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Nursing manual General definitions Abuse of an adult individual with a developmental disability includes but is not limited to:
Alternative To Employment (ATE) - includes services for individuals whose age or condition preclude employment situations. The overall purpose is to provide opportunities for integration, independence and productivity, which are based on the individual's needs. Americans with Disabilities Act (ADA) - The ADA prohibits discrimination on the basis of disability in employment, programs and services provided by state and local governments, goods and services provided by private companies, and in commercial facilities. The ADA was signed into law on July 26, 1990. It contains requirements for new construction, for alterations or renovations to buildings and facilities, and for improving access to existing facilities of government that provide programs offered to the public. The ADA also covers effective communication with people with disabilities, eligibility criteria that may restrict or prevent access, and requires reasonable modifications of policies and practices that may be discriminatory. Assignment - means that the Registered Nurse, or Licensed Practical Nurse, at the discretion of the Registered Nurse, authorizes an unlicensed person to perform a basic task of client care with knowledge that the unlicensed person has been taught the task and is competent to perform the task. Assignment may require, at the discretion of the RN, that a licensed nurse periodically supervise and evaluate the unlicensed person performing the basic task of client care. Case Manager - is an employee of the community mental health program or other agency that contracts with the County Mental Health and Developmental Disability Program or with the state Mental Health and Developmental Disability Services Division, who is selected to plan, procure, coordinate, monitor ISP services and to act as an advocate for the person. Core Competencies (Oregon Core Competencies) - is a list of skills and knowledge for newly hired staff in the areas of health, safety, rights, values, personal regard and the service provider's mission. They have associated timelines in which newly hired staff must demonstrate competency. Delegation - means that a Registered Nurse authorizes an unlicensed person to perform special tasks of client/nursing care in selected situations and indicates that authorization in writing and leaves written instructions. The delegation process includes nursing assessment of a client in a specific situation, evaluation of the ability of the unlicensed person, teaching the task and ensuring supervision by the RN. Developmental Disability (DD)- for an adult means a disability attributable to mental retardation, autism, cerebral palsy, epilepsy, or other neurologically handicapping conditions which require training or support similar to that required by individuals with mental retardation, and the disability:
Back to top Developmental Disabilities Nurses Association (DDNA) - is a professional organization for nurses serving individuals with developmental disabilities. It was incorporated in 1992 to meet the professional needs of nurses in this field. Diversion - is a service provided for individuals to prevent loss of their home. The division - refers to the Mental Health and Developmental Disability Services Division (MHDDSD) which is one of five Divisions and three major Offices of the Department of Human Services for the State of Oregon. Exceptional Needs Care Coordinator (ENCC)- is a resource person provided by each managed care plan under the Oregon Health Plan for members who are elderly or disabled. Some of the things an ENCC can do are:
Incident report (IR)- is a written report of any injury, accident, act of physical aggression, medication irregularities or unusual incident involving an individual with a developmental disability. Individual Support Plan (ISP)- means a written plan of support and training services for an individual, revised at least annually, which addresses an individual's support needs. Individual Support Plan Team (ISP Team)- is a team composed of the individual, case manager, the person's legal guardian, representatives of all current service providers, and advocates or others determined appropriate by the person receiving services. Integration- means that persons with developmental disabilities who live in the community, use the same community resources that are used by other members of the community, participate in community activities and have contact with other community members. Mental Health and Developmental Disability Services Division (MHDDSD or "The Division")- is one of five Divisions of the Department of Human Services for the State of Oregon. Mental Retardation (MR)- means significantly sub-average general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period (considered by the 18th birthday). Persons of borderline intelligence may be considered mentally retarded if there is also serious impairment of adaptive behavior. Office of Developmental Disability Services (ODDS) or "DD Office"- means the Office of Developmental Disability Services of the Mental Health and Developmental Disability Services Division of the State of Oregon. Back to top Oregon Administrative Rule (OAR)- is a group of laws that prescribe the standards and procedures for the delivery of care and services. There are numerous sets of rules, including those for "24 Hr. Residential", "Supported Living", "Adult and Child Foster Homes", "Employment and Alternative to Employment", "Case Management" and "Individual Support Plan." Oregon Health Plan (OHP)- is the Medicaid demonstration project that expands Medicaid eligibility to Oregon residents with an income of less that 100% of the Federal Poverty Level and children with incomes up to 200% of the Federal Poverty Level. The Oregon Health Plan relies substantially upon prioritization of health services and managed care to achieve the public policy objectives of access, cost containment, efficacy, and cost effectiveness in the allocation of health resources. Oregon Intervention System (OIS)- is a continuum of behavior management services designed to support individuals who may present challenging behaviors. OIS emphasizes a philosophy of individualized positive behavior supports, functional behavioral assessment and adaptations of the environment and the structure of daily life. Office of Medical Assistance Programs (OMAP)- is an Office of the Department of Human Services responsible for coordinating Medicaid medical services, the Oregon Health Plan. OMAP writes and administers the state Medicaid rules for medical services, contracts with providers and maintains records of client eligibility. Oregon Revised Statute (ORS)- are laws passed by the Oregon Legislature. The Oregon Administrative Rules are based upon these laws. Oregon State Board of Nursing (OSBN)- an agency of the State of Oregon whose mission is to govern and regulate nursing practice and education for the purpose of protecting the public's health, safety and well being. The Board exists to protect the public from unsafe, incompetent or unauthorized practice of nursing. Oregon Technical Assistance Corporation (OTAC)- is a private, not-for-profit agency that provides a range of technical assistance in the areas of human services. Its mission is to promote full participation in community life for individuals with disabilities and families through delivery of training, technical assistance and related services. Physical restraint- means restricting the movement of an individual or restricting the movement or normal function of a portion of the individual's body. Pre-Admission Screening Resident Review (PASRR)- is a federally mandated screening program conducted prior to admission of any individual into a Medicaid certified nursing care facility. The goals are to prevent inappropriate placements of indivudals with Mental Illness and/or Mental Retardation and/or Developmental Disabilities diagnosis into nursing care facilities. Another goal is to assure any special services related to those diagnoses are being met. Back to top Priority population- means individuals with developmental disabilities possessing one or more of the following characteristics:
Provider- is a term used when identifying or referring to the non-profit or for profit organization that provides residential and/or employment services to the person with developmental disabilities. Psychotropic Medications (Behavior Medications)- are defined as a medication whose prescribed intent is to affect or alter thought processes mood, or behavior. This includes, but is not limited to, anti-psychotic, antidepressant, anti-anxiety and behavior medications. Because a medication may have many different effects, its classification depends upon its stated, intended effect when prescribed. Self-Directed Supports- is an approach to delivering services to individuals with developmental disabilities and their families. The main goal is to assist the individuals and families with determining the types and duration of supports needed for living the lives they choose. Self-Injurious Behavior (SIB)- is a repeated non-accidental behavior initiated by the individual that directly results in physical injury to themselves. Serious Event Review Team (SERT)- is a quality assurance/quality improvement system at the county and state level that reviews, monitors, and responds to serious events that occur within the Developmental Disability services system. Supported Living- is a service that provides the support for persons with DD to live in a residence of their own choice within the community. Supported living provides the opportunity for individuals to live where they want, with whom they want. Twenty-Four Hour Residential Services- is a service that provides 24 hour residential support for individuals with developmental disabilities. Tardive Dyskenesia- is a condition of slow, rhythmical, automatic stereotyped movements, either generalized or in single muscle groups. These occur as an undesired effect of therapy with certain psychotropic drugs especially the phenothiazines. Back to top Variance- is an approved exception granted by the licensing or certification body (usually ODDS) to an OAR. Insurance and Governmental Income DefinitionsDually Eligible - People who are eligible for both Medicare and Medicaid. Medicare becomes the primary payer, but these individuals are entitled to the more comprehensive benefits of Medicaid. Exceptional Needs Care Coordinator (ENCC)- is a resource person provided by each Oregon Health Plan for members who are elderly or disabled. Some of the things an ENCC can do are:
MCO - Managed Care Organization --see HMO. Medicaid - Title XIX - A funding source from the federal government that was originally intended to provide health care for people with low incomes. Currently in Oregon, the health care provided by Medicaid is called the Oregon Health Plan. Waivers through both the Office of DD Services and Senior and Disabled Services Division (SDSD) allow those Divisions to provide Home and Community-based Services, instead of providing services in an ICF/MR (nursing home for people with mental retardation) or nursing home. In Medicaid, the state is required to provide a significant portion of the funds. In Oregon about $60 of every $100 spent must come from the state. For most people with a developmental disability, eligibility for Medicaid is completed at the local SDSD office. Back to top Medicare - A health insurance program funded through the federal government for people who have worked (or their dependents) and are now elderly or disabled. It is funded through federal payroll deductions. The benefits are more limited than Medicaid. OHP - Oregon Health Plan - Insurance or payment mechanism for health care for people with low incomes in the State of Oregon. Health services are ranked in order of benefit and some services are not funded. Most people in OHP are enrolled in managed care plans. PCCM - Primary Care Case Manager - A PCP who agrees to manage the care of OHP members for a small monthly fee. These health practitioners are available to OHP members who live in areas without MCO's or whose health needs can't be met by an MCO. PCP - Primary Care Physician - Health care provider who provides routine health care. PCP's are required to provide access 24 hours per day, 7 days a week. Most PCP's are family physicians, pediatricians, internists, or nurse practitioners. Most managed care plans require a referral from the PCP for access to specialists. SSB - (Social Security Benefit) - Income from the federal government for workers who are now older (Social Security) or are disabled (SSDI) and their dependents (adult children with disabilities or the spouse) if the worker also qualifies for SSB. Eligibility for SSB (either SSDI or SS) entitles a person for eligibility in Medicare, but the income may be too high to retain eligibility in Medicaid. SSDI - Social Security Disability Income - A disability insurance plan from the federal government for workers who become disabled or for dependents who are disabled if the worker/parent is also disabled or elderly. Eligibility for SSDI entitles a person for eligibility in Medicare, but the income may be too high to retain eligibility in Medicaid. SSI - Supplemental Security Income - A social benefit payment by the federal government to people with significant disabilities and very low incomes. People apply for SSI at the local Social Security Office. Eligibility for SSI entitles a person to eligibility to Medicaid. The payment is meant to assist with those routine costs that are greater because of the disability. TANF - Temporary Aid for Needy Families - Used to be know as "Aid for Families with Dependent Children" (AFDC) or more commonly "welfare." Provides income assistance with numerous restrictions to families with children. This is usually accessed through Adult and Family Services (AFS). Waiver - Permission by the federal government to "break their rules." The SDSD and DD waivers include permission to serve people outside of the traditional Medicaid settings - nursing homes and ICF/MR's, institutions that serve persons with mental retardation and/or developmental disabilities. Back to top |
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