TERMS AND DEFINITIONS

Beneficiary

is the person benefitting from a trust.

Activities of Daily Living - ADLs

are daily, routine skills an individual needs in order to function.  Examples include:  eating, bathing, moving, toileting and grooming.

Day Training & Habilitation Program - DT&H

is a licensed organization that assists individuals with disabilities to develop and maintain life skills, participate in community life, and engage in activities of their own choosing.

Department of Human Resources - DHS

provides health care, economic assistance and other essential services for those who do not have the resources to meet their basic needs and are least able to help themselves.

Developmental Disability - DD

is a mental and/or physical condition that manifests before age 22, substantially affects functioning in several major life activities, and usually lasts through life.

Employment Network - EN

is an entity that contracts with the Social Security Administration (SSA) that provides and coordinates the delivery of necessary services to Social Security disability beneficiaries participating in the Ticket to Work program.

Formal Supports

are community supports for individuals with disabilities that are provided by services and programs.

Global Developmental Delay

is a significant lag in meeting important developmental milestones, including:  physical, cognitive, behavioral and social development.

Informal Supports

are community supports for individuals with disabilities that are provided by family, friends and social network groups.

Instrumental Activities of Daily Living - ADLs

are basic skills an individual needs in order to function.  Examples include:  shopping, managing fnances, essential household chores, planning and preparing meals.

Intermediate Care Facility for Persons with Developmental Disabilities - ICF DD

is a residential facility or licensed health care institution that provides health and rehabilitatiave services for persons with developmental disabilities or related conditinos who require active treatment.

Irrevocable Trust

is a trust that cannot be changed or cancelled after it has been created.

Medical Assistance - MA

is a publicly funded health care program for individuals who meet certain income and other criteria, including persons with disabilities.

Minnesota Department of Health - MDH

is a state agency whose mission is to protect, maintain and improve the health of all Minnesotans.

Nursing Facility - NF

is a facility or part of a facility licensed to provide nursing care for persons who are unable to properly care for themselves.

Parental Fee

is a monthly amount paid by parents of children under 18 accessing TEFRA.  It is based on family income and size.

Personal Care Assistant/Assistance - PCA

provides day-to-day assistance and support to individuals with disablities to help them be more independent in their homes and in the community.

Plan for Achieving Self Support - PASS

is a Supplemental Security Income (SSI) work initiative that lets individuals with disabilities set aside money and other assets for items or services to reach specific work goals.

Related Condition

is a condition closely related to a developmental disability that is severe, chronic, results in impairment of general intellectual functioning or adaptive behavior, requires treatment or services similar to those required for persons with developmental disabilities, manifests before age 22, is likely to continue indefinitely, is not attributable to mental illness, and results in substantial functioning limitations.

Revocable Trust

is a trust that can be changed or cancelled after it has been created.

Social Security Administration - SSA

is a federal agency that administers Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs.  These two major programs provide cash benefits to persons with disabilities.

Social Security Disability Income - SSDI

is a program under Retirement, Survivor and Disablity Insurance (RSDI) that provides cash benefits to individuals who have a disabilty and have worked a certain number of quarters or had a parent or spouse who worked a certain number of quarters and have paid into the Social Security System.  SSDI helps offset the costs of food, clothing and shelter with monthly benefits.

Spenddown

is an amount of money that a person enrolled in a Minnesota Health Care Program (MHCP) is required to pay before they are eligble for Medical Assistance (MA).

State Medical Review Team - SMRT

is a division of the Department of Human Services (DHS) that makes disability determinations using criteria from the Social Security Administration (SSA).

Supplemental Security Income - SSI

is a federal needs-based program for children and adults who have been been able to work or have not worked enough to pay into the Social Security System.  SSI helps to offset the costs of food, clothing and shelter with monthly benefit payments.

Tax Equity Fairness and Responsibility Act - TEFRA

is a component of Medical Assistance (MA) that helps cover health care costs for children with disabiilties.  Only the child's income is used to determine eligibility; however there may be parental fees, depending on family income and size.

Trustee

is the person or entity responsible for the management and distribution of the assets of a trust.

Personal Care Assistance (PCA)

Personal care assistants (PCAs) provide day-to-day assistance and support to individuals with disabilities to help them be more independent in their homes and in the community. The personal care assistance program is funded by a combination of federal and state funds.  Definitions of terminology highlighted in Green Italics can be found in the right sidebar.

A PCA assists with

  • Activities of daily living (ADL's).  May be limited with children.
  • Health-related tasks.  Examples:  assistance with self-administered medications and monitoring seizure disorders
  • Observation and redirection of behaviors
  • Instrumental activities of daily living (IADLs) related to an ADL need
  • Being in the community, including:  assisting at work, shopping, medical appointments and recreation/leisure activities

PCA Requirements

  • Be 18 years or older, excluding  paid legal guardian of an adult, legal guardian of a minor, parent or stepparent of a minor child, recipient of PCA services, responsible party or spouse. (Persons 16 or 17 years old may be a PCA but must meet additional requirements.)
  • Be employed by a PCA provider agency
  • Be enrolled with the Minnesota Department of Human Services (DHS)
  • Complete a criminal background study

DHS Eligibility Criteria – must meet all of the following:

  • Be eligible for Medical Assistance (MA)
  • Require services that are medically necessary  
  • Be able to make decisions about your own care or have someone who can make decisions for you

How to apply for PCA Services

Contact the Washington County Community Services Intake at 651-430-6484 or your health plan provider for assessment information for PCA services. The assessment includes information on current health status, the need for PCA services and a service plan with follow-up plans.  The Department of Human Services (DHS) website is a good resource for changes in the PCA program, including instructions on who to call if the consumer has fee for service MA, a health plan, or other funding sources.

Options for PCA Services

PCA Choice Option  - The PCA Choice Option provides greater control and choice to hire, train and manage PCAs through the use of a PCA Choice agency.   

Shared Service Option – A PCA may provide shared services for two or three individuals in a child care setting, in a home setting or outside the home at the same setting.  All individuals must use the same PCA agency, and the agency must assure that it is appropriate with regard to the individuals and their needs. Home Care Shared Services Agreement

What can you do if PCA services are denied?

You have the right to appeal any decisions made regarding these changes if you feel your child should remain eligible for PCA services.   This should be done within 30 days of the date of the notice of denial.

Frequently asked questions about state appeal hearings (DHS) 

Information and options for individuals who no longer qualify for PCA Services can be found here.