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.
Acquired brain injury (ABI) is 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 (e.g., ruptured arterio-venous malformation, aneurysm), tumors, infectious diseases (e.g., encephalitis, meningitis), hypoxic injuries (e.g., asphyxiation, near drowning, anesthetic incidents, hypovolemia), metabolic disorders (e.g., insulin shock, liver, or kidney disease), and toxin exposure (e.g., inhalation, ingestion). 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. (This definition is from the World Health Organization’s International Classification of Functioning, Disability, and Health [ICF].)
Activity limitations
Difficulties an individual may have in executing activities. (This definition is from the World Health Organization’s International Classification of Functioning, Disability, and Health [ICF].)
Adaptive equipment
The Roland Center 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. The Roland Center business affairs include 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. Included is the right to accept or refuse medical or surgical treatment. Includes psychiatric advance directives were allowed by law.
Adverse events
An untoward, undesirable, and usually unanticipated event such as a death of a person served, an employee, a volunteer, or a visitor in The Roland Center. 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 or person served.
The Roland Center Advocacy services
The Roland Center services that may include one or more of the following for persons with disabilities or other populations historically in need of advocacy:
- Personal advocacy: one-on-one advocacy to secure the rights of the person served.
- Systems advocacy: seeking to change a policy or practice that affects the person served.
- Legislative advocacy as permitted by law: seeking legislative enactments that would enhance the rights of and/or opportunities for the person served.
- Legal advocacy: using the judicial and quasi-judicial systems to protect the rights of the person served.
- 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
The Roland Center operations designed and directed to create substantial economic opportunities for persons with disabilities.
Alzheimer’s disease
Alzheimer’s disease is 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
The Roland Center 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.
Behavioral health
A category of medicine and rehabilitation that combines the areas of alcohol and other drug services, mental health, and psychosocial rehabilitation.
Board
See Governing board.
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
The Roland Center supports program efforts to help minimize negative impact on the community, promote peaceful coexistence, and plan for change and program growth.
Community resources
The Roland Center 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
The Roland Center locations in the community are owned or leased and under the control of another entity, organization, or agency, and where The Roland Center personnel go for the purpose of providing services to persons in those locations. Examples include: community job sites that are owned or leased by the employer(s) where the organization may provide employment supports such as job coaching, vocational evaluation, or work adjustment; school settings where services such as early intervention or prevention services may be provided during the school’s regular school, pre-school, or after-school program hours; or public or private sites such as libraries, recreational facilities, shopping malls, or museums where services such as community integration, case management, or community support may be provided.
Comparative analysis
The comparison of past and present data to ascertain change, or the comparison of present data to external benchmarks. Consistent data elements facilitate comparative analysis.
Competency
The criteria established for the adequate skills, knowledge, and capacity required to perform a specific set of job functions.
Competency-based training
The Roland Center 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 Roland Center instructional area that teaches the skills necessary to use specialized display equipment to operate computers. This includes evaluating the person served with large print, synthetic speech, and Braille access devices to perform word processing functions and other computer-related activities.
Concurrent physician care
The Roland Center services delivered by more than one physician.
Concurrent services
The Roland Center 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. In a consolidation, the consolidated entity has its own name and identity and acquires the assets and liabilities of the disappearing entities.
Continuum of care/Continuum of services
A system of The Roland Center Glossary 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. Such a system of The Roland Center services may be achieved by accessing a single provider, multiple providers, and/or a network of providers. The intensity and diversity of The Roland Center services may vary depending on the functional and psychosocial needs of the persons served.
Contract
A written agreement between two or more parties that sets forth enforceable obligations between or among the parties.
Controlled/operated
The right or responsibility to exercise influence over the physical conditions of The Roland Center where service delivery/administrative operations occur. The Roland Center is considered in control of all facilities where it delivers services to persons who are present at the time-of-service delivery for the sole purpose of receiving services from The Roland Center. The Roland Center is not considered in control of facilities where it delivers services to persons who are present at the time-of-service delivery for purposes other than receiving services from the.
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. They are a small set of timeless guiding principles that require no external justifications. They have intrinsic value and importance to those inside the organization.
Corporate citizenship
The Roland Center efforts, activities, and interest in integrating, contributing, and supporting the communities where it delivers services to better address the needs of persons served.
Corporate status
The existence of an entity as a corporation under applicable law. Maintenance of corporate status typically requires ongoing compliance with state requirements.
Costs
The expenses incurred to acquire, produce, accomplish, and maintain The Roland Center goals. These include both direct costs, such as those for salaries and benefits, materials, and equipment, and indirect costs, such as those for electricity, water, building maintenance, and depreciation of equipment.
Cultural competency
The Roland Center 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
The Roland Center team members 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. This requires the use of The Roland Center service delivery systems and settings that adapt to the changing norms and patterns of communities in which the persons served function to incorporate the following features:
- Rhythms of the day, week, and year and life cycles that are “normal” or typical of the community.
- A range of choices, with personal preferences and self-determination receiving full respect and consideration.
- A variety of social interactions and settings, including family, work, and leisure settings and opportunities for personal intimacy.
- Normal economic standards.
- Life in housing is typical of the local neighborhoods.
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.
Data
A set of values of qualitative or quantitative variables, e.g., facts, objective information, or statistics collected, assembled, or compiled for reference, analysis and use in decision-making.
Dementia
Dementia is not a specific disease but is rather 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. Though dementia mostly affects older adults, it is not a part of normal aging.
Demonstrate
To show, explain, or prove by evidence presented in The Roland Center program documentation, interviews, and behavior how an organization or a program consistently conforms to a given standard.
Debt covenants
Requirements found in loan documents that require The Roland Center to meet certain predefined performance targets to be measured at predefined time periods. The performance targets can be financial (for example, the organization must maintain a certain level of days with cash on hand) or nonfinancial (The Roland Center must maintain a certain occupancy level).
Detoxification treatment
Dispensing an opioid agonist treatment medication in decreasing doses to an individual to alleviate adverse physical or psychological effects of withdrawal from the continuous or sustained use of an opioid drug and as a method of bringing the individual to a drug-free state within such period.
Developmental Primary Care
The Roland Center Developmental Primary Care for people with developmental disabilities is interdisciplinary, team-based care, with patients and caregivers at The Roland Center team. The Roland Center Developmental Primary Care was developed to build the healthcare system’s capacity to serve adults with developmental disabilities through clinical services, advocacy, research, training, and technical assistance. The Roland Center Developmental Primary Care is dedicated to improving health outcomes for people with developmental disabilities across the lifespan.
Discharge summary
A document prepared at discharge by The Roland Center staff members designated with the responsibility for service coordination that summarizes the person’s course of treatment, level of goal(s) achievement, final assessment of current condition, and recommendations and/or arrangements for further treatment and/or aftercare.
Diversion control plan
The Roland Center document that contains specific measures to reduce the possibility of diversion of controlled substances from legitimate treatment use and must assign specific responsibility to medical and administrative staff for implementation.
Diversity
Differences due to cognitive or physical ability, culture, ethnicity, language, religion, economic status, gender, age, or sexual orientation.
Donated location/space
Physical space not owned or leased by The Roland Center but made available to the organization without charge for the purposes of delivering services or for administrative operations on an ongoing basis and which the organization controls or operates during the time-of-service delivery/administrative operations. The location and availability of The Roland Center space does not vary at the discretion of the donating entity.
Durability
Maintenance or improvement over time of outcomes achieved by persons served at the time of discharge.
Duty of care
Obligation of The Roland Center governing board members to act with the care that an ordinarily prudent person in a similar position would use under similar circumstances. This duty requires governing board members to perform their duties in good faith and in a manner, they reasonably believe to be in The Roland Center’s best interest.
Duty of loyalty
Obligation of The Roland Center governing board members to refrain from engaging in personal activities that would harm or take advantage of the organization. This duty prohibits The Roland Center governing board members from using their position of trust and confidence to further their private interests. It requires an undivided loyalty to the organization and demands that there be no conflict between a governing board member’s corporate duty and self-interest.
Duty of obedience
Obligation of The Roland Center governing board members to perform their duties according to applicable statutes and the provisions of the organization’s articles of incorporation and bylaws.
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). Can apply to different domains (e.g., change in disability or impairment, function, participation in life’s activities, work, and many other domains relevant to The Roland Center).
Efficacy
The ability to produce an effect, or effectiveness.
Efficiency
Relationship between The Roland Center resources used, and results or outcomes obtained. The Roland Center resources can include, for example, time, money, or staff/FTEs. Can apply at the level of the person served, program, or groups of persons served or at the level of The Roland Center as a whole.
Employee-owner
An individual who delivers administration or services on behalf of The Roland Center if such individual is also:
- with respect to a for-profit organization, a person holding an ownership interest in the organization; or
- with respect to a nonprofit organization, a person with the right to vote for the election of the organization’s directors, unless that right derives solely from the person’s status as a delegate or director.
Entitlements
Governmental benefits available to persons served and/or their families.
Executive leadership
The Roland Center principal management employee, often referred to as the chief executive officer, president, or executive director. The executive leadership is hired and evaluated directly by The Roland Center’s governing board and is responsible for leading management in conducting the organization’s business and affairs.
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.
Family
A person’s parents, spouse, children, siblings, extended family, guardians, legally authorized representatives, or significant others as identified by the person served.
Family of origin
Birth family or first adoptive parents.
Fee schedule
A listing of prices for The Roland Center 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. The Roland Center accommodation strategies for those with reduced functional literacy may include picture instructions and audio or video recordings.
Governance authority
The Roland Center provides direction, guidance, and oversight and approves decisions specific to the Roland Center and its services. This is the individual or group to which the chief executive reports.
Governing board
The Roland Center 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. The Roland Center advisory and community relations boards and management committees do not constitute governing boards.
Governmental
Regarding any city, county, state, federal, tribal, provincial, or similar jurisdiction.
Grievance
A perceived cause for complaint.
Home
(Employment and Community Services)
The individual’s living environment as impacted by the individual’s personal articles, friends, roommates, or significant others. Individuals’ homes are considered central to their identity.
Host organization
Employer of an individual eligible for The Roland Center employee assistance program services.
Impairment
Problems in body function or structure such as a significant deviation or loss. (This definition is from the World Health Organization’s International Classification of Functioning, Disability, and Health [ICF].)
Implement
Consistent actions that demonstrate The Roland Center policy, plan, procedure, or practice is in effect.
Independent (board representation)
The absence of conflict of interest by The Roland Center governing board member with respect to any organizational transaction. The Roland Center governing board member is typically independent with respect to a transaction if neither the individual nor any related person or entity benefits from the transaction or is subject to the direction or control of a person or entity that benefits from the transaction. (See definition of unrelated.) For purposes of the foregoing, direction or control is often evidenced by the existence of an employment relationship or other compensation arrangement.
Individual plan
The Roland Center written statement of the proposed service/treatment process to guide The Roland Center 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 Roland Center services to be provided, persons responsible for providing services, and input from the person served.
Information
Understanding derived from looking at facts; conclusions from looking at data.
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. Participation means that the people served maintain social relationships with family members, peers, and others in the community who do not have disabilities. In addition, the people served have equal access to and full participation in community resources and activities available to the general public.
Integration
The opportunity for involvement in all aspects of community life. Integration into communities, work settings, and schools provides all individuals opportunities to be active, fully participating members of those communities or environments. In integrated settings, diversity is viewed as a goal; it is recognized that diversity enriches all community members.
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 The Roland Center disciplines that participate in the assessment, planning, and/or implementation of a person’s program. There must be close interaction and integration among The Roland Center disciplines to ensure that all members of the team interact to achieve team goals.
Investigation
A detailed inquiry or systematic examination by a third party into the appropriateness of acts by The Roland Center or its personnel, if such acts: (a) relate directly to conformance or nonconformance to applicable standards; or (b) are of such breadth or scope that The Roland Center’s entire operations may be affected. Without limiting the foregoing, an investigation includes any governmental notice of regulatory or other noncompliance that requires submission of a written corrective action plan.
Joint venture
A business undertaking by two or more legal entities in which profits, losses, and control are shared, which may or may not involve the formation of a new legal entity. If a new entity is formed, the original entities continue to exist.
Leadership
The Roland Center 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. It is responsible for the integration of The Roland Center’s core values and performance expectations into its management system. The Roland Center leadership promotes and advocates for the organizations and community’s commitment to the people served.
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. Legal terminology may vary from jurisdiction to jurisdiction, e.g., healthcare power of attorney, power of attorney, and guardianship.
Linkages
Established connections and networks with a variety of agencies, companies, and people in the community.
Living arrangements
The Roland Center individual model of services delivered—Supported Living, Independent Living, Group Home, Intermediate Care Facility (ICF), etc.
Long-term detoxification treatment
Detoxification treatment for more than 30 days but no more than 180 days.
Maladaptive behavior
Behavior that is destructive to oneself, others, or The Roland Center environment, demonstrating a reduction or lack of the ability necessary to adjust to environmental demands.
Manual skills
The instructional area is designed to assess and enhance skills in all aspects of sensory awareness with an emphasis on adaptive and safety techniques. The Roland Center skill training focuses on organization, tactual awareness, spatial awareness, visual skills, memory sequencing, problem solving, and confidence building. Activities range from basic tasks using hand tools to advanced tasks using power tools and woodworking machinery.
Material litigation
A legal proceeding initiated by a third party concerning the appropriateness of acts by an organization or its personnel, if such acts: (a) relate directly to conformance or nonconformance to applicable standards; or (b) are of such breadth or scope that the organization’s entire operations may be affected.
Medical director
A physician, licensed to practice medicine in the jurisdiction in which the Developmental Medicine Primary Care program is located, who assumes responsibility for administering all The Roland Center medical services performed by the program either by performing them directly or delegating specific responsibility to authorized program physicians and healthcare professionals functioning under the medical director’s direct supervision.
Medically complex
Persons who have a serious ongoing illness or a chronic condition that meets at least one of the following criteria:
- 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 by appropriately trained personnel, which may include parents or other family members.
- Requires the routine use of a medical device or the use of assistive technology to compensate for the loss of usefulness of a body function needed to participate in activities of daily living.
- The medically complex condition of the person served presents an ongoing threat to his or her health status.
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. Additionally, this individual may require daily ongoing medical treatments and monitoring by appropriately trained Roland Center personnel, which may include parents or other family members. Moreover, this individual may require the routine use of a medical device or the use of assistive technology to compensate for the loss of usefulness of a body function needed to participate in activities of daily living.
Medically supervised withdrawal (MSW)
A medically supervised, gradual reduction or tapering of dose over time to achieve the elimination of tolerance and physical dependence to methadone or other opioid agonists or partial agonists.
Medication-assisted treatment
Medication-assisted treatment (MAT) is 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. MAT is clinically driven with a focus on individualized patient care. (Definition from SAMHSA)
Medication control
The Roland Center practice of providing a secure storage area and controlled access for medications that are brought into a program and used by the person served. This would include medications self-administered by the persons served or the use of samples.
Medication management
The Roland Center practice of prescribing, administering, and/or dispensing medication by qualified personnel. It is considered management when The Roland Center personnel in any way effect dosage, including taking pills out of a bottle or blister pack; measuring liquids; or giving injections, suppository, or PRN medications.
Medication monitoring
The Roland Center practice of providing a secure storage area and controlled access for medications that are brought into a program and used by the person served. The person served must take the medication without any assistance from The Roland Center personnel.
Medication unit
The Roland Center that is part of but geographically separate from The Roland Center treatment program from which licensed private practitioners or community pharmacists dispense or administer an opioid agonist treatment medication or collect samples for drug testing or analysis.
Medication use
The Roland Center practice of handling, prescribing, dispensing and/or administering medication to persons served in response to specific symptoms, behaviors, and conditions for which the use of medications is indicated and deemed efficacious.
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. In a merger, the surviving entity retains its name and identity and acquires the assets and liabilities of the disappearing entities.
Mission
The Roland Center’s reason for being. An effective Roland Center mission statement reflects people’s idealistic motivations for doing the organization’s work.
Natural proportions
The Roland Center principle that states that the number of persons served in any given setting, such as a work setting, are in proportion to the number of persons with disabilities in the general population.
Natural supports
The Roland Center 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 but may be initiated or planned, facilitated in partnership with The Roland Center.
Natural supports
The Roland Center supports events that occur naturally in the community, at work, or in a social situation that enable the people served to accomplish their goals in life without the use of paid support.
Non-Pharmacological Interventions
The Roland Center non-pharmacological intervention: defined as 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.
Offender
An inmate, detainee, or anyone under the community supervision of a criminal justice agency.
On-the-job evaluation
The Roland Center evaluation performed in a work setting located outside the organization in which a person is given the opportunity to experience the requirements necessary to do a specific job. Real work pressures are exerted by the employer, and the person’s performance is evaluated by the employer and the evaluator.
Organization
A legal entity that provides an environment within which The Roland Center services or programs are offered.
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 The Roland Center services.
Outcomes measurement and outcomes management
The Roland Center 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. The Roland Center outcomes management system measures outcome by obtaining, aggregating, and analyzing data regarding how well the persons served are functioning after transition/exit/discharge from a specific service. The Roland Center outcomes measures are related to the goals that recent services were designed to achieve. Other measures in The Roland Center outcomes management system may include progress measures that are appropriate for long-term services (longer than six months in duration) that serve persons demonstrating a need for a slower pace in order to achieve gains or changes in functioning.
Paid work
The Roland Center employment of a person served those 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. (This definition is 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. (This definition is 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.
Pediatric medicine
The branch of medicine dealing with the growth, development, and care of infants, children, and adolescents and with the treatment of their diseases.
Performance indicator
A quantitative expression that can be used to evaluate key performance in relation to The Roland Center objectives. It is often expressed as a percent, rate, or ratio. For example, a performance indicator on return to work might be the percentage of clients in competitive employment 90 days after closure.
Performance target
The Roland Center measurable level of achievement identified to show progress toward an overall Roland Center objective. This could be set internally by the program, organization, or it could be a target established by an external entity. The Roland Center performance target could be expressed as a certain percentage, ratio, or number to be reached.
Periodically
Occurring at intervals determined by The Roland Center organization. The Roland Center organization uses information about and input from the persons served and other stakeholders to determine the frequency of the intervals.
Person served.
Persons served are the primary consumers of The Roland Center services. They are the principal decision makers throughout the course of The Roland Center program/service. Persons served have the right to choose whether members of the family, support system, or advocates may participate in that decision-making process. In circumstances when the person served is unable to exercise self-representation at any point in the decision-making process, the person served is interpreted to also encompass those persons legally authorized to make decisions on behalf of the person served.
Personal care
The Roland Center 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.
Personal representative
An individual who is designated by a person served or, if appropriate, by a parent or guardian to advocate for the needs, wants, and rights of the person served.
Personnel
The Roland Center team members are involved in the delivery, oversight, and support of the programs/services seeking accreditation, regardless of employment status.
Persons with severe and persistent mental illness
Adults with a primary diagnosis of schizophrenia, psychiatric disorders, major affective disorders (such as treatment resistant major depression and bipolar disorder), or other major mental illness according to the current Diagnostic and Statistical Manual of Mental Disorders, which may also include a secondary diagnosis.
Pharmacotherapy
Any Roland Center treatment of the persons served with prescription medications, including methadone or methadone-like drugs.
Plan
The Roland Center written direction that is action oriented and related to a specific project or defined goal, either present and/or future oriented. The Roland Center plan may include the steps to be taken to achieve stated goals, a timeline, priorities, the resources needed and/or available for achieving the plan, and the positions or persons responsible for implementing the identified steps.
Plan of care
The Roland Center document contains the program that has been designed to meet the needs of the person served. This document is prepared with input from The Roland Center interdisciplinary team, including the person served. The Roland Center plan is modified and revised, as needed, depending upon the needs of the person served.
Policy
The Roland Center written course of action or guidelines adopted by leadership and reflected in actual practice.
Polypharmacy
The use of multiple medications to treat different conditions.
Predicted outcomes.
The outcomes were established by The Roland Center team at the time of the completion of the initial assessment.
Preferred practice patterns
The Roland Center statements developed as a guideline for blind rehabilitation specialists that specify procedures, clinical indications for performing the procedures, clinical processes, setting, equipment specifications, documentation aspects, and expected outcomes.
Primary care
The Roland Center active, organized, structured treatment for a presenting illness.
Private homes
The Roland Center apartment, duplex, house, or condominium owned or leased by a person served. If a person served and The Roland Center co-signs a lease for the person served for an apartment, duplex, or townhouse, this living arrangement will be considered a private home. The Roland Center will not technically be considered a lessor of this private home for the person served but will be considered a financial guarantor for the person served who is leasing his or her own private home.
Procedure
A “how to” description of actions to be taken. Not required to be written unless specified.
Prognosis
The process of projecting:
- The likelihood of a person achieving stated goals.
- The length of time necessary for the person to achieve his or her rehabilitation goals.
- The degree of independence the person is likely to achieve.
- The likelihood of the person maintaining outcomes achieved.
Program
A system of The Roland Center activities performed for the benefit of the persons served.
Program sponsor
The person named in the application for certification as responsible for The Roland Center opioid treatment program and who assumes responsibility for all its employees, including any practitioners, agents, or other persons providing medical, rehabilitative, or counseling services at the program or any medication units.
Proprietary organization
An organization that is operated for profit.
Publicly operated organization
An organization that is operated by a governmental entity.
Qualified behavioral health practitioner
The Roland Center person certified, licensed, registered, or credentialed by a governmental entity or professional association as meeting the educational, experiential, or competency requirements necessary to provide mental health or alcohol and other drug services. Persons other than a physician who are designated by a program to order seclusion or restraints must be permitted to do so by federal, state, provincial, or other regulations.
Qualified practitioner
A person who is certified, licensed, registered, or credentialed by a governmental entity or professional association as meeting the educational, experiential, or competency requirements necessary to provide human services.
Reasonable accommodations
The Roland Center modifications or adjustments, which are not unduly burdensome, that assist the people served or the Roland Center team members to access benefits and privileges that are equal to those enjoyed by others. Examples taken from the Americans with Disabilities Act include making existing facilities readily accessible to and usable by persons with disabilities; restructuring jobs; modifying work schedules; reassigning persons to vacant positions; acquiring or modifying equipment or assistive devices; adjusting or modifying examinations, training materials, policies, and procedures; and providing qualified readers or interpreters.
Regular
Occurring at fixed, uniform intervals of time determined by The Roland Center. The organization assesses and uses information about and input from the persons served and other stakeholders to determine the frequency necessary.
Rehabilitation
The process of providing those comprehensive Roland Center services deemed appropriate to the needs of persons with disabilities in a coordinated manner in a program or service designed to achieve objectives of improved health, welfare, and realization of the person’s maximum physical, social, psychological, and vocational potential for useful and productive activity. The Roland Center rehabilitation services are necessary when a person with a disability is in need of assistance, and it is beyond the person’s personal capacities and resources to achieve his or her maximum potential for personal, social, and economic adjustment and beyond the capabilities of the services available in the person’s usual daily experience. Such assistance continues if the person makes significant and observable improvement.
Rehabilitation nursing services
The formalized Roland Center organizational structure that delineates the appropriate accountability, staff mix, and competencies and provides a process for establishing, implementing, and maintaining patient care standards and nursing policies that are specific to rehabilitation nursing. The Roland Center nursing staff includes members who provide direct care and those who provide supervision and perform support functions. This staff usually includes clinical nurse specialists, registered nurses, licensed practical (vocational) nurses, nursing assistants, and unit clerical support. The Roland Center nursing services are provided under the direct supervision of a registered nurse unless supervision is otherwise defined by applicable state practice acts or provincial legislation for nursing.
Rehabilitative treatment environment
The Roland Center rehabilitation setting that provides for:
- The provision of a range of choices, with personal preference and self-determination receiving full respect and consideration.
- A variety of social interactions that promote community integration.
- Treatment of a sufficient volume of persons served to ensure that there is an environment of peer support and mentorship.
- Treatment of a sufficient volume of persons served to support professional team involvement and competence.
- A physical environment conducive to enhancing the functional abilities of the persons served.
Reliability
The process of obtaining data in a consistent or reproducible manner.
Representative sample/sampling
A group of randomly selected individuals determined through a procedure such that each person has an equal probability of inclusion in the sample. If sampling is used, the sample should reflect the population to which the results are generalized. Although no specific percentage of persons served is required to be included in the sample, general principles of data analysis state that the larger the sample, the less the error that is expected in comparing the sample to the entire population of persons served. The number of persons sampled within each Roland Center program area or subgroup should be sufficient to give confidence that the characteristics of the sample reflect the distribution of the entire population of persons served.
Residence
The actual building or structure in which a person lives.
Residential settings
The individual model of The Roland Center services delivered—Supported Living, Independent Living, Group Home, Intermediate Care Facility (ICF), etc.
Respite
The Roland Center respite care provides 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. The Roland Center respite care can take place at home, in a health care facility, or at an adult day care center.
Restraint
The use of physical, mechanical, or other means to temporarily subdue an individual or otherwise limit a person’s freedom of movement. Restraint is 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. The Roland Center risk can be external, such as a natural disaster, injury that occurs on the property of a program, or fire. The risk can be internal to The Roland Center and include things such as back injuries while performing job duties, it can involve liability issues such as the sharing of information about a person served without consent, or it can jeopardize the health of those internal or external to the organization due to such things as poor or nonexistent infection control practices.
Risk factors
Certain conditions and situations that precede and may predict the later development of behavioral health problems. Examples of risk factors may include poverty, family instability, or poor academic performance. Examples of protective factors may include an internal locus of control, a positive adult role model, and a positive outlook.
Risk factors
Aspect of personal behavior or lifestyle, environmental exposure, or variable or condition that increases the likelihood of an adverse outcome.
Screening
A face-to-face, computer-assisted, or telephone interview with a person is served to determine his or her eligibility for The Roland Center 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 within The Roland Center program involving death or serious physical or psychological injury or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase “or risk thereof” includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Such an event is called sentinel because it signals the need for immediate investigation and response. Without limiting the foregoing, a sentinel event includes any governmental notice of regulatory or other noncompliance that results in immediate jeopardy to the health or safety of any person (e.g., a Level 4 deficiency issued by the U.S. Centers for Medicare & Medicaid Services).
Service
The Roland Center activities performed for the benefit of persons served.
Service access
The Roland Center capacity to provide services to those who desire or need receiving it.
Service referral
The Roland Center practice of arranging for a person to receive the services provided by a given professional service unit of the organization or through some other appropriate agent. This arrangement, which is usually made by the individual responsible for the program of the person served, is documented by notation in the person’s permanent record.
Short-term detoxification treatment
Detoxification treatment for no more than 30 days.
Skilled healthcare provider
The Roland Center licensed, certified, or registered healthcare provider (e.g., nurse, physician, or respiratory therapist).
Skilled healthcare provider
The Roland Center licensed, certified, or registered healthcare provider (e.g., nurse, physician, or respiratory therapist). Can also include specifically trained natural or foster family members knowledgeable in the care of the specific individual.
Staff member
A person who is directly employed by The Roland Center on either a full- or part-time basis.
Stakeholders
Individuals or groups who have an interest in the activities and outcomes of The Roland Center and its programs and services. They include, but are not limited to, 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.
Supervisor
The lead person who is responsible for The Roland Center job performance. The Roland Center supervisor may be a manager or a person with another title.
Supports
Individuals significant to a person served and/or activities, materials, equipment, or other Roland Center services designed and implemented to assist the person served. Examples include instruction, training, assistive technology, and/or removal of architectural barriers.
Team
At a minimum, the person served and the primary The Roland Center personnel directly involved in the participatory process of defining, refining, and meeting the person’s goals. The Roland Center team members may also include other significant persons such as employers, family members, and/or peers at the option of the person served and the organization.
Team integration
The process of bringing individuals together or incorporating them into a collaborative Roland Center interdisciplinary team. The entire Roland Center interdisciplinary team becomes the dominant culture and decision-making body for the rehabilitation process. There is recognition of and respect for the value of information provided by an individual team member, with a focus on the interdependence and coordination of all team members. Through coordinated communication, there is accountability by the team 24 hours per day, 7 days per week for all decisions made.
Transition (from school)
The process of moving from education services to The Roland Center adult services, including living and working in the community.
Transition
The process of moving from one level of care or The Roland Center service/support to another, changing from child/adolescent service systems to adult systems, or leaving care or services/supports.
Transition plan
The Roland Center document developed with the full participation of the person served that (a) focuses on a successful transfer/transition between The Roland Center program or service phases/levels/steps or (b) focuses on a successful transition to a community living situation. The Roland Center plan is part of the individual plan and details how the person served will maintain the gains made during services and support ongoing recovery and/or continued well-being at the next phase/level/step.
Treatment
The Roland Center professionally recognized approach that applies accepted theories, principles, and techniques designed to achieve recovery and rehabilitative outcomes for the persons served.
Unrelated (board representation)
The absence of an affiliation between a governing board member and any person or entity that benefits from any organizational transaction. For purposes of the foregoing, affiliation generally means a relationship that is:
- Characterized by control of at least a 35 percent voting, profits, or beneficial interest by the member; or
- Substantially influenced by the member.
Validity
Refers to the appropriateness, meaningfulness, and usefulness of The Roland Center 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 The Roland Center service delivery to one person served on one day by one service or discipline.
Visual skills
The Roland Center instructional area that addresses the needs of persons with partial vision to gain a better understanding of their eye problems through patient education and teaches them how to utilize their remaining vision effectively using low vision techniques. It also includes The Roland Center assessment and training with special optical aids and devices designed to meet the various needs of the people served. These needs may include reading, activities of daily living, orientation, mobility, and home repairs.
Wellness education
The Roland Center learning activities that are intended to improve the patient’s health status. These include but are not limited to healthcare education, self-management of medication(s), nutritional instruction, exercise programs, and training in the proper use of exercise equipment.
Youth
The time a person is young—generally referring to the time between childhood and adulthood.