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111 rules
Internal management rules.
119 rules
Rules that impact external entities and must go through the public constituency process.
408
A budget line item implementing the fiscal aspects of the mental health act of 1988. Funds in this line item shift over multiple years from the Ohio Department of Mental Health (ODMH) to local mental health boards to pay for inpatient services as well as community services for people with severe mental illnesses.
419
A budget line item that provides funding for community medication subsidies.
505
A budget line item that provides funding to community mental health (CMH) and alcohol, drug addiction and mental health (ADAMH) boards to provide local mental health services.
835
Health Care Claim Payment Advice (Electronic HIPAA Format) -- electronic format for explaining the payments of health care claims.
837P
Professional Health Care Claim (Electronic HIPAA format) used in MACSIS for services provided on or after July 1, 2003.
1199
District 1199 Service Employees International Union (SEIU), AFL-CIO, Hospital and Health Care Workers.
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ABD
Aged, Blind and Disabled. A Medicaid eligibility category defined as those Ohioans who financially qualify and are 65 or older, blind or who have disabilities.
ACCESS
The assurance that consumers are aware of the local array of mental health services and are afforded the opportunity to receive needed services and supports in a timely manner.
ADULT CARE FACILITY (ACF)
Facilities licensed by the Ohio Department of Mental Health that provide room, board and personal assistance to individuals in need across the state of Ohio.
ACMS
Automated Cost Management System.
ACUTE
Severe but of short duration, not chronic.
ACT
Assertive Community Treatment.
ADAMH/CMH
Alcohol, drug addiction and mental health/community mental health boards. One of the 50 community mental health boards established by Ohio Revised Code, Chapter 340.03 to provide planning, management and funding of mental health services in Ohio at the local level.
ADC
Aid to Families with Dependent Children. A Medicaid eligibility category also referred to as Ohio Works First (OWF) or TANF (Temporary Assistance to Needy Families).
ADRP
Average Daily Resident Population. Measurement describing hospital utilization.
ADVANCE DIRECTIVES
A legal means (document) by which a person can specify his/her choice about how he/she will be treated in the event that his/her illness renders him/her incapable of exercising choice.
ADVOCACY
Activities in support of individuals with mental illness, including rights protection, legal and services assistance, as well as system or policy changes.
AFSCME
American Federation of State, County and Municipal Employees.
AGED, BLIND AND DISABLED (ABD)
Medicaid eligibility category defined as those Ohioans who financially qualify and are 65 or older, blind or who have disabilities.
AGEISM
Myths and misperceptions about older people.
AID TO FAMILIES WITH DEPENDENT CHILDREN (ADC)
A Medicaid eligibility category also referred to as Ohio Works First (OWF) or TANF (Temporary Assistance to Needy Families).
ALTERNATIVE EDUCATION INITIATIVE
A statewide interagency effort to improve school success for high-risk children and youth, including removing barriers to student learning.
AMI
National Alliance for the Mentally Ill of Ohio. An organization dedicated to self-help and family advocacy and improving the lives of those with severe mental illnesses. The organization was built with four cornerstones in mind: support, education, advocacy and research.
AOD
Alcohol or Other Drug services or diagnosis.
AVERAGE DAILY RESIDENT POPULATION (ADRP)
Measurement describing inpatient hospital utilization.
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BAA (SEE BUSINESS ASSOCIATE AGREEMENT)
BALANCED SCORECARD
A management tool to measure, assess and improve organizational performance. The balanced scorecard develops key measures across four major perspectives (financial, customer, internal process and learning/technology). The Ohio Department of Mental Health has formally adopted the balanced scorecard as part of its strategic planning process.
BEHAVIORAL HEALTH
Describes the combination of mental health and chemical dependency services.
BEST PRACTICES
Interventions and services that have been evaluated and have demonstrated good outcomes for mental health consumers. In general, best practices are approaches that 1) are judged to be exemplary 2) have been developed or based on systematic processes 3) are designed to produce successful outcomes and 4) have undergone rigorous evaluation and research.
BLOCK GRANT
Block Grant funds are provided in a lump sum for a broad range of related activities with less precise purposes and are subject to relatively few regulations, with some approval required for expenditure.
BOARD
One of the 50 community mental health boards established by Ohio Revised Code, Chapter 340.03, to provide local planning, management and funding of mental health services in Ohio at the local level.
BUSINESS ASSOCIATE AGREEMENT (BAA)
An agreement between a covered entity and a person or organization that performs a function or activity on behalf of a covered entity but is not part of the covered entity's workforce. A business associate can also be a covered entity in its own right.
BVR
Bureau of Vocational Rehabilitation of the Ohio Rehabilitation Services Commission (RSC).
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CAB
Citizen's Advisory Board.
CAFE
Clinical and Financial Efficiency. Personnel who examine ways to provide efficiencies for the clinical administration of behavioral healthcare organizations (BHOs) and preserve financial effectiveness for BHOs and Community Support Networks (CSNs).
CAP
1. Client Assistance Program.
2. An upper limit established on a specific category of expenditures.
CAPITATION/CAPITATION RATE
A form of cost containment that pays for a service based on a set rate per person per time period. The insurer pays providers a fixed amount in advance (prospectively) for each person eligible for service, usually on a monthly or annual basis, regardless of the number and type of services used.
CARF
Commission on Accreditation of Rehabilitation Facilities (one of the national accrediting bodies).
CARVE OUT
A benefit strategy in which certain benefits are administered separately from other benefits.
CASE MANAGEMENT
Services that link the individual with appropriate service providers, monitors progress and provides advocacy services.
CATEGORICAL GRANT
Federal money given to states or state money given to boards for a specific set of purposes, subject to a relatively large number of regulations See Block Grant.
CCOE
Coordinating Center of Excellence. Expert resources in Ohio responsible for promoting the use of a specific set of clinical best practices that support recovery and resiliency among individuals receiving mental health services.
CENTER FOR INNOVATIVE PRACTICES (CFIP)
An Ohio Department of Mental Health supported/sponsored Center of Excellence focused on assisting communities to implement multi-systemic therapy.
CENTERS OF EXCELLENCE
Expert resources in Ohio responsible for promoting the use of a specific set of clinical best practices that support recovery and resiliency among individuals receiving mental health services.
CCO
Chief Clinical Officer.
CEO
Chief Executive Officer.
CERTIFICATION
Refers to written authorization from the Ohio Department of Mental Health for an agency to operate specific services and provide activities according to the Ohio Administrative Code. These services and activities are included in the agency's contract or subcontract with a community mental health board or for a non-contract agency that has voluntarily applied.
CFR
Code of Federal Regulations.
CIT
Crisis Intervention Training.
CLINICAL BEST PRACTICES
Consumer-focused, evidence-based interventions and services that are believed to result in good outcomes for consumers.
CLINICAL QUALITY AGENDA
Focuses on the use of auality improvement, consumer outcomes and evidence-based practices within the framework of recovery, resiliency and cultural competence.
CLINICAL QUALITY SERVICES
Convenient, comprehensive services that meet individual needs and are delivered in a clinical and culturally competent manner.
CLUSTER GROUPS
A group of state and/or local agencies that cooperate to plan and provide services for difficult-to-serve populations.
CMHC
Community Mental Health Center.
CMHS
Center for Mental Health Services (National Institutes for Health).
CMS
Centers for Medicare and Medicaid Services (formerly know as Health Care Financing Agency - HCFA). This is the U.S. Health and Human Services (HHS) agency responsible for Medicare and parts of Medicaid. CMS is responsible for oversight of the Health Insurance Portability and Accountability Act (HIPAA) administrative simplification transaction and code sets, health identifiers and security standards. CMS also maintains the Health Care Common Procedure Coding System (HCPCS) medical code set and the Medicare Remittance Advice Remark Codes administrative code set.
CNM
Clinical Nurse Manager.
COA
Council on Accreditation for Children and Family services (one of the national accrediting bodies).
COB
Consumer-Operated Business.
COEDI
Children's Ohio Eligibility Determination Instrument. Refers to a test that determines the eligibility of people for state and county mental retardation and developmental disabilitiy services.
COLLABORATIVE
Regional planning committee comprised of the local mental health boards and area behavioral healthcare organizations that mutually plan for the utilization of inpatient and Community Support Network (CSN) services as well as the joint development of clinical initiatives and best practices.
CoMD
Council of Medical Directors.
COMMUNITIES THAT CARE
A risk and protection-focused prevention model based on decades of research on the causes and correlations of juvenile problem behavior.
COMMUNITY LINKAGE
A program that is designed to link individuals being released from incarceration to community mental health services.
COMMUNITY LINKAGE CONTACT
A person, agency or entity designated by the alcohol, drug addiction and mental health services and community mental health services (ADAMHS/CMH) boards to be contacted to assist in making community agency appointments for offenders with mental illness who are being released from prison.
COMMUNITY MENTAL HEALTH BOARD
One of the 50 community mental health boards established by the Ohio Revised Code that provides local planning, management and funding of mental health services in Ohio at the local level.
COMMUNITY MENTAL HEALTH CENTERS ACT
Federal legislation that authorized federal funding for the creation of comprehensive community-based mental health centers; such centers were mandated to provide a specific set of services on a discretionary basis.
COMMUNITY SUPPORT NETWORK (CSN)
Community mental health services provided by state mental health workers to people with severe mental illnesses who are living in the community. This was formerly called State Operated Services (SOS).
COMMUNITY SUPPORT PROGRAM (CSP)
A system of services to meet the needs of children and adults with serious mental illness who are capable of living in the community with appropriate rehabilitation and support services.
COMPETENCE
1. Implies having the capacity to function effectively.
2. Refers to a legal term (i.e. competency to stand trial).
COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE)
A system used in the Integrated Behavioral Health Care System (IBHS) behavioral healthcare organizations to facilitate online entering of medication orders into the Patient Care System (PCS).
CONCURRENT REVIEW
The managed care technique of continuously evaluating the appropriateness of service usage.
CONSUMER
A person who has been or is receiving mental health services and/or supports.
CONSUMER OUTCOMES
See Ohio Mental Health Consumer Outcomes Initiative.
CONTINUUM OF CARE OR SERVICES
A range of services including: medical, psychological, pre-vocational, vocational, educational, recreational, social and residential, which enable a person to progress and maintain the highest possible level of functioning.
CO-OCCURING DISORDERS
The simultaneous presence of two or more disorders (e.g. substance abuse and mental illness).
COORDINATING CENTER OF EXCELLENCE (CCOE)
Expert resources in Ohio responsible for promoting the use of a specific set of clinical best practices that support recovery and resiliency among individuals receiving mental health services.
COS
Consumer Operated Service.
COUNCIL
A term frequently used to refer to Ohio Council of Behavioral HealthCare Providers.
CPOE
Computerized Physician Order Entry. A system used in the IBHS BHOs to facilitate online entering of medication orders into the Patient Care System (PCS).
CRA
Client Rights Advocate.
CRO
Client Rights Officer.
CSN
Community Support Network. Community mental health services provided by state mental health workers to people with severe mental illnesses who are living in the community. Formerly called State Operated Services (SOS).
CSP
Community Support Program. A system of services to meet the needs of children and adults with serious mental illness who are capable of living in the community with appropriate rehabilitation and support services.
CULTURE
The integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values and institutions of racial, ethnic, religious, age or social groups and demographics.
CULTURAL COMPETENCE
A set of congruent behaviors, attitudes and policies that integrate within a system, agency or among professionals, and enables that system, agency or professional to work effectively in cross-cultural situations.
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DAILY LIVING SKILLS TRAINING
Training or retraining in basic skills of daily living in actual living situations, such as cooking, shopping, budgeting and cleaning.
DEINSTITUTIONALIZATION
Preventing unnecessary retention in and admission to public hospitals through the timely discharge of admitted patients and the diversion of potential candidates for admission to other treatment services and facilities. With the passage of the Community Mental Health Centers Act of 1963, deinstitutionalization of mentally disabled people became a national mental health policy.
DEVOLVED
A practice of moving the responsibilities down to more local levels of government.
D/HOH
Deaf/Hard of Hearing.
DIVERSION PROGRAMS
Programs designed to screen people out of the criminal justice system and into appropriate mental health/drug/alcohol services before the person becomes incarcerated.
DON
Director of Nursing.
DUNN v. VOINOVICH
This lawsuit grew out of the Lucasville prison riots and was settled out of court. It restructured the way mental health services are delivered within state prisons in Ohio.
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EARLY CHILDHOOD MENTAL HEALTH
Early childhood mental health is the social, emotional and behavioral well-being of children birth through five years, including the developing capacity to: experience, regulate and express emotion; form close, secure relationships; and explore the environment and learn. ODMH supports an initiative that provides parents and caregivers of young children with the knowledge and skills necessary to help their children develop into mentally healthy individuals.
EDI
Electronic Data Interchange. Refers to the exchange of routine business transactions from one computer to another in a standard format, using standard communications protocols.
ELECTRONIC DATA INTERCHANGE (EDI)
Refers to the exchange of routine business transactions from one computer to another in a standard format, using standard communications protocols.
EMERGING BEST PRACTICES
Defines the current best practices that consumers, clinicians and community supports use to facilitate the recovery process. New best practices are continuing to emerge.
EPMC
Executive Policy Management Committee.
ERISA
Employee Retirement Income Security Act. Refers to federal laws that govern employer-based retirement, health care coverage and other employee benefit plans. ERISA supercedes almost all state laws that affect employee benefits.
ERA
Electronic Remittance Advice (Pre-HIPAA format).
ET (Executive Team)
An Ohio Department of Mental Health team comprised of the director and deputy directors.
EVIDENCE-BASED PRACTICES (EBP)
The conscientious, explicit and judicious use of current best evidence in making decisions about the care of an individual.
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FAMILY AND CHILDREN FIRST CABINET COUNCIL
This council includes the directors of the following Ohio departments: Alcohol and Drug Addiction Services; Budget and Management; Education; Health, Job and Family Services; Mental Health; Mental Retardation and Developmental Disabilities and Youth Services. The Governor or his designee chairs the Council.
FAMILY STABILITY INCENTIVE FUND
A performance based, multi-agency program designed to reduce the number of children and youth placed out of their homes. Services include but are not limited to financial assistance, family support, crisis counseling and respite care.
FAMILY SUPPORT
People identified by the consumer as either family members or significant others who provide the necessary support needed for recovery.
FEE FOR SERVICE
Refers to the predominant method of payment for healthcare in which a payor pays a provider for treatment provided upon submission of a valid claim, in accordance with agreed upon business rules. This payment method is distinguished from those used in some managed care plans, such as capitation or case rate.
FIDELITY
Research-established criteria used to measure a program's fit with a best practice or an evidence-based program.
FORENSIC
A term used to describe a person with mental illness involved in the criminal justice system. This includes people who are found incompetent to stand trial, not guilty by reason of insanity and those in jails and prisons who have mental illnesses and have been referred to the mental health system by the criminal court for evaluation and treatment.
FTE
Full Time Equivalent (2,080 hours per year).
FY
Fiscal Year. July 1-June 30 is the state fiscal year and October 1-September 30 is the federal fiscal year.
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GRADUATE PREPARED PERSON
Person who has attended and graduated from a college/university accredited program to perform or provide services requiring specialized knowledge and skills. An example would be a person practicing in the mental health field who has at least a master's degree or higher in a related field.
GRF
General Revenue Funds (state appropriation).
GROUP HOME
Small community-based residential facility intended for disabled individuals who are capable of living in the community but whose mental health problems or other disabilities prevent them from living independently. Usually such facilities have staff 24 hours a day.
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HALFWAY HOUSE
A place where people are aided in re-adjusting to society following a period of imprisonment, hospitalization or beginning the recovery process from addiction.
HAP
Housing Assistance Program. A short-term rental program to provide subsidy and/or loan assistance for start-up costs. Used with housing that includes a standard tenant landlord lease and no requirements for clinical treatment required as part of the assistance.
HCCC
Home and Community Care Council.
HCFA
Health Care Finance Administration (now called Centers for Medicare and Medicaid Services or CMS).
HEALTH INSURANCE PORTABILITY ACCOUNTABILITY ACT OF 1996 (HIPAA)
A federal law that allows people to qualify immediately for comparable health insurance coverage when they change their employment relationships. HIPAA gives the U.S. Department of Health and Human Services the authority to mandate the use of standards for the electronic exchange of health care data; specify what medical and administrative code sets should be used within those standards; require the use of national identification systems for health care patients, providers, payers (or plans), and employers (or sponsors) and specify the types of measures required to protect the security and privacy of personally identifiable health care information. Also known as the Kennedy-Kassebaum Bill, the Kassebaum-Kennedy Bill, K2 or Public Law 104-191.
HIM
Health Information Manager.
HIPAA
Health Insurance Portability Accountability Act of 1996. A federal law that allows people to qualify immediately for comparable health insurance coverage when they change their employment relationships. HIPAA gives the U.S. Department of Health and Human Services the authority to mandate the use of standards for the electronic exchange of health care data; specify what medical and administrative code sets should be used within those standards; require the use of national identification systems for health care patients, providers, payers (or plans), and employers (or sponsors) and specify the types of measures required to protect the security and privacy of personally identifiable health care information. Also known as the Kennedy-Kassebaum Bill, the Kassebaum-Kennedy Bill, K2 or Public Law 104-191.
HOPE
Housing Outcomes Performance Evaluation. Evaluation that is funded through a 508H/Block Grant and monitored through the housing outcomes process, allowing boards to plan--in the most flexible manner--with a focus on outcome accountability, to meet the array of housing needs that exist in that community.
HOUSING ASSISTANCE PROGRAM (HAP)
A short-term rental program to provide subsidy and/or loan assistance for start-up costs. Used with housing that includes a standard tenant landlord lease and no requirements for clinical treatment required as part of the assistance.
HOUSING OUTCOMES PERFORMANCE EVALUATION (HOPE)
Evaluation that is funded through 508H/Block Grant and monitored through the Housing Outcomes process, allowing boards to plan--in the most flexible manner with a focus on outcome accountability--to meet the array of housing needs that exist in that community.
HUD SECTION 8 VOUCHERS
The section 8 rental voucher and rental certificate programs are the federal government's major programs for assisting very low-income families, the elderly and the disabled to rent decent, safe and sanitary housing in the private market. Since the rental assistance is provided on behalf of the family or individual, participants are able to find and lease privately owned housing, including single family homes, townhouses and apartments. The participant is free to choose any housing that meets the requirements of the program and is not limited to units located in subsidized housing projects.
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ICF
Intermediate Care Facility. An institution licensed under state law to provide health-related care and services to individuals who do not require the degree of care or treatment that a hospital or skilled nursing facility provides.
ICFMR
Intermediate Care Facility (for people who are) mentally retarded.
IMD
Institution for Mental Disease.
IMD WAIVER
Refers to the waiver of federal requirements granted by the U.S. Secretary of Health and Human Services, permissible only in federal demonstration waivers. This allows Medicaid to pay for services for people between the ages of 22 and 64 who are receiving treatment in private or public free-standing psychiatric hospitals.
INCIDENT
Any occurrence which is not consistent with the routine care of a client; the routine services provided by the regional psychiatric hospital or the routine standard of care for the hospital. Incidents include accidents, unusual occurrences or situations that might result in injury to a person or damage to property or equipment. Incidents may involve clients, employees, visitors and other people (O.A.C. § 5122-3-13).
INCIDENT (Community)
Any event that poses a danger to the health and safety of clients, staff and/or visitors of an agency and is not consistent with routine care of people served or routine operations of the agency (O.A.C. § 5122-26-13).
INTENSIVE HOME AND COMMUNITY BASED SERVICES (IHCBS)
Refers to a federal waiver of Medicaid requirements that permits payment for services not ordinarily covered by Medicaid. Also permits individuals to receive income and accumulate resources at levels higher than ordinarily permitted for individuals receiving institutional services paid by Medicaid. Most of the current IHCBS waiver programs are for mentally retarded and developmentally disabled people. This program has very limited applicability for people with mental illness because Medicaid does not pay for institutional services for most adults. See IMD waiver.
INTENSIVE AND SPECIALIZED SERVICES (ISS)
Integrated Behavioral Healthcare System product line. The ISS product line is a continuum of high quality services for adults with acute and/or severe mental illness who require inpatient care. The intensity and specialization of these services is responsive to the unique clinical needs of the individual and board with the goal of recovery.
INTERMEDIATE CARE
Health-related care and services to individuals who do not require the degree of care or treatment that a hospital or skilled nursing facility is designed to provide, but who, because of a mental or physical condition, requires 24-hour availability of nursing care and other services.
INTERMEDIATE CARE FACILITY (ICF)
An institution licensed under state law to provide health-related care and services to individuals who do not require the degree of care or treatment that a hospital or skilled nursing facility provides.
INVOLUNTARY CIVIL COMMITMENT
Standards that permit a state to hospitalize people who are mentally ill against their will because they pose a danger to self or others.
INVOLUNTARY OUTPATIENT COMMITMENT
Enables courts to compel outpatient treatment for those with mental illness who need treatment but who are incapable of deciding voluntarily to seek or comply with treatment orders.
IST-R
Legal status that refers to Incompetent to Stand Trial - Restoration Treatment, pursuant to Section 2945.38(B) of the O.R.C. See the ODMH Forensic Manual for additional information on forensic legal statuses.
IST-U
Legal status that refers to Incompetent to Stand Trial - Unrestorable, pursuant to Section 2945.38(H)(4) of the O.R.C. See the ODMH Forensic Manual for additional information on forensic legal statuses.
IST-U-CJ
Legal status that refers to Incompetent to Stand Trial-Unrestorable-Criminal Court Jurisdiction, pursuant to Section 2945.39(A)(2) of the O.R.C. See the ODMH Forensic Manual for additional information on forensic legal statuses.
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JCARR
Joint Committee on Agency Rule Review is a legislative committee that approves administrative rules.
JCAHO
Joint Commission on Accreditation of Healthcare Organizations.
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LC
Integrated Behavioral Healthcare Leadership Council.
LCO STUDY
Longitudinal Study of Mental Health Services and Consumer Outcomes. This longitudinal study contains two parts. The first part focuses on the effects of system changes on the yearly service patterns of individuals with severe mental illness. The second part focuses on consumers' individual experiences within the mental health system and includes five waves of measurement.
LEAST RESTRICTIVE SETTING
A therapeutic or care-giving setting that allows the maximum amount of freedom of movement consistent with the person's clinical and risk management needs.
LICENSURE (Private Psych)
The Ohio Department of Mental Health's written approval and authorization for an inpatient psychiatric service provider to receive people with a mental disorder for care and treatment as outlined in Section 5122-14-01 of the O.A.C.
LICENSURE (Residential)
Refers to the signed, numbered and dated document issued by the department to the facility that specifies the maximum number of residents for type 1 facilities and the number of household members for type 2 or type 3 facilities. The license shall include the type 1, 2, or 3 and term of licensure (full, probationary or interim). See Reference Section 5122-30 of the O.A.C. for additional information.
LINKAGE PROGRAMS
Programs designed to link individuals being released from the criminal justice system after completing their sentences to ensure appropriate follow-up services.
LONGITUDINAL STUDY OF MENTAL HEALTH (LCO)
This longitudinal study contains two parts. The first part focuses on the effects of system changes on the yearly service patterns of individuals with severe mental illness. The second part focuses on consumers' individual experiences within the mental health system and includes five waves of measurement.
LONG-TERM CARE
Health and/or personal care services required by people who are chronically ill, aged and/or disabled in an institution or at home on a long-term basis. The term is often used more narrowly to refer only to long-term institutional care such as that provided in nursing homes.
LONG-TERM CARE POLICY
Insurance policies that cover specified services for a specified period of time. Long-term care policies (and their prices) vary significantly. Covered services often include nursing care, home health care services and custodial care.
LOS
Length of Stay (number of days in hospital).
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MACSIS
Multi-Agency Community Services Information System. An Ohio automated payment and management information system for mental health services. The outpatient payment information system compiles behavioral health care services for both Medicaid paid and non-Medicaid paid services. Additional information is available on the MACSIS Web site.
MAJOR UNUSUAL INCIDENT(MUI)
An occurrence severe enough to warrant special categorization for purposes of reporting, as described in Section 5122-3-13 of the O.A.C.
MANAGED CARE
A health care delivery system that attempts to keep costs down by managing the care to eliminate unnecessary treatment and to reduce expensive hospital care. The most familiar models are health maintenance organizations (HMOs) and preferred provider organizations (PPOs).
MANDATED HEALTH INSURANCE
State laws requiring insurance companies to offer or provide minimum health benefits.
MATCHING FUNDS
Incentive for local governments to raise local dollars to obtain state or federal funds for the provision of services.
MEDICAID
Federal program that provides health insurance to low-income families who meet certain categorical and financial criteria.
MEDICAID BUY-IN
A federal Medicaid reform enacted by Congress that allows states to modify Medicaid eligibility rules to permit disabled people returning to work to secure extended Medicaid coverage. It also requires these people to contribute toward such coverage.
MEDICAID MATCH
The federal government requires that each state/local government match the federal government funds for Medicaid reimbursement. In Ohio, this is approximately a 60 percent (federal) and 40 percent (state/local) match.
MEDICAID SPEND DOWN
Refers to a set of Medicaid eligibility rules that permits disabled individuals whose income exceeds Ohio's need standard to become eligible for Medicaid by showing proof of expenditures, unusually on a monthly basis, for medical services.
MEDICAID WAIVER
Provision of Omnibus Budget Reconciliation Act of 1981, which allowed for a waiver of regulations prohibiting Medicaid reimbursement for certain community-based services. Waived services must be necessary to prevent institutionalization and cannot include room and board costs.
MEDICALLY NECESSARY
Refers to criteria established by public and private health insurers to ensure medical treatment is necessary and appropriate for the condition or disorder for which treatment is provided. Review methods employed by insurers include retrospective, concurrent and pretreatment reviews.
MEDSTAT STUDY
A study of health care expenditures performed by MEDSTAT, a health information company that provides decision support systems, market intelligence, databases and research for managing the purchase, administration and delivery of health services and benefits.
MENTAL DISORDERS
Health conditions that are characterized by alterations in thinking, mood or behavior (or some combination thereof) associated with distress and/or impaired functioning.
MENTAL HEALTH
A state of successful performance of mental function, resulting in productive activities, fulfilled relationships with other people and the ability to adapt to change and to cope with adversity. From early childhood until death, mental health is the springboard of thinking and communication skills, learning and emotional growth, resilience and self-esteem.
MENTAL HEALTH ACT OF 1988
The Mental Health Act of 1988 changed funding allocations and mandated each alcohol, drug addiction and mental health (ADAMH) board to establish a community support system, provided that people civilly committed would be committed to a board and not a hospital. The act also established a risk fund and clarified the responsibilities of the ADAMH boards as the single authority for the mental health system in each community, including provisions for the community mental health plan.
MENTAL HEALTH ASSOCIATION (MHA)
Any of a number of chapters of the National Mental Health Association, an organization of advocates, providers and others interested in mental health services.
MENTAL HEALTH CORPORTATIONS OF AMERICA
National organization that has a nationwide mental health database. It is used by some boards and their providers to compare their consumer satisfaction data.
MENTAL HEALTH COURTS
Courts that provide continuing judicial supervision of non-violent offenders with mental illnesses or co-occurring disorders.
MENTAL HEALTH SERVICES TO JUVENILE OFFENDERS PROJECT
A pilot project to create comprehensive systems of care for juvenile offenders with mental illnesses.
MENTAL ILLNESS
A term that collectively refers to all mental disorders.
MHA
Mental Health Association. Any of a number of chapters of the National Mental Health Association, an organization of advocates, providers and others interested in mental health services.
MHIS
Mental Health Information System.
MI-MR/DD
Co-occurring mental illness and mental retardation/developmental disabilities.
MOA
Memorandum of Agreement.
MOM
MACSIS Operations Management Team.
MOST IN NEED
The most severely mentally disabled adults.
MSPA
Mutual System Performance Agreement.
MUI
Major Unusual Incident. An occurrence severe enough to warrant special categorization for purposes of reporting, as described in Section 5122-3-13 of the O.A.C.
MULTI-SYSTEMIC THERAPY (MST)
An intensive family and community-based treatment that addresses the multiple determinants of serious anti-social behavior in juvenile offenders. MST addresses the factors known to be related to delinquency across the key settings or systems within which youths are embedded (e.g., family, peers, schools, neighborhoods). MST strives to promote behavior change in the youth's natural environment, using the strengths of each system to facilitate the change.
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NAMI-OHIO
National Alliance for the Mentally Ill of Ohio. An organization dedicated to self-help and family advocacy and improving the lives of those with severe mental illnesses. The organization was built with four cornerstones in mind: support, education, advocacy and research.
NASMHPD
National Association of State Mental Health Program Directors. This non-profit organization is dedicated to serving the needs of the nation's public mental health system through policy development, information dissemination and technical assistance.
NATIONAL ALLIANCE FOR THE MENTALLY ILL OF OHIO (NAMI-OHIO)
An organization dedicated to self-help, family advocacy and improving the lives of those with severe mental illnesses. The organization was built with four cornerstones in mind: support, education, advocacy and research.
NATIONAL ASSOCIATION OF STATE MENTAL HEALTH PROGRAM DIRECTORS (NASMHPD)
NASMHPD is a non-profit organization dedicated to serving the needs of the nation's public mental health system through policy development, information dissemination and technical assistance.
NATIONAL SUICIDE PREVENTION STRATEGY
A strategy that includes 15 key recommendations to assist national, state and local entities in shaping policies and allocating resources to programs.
NEEDS ASSESSMENT
A study that attempts to identify the service needs of populations or special subgroups. A needs assessment may also include an examination of services that are in place and an identification of service gaps.
NGRI
Legal status that refers to Not Guilty by Reason of Insanity, pursuant to Section 2945.40 of the O.R.C. See the ODMH Forensic Manual for additional information on forensic legal statuses.
NIMH
National Institute for Mental Health (now Center for Mental Health Services, National Institutes for Health)
NRI
National Research Institute, a division of the National Association of State Mental Health Program Directors.
NTAC
National Technical Assistance Center, a division of the National Association of State Mental Health Program Directors.
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O.A.C.
Ohio Administrative Code. Codes sections are available online.
OACBHA
Ohio Association of County Behavioral Healthcare Authorities.
OBM
Office of Budget and Management.
OCBHP
Ohio Council of Behavioral Health Professionals. An organization whose vision is to improve the health status of Ohio's communities. It also promotes effective and adequate behavioral health care through its members (providers of mental health and addiction services).
OCSEA
Ohio Civil Service Employees Association. See AFSCME.
ODA
Ohio Department of Aging.
ODADAS
Ohio Department of Alcohol and Drug Addiction Services.
ODDC
Ohio Developmental Disabilities Council.
ODH
Ohio Department of Health.
ODJFS
Ohio Department of Job and Family Services.
ODMH
Ohio Department of Mental Health.
ODMR/DD
Ohio Department of Mental Retardation and Developmental Disabilities.
ODYS
Ohio Department of Youth Services.
OEC
Formed during 2009, the Ohio Empowerment Coalition is a network of individual members and affiliate organizations dedicated to mental health recovery and establishment of a shared vision for mental health advocacy. The OEC is an independent, consumer-run group funded by, but autonomous from, the Ohio Department of Mental Health.
OHA
Ohio Hospital Association.
OHIO ACCESS INITIATIVE
A process initiated by former Governor Taft to provide a comprehensive review of Ohio's services and support systems for people with disabilities and to make recommendations for improving these services.
OHIO ADMINISTRATIVE CODE (O.A.C.)
Codes sections are available online at http://codes.ohio.gov/oac
OHIO CARE
Ohio's proposal to replace the current Medicaid acute care financing system with a managed, comprehensive health care benefit plan to all Ohioans with family incomes at or below 100 percent of poverty (also see BBP and SHRS).
OHIO MENTAL HEALTH CONSUMER OUTCOMES SYSTEM
A standardized way of measuring and reporting outcomes of consumers receiving services in the Ohio community mental health system.
OHIO REVISED CODE
Codes are available online at http://codes.ohio.gov/orc.
OHIO WORKS FIRST
A program administered by the Ohio Department of Jobs and Family Services (ODJFS) that provides cash assistance and job-finding services and training to needy families.
OLMSTEAD V. LC
Olmstead v. LC is a U.S. Supreme Court decision that found that people with a disability have a right to services in the least restrictive environment.
OLRS
Ohio Legal Rights Services.
OPA
Ohio Psychiatric Association.
OPA
Ohio Psychological Association.
O.R.C.
Ohio Revised Code. Code sections are available online.
ORYX INDICATORS
Tracking system used by hospitals to measure clinical performance.
OSPP
Ohio's Suicide Prevention Plan.
OSS
Office of Support Services. An Ohio Department of Mental Health office that provides auxiliary services to state facilities and select community agencies. OSS provides wholesale food and pharmacy, as well as consultation in dietary, cycle menu planning, pharmacy and drug information services. Services are provided to state facilities within the Departments of Mental Health, Mental Retardation and Developmental Disabilities, Rehabilitation and Correction and Youth Services, as well as community mental health agencies.
OUTCOMES
Impact on the person or system served.
OUTCOME MEASURE
A measure that indicates the result of the performance (or non-performance) of a function or process.
OUTPATIENT
An individual (patient) who receives health care services (such as surgery) on an outpatient basis, meaning he/she does not stay overnight in a hospital or inpatient facility.
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PACT
Program of Assertive Community Treatment. A highly structured, multidisciplinary program of intensive treatment, rehabilitation and support services to clients in their homes, on the job and in social settings.
PAIMI
Protection and Advocacy for Individuals labeled as mentally ill. An advisory council to Ohio Legal Rights Service (OLRS).
PARITY
Refers to a series of initiatives at the national and state levels to achieve a greater recognition of the efficacy of and equitable coverage for treatment for mental disorders compared to physical illnesses by private and public health insurers.
PASRR
Pre-admission Screening and Annual Resident Review Program is required for individuals with serious mental illness or mental retardation/developmental disabilities who seek to enter a nursing facility. It's also for residents who have a significant change in their conditions.
PATHWAYS PROGRAM
An employment training program jointly funded by local community systems, the Ohio Rehabilitation Services Commission and the federal government to provide streamlined services for particular disability groups.
PCS
Patient Care System. The automated system that is used in regional psychiatric hospitals operated by the Ohio Department of Mental Health.
PCSA
Public Children Services Agency. County agencies charged with preventing child abuse and neglect in Ohio.
PEER SUPPORT
Services offered by mental health consumers, people with addictions or others to provide support to one another. Peer support services can include drop-in centers, peer respite care or support groups. See self-help.
PENETRATION RATE
The percent of eligible people who will use a service or program in a given period, usually a contract year.
PER DIEM
The daily rate charged or reimbursable for goods and services, e.g., the cost paid by mental health boards for a day of inpatient care at a regional psychiatric hospital.
PHI
Protected Health Information. Individually identifiable information received from or on behalf of a partner related to the past, present or future physical or mental health condition of an individual, provision of health care to an individual or the past, present or future payment for health care provided to an individual. For more information reference 45 CFR 164.501.
PORT
Patient Outcomes Research Team. A study funded by the Agency for Health Care Policy and Research and the National Institute for Mental Health to develop and disseminate recommendation for the treatment of schizophrenia based upon existing scientific evidence.
PRE-ADMISSION REVIEW/ADMISSION REVIEW
A review of an individual's health care status or condition, prior to an individual being admitted to an inpatient health care facility, such as a hospital.
PROSPECTIVE PAYMENT
A method of determining payments for medical care in advance of delivery of services.
PROVIDER
A person or organization that manages and delivers clinical and/or support services.
PSYCHOSOCIAL REHABILITATION
Traditional mental health services, as well as a variety of social learning, vocational and community living programs.
PSYCHOTROPIC MEDICATION
Type of drugs prescribed by physicians to control some of the symptoms of mental illness.
PUBLIC MENTAL HEALTH SYSTEM
Refers to the network (ODMH, CMH/ADAMH boards) of administrative and service organizations responsible for the provision of publicly funded services to people who require mental health treatment.
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QUALITY ASSURANCE
The efforts to determine the quality of care, to develop and maintain programs at an acceptable level and to institute improvements when the opportunity arises or the care does not meet the desired standard of care.
QUALITY IMPROVEMENT
An approach to the continuous study and improvement of the processes of providing health care services to meet the needs of individuals and others. Synonyms include continuous quality improvement, continuous improvement, organization-wide performance improvement and total quality management.
QUALITY OF CARE
The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Dimensions of performance include the following: patient perspective issues, safety of care environment, as well as accessibility, appropriateness, continuity, effectiveness, efficacy, efficiency and timeliness of care.
QUALITY SERVICE
Convenient, comprehensive services that meet individual needs and are delivered in a clinical and culturally competent manner.
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RECOVERY
A personal process of overcoming the negative impact of a psychiatric disability, despite its continued presence.
REGIONAL PSYCHIATRIC HOSPITAL
A facility that provides inpatient and community-based care and is supported primarily through state appropriations.
REHABILITATION OPTION
The Medicaid Rehabilitation Option (the "Rehab Option") refers to the optional rehabilitative services that a state Medicaid program may add to its state Medicaid plan. Rehabilitative services are defined in 42 CFR §440.130 as "any medical or remedial services recommended by a physician or other licensed practitioner of the healing arts, within the scope of his practice under state law, for maximum reduction of physical or mental disability and restoration of a recipient to his best possible functional level." Ohio participates in the Rehab Option for Mental Health Services.
REHABILITATION SERVICES
Services specifically tailored to assist a person to improve physical, psychosocial and vocational functioning. Provides assistance in job training, education, community support, transportation, living skills and other basic needs.
RELAPSE PREVENTION PLAN
A shared understanding between the consumer, clinicians and significant others of behaviors, feelings and thoughts that indicate the onset of symptom destabilization, actions and activities that will avert the continued progress of symptom destabilization. A formal written acknowledgement of this plan is called an advance directive.
RESILIENCY
The personal and community qualities that enable individuals to rebound from adversity, trauma, tragedy, threats or other stresses and to go on with life with a sense of mastery, competence and hope.
RESPITE CARE
A service designed to provide temporary residence for a person with a disability who ordinarily lives with family or friends or to assume temporary responsibility for care of the person in his or her own home. Provides back-up support and in some cases a relief to people responsible for care of ill or disabled person who ordinarily lives in their household.
REVOLVING DOOR SYNDROME
Repeated cycling into and out of inpatient facilities.
RISK ASSESSMENT
An assessment that is completed on individuals for the purpose of making short-term clinical estimates of violent behavior and identifying static and dynamic risk factors to be addressed in an aggressive prevention treatment plan.
ROA
Release of Information.
RSC
The Ohio Rehabilitation Services Commission, a state agency comprised of three bureaus: Bureau of Vocational Rehabilitation (BVR), Bureau of Services for the Visually Impaired (BSVI) and Bureau of Disability Determination (BDD).
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SAFETY NET
The responsibility of the public mental health system to serve people with mental health needs who would not otherwise receive services.
SA/MI
Co-occurring substance abuse/mental illness (dual diagnosis).
SAMI COURT
Substance Abuse and Mentally Ill Court. A judge creates a special docket for offenders with major mental illnesses and substance abuse disorders.
SCHIZOPHRENIA PATIENT OUTCOMES RESEARCH TEAM (PORT STUDY)
A study funded by the Agency for Health Care Policy and Research and the National Institute for Mental Health to develop and disseminate recommendations for the treatment of schizophrenia based upon existing scientific evidence.
SED
Severely Emotionally Disturbed. A designation for those individuals under 18 years of age who have serious emotional disturbances and are at the greatest risk for needing services. The SED designation has been made using three components: diagnosis, duration of impairment and level of functioning.
SELF-HELP
When consumers, their families or friends contact each other to share their experiences and suggest strategies for coping or for change.
SERIOUSLY OR CHRONICALLY DISABLED
Term used to describe people who suffer certain mental or emotional disorders that erode or prevent the development of their functional capacities in relation to such primary aspects of daily life as personal hygiene and self-care, self-direction, interpersonal relationships, social transactions, learning and recreational activities and that erode or prevent the development of their economic self-sufficiency. See SMD and SED.
SHOP
Supportive Housing Option for Prosperity. Funds used to meet housing and residential needs other than rental assistance, e.g., supportive housing staff and lease technicians, etc.
SHORT-TERM CARE
Care and treatment provided for short duration of time, usually not exceeding 30 days in length.
SINGLE POINT OF AUTHORITY
Authority responsible for all mental health and/or alcohol, drug addiction funding and delivery of services.
SKILLED NURSING FACILITY (SNF)
An institution that has a transfer agreement with one or more participating hospitals and is primarily engaged in providing inpatient skilled nursing care and rehabilitative services; meets specific regulatory certification requirements.
SMD
Severely Mentally Disabled. A designation for those adults with severe and persistent mental illnesses who are at the greatest risk for needing services. The SMD designation has been made using four components: the receipt of SSI/SSDI for a mental impairment, diagnosis, duration of impairment and level of functioning.
SMRCY
State Mental Health Representative for Children and Youth.
SOCIAL SERVICES BLOCK GRANT
Created by the Omnibus Budget and Reconciliation Act of 1981 to consolidate federal assistance to states for social services into a block grant. States are allowed to use the money for almost any community or social service for virtually any individual or family.
SPT
Suicide Prevention Team
SSDI
Social Security Disability Insurance provides benefits to disabled or blind individuals who are insured by workers' contributions to the Social Security Trust Fund.
SSI
Supplemental Security Income Program makes cash assistance payments to aged, blind and disabled people (including children age 18) who have limited income and resources. The federal government funds SSI from general tax revenue.
STAR
System Team Assessing Risk. This Ohio Department of Mental Health (ODMH) central office develops, refines and implements an approach that provides ODMH with the ability to identify indicators of risk(s) to people seeking and/or receiving publicly funded mental health services. It also implements specific, timely interventions to prevent, reduce and minimize risk exposure to people in community mental health and residential facilities settings. The approach is focused on risks related to inadequate access to services and receipt of poor quality care. This approach includes use of information from the community, data analysis and improved responsiveness by ODMH to concerns that are raised through these channels.
STATE MENTAL HEALTH AUTHORITY
Refers to the single state agency designated by each state's governor to be the entity responsible for the administration of publicly funded mental health programs.
STIGMA
Stereotypes associated with mental illness that hinder and/or negatively impact the recovery process.
SUPPORTED EMPLOYMENT
A well-defined approach to helping people with disabilities participate as much as possible in the competitive labor market, working in jobs they prefer with the level of professional help they need. According to the federal definition, supported employment means “competitive work in integrated work settings … consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests and informed choice of the individuals, for individuals with the most significant disabilities for whom competitive employment has not traditionally occurred or for whom competitive employment has been interrupted or intermittent as a result if a significant disability.”
SURGEON GENERAL'S REPORT
A review of research on mental disorders from former U.S. Surgeon General David Satcher. The first U.S. Surgeon General's report, Mental Health: A Report of the Surgeon General, was published in December 1999. It captures progress made in the last 10 years in understanding and treating mental illness and reducing stigma. In addition, the report examines such things as treatment, what people go through when seeking care and the care system.
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TAKE-UP RATE
The percent of the population that establishes Medicaid eligibility.
TDD
Teledictation Device for the Deaf (permits a person who is deaf to communicate by phone with another person with a TDD by typing words on a keyboard. The words are printed in LED display or typed on the other end). See TTY.
TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999
Federal legislation that increases beneficiary choice in obtaining rehabilitation and vocational services; removes barriers that require people with disabilities to choose between health care coverage and work and aims to provide Americans with disabilities a better opportunity to participate in the workforce.
Title XX
Title XX of the Social Security Act (Block Grants to States for Social Services).
TPA
Trading Partner Agreement (HIPAA term).
TRANSITION
The time in which an individual is moving from one life/development stage to another; for example, the change from childhood to adolescence, adolescence to adulthood and adulthood to older adult.
TTY
Teletypewriter, currently preferred term for device that permits a person who is deaf or severely hearing impaired to communicate by phone with another TTY user. See TDD.
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UCI
Unique Client Identifier. Used in MACSIS.
UFMS
Uniform Financial Management System.
UNBUNDLED SERVICES
When a residential provider takes services apart. Instead of charging a flat per diem (per day fee), the provider charges for individual services.
UR
Utilization Review. In contracting with a community mental health agency, a board shall consider the cost effectiveness of services provided by that agency and the quality and continuity of care. It may review cost elements, including salary costs of the services to be provided. A utilization review process shall be established as part of the contract for services entered into between a board and a community mental health agency. The board may establish this process in a way that is most effective and efficient in meeting local needs. [O.R.C. § 340.03(A)(8)(a)]
URIP
Utilization Review for psychiatric inpatient services. Through competitive RFP process, Health Care Excel, Inc. (HCE) in close collaboration with its subcontractor, First Mental Health, Inc. (FMH) has been selected to operate the URIP program. Program includes a) preadmission certification of in-patient psychiatric admissions and b) post-payment review (including on-site chart review) of inpatient psychiatric admissions.
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