{"id":8861,"date":"2026-08-12T13:29:52","date_gmt":"2026-08-12T13:29:52","guid":{"rendered":"https:\/\/exploreltssinitiatives.org\/staging\/4085\/?page_id=8861"},"modified":"2026-08-12T18:03:34","modified_gmt":"2026-08-12T18:03:34","slug":"glossary","status":"publish","type":"page","link":"https:\/\/exploreltssinitiatives.org\/staging\/4085\/glossary","title":{"rendered":"Glossary"},"content":{"rendered":"\t\t
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Glossary<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Understanding Key Terms in Caregiving and Long-Term Services and Supports<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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This glossary provides clear, plain-language definitions of important terms frequently used in caregiving research, policy, and practice. As you explore the interactive caregiving compendium and related materials, this resource can help clarify concepts like Instrumental Activities of Daily Living (IADLs) and Person-Centered Care. These definitions are intended to support a shared understanding among policymakers, practitioners, caregivers, researchers, and advocates seeking to strengthen the systems and supports that help individuals and families thrive.<\/p>

Click the letters OR select the term below to expand and view key term definitions.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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#<\/span>A<\/a>B<\/a>C<\/a>D<\/a>E<\/a>F<\/a>G<\/a>H<\/a>I<\/a>J<\/span>K<\/span>L<\/a>M<\/a>N<\/a>O<\/a>P<\/a>Q<\/a>R<\/a>S<\/a>T<\/a>U<\/a>V<\/a>W<\/span>X<\/span>Y<\/span>Z<\/span><\/div>
A<\/div>
Activities of Daily Living<\/svg><\/div>

\n

Activities of daily living (ADLs) are basic personal care actions that people perform on a daily basis. There are six basic ADLs: (a) bathing<\/strong>; (b) dressing<\/strong>; (c) toileting<\/strong>; (d) transferring<\/strong> (moving to and from a bed or a chair); (e) eating<\/strong>; and (f) caring for incontinence.<\/strong> Many LTSS and LTC programs evaluate the inability to perform a certain number of ADLs and instrumental activities of daily living (IADLs) in order to determine when individuals are eligible for benefits. Loss in individuals\u2019 ability to do these basic ADLs is an objective and reliable indicator of the need for LTSS<\/strong>.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Adjusted Gross Income<\/svg><\/div>

\n

Adjusted gross income, also known as (AGI), is defined as total income minus deductions, or
\u201cadjustments\u201d to income that one is eligible to take. Gross income includes wages, dividends,
capital gains, business and retirement income as well as all other forms income.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Adverse Selection<\/svg><\/div>

\n

Adverse selection is a situation where one party in a transaction has significantly more
information about the product or service than the other party, allowing them to exploit that
knowledge to their advantage, often at the expense of the less informed party. The term is
typically applied to insurance markets where high-risk individuals are more likely to purchase
coverage while low-risk individuals may choose not to, leading to higher premiums for
everyone.<\/p>\n<\/p><\/div><\/div>

Alzheimer\u2019s Disease<\/svg><\/div>

\n

Alzheimer\u2019s disease is a progressive, degenerative form of dementia that causes severe intellectual deterioration. Individuals with Alzheimer\u2019s Disease often have problems with short-term memory and with orientation to person, place, or time. They are often able to independently perform personal care but may require supervision to keep themselves safe and to ensure that they do not wander or get lost.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Appropriation<\/svg><\/div>

\n

Appropriation refers to the legislative act of putting aside a specific amount of money from the public treasury for designated purposes. It is a legally binding process that grants federal agencies the authority to incur obligations and make payments for authorized programs. Annual appropriations are made for a specified fiscal year, and funds typically expire at the end of the fiscal year.\u00a0<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

The Administration for Community Living (ACL)<\/svg><\/div>

\n

Administration for Community Living<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

The Assistant Secretary for Planning and Evaluation (ASPE)<\/svg><\/div>

\n

Office of the Assistant Security for Planning and Evaluation<\/p>\n<\/p><\/div><\/div><\/div>

B<\/div>
Bathing<\/svg><\/div>

\n

An ADL<\/strong>, bathing is defined as washing by sponge bath, or in either a tub or shower. This activity also includes the task of getting into or out of the tub or shower.\u00a0<\/p>\n<\/p><\/div><\/div>

Brookings\/ICF Long Term Care Financing Model<\/svg><\/div>

\n

Using microsimulation techniques, this model projects the utilization and sources of financing for nursing home and home care services among the elderly to the year 2020.\u00a0 It is often used to estimate future costs for a variety of LTSS finance and program proposals.<\/p>\n<\/p><\/div><\/div><\/div>

C<\/div>
Cafeteria Plan<\/svg><\/div>

\n

A \u201ccafeteria plan\u201d is an employee benefit plan where employees can choose from a variety of
pre-tax benefits, similar to selecting options at a cafeteria, allowing them to customize their
benefits package by picking the ones that best suit their needs, like health insurance, dental,
vision, and flexible spending accounts (FSAs), all deducted from their paycheck before taxes
are calculated; it is also often called a \u201cSection 125 plan\u201d due to the IRS code that governs it
or a \u201cflexible benefits plan.\u201d<\/p>\n<\/p><\/div><\/div>

Care Management<\/svg><\/div>

\n

Care management consists of services that help an individual and their family identify care
needs and arrange for services. These services may be provided by a Care Advisor\/Manager,
usually a nurse or social worker specially trained in the LTSS field, who helps to monitor
and coordinate services to address care needs as they change over time. Care Advisors\/
Managers consult with the individual and their family and develop a plan of care consistent
with their needs and preferences.<\/p>\n<\/p><\/div><\/div>

Caregiver Assessment<\/svg><\/div>

\n

A caregiver assessment is a systematic process of gathering information about a caregiver\u2019s situation, including identifying their needs, strengths, challenges, and resources to develop a supportive care plan for both the caregiver and care recipient.\u00a0<\/p>\n<\/p><\/div><\/div>

Caregiver Training<\/svg><\/div>

\n

Caregiver training is an educational process equipping individuals with the skills and knowledge needed to provide effective care for those facing health challenges. This includes basic care skills, communication techniques, emotional support skills, time management and organization, safety protocols, and understanding various medical conditions. <\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Cash and Counseling<\/svg><\/div>

\n

Cash and Counseling is a financial and care assistance program usually associated with
Medicaid, that gives the beneficiary cash assistance and the flexibility to \u201cself-direct\u201d how to
spend it on the providers and services they prefer.<\/p>\n<\/p><\/div><\/div>

Cash Benefit<\/svg><\/div>

\n

A type of program payment that does not require one to receive paid care in order for them to receive a program payout.\u00a0 While the participant is generally required to satisfy the specified criteria for being functionally or cognitively impaired, the benefit paid to them would be an established cash amount, without regard for whether and\/or how much they spend on care or services. (Some private insurance companies also use the phrase \u201cindemnity\u201d to describe this type of benefit payment.\u00a0\u00a0 But, because that phrase can also mean a flat benefit payment amount when paid care is received, but without regard to the amount paid for care, the term \u201cCash Benefit\u201d is more clear and correct for this purpose.<\/p>\n<\/p><\/div><\/div>

Catastrophic Coverage (Back-end)<\/svg><\/div>

\n

This refers to a public program that has an extended waiting period before benefits are paid.\u00a0 This could be measured in time (e.g., a 2 year waiting period from the onset of qualifying disability until benefits begin) or in terms of the cost and amount of services provided before benefits will begin.\u00a0 Most often, catastrophic coverage has no end limit; benefits are paid for as long as care needs continue.\u00a0 However, some public program models contemplate offering a \u201climited catastrophic plan\u201d which may have an upper limit such as 5 years or 7 years or a specific dollar amount (e.g., one million dollars.)<\/p>\n<\/p><\/div><\/div>

Centers for Medicaid and Medicare Service (CMS)<\/svg><\/div>

\n

Centers for Medicaid and Medicare Service<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Children\u2019s Health Insurance Program (CHIP)<\/svg><\/div>

\n

The Children\u2019s Health Insurance Program (CHIP) provides health coverage to children who are in families with incomes too high to qualify for Medicaid, but too low to afford private coverage. CHIP is managed by states and abide by federal requirements and is funded by both states and the federal governments. CHIP provides health coverage to eligible children through both Medicaid and separate CHIP programs.<\/p>\n<\/p><\/div><\/div>

Chronic Disease Management<\/svg><\/div>

\n

This refers to best practice programs specifically designed to treat and support individuals with certain chronic diseases so that the best outcomes can be achieved.\u00a0 They often use interdisciplinary approaches such as detection, prevention, nutrition, patient education and monitoring, exercise, counseling and more.\u00a0 These structured treatment plans for people who have a chronic disease are meant to provide high quality care, reduce adverse outcomes, and in many cases reduce the costs of caring for the chronic disease.<\/p>\n<\/p><\/div><\/div>

Cognitive Impairment<\/svg><\/div>

\n

Cognitive impairment is a deficiency in a person\u2019s short or long-term memory, their
orientation to person, place and time, their deductive or abstract reasoning, or in their
judgment as it relates to safety awareness. (A well-known example of a severe cognitive
impairment is Alzheimer\u2019s disease.)<\/p>\n<\/p><\/div><\/div>

Community Care Corps (Volunteer Caregiver Support)<\/svg><\/div>

\n

The Community Care Corps is a national program supported by the Administration of Community Living that awards funds to organizations to increase the number of community- and home-based volunteer programs available to provide nonmedical assistance to family caregivers,<\/strong> older adults, or adults with disabilities age 18 and older to maintain independence in the community.<\/p>\n<\/p><\/div><\/div>

Companion Bill<\/svg><\/div>

\n

A companion bill is an identical bill that is introduced in both the House and the Senate at roughly the same time, intended to speed up the process and increase the chances of passage by allowing simultaneous consideration.<\/p>\n<\/p><\/div><\/div>

Comprehensive Coverage<\/svg><\/div>

\n

This refers to a public program that pays benefits across nearly the entire span of time during which covered persons need care.\u00a0 It may have a short or small waiting period (e.g., 60 to 90 days), but it then pays benefits for as long as care is needed.<\/p>\n<\/p><\/div><\/div>

Congressional Budget Office (CBO)<\/svg><\/div>

\n

The Congressional Budget Office (CBO) is\u00a0an independent, nonpartisan agency within the legislative branch that provides Congress with objective, nonpartisan analysis and estimates related to federal economic and budgetary decisions, supporting the Congressional budget process.\u00a0<\/p>\n<\/p><\/div><\/div>

Continence<\/svg><\/div>

\n

An activity of daily living (ADL), continence consists of the ability to maintain control of bowel
and bladder function, or when unable to maintain control of these functions, the ability to
perform associated personal hygiene (including caring for a catheter or colostomy bag).<\/p>\n<\/p><\/div><\/div>

Coverage Structure<\/svg><\/div>

\n

Coverage Structure refers to the start time and duration over which benefits will be paid.\u00a0 Specifically, once someone meets the criteria for receiving benefits, the program structure defines when benefits begin, how long they continue, and when they end. The three basic structures are front-end, back-end\/catastrophic and comprehensive.\u00a0 With a\u00a0front-end<\/a><\/strong> structure, benefits begin as soon as the benefit criteria are met (or shortly thereafter if there is an elimination period).\u00a0 But they only last for a limited time period (e.g., 1-2 years) or up to a certain dollar amount\u00a0 In a program with a\u00a0back-end<\/a> <\/strong>catastrophic\u00a0coverage structure, there is an extended period up-front where no benefits are payable (waiting period).\u00a0Benefits begin after someone is disabled for the extended period of time (e.g., 2 years), but it generally continues as long as care is needed.\u00a0 A\u00a0comprehensive<\/a>\u00a0<\/strong>program structure pays benefits during the entire period of need.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div><\/div>

D<\/div>
Daily\/Monthly Benefit Limit<\/svg><\/div>

\n

The daily\/monthly benefit limit is typically the maximum dollar amount that a LTC insurance
policy or program will pay to reimburse the costs of covered services. The limit is expressed
as either an amount per day or an amount per month.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Dedicated\/Earmarked<\/svg><\/div>

\n

“Dedicated” means to set apart for a specific purpose or use, while “earmarked” specifically refers to funds or resources that are reserved or set aside for a particular purpose or project.\u00a0<\/p>\n<\/p><\/div><\/div>

Deficit Reduction<\/svg><\/div>

\n

Refers to taxation, spending, and economic policy debates and proposals designed to reduce the federal government budget deficit. Government agencies including the\u00a0Government Accountability Office<\/a>\u00a0(GAO),\u00a0Congressional Budget Office<\/a>\u00a0(CBO), the\u00a0Office of Management and Budget<\/a>\u00a0(OMB), and the\u00a0U.S. Treasury Department<\/a>\u00a0have reported that the federal government is facing a series of important long-run financing challenges, mainly driven by an aging population, rising healthcare costs per person, and rising interest payments on the\u00a0national debt<\/a>.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Department of Labor (DOL)<\/svg><\/div>

\n

Department of Labor<\/p>\n<\/p><\/div><\/div>

Direct Care Workforce<\/svg><\/div>

\n

The direct care workforce consists of professionals like Home Health Aides, Personal Care Aides, Nursing Assistants, and Direct Support Professionals who provide hands-on support for daily living, personal care, and medical assistance to older adults and people with disabilities, often in homes or community settings, helping them live independently.\u00a0<\/p>\n<\/p><\/div><\/div>

Dressing<\/svg><\/div>

\n

An ADL<\/strong>, dressing involves putting on and taking off all items of clothing and any necessary braces, fasteners, or artificial limbs. Dressing includes the ability to get to and from the closet or dresser and obtain clothing.\u00a0<\/p>\n<\/p><\/div><\/div>

Dual Eligible<\/svg><\/div>

\n

A dual eligible individual is someone who is eligible for both Medicare and Medicaid benefits.
People can become dual eligible due to age, disability, or low income. They can enroll in
Medicare first and then qualify for Medicaid, or vice versa.<\/p>\n<\/p><\/div><\/div>

The Department of Defense (DOD)<\/svg><\/div>

\n

Department of Defense<\/p>\n<\/p><\/div><\/div><\/div>

E<\/div>
Department of Education (ED)<\/svg><\/div>

\n

Department of Education<\/p>\n<\/p><\/div><\/div>

Eating<\/svg><\/div>

\n

An ADL<\/strong>, eating consists of feeding by getting food into the body from a receptable (such as a plate, cup, or table) or by a feeding tube or intravenously. Eating does not mean preparing the food to be consumed.\u00a0<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Elimination Period (waiting period)<\/svg><\/div>

\n

The elimination period and the deductible period are insurance and program terms used
interchangeably to describe the length of time an insured person must pay for covered
services or be disabled before a LTC insurance policy or program will begin to make
payments. The longer the elimination period, the more an individual has to personally bear the
costs of care and the lower the insurance premium.<\/p>\n<\/p><\/div><\/div><\/div>

F<\/div>
Facility Care Only<\/svg><\/div>

\n

When program benefits pay for care provided in a nursing home or nursing care facility or an assisted living or residential care facility, but not for care at home or in the community.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Family and Medical Leave Act<\/svg><\/div>

\n

The Family Medical Leave Act (FMLA) refers to federal legislation which offers eligible employees up to 12 weeks of unpaid, job-protected leave for significant family and medical reasons, like the birth of a child, adoption, or caring for a family member with a serious health condition, while maintaining health insurance coverage. It applies to public agencies and private companies with at least 50 employees, with some states offering more expansive, sometimes paid, leave. \u00a0<\/p>\n<\/p><\/div><\/div>

Family Caregiver<\/svg><\/div>

\n

A family caregiver is a person who provides care to a family member, friend, or neighbor who needs help with daily tasks. Most family caregivers are unpaid, but some may receive a stipend or be paid to help provide care. This care can be due to illness, disability, aging, mental health problems, or addiction. Family caregivers can be spouses, parents, children, siblings, or other relatives. They can also be members of a family of choice such as neighbors, friends, or the like.\u00a0<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Federal Medicaid Assistance Percentage (FMAP)<\/svg><\/div>

\n

The Federal Medical Assistance Percentage (FMAP) is the federal government\u2019s share of state Medicaid<\/strong> costs, determined by a formula based on each state\u2019s per capita income. This supports caregivers through programs like HCBS<\/strong>. Congress can adjust the FMAP and has done so to increase it for specific Medicaid programs (e.g., Medicaid expansion or 1915(k) Community First Choice) or during an emergency (e.g., the COVID pandemic).<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Flexible Spending Account<\/svg><\/div>

\n

A Flexible Spending Account (FSA) is an employer-sponsored account that lets an individual set aside pre-tax money from their payment to pay for eligible out-of-pocket health care or dependent care expenses, saving money on reducing one\u2019s taxable income. This tax-free money can be used on certain medical expenses, like co-pays, deductibles, prescriptions, dental, and vision care.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Front-End Coverage<\/svg><\/div>

\n

This refers to a public program that pays benefits from the start of eligibility for benefits, but only up to a limited dollar amount or period of time.\u00a0 This may generally be set at $36,500 or $75,000 or some other amount, which roughly equates to 1 or 2 years of coverage.\u00a0 A dollar amount provides more flexibility for the covered person to use benefits only on days when family care is not available so that they can make the front-end coverage last longer, from a time period perspective.<\/p>\n<\/p><\/div><\/div>

Full Retirement Age<\/svg><\/div>

\n

Full retirement age, also known as normal retirement age, is the age at which individuals can
receive full Social Security benefits. It ranges from those who are born in 1957 or earlier who
are already eligible for full benefits, to age 67 for those born in 1960 or later.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Functional Criteria<\/svg><\/div>

\n

Functional criteria refer to the degree and nature of loss in the ability to perform ADLs. The
precise definition of the functional criteria is what defines the circumstances under which a
LTC insurance policy or program pays for LTSS.<\/p>\n<\/p><\/div><\/div><\/div>

G<\/div>
General Appropriations<\/svg><\/div>

\n

An appropriation is a legal process where a legislative body (like Congress or a state legislature) grants permission for government agencies or departments to spend money from public funds.\u00a0 The purpose of an appropriation is to authorize spending for specific programs, projects, or activities.\u00a0<\/strong><\/p>\n<\/p><\/div><\/div>

Guaranteed Issue<\/svg><\/div>

\n

This refers to a very streamlined underwriting or medical screening used to qualify someone for long term care insurance.\u00a0 It is generally only used for policies sold to actively-at-work employees on a group policy.\u00a0 This means they are automatically eligible for the coverage simply because they are currently actively at work for a pre-defined number of hours per week and for a certain period prior to the offer of the insurance policy.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div><\/div>

H<\/div>
Department of Health and Human Services (HHS)<\/svg><\/div>

\n

Department of Health and Human Services<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Health Insurance Portability and Accountability Act (HIPAA)<\/svg><\/div>

\n

The Health Insurance Portability and Accountability Act (HIPPA) of 1996 clarified the tax treatment of LTC insurance premiums and benefits, created standards that policies must meet to be deemed as a tax-qualified (TQ) LTC policy. The IRS treats LTC insurance premiums and LTC costs as medical expenses that are deductible under certain circumstances (e.g., age-based limits).\u00a0<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Health Resources and Services Administration (HRSA)<\/svg><\/div>

\n

Department of Health Services and Resource Administration<\/p>\n<\/p><\/div><\/div>

Health Savings Account<\/svg><\/div>

\n

Health Savings Account (HSA) is a type of savings account that lets individuals set aside money on a pre-tax basis to use as needed, to pay for qualified medical expenses. By using untaxed dollars in an HSA to pay for deductibles, copayments, coinsurance, and other expenses not covered by insurance (e.g., vision, dental, or medications), individuals may be able to lower out-of-pocket health care costs. Only someone who has a qualified health insurance policy that is eligible as a High-Deductible Health Plan can establish an HSA. An HSA may earn interest or other earnings, which are not taxable. Banks, credit unions, and other financial institutions offer HSAs.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Home and Community-Based Services (HCBS)<\/svg><\/div>

\n

Home and community-based services (HCBS) refer to a broad range of services provided in the home or community when someone needs help with ADLs<\/strong> or IADLs <\/strong>due to a cognitive impairment<\/strong> or other physical or mental disability. HCBS includes skilled nursing and personal care, adult day care, respite care, home-delivered meals, in-home or community-based therapies and supports, transportation, habilitation, residential supports, hospice care, nutrition care, medication management, and more.\u00a0<\/p>\n<\/p><\/div><\/div>

Home Health Care Services<\/svg><\/div>

\n

Home health care services include a wide range of services that can be received in the home, aimed at helping patients recover, manage chronic conditions, and regain independence. Home health care services typically involve skilled nursing, therapy, and aide services for support with medication management, rehabilitation, wound care, and other elements as needed.\u00a0<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Hospice Care<\/svg><\/div>

\n

Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life. Similar to palliative care, hospice care provides comprehensive care to the family. Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live.<\/p>\n<\/p><\/div><\/div><\/div>

I<\/div>
Immediate Life Annuity<\/svg><\/div>

\n

This is an insurance product purchased with a single premium payment (i.e., lump sum of money) to an insurance company.\u00a0 Shortly after purchase, the buyer receives a guaranteed income stream payout as specified in the terms of the insurance contract.\u00a0 This is a retirement insurance product that is used to convert a defined amount of savings into a guaranteed stream of income, often paid out for the individual\u2019s life.<\/p>\n<\/p><\/div><\/div>

Inflation Adjustment<\/svg><\/div>

\n

Inflation adjustment is a policy provision that allows benefit payments to increase over time,
either automatically or periodically. These increases help coverage keep pace with inflationdriven
increases in the costs of care. Inflation protection provisions are structured in many
different ways. The insured generally chooses from several options for how they want this
provision to work within their policy, or they can choose not to have their benefits increase
over time.<\/p>\n<\/p><\/div><\/div>

Instrumental Activities of Daily Living (IADLs)<\/svg><\/div>

\n

Instrumental activities of daily living (IADLs) are activities that allow an individual to live independently in a community. The major domains of IADLs include cooking, cleaning, transportation, laundry, and managing finances. IADLs require more advanced skills than basic ADLs.<\/strong><\/p>\n<\/p><\/div><\/div>

Internal Revenue Code<\/svg><\/div>

\n

The Internal Revenue Code (IRC) of 1986 is the domestic portion of federal statutory tax law in the U.S. It covers federal income tax, payroll tax, and estate, gift and excise taxes.\u00a0<\/p>\n<\/p><\/div><\/div>

Internal Revenue Service (IRS)<\/svg><\/div>

\n

Bureau of Internal Revenue Service<\/p>\n<\/p><\/div><\/div><\/div>

L<\/div>
Licensed Health Care Practitioner<\/svg><\/div>

\n

A licensed health care practitioner, as defined within Chapter 26 of the U.S Code Section 7702B(c)(4), is any physician and any registered nurse, licensed social worker, or other individual who meets such requirements as may be prescribed by the Secretary of Health and Health Services.<\/p>\n<\/p><\/div><\/div>

Lifespan Respite Care Program<\/svg><\/div>

\n

The Lifespan Respite Care Program provides temporary relief for family caregivers of children and adults across all age groups, disabilities, and chronic conditions. Since 2009, the federal government has awarded grants to state agencies to provide accessible, community-based respite care services.<\/p>\n<\/p><\/div><\/div>

Lifetime Benefit Limit<\/svg><\/div>

\n

The Lifetime Benefit Limit is the maximum dollar benefit an individual may receive under an
insurance policy, plan, or program. Once the lifetime limit is reached, no additional benefits
or payments will be made.<\/p>\n<\/p><\/div><\/div>

Long-term Care (LTC)<\/svg><\/div>

\n

LTC is a term used interchangeably with LTSS.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Long-term Services and Supports (LTSS)<\/svg><\/div>

\n

Long term services and supports (LTSS) encompass the broad range of paid and unpaid medical and personal care services that assist with ADLs<\/strong> and IADLs<\/strong>. LTSS are provided to people who need care because of aging, chronic illness, or disability. LTSS includes institutional care and care provided in the community known as HCBS<\/strong>. LTSS includes nursing facility care, adult day care, home health aide, personal care services, transportation, and more. LTSS may be provided over a period of several weeks, months, or year.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div><\/div>

M<\/div>
Mandatory<\/svg><\/div>

\n

Mandatory refers to the requirement that anyone and everyone who meets the eligibility
requirements for a specified program is required to enroll\/participate in it. The only exception
might be if conditions or time periods for the ability to \u201copt out\u201d are specified in the program
rules.<\/p>\n<\/p><\/div><\/div>

Medicaid<\/svg><\/div>

\n

Medicaid is jointly financed and administered by federal and state governments authorized under Title XIX of the Social Security Act Amendments of 1965. It pays for health care services for those with very limited assets and low incomes, or those who have very high medical bills in relation to their income and\/or assets.\u00a0<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Medicaid Home and Community-Based Service (HCBS) Waivers<\/svg><\/div>

\n

Medicaid Home- and Community-Based Service (HCBS) waivers are state-run programs allowing Medicaid to fund long-term care services in homes or communities instead of institutions, like nursing homes. States can offer a variety of services under an HCBS waiver program, including case management, homemaker, home health aide, personal care, adult day health services, habitation, and respite care.<\/p>\n<\/p><\/div><\/div>

Medicaid Self-Directed LTSS Program<\/svg><\/div>

\n

A Medicaid Self-Directed LTSS Program is a delivery model that prioritizes personal choice and control, allowing people with LTSS <\/strong>needs to live in their home or a home-like setting in the community. Self-direction is an HCBS <\/strong>delivery model that allows the individual choice in their service provider(s) and control over the amount, duration, and scope of services and supports in their person-centered service plan.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Medicare<\/svg><\/div>

\n

Medicare is the federal program organized under the Health Insurance for the Aged Act, Title
XVIII of the Social Security Amendments of 1965. It provides hospital and medical expense
benefits for persons age 65+, or those meeting specific disability standards. Benefits for
nursing facility and home health services under Medicare are very limited.<\/p>\n<\/p><\/div><\/div>

Medicare Advantage<\/svg><\/div>

\n

Medicare Advantage consists of Medicare-approved plans from private companies that offer alternatives to traditional Medicare for health care coverage. These \u201cbundled\u201d plans include Part A, Part B, and usually Part D. Plans may offer some extra benefits that traditional Medicare does not (e.g., limited dental, vision, hearing, etc.)\u00a0<\/p>\n<\/p><\/div><\/div>

Medicare Part A<\/svg><\/div>

\n

This refers to the\u00a0Hospital Insurance\u00a0portion of Medicare that pays for inpatient hospital stays, skilled nursing facility care, hospice, and some limited home health care. Most people receive Part A for free because they or their spouse paid Medicare taxes for at least 10 years, but some may need to pay a monthly premium.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Medicare Part B<\/svg><\/div>

\n

This part of Medicare coverage pays medically necessary services and supplies outside of a hospital stay, such as outpatient care, preventative services, and doctor visits.\u00a0 Individuals generally pay a monthly premium for Part B ($206.50 in 2026) and must also satisfy a $288 deductible before they can receive benefits.\u00a0 There is also generally a 20% copayment on covered care.<\/p>\n<\/p><\/div><\/div>

Modified Guaranteed Issue (MGI).<\/svg><\/div>

\n

This is another type of underwriting or medical screening used to determine if someone can qualify for long term care insurance.\u00a0 It is significantly abbreviated when compared to the full underwriting generally used for purchase of individual long term care insurance.\u00a0 Typically, someone would qualify for a policy under MGI if they do not currently need long term care and are currently independent in their activities of daily living and do not have any cognitive impairment.\u00a0 They also must not have one of a handful of neurodegenerative diseases that are strongly associated with the need for long term care such as multiple sclerosis, Parkinsons\u2019 disease and others.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Money Follows the Person (MFP)<\/svg><\/div>

\n

Money Follows the Person (MFP) refers to a federal demonstration program that aims to shift long-term care spending from institutions to HCBS<\/strong>. MFP allow Medicaid <\/strong>funds to follow the individual and provides enhanced federal funding during their first year of transition, allowing them to live independently and promoting care in the community.\u00a0<\/p>\n<\/p><\/div><\/div>

Multisector Plan for Aging<\/svg><\/div>

\n

A multisector plan for aging (MPA) is an umbrella term for a state-led, multi-year planning process that convenes cross-sector agencies and stakeholders to collaboratively address the needs of older adults, and some plans also include people with disabilities.<\/p>\n<\/p><\/div><\/div><\/div>

N<\/div>
National Association of Insurance Commissioners<\/svg><\/div>

\n

The National Association of Insurance Commissioners (NAIC) is a trade association of state
insurance commissioners that issues model insurance acts and regulations that states can
adopt.<\/p>\n<\/p><\/div><\/div>

National Family Caregiver Support Program (NFCSP)<\/svg><\/div>

\n

Established in 2000, the National Family Caregiver Support Program (NFCSP) provides grants to states and territories to fund various supports that help family and informal caregivers care for older adults in their homes for as long as possible. Specifically, it provides information to caregivers about available services, assistance to caregivers in gaining access to the services, individual counseling, organization of support groups, and caregiver training, respite care, and supplemental services.<\/p>\n<\/p><\/div><\/div><\/div>

O<\/div>
Office of Management and Budget (OMB)<\/svg><\/div>

\n

Office of Management and Budget<\/p>\n<\/p><\/div><\/div>

Older Americans Act (OAA)<\/svg><\/div>

\n

The primary federal law, enacted in 1965, that supports community-based services for adults aged 60 and older. Through state and local aging agencies, the OAA funds programs that help older adults live independently and with dignity in their homes and communities, including nutrition services, transportation, health promotion, legal assistance, information and referral, senior centers, and family caregiver support through the\u00a0National Family Caregiver Support Program (NFCSP)<\/strong>.<\/p>\n<\/p><\/div><\/div>

Organic Brain Dysfunction<\/svg><\/div>

\n

Organic brain dysfunction or organic brain disorder is an older, umbrella term for impaired mental functioning (cognition, memory, behavior, mood) caused by a known physical or psychological brain issue, often resulting from injury, diseases (like Alzheimer\u2019s Disease), infection, or toxins, now often called a neurocognitive disorder. Symptoms include confusion, memory loss, personality changes, or delirium.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div><\/div>

P<\/div>
Palliative Care<\/svg><\/div>

\n

Palliative care focuses on improving the quality of life for people with serious illnesses and their caregivers. The major elements of palliative care include managing a person\u2019s symptoms effectively and ensuring that their care is coordinated. Palliative care can start as early as a person\u2019s diagnosis or not until later in their illness, and it can occur alongside other types of treatment for the disease.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Partnership-Qualified Long-Term Care Insurance Plan<\/svg><\/div>

\n

A partnership qualified LTC insurance plan is a type of private LTC coverage that allows
individuals to keep some additional assets beyond the usual Medicaid impoverishment limits,
if they apply for Medicaid after using up the benefits of private LTC coverage. The amount of
\u201cspend down protection\u201d received (i.e., the additional amount of assets individuals can keep)
is equal to the amount of benefits paid to under a private Partnership policy.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Person-Centered Care<\/svg><\/div>

\n

Person-centered care (PCC) is a way of delivering health care that focuses on the needs of each individual and takes account and places at the center of care their goals, values, and preferences. It is based on the idea that people should be treated as individuals, not just as a bundle of conditions to be treated.\u00a0<\/p>\n<\/p><\/div><\/div>

Personal Health Information<\/svg><\/div>

\n

Personal health information refers to confidential data related to an individual’s health, which must be protected according to the privacy rules outlined in the Health Insurance Portability and Accountability Act<\/a> (HIPAA) and state laws.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Program of Comprehensive Assistance for Family Caregivers (PCAFC)<\/svg><\/div>

\n

The Program of Comprehensive Assistance for Family Caregivers (PCAFC), run by the U.S. Department of Veterans Affairs (VA), offers clinical support, education, and financial support to family caregivers of eligible Veterans with serious service-connected injuries or illnesses needing significant personal care, aiming to support the caregiver\u2019s well-being alongside the Veteran\u2019s. Benefits can include stipends, health insurance, mental health counseling, respite care<\/strong>, and training, provided the Veteran requires daily help with at least one ADL<\/strong>.<\/p>\n<\/p><\/div><\/div>

Program of General Caregiver Support Services (PGCSS)<\/svg><\/div>

\n

The Program of General Caregiver Support Services (PGCSS) is a U.S. Department of Veterans Affairs (VA) initiative offering support like peer mentoring, coaching, skills training, and online resources to caregivers of Veterans enrolled in VA healthcare, helping them manage caregiver responsibilities, connect with others, and enhance their skills without requiring specific family ties with the Veteran.<\/p>\n<\/p><\/div><\/div>

Public Health Service Act (PHSA)<\/svg><\/div>

\n

The Public Health Service Act (PHSA) is a federal statute that grants authority to the Department of Health and Human Services to enforce quarantine regulations, prevent communicable diseases, develop plans to control epidemics, and respond to public health emergencies.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

The Program of All-Inclusive Care for the Elderly (PACE)<\/svg><\/div>

\n

The Program of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program
that helps people meet their health care needs in the community instead of going to a
nursing facility or other care facility.<\/p>\n<\/p><\/div><\/div><\/div>

Q<\/div>
Qualified Medicare Beneficiary (QMB) Program<\/svg><\/div>

\n

This is a state program to help low-income individuals pay for the out of pocket expenses (deductibles, premiums, and copayments) associated with Medicare.\u00a0 Individuals qualify for the QMB program support once they meet specified income and asset limits.<\/p>\n<\/p><\/div><\/div><\/div>

R<\/div>
RAISE Family Caregiver Act<\/svg><\/div>

\n

The RAISE (Recognize, Assist, Include, Support, & Engage) Family Caregivers Act is a 2018 U.S. law directing the Department of Health and Human Services to develop a national strategy to support family caregivers<\/strong>, recognizing their vital role in elder care, disability support, and chronic illness management by creating a roadmap with actions for federal, state, and private sectors to improve caregiver access to education, financial security, training, and respite s<\/strong>ervices.<\/p>\n<\/p><\/div><\/div>

Related Bill<\/svg><\/div>

\n

A related bill is a legislative measure that shares significant text, purpose, or subject matter with another bill. These are identified by Congress.gov, the House, the Senate, or the Congressional Research Service to help track similar legislative action. A bill that was introduced in a prior session of Congress would be considered a related bill to the current version.<\/p>\n<\/p><\/div><\/div>

Research, Demonstration, and Evaluation Center for the Aging Network<\/svg><\/div>

\n

The Research, Demonstration, and Evaluation Center for the Aging Network, which the Administration for Community Living refers to as the ACL Innovation Lab, was created in 2023 in effort to identify, test, and scale effective programs for older adults, focusing on areas like falls prevention.<\/p>\n<\/p><\/div><\/div>

Respite Care<\/svg><\/div>

\n

Respite care is temporary care in a nursing facility, assisted living facility, adult day care center, or at home or community-based setting. Respite care is intended to provide time off for informal caregivers who ordinarily care for individuals on a regular basis. Respite care is usually short-term \u2013 typically 14 to 21 days of care per year.\u00a0<\/p>\n<\/p><\/div><\/div><\/div>

S<\/div>
Service-based Disability Payment.<\/svg><\/div>

\n

This is like a cash benefit payment; however, it is only paid to the care recipient if there is evidence of provision of a service or that a service-related expenses has been incurred.\u00a0 Quite often, the disability payment amount may be pre-established without regard to the service costs or expenditures, but it is not paid unless a service is provided or an expense is incurred.\u00a0 In contrast, a pure cash disability payment is triggered only upon the individual satisfying a specified level and type of disability (e.g., loss in 2 or more ADLs) and does not additionally require the use of services.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Social Insurance<\/svg><\/div>

\n

Social insurance is a universally funded financial safety net administered by the government.
Programs include Social Security, unemployment insurance, and Medicare, among others.
Social insurance differs from public assistance based on funding sources. Social insurance is
funded by contributions of each citizen who benefits from the services (typically through a
tax on payroll or premium) rather than exclusively on general tax revenues.<\/p>\n<\/p><\/div><\/div>

Social Security<\/svg><\/div>

\n

Social security is a U.S. federal insurance program providing retirement, disability, and survivor benefits, funded by payroll taxes from workers and employers, offering financial security for eligible Americans when they can\u2019t work or after retirement. Social security is administered by the Social Security Administration.\u00a0<\/p>\n<\/p><\/div><\/div>

Social Security Administration (SSA)<\/svg><\/div>

\n

Social Security Administration<\/p>\n<\/p><\/div><\/div>

Standard Occupational Classification System<\/svg><\/div>

\n

The Standard Occupational Classification system is federal statistical standard used by federal agencies to classify workers into occupational categories for the purpose of collecting, calculating, or disseminating data.<\/p>\n<\/p><\/div><\/div>

State Plan Amendment (SPA)<\/svg><\/div>

\n

State Plan Amendment (SPA) is the formal procedure and documentation that a state is
required to use when it is planning to make a change in its Medicaid program coverage or
administrative or eligibility procedures.<\/p>\n<\/p><\/div><\/div>

Supporting Grandparents Raising Grandchildren Act<\/svg><\/div>

\n

The Supporting Grandparents Raising Grandchildren (SGRC) Act of 2018 established a federal Advisory Council to Support Grandparents Raising Grandchildren, tasking it with identifying and disseminating resources, best resources, and information to help relative caregivers meet children\u2019s help, education, nutrition, and other needs while maintaining their own physical, mental, and emotional well-being.<\/p>\n<\/p><\/div><\/div><\/div>

T<\/div>
Tax Credit<\/svg><\/div>

\n

A tax credit is a dollar-for-dollar amount taxpayers claim on their tax return to reduce the income tax they owe. Eligible taxpayers can use them to reduce their tax bill and potentially increase their refund.<\/p>\n<\/p><\/div><\/div>

Tax Deduction<\/svg><\/div>

\n

A tax deduction reduces the amount of a taxpayer\u2019s income that\u2019s subject to tax, generally reducing the amount of tax the individual may have to pay. Most taxpayers qualify for the standard deduction, a specific dollar amount the IRS adjusts each year for inflation, and some taxpayers choose to itemize their deductions.<\/p>\n<\/p><\/div><\/div>

Tax-Qualified Long-Term Care Insurance Plan<\/svg><\/div>

\n

A tax-qualified LTC insurance plan is a policy that conforms to certain standards in federal
law and offers certain federal tax advantages to people buying the policy.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Technical Assistance (TA)<\/svg><\/div>

\n

Technical assistance (TA) is a category of activities undertaken by federal agencies and grant recipients to provide resources to stakeholders to assist with navigating the federal grant process and to increase the capacity of grant applicants and recipients to apply for, and manage, federal grant funding.<\/p>\n<\/p><\/div><\/div>

Toileting<\/svg><\/div>

\n

An activity of daily living (ADL)<\/strong>, toileting involves getting to and from, and on and off the
toilet, and performing associated personal hygiene.<\/p>\n<\/p><\/div><\/div>

Transferring<\/svg><\/div>

\n

An activity of daily living (ADL), transferring involves moving into and out of a bed, chair or
wheelchair.<\/p>\n<\/p><\/div><\/div>

Transforming Healthcare Structures<\/svg><\/div>

\n

This refers to finance reform that includes a combination of approaches from various categories that include expanding Medicare, reforming Medicaid structures, creating a new program, and\/or introducing incentives for private market performance improvements and expansion.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div><\/div>

U<\/div>
Universal<\/svg><\/div>

\n

Universal refers to the type of coverage where anyone and everyone who meets the eligibility
requirements for a specified program is required to enroll\/participate in it. The only exception
might be if conditions or time periods for the ability to \u201copt out\u201d are specified in the program
requirements.<\/p>\n<\/p><\/div><\/div><\/div>

V<\/div>
The United States Department of Veterans Affairs (VA)<\/svg><\/div>

\n

US Department of Veterans Affairs<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

VA Caregiver Support Program (CSP)<\/svg><\/div>

\n

The Department of Veteran Affairs (VA) Caregiver Support Program (CSP) offers clinical services to caregivers of eligible and covered Veterans enrolled in the VA health care system. The program\u2019s mission is to promote the health and well-being of family caregivers <\/strong>who care for the nation\u2019s Veterans, through education, resources, support, and services.<\/p>\n\n\n\n

<\/p>\n<\/p><\/div><\/div>

Voluntary<\/svg><\/div>

\n

In the context of a public insurance program, voluntary refers to the fact that participation in the program is at the discretion of the individuals eligible to participate.\u00a0 It is not mandatory, but optional to them whether or not they participate.<\/p>\n<\/p><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t\t
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<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Glossary Understanding Key Terms in Caregiving and Long-Term Services and Supports This glossary provides clear, plain-language definitions of important terms frequently used in caregiving research, policy, and practice. As you explore the interactive caregiving compendium and related materials, this resource can help clarify concepts like Instrumental Activities of Daily Living (IADLs) and Person-Centered Care. 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