recipient for more than eight hours per week.

 

Information Services (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.

 

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 the North Dakota State Plan on Aging.

 

Legal Assistance- See Service Chapter 650-25-55

 

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.

 

Local Contact Agency (LCA) Operating- Day-to-day activities necessary to implement and maintain Local Contact Agency services.

 

Local Contact Agency (LCA) Services- Activities completed to address requirements of the Minimum Data Set (MDS) 3.0 – Section Q to inform residents of nursing facilities of available services and supports for potential transition to community living. LCA services follow the ADRL Options Counseling principles and core competencies.

 

Long-Term Care- Any service, care, or item (including an assistive device), including:

  1. disease prevention and health promotion service,
  2. an in-home service, and
  3. a case management service
  1. intended to assist individuals in coping with, and to the extent practicable compensate for, a functional impairment in carrying out activities of daily living;
  2. furnished at home, in a community care setting, or in a long-term care facility; and
  3. 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(3), as any skilled nursing facility, basic care facility, nursing home as defined in subsection 3 of section 42-34-01, assisted living facility, 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 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 USC 6001). Services are funded under Title III-E of the Older Americans Act.

 

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 wellbeing. 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).

 

Older Americans Act of 1965, as amended – See Older Americans Act (OAA)

 

Older Individual (Person) - An individual who is 60 years of age or older.

 

Older Relative Caregiver (Family Caregiver Support Program) - A caregiver who is age 55 or older and lives with, is the informal provider of in-home and community care to, and is the primary caregiver for, a child or an individual with a disability. In the case of a caregiver for a child: is the grandparent, step-grandparent, or other relative (other than the parent) by blood, marriage, or adoption of the child; is the primary caregiver of the child because the biological or adoptive parents are unable or unwilling to serve as primary caregivers of the child; and has a legal relationship to the child such as legal custody, adoption, or guardianship, or is raising the child informally. In the case of a caregiver for an individual with a disability, is the parent, grandparent, or other relative by blood, marriage, or adoption of the individual with a disability.

 

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.

 

Qualified Family Member (Family Caregiver Support Program) - A qualified family member is the spouse of or one of the following relatives, or the current or former spouse of one of the following relatives of the care recipient: parent, grandparent, adult child, adult sibling, adult grandchild, adult niece, or adult nephew.

 

Qualified Respite Care Provider (Family Caregiver Support Program) - A qualified respite care provider may include an agency or individual enrolled as a respite care qualified service provider (QSP) with the Department of Human Services. With appropriate credentialing, an adult/child day care facility, licensed adult/child foster care home, home health care provider, basic care facility, memory care facility, swing bed unit, or long-term care facility may also be qualified respite providers.

 

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

 

Respite Care (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

  1. 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;
  2. 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;
  3. 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;
  4. 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,
  1. a plan for services for such individual that specifies which services such individual will be responsible for directing;
  2. a determination of the role of family members (and others whose participation is sought by such individual) in providing services under such plan; and
  1. 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.

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.

 

Services that Provide Relief from Direct Care and/or Supervision of a Care Recipient (Family Caregiver Support Program) - Services included, but not limited to in-home and institutional respite care, adult day care, companionship, supervision, and personal care services.

 

Severe Disability - A severe, chronic condition attributable to mental or physical impairment, or a combination of mental and physical impairments that

  1. is likely to continue indefinitely; and
  2. results in substantial functional limitation in three or more of the following major life activities:
  1. self-care;
  2. receptive and expressive language;
  3. learning;
  4. mobility;
  5. self-direction;
  6. capacity for independent living; and
  7. 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.

 

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 (Family Caregiver Support Program) - Services provided on a limited basis to complement the care provided by caregivers. Reimbursement can be made for incontinent supplies including pads, diapers, wipes, and other protective products; and assistive safety devices including adaptive equipment.

 

Twenty-Four Hour Care (Family Caregiver Support Program) - Provision of care to a care recipient on a twenty-four-hour basis; for the purposes of the FCSP, the caregiver may be out of the home for a short period of time (two hours or less per day) if the welfare and safety of the care recipient can be maintained.

 

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.

 

Tribal Home Visit - Periodic visits to isolated older individuals residing on a Reservation to monitor their health and well-being and identify service needs with an emphasis on referral and linkage to available services.

 

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.