Resources

Glossary – The Roland Center

A

Access: Barriers or lack thereof for persons in obtaining The Roland Center services. May apply at the level of the individual persons served (timeliness or other barriers) or the target population for The Roland Center.
Acquired brain injury (ABI): An insult to the brain that affects its structure or function, resulting in impairments of cognition, communication, physical function, or psychosocial behavior. ABI includes both traumatic and nontraumatic brain injury. Traumatic brain injuries may include open head injuries (e.g., gunshot wound, other penetrating injuries) or closed head injuries (e.g., blunt trauma, acceleration/deceleration injury, blast injury). Nontraumatic brain injuries may include those caused by strokes, nontraumatic hemorrhage, tumors, infectious diseases, hypoxic injuries, metabolic disorders, and toxin exposure. ABI does not include brain injuries that are congenital, degenerative, or induced by birth trauma.
Acquired impairment: An impairment that has occurred after the completion of the birthing process.
Acquisition: The purchase by one legal entity of some or all of the assets of another legal entity. In an acquisition, the purchasing entity may or may not assume some or all the liabilities of the selling entity. Generally, the selling entity continues in existence.
Activities of daily living (ADL): The instructional area that addresses the daily tasks required to function in life. The Roland Center ADL encompasses a broad range of activities, including maintaining personal hygiene, preparing meals, and managing household chores.
Activity: The execution of a task or action by an individual. (From the World Health Organization's International Classification of Functioning, Disability, and Health [ICF].)
Activity limitations: Difficulties an individual may have in executing activities. (From the World Health Organization's International Classification of Functioning, Disability, and Health [ICF].)
Adaptive equipment: Equipment or devices, such as wheelchairs, walkers, communication devices, adapted utensils, and raised toilet seats, that help persons perform their activities of daily living.
Adjudicated: Sentenced by a juvenile court or criminal court.
Administration: The act of managing or supporting management of The Roland Center's business affairs, including activities such as strategic planning, financial planning, and human resources management.
Administrative location: Sites where The Roland Center carries out administrative operations for the programs or services and/or personnel who provide the programs or services are located.
Adolescence: The period of life of an individual between childhood and adulthood, beginning at puberty and ending when one is legally recognized as an adult in one's state or province.
Advance directives: Specific instructions given by a person served to The Roland Center team members regarding the level and extent of care he or she wishes to receive. The intent is to aid competent adults and their families to plan and communicate in advance their decisions about medical treatment and the use of artificial life support.
Adverse events: An untoward, undesirable, and usually unanticipated event such as a death of a person served, an employee, a volunteer, or a visitor. Incidents such as a fall or improper administration of medications are also considered adverse events even if there is no permanent effect on the individual.
Advocacy services: Services that may include one-on-one advocacy to secure the rights of the person served; personal advocacy seeking to change a policy or practice; systems advocacy seeking legislative enactments; legal advocacy using judicial systems to protect rights; and self-advocacy enabling the person served to advocate on his/her own behalf.
Affiliation: A relationship, usually signified by a written agreement, between two organizations under the terms of which one organization agrees to provide specified services and personnel to meet the needs of the other, usually on a scheduled basis.
Affirmative enterprises: Operations designed and directed to create substantial economic opportunities for persons with disabilities.
Alzheimer's disease: The most common type of dementia. It is a progressive disease beginning with mild memory loss and possibly leading to loss of the ability to carry on a conversation and respond to the environment. Alzheimer's disease involves parts of the brain that control thought, memory, and language.
Assessment: A formal process used with the person served to collect information related to his or her history and strengths, needs, abilities, and preferences to determine the diagnosis, appropriate services, and/or referral.
Assistive technology: Any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase or improve functional capabilities of individuals.
Aversive conditioning: Procedures that are punishing, physically painful, emotionally frightening, deprivational, or put a person served at medical risk when they are used to modify behaviors.

B

Behavioral health: A category of medicine and rehabilitation that combines the areas of alcohol and other drug services, mental health, and psychosocial rehabilitation.

C

Catastrophe: A disaster or accident that immediately impacts The Roland Center's ability to provide its programs or services or significantly impacts how the programs or services will be provided in the future.
Child/adolescent: An individual up to the age at which one is legally recognized as an adult according to state or provincial law.
Commensurate wage: A wage that is proportionate to the prevailing wage paid to experienced workers in the vicinity for essentially the same type of work. It is based on the quantity and quality of work produced by the worker with a disability compared to the work produced by experienced workers.
Communication skills: The instructional area that teaches the use of adaptive skills and assistive technology for accomplishing tasks such as reading, writing, typing, managing finances, and storing and retrieving information.
Community integration: Being part of the mainstream of family and local community life, engaging in typical roles and responsibilities, and being an active and contributing member of one's social groups, local town or area, and of society as a whole.
Community relations plan: Program efforts to help minimize negative impact on the community, promote peaceful coexistence, and plan for change and program growth.
Community resources: Services and/or assistance programs that are available to the members of a community. They commonly offer people help to become more self-reliant, increase their social connectedness, and maintain their human rights and wellbeing.
Community settings: Locations in the community owned or leased and under the control of another entity where The Roland Center personnel go for the purpose of providing services to persons in those locations.
Comparative analysis: The comparison of past and present data to ascertain change, or the comparison of present data to external benchmarks.
Competency: The criteria established for the adequate skills, knowledge, and capacity required to perform a specific set of job functions.
Competency-based training: An approach to education that focuses on the ability to demonstrate adequate skills, knowledge, and capacity to perform a specific set of job functions.
Computer access training: The instructional area that teaches the skills necessary to use specialized display equipment to operate computers, including evaluating the person served with large print, synthetic speech, and Braille access devices.
Concurrent physician care: Services delivered by more than one physician.
Concurrent services: Services delivered by multiple practitioners to the same person served during the same time period.
Congenital impairment: An impairment that is present at the completion of the birthing process.
Consolidation: The combination of two or more legal entities into a single legal entity, where the entities unite to form a new entity and the original entities cease to exist.
Continuum of care / Continuum of services: A system of services addressing the ongoing and/or intermittent needs of persons at risk or with functional limitations resulting from disease, trauma, aging, and/or congenital and/or developmental conditions.
Contract: A written agreement between two or more parties that sets forth enforceable obligations between or among the parties.
Co-pharmacy: The use of two or more medications from the same class, e.g., two antidepressant medications or two antipsychotic medications.
Core values: The essential and enduring tenets of The Roland Center. A small set of timeless guiding principles that require no external justifications and have intrinsic value and importance to those inside the organization.
Corporate citizenship: Efforts, activities, and interest in integrating, contributing, and supporting the communities where The Roland Center delivers services to better address the needs of persons served.
Cultural competency: The ability to recognize, respect, and address the unique needs, worth, thoughts, communications, actions, customs, beliefs, and values that reflect an individual's racial, ethnic, religious, and/or social groups or sexual orientation.
Culturally normative: Providing the people served with an opportunity to experience patterns and conditions of everyday life that match as closely as possible those patterns and conditions typical of the mainstream experience in the local society and community.
Culture: The integrated pattern of human behavior that includes the thoughts, communication, actions, customs, beliefs, values, and institutions of a racial, ethnic, religious, social, or other group.
Customers: The people served, families, communities, funding agencies, employers, etc., who receive or purchase services from The Roland Center.

D

Data: A set of values of qualitative or quantitative variables — facts, objective information, or statistics collected, assembled, or compiled for reference, analysis and use in decision-making.
Dementia: Not a specific disease but a general term for the impaired ability to remember, think, or make decisions that interferes with doing everyday activities. Alzheimer's disease is the most common type of dementia.
Developmental Primary Care: Interdisciplinary, team-based care, with patients and caregivers at the center of the team. Developed to build the healthcare system's capacity to serve adults with developmental disabilities through clinical services, advocacy, research, training, and technical assistance.
Discharge summary: A document prepared at discharge that summarizes the person's course of treatment, level of goal achievement, final assessment of current condition, and recommendations and/or arrangements for further treatment and/or aftercare.
Diversity: Differences due to cognitive or physical ability, culture, ethnicity, language, religion, economic status, gender, age, or sexual orientation.
Durability: Maintenance or improvement over time of outcomes achieved by persons served at the time of discharge.
Duty of care: Obligation of governing board members to act with the care that an ordinarily prudent person in a similar position would use under similar circumstances.
Duty of loyalty: Obligation of governing board members to refrain from engaging in personal activities that would harm or take advantage of the organization.
Duty of obedience: Obligation of governing board members to perform their duties according to applicable statutes and the provisions of the organization's articles of incorporation and bylaws.

E

Effectiveness: Results achieved and outcomes observed for persons served. Can apply to different points in time (during, at the end of, or at points in time following services) and to different domains such as change in disability or impairment, function, and participation in life's activities.
Efficacy: The ability to produce an effect, or effectiveness.
Efficiency: Relationship between resources used and results or outcomes obtained. Resources can include time, money, or staff/FTEs.
Entitlements: Governmental benefits available to persons served and/or their families.
Executive leadership: The principal management employee, often referred to as the chief executive officer, president, or executive director. Hired and evaluated directly by the governing board and responsible for leading management in conducting the organization's business and affairs.

F

Family / support system: A group of persons of multiple ages bonded by affection, biology, choice, convenience, necessity, or law for the purpose of meeting the individual needs of its members.
Fee schedule: A listing of prices for services rendered. These prices may be designed for and used with third-party payers, outside funding sources, and/or the persons served, their families, and caregivers.
Functional literacy: The ability to read, comprehend, and assimilate the oral and written language and numerical information required to function in a specific work or community environment.

G

Governing board: The body vested with legal authority by applicable law to direct the business and affairs of a corporate entity. Such bodies are often referred to as boards of directors, trustees, or governors.
Grievance: A perceived cause for complaint.

I

Impairment: Problems in body function or structure such as a significant deviation or loss. (From the World Health Organization's International Classification of Functioning, Disability, and Health [ICF].)
Individual plan: A written statement of the proposed service/treatment process to guide team members and a person served throughout the duration of service/treatment. It identifies the input from the person served regarding goals and objectives and the services to be provided.
Informed choice: A decision made by a person served that is based on sufficient experience and knowledge, including exposure, awareness, interactions, or instructional opportunities, to ensure that the choice is made with adequate awareness of the alternatives to and consequences of the options available.
Integration: Presence and participation in the mainstream of community life. Means that the people served maintain social relationships with family members, peers, and others in the community who do not have disabilities, and have equal access to and full participation in community resources.
Interdependence: Movement from dependence toward interdependence may be demonstrated by an increase in self-sufficiency, self-advocacy, or self-determination, with offsetting decreases in artificial or paid services.
Interdisciplinary: Characterized by a variety of disciplines that participate in the assessment, planning, and/or implementation of a person's program, with close interaction and integration among disciplines to ensure that all members of the team interact to achieve team goals.

L

Leadership: Creates and sustains a focus on the people served, the organization's core values and mission, and the pursuit of organizational and programmatic performance excellence.
Legal representative: An individual who is legally authorized to make decisions on behalf of the person served regarding healthcare choices, financial decisions, or life care planning.
Living arrangements: The individual model of services delivered — Supported Living, Independent Living, Group Home, Intermediate Care Facility (ICF), etc.

M

Maladaptive behavior: Behavior that is destructive to oneself, others, or the environment, demonstrating a reduction or lack of the ability necessary to adjust to environmental demands.
Manual skills: The instructional area designed to assess and enhance skills in all aspects of sensory awareness with an emphasis on adaptive and safety techniques. Skill training focuses on organization, tactual awareness, spatial awareness, visual skills, memory sequencing, problem solving, and confidence building.
Medically complex: Persons who have a serious ongoing illness or a chronic condition that has lasted or is anticipated to last at least twelve months, has required at least one month of hospitalization, requires daily ongoing medical treatments and monitoring, or requires the routine use of a medical device or assistive technology.
Medically fragile: An individual who has a serious ongoing illness or a chronic physical condition that has lasted or is anticipated to last at least 12 months or who has required at least one month of hospitalization, and may require daily ongoing medical treatments, monitoring, or the routine use of a medical device.
Medication-assisted treatment (MAT): The use of medications, in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders. Research shows that when treating substance use disorders, a combination of medication and behavioral therapies is most successful.
Medication management: The practice of prescribing, administering, and/or dispensing medication by qualified personnel.
Mental status: A person's orientation, mood, affect, thought processes, developmental status, and organic brain function.
Merger: The combination of two or more legal entities into a single legal entity, where one entity continues in existence and the others cease to exist.
Mission: The Roland Center's reason for being. An effective mission statement reflects people's idealistic motivations for doing the organization's work.

N

Natural proportions: The principle that states that the number of persons served in any given setting are in proportion to the number of persons with disabilities in the general population.
Natural supports: Supports provided that assist the persons served to achieve their goals of choice and facilitate their integration into the community. Natural support is provided by people who are not paid staff members of a service provider.
Non-Pharmacological Interventions: Any sort of intervention not directly involving a medication; attempting to optimize a complex patient's healthcare needs or to better manage their chronic illness.

O

Offender: An inmate, detainee, or anyone under the community supervision of a criminal justice agency.
Orientation and Mobility (O&M): The instructional area that addresses the use of the remaining senses in combination with skill training utilizing protective techniques and assistive devices to travel independently in a safe, efficient, and confident manner in both familiar and unfamiliar environments.
Outcome: Result or end point of care or status achieved by a defined point following delivery of services.
Outcomes measurement and outcomes management: A systematic procedure for determining the effectiveness and efficiency of results achieved by the persons served during service delivery or following service completion and of the individuals' satisfaction with those results.

P

Paid work: Employment of a person served that results in the payment of wages for the production of products or provision of services. Paid work meets the state and/or federal definition of employment.
Participation: An individual's involvement in life situations. (From the World Health Organization's International Classification of Functioning, Disability, and Health [ICF].)
Participation restrictions: Problems an individual may experience in involvement in life situations. (From the World Health Organization's International Classification of Functioning, Disability, and Health [ICF].)
Pathological aging: Changes due to the impact of disease versus the normal aging process.
Performance indicator: A quantitative expression that can be used to evaluate key performance in relation to objectives. It is often expressed as a percent, rate, or ratio.
Performance target: A measurable level of achievement identified to show progress toward an overall objective. Could be set internally by the program or organization, or established by an external entity.
Person served: The primary consumers of The Roland Center services. They are the principal decision makers throughout the course of the program/service and have the right to choose whether members of the family, support system, or advocates may participate in that decision-making process.
Personal care: Services and supports including bathing, hair care, skin care, shaving, nail care, and oral hygiene; alimentary procedures to assist one with eating and with bowel and bladder management; positioning; care of adaptive personal care devices; and feminine hygiene.
Plan of care: A document containing the program designed to meet the needs of the person served, prepared with input from the interdisciplinary team including the person served. The plan is modified and revised as needed.
Polypharmacy: The use of multiple medications to treat different conditions.
Prognosis: The process of projecting the likelihood of a person achieving stated goals, the length of time necessary to achieve rehabilitation goals, the degree of independence the person is likely to achieve, and the likelihood of the person maintaining outcomes achieved.

R

Reasonable accommodations: Modifications or adjustments, which are not unduly burdensome, that assist the people served or team members to access benefits and privileges that are equal to those enjoyed by others.
Rehabilitation: The process of providing comprehensive services deemed appropriate to the needs of persons with disabilities in a coordinated manner designed to achieve objectives of improved health, welfare, and realization of the person's maximum physical, social, psychological, and vocational potential.
Reliability: The process of obtaining data in a consistent or reproducible manner.
Residence: The actual building or structure in which a person lives.
Respite: Short-term relief for primary caregivers, giving them time to rest, travel, or spend time with other family and friends. The care may last anywhere from a few hours to several weeks at a time.
Restraint: The use of physical, mechanical, or other means to temporarily subdue an individual or otherwise limit a person's freedom of movement. Used only when other less restrictive measures have been found to be ineffective to protect the person served or others from injury or serious harm.
Risk: Exposure to the chance of injury or loss. Risk can be external (natural disaster, injury on property, fire) or internal (liability issues, health risks from poor infection control practices).

S

Screening: A face-to-face, computer-assisted, or telephone interview with a person served to determine his or her eligibility for services and/or proper referral for services.
Seclusion: The separation of an individual from normal program participation in an involuntary manner. The person served is in seclusion if freedom to leave the segregated room or area is denied. Voluntary time-out is not considered seclusion.
Sentinel event: An unexpected occurrence involving death or serious physical or psychological injury or the risk thereof. Serious injury specifically includes loss of limb or function. Such an event signals the need for immediate investigation and response.
Service access: The capacity to provide services to those who desire or need receiving it.
Stakeholders: Individuals or groups who have an interest in the activities and outcomes of The Roland Center and its programs and services. They include the persons served, families, governance or designated authority, purchasers, regulators, referral sources, personnel, employers, advocacy groups, contributors, supporters, landlords, business interests, and the community.
Strategic planning: The Roland Center's directional framework, developed and integrated from a variety of sources, including but not limited to financial planning, environmental scans, and organizational competencies and opportunities.

T

Team: At a minimum, the person served and the primary personnel directly involved in the participatory process of defining, refining, and meeting the person's goals. Team members may also include other significant persons such as employers, family members, and/or peers.
Team integration: The process of bringing individuals together or incorporating them into a collaborative interdisciplinary team. The entire interdisciplinary team becomes the dominant culture and decision-making body for the rehabilitation process.
Transition: The process of moving from one level of care or service/support to another, changing from child/adolescent service systems to adult systems, or leaving care or services/supports.
Transition plan: A document developed with the full participation of the person served that focuses on a successful transfer/transition between program or service phases/levels/steps or on a successful transition to a community living situation.
Treatment: A professionally recognized approach that applies accepted theories, principles, and techniques designed to achieve recovery and rehabilitative outcomes for the persons served.

V

Validity: Refers to the appropriateness, meaningfulness, and usefulness of a measure and the inferences made from it. Commonly regarded as the extent to which a test measures what it is intended to measure.
Value: The relationship between quality and cost.
Visit: Episode of service delivery to one person served on one day by one service or discipline.
Visual skills: The instructional area that addresses the needs of persons with partial vision to gain a better understanding of their eye problems and teaches them how to utilize their remaining vision effectively using low vision techniques.

W

Wellness education: Learning activities that are intended to improve the patient's health status, including healthcare education, self-management of medication(s), nutritional instruction, exercise programs, and training in the proper use of exercise equipment.

Y

Youth: The time a person is young — generally referring to the time between childhood and adulthood.