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Public Health & Philanthropy Lexicon

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access to health care — an individual's ability to obtain appropriate health care services. Barriers to access can be financial (e.g., insufficient monetary resources), geographic (e.g., long distances to providers), organizational (e.g., lack of available providers) and sociological (e.g., discrimination and language barriers). Efforts to improve access to health care often focus on providing and improving health coverage.

activities of daily living — walking, dressing, eating, using the toilet, bathing and getting into and out of bed. The term is often used when discussing disabled individuals and the elderly.

advocacy — an action that speaks in favor of, supports, or defends a cause on behalf of others. Examples of advocacy include public policy research, education of legislators, public education campaigns, conferences, and speaking and testifying at public meetings. Advocacy can take place at local, statewide, national and international levels.

Affordable Care Act — a federal statute signed into law in March 2012 under the title The Patient Protection and Affordable Care Act. The law, also known as Obamacare, includes multiple provisions, including expansion of Medicaid eligibility, the establishment of health insurance exchanges and the prohibition of health insurers from denying coverage of people with pre-existing conditions.

at-risk youth — teens and young adults who, because of circumstances such as poverty, emotional trauma, abuse or neglect, are more likely than other youth to experience poverty, drug addiction, incarceration and/or other situations that adversely affect their health and wellness. Signs of a youth being at risk include: violence in the home, poor academic performance in school, arrest(s), depression, unsafe sexual behavior, drug and alcohol use and/or a disinterest in activities the youth once enjoyed. Cal Wellness prefers using the term resilient youth as an alternative to at-risk youth.

capacity building — activities that increase the capabilities, knowledge and resources needed for an organization to perform core functions in pursuit of its mission. Examples of capacity building include strategic planning, board development, fundraising, technology improvements and program evaluation.

case management — the monitoring and coordination of treatment required to meet a client’s health and human service needs, which includes assessment, planning, implementation, coordination, monitoring and evaluation of options and services.

catchment area — the geographical area served by a particular agency or organization. For example, an after-school program might define its catchment area as a nearby school district.

Centers for Disease Control and Prevention — based in Atlanta, Georgia, and charged with protecting the nation’s public health by providing direction in the prevention and control of communicable and other diseases and responding to public health emergencies. Within the U.S. Public Health Service, the CDC is the agency that led efforts to prevent such diseases as malaria, polio, smallpox, toxic shock syndrome, Legionnaire's disease and, more recently, AIDS and tuberculosis. CDC's responsibilities evolve as the agency addresses contemporary threats to health, such as injury, environmental and occupational hazards, behavioral risks and chronic diseases.

chemical environment — encompasses the composition of synthetic and naturally occurring chemicals and toxins in the air, water and ground. Chemical hazards in the environment can cause immediate, dangerous health effects and can contribute to chronic problems. Projects to improve the chemical environment include environmental risk assessments of communities; health education and awareness campaigns on lead, pesticides and air particulates; environmental justice activities that develop, implement and enforce environmental laws, regulations and policies; and health advocacy activities that focus on improving waste management and sanitation in communities.

chronic care — care and treatment rendered to individuals whose health problems are of a long-term and continuing nature. Rehabilitation facilities, nursing homes and mental hospitals may be considered chronic care facilities.

chronic disease — a disease that has one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alternation; requires special training of the patient for rehabilitation; or may be expected to require a long period of supervision, observation or care.

civic engagement — actions designed to identify and address issues of concern within the broader community. Examples of civic engagement include volunteering, voting, serving on neighborhood associations and committees, writing letters to elected officials, and organizing and participating in fundraising events.

clinic — a facility, or part of one, devoted to diagnosis and treatment of outpatients. It may either include or exclude physicians' offices; may be limited to describing a facility that serves low-income patients; and may be limited to a facility in which graduate or undergraduate medical education is done.

community action for health — collective efforts by communities directed toward increasing community control over the determinants of health and thereby improving health.

community-based care — the blend of health and social services provided to individuals and families in their places of residence for the purposes of promoting, maintaining or restoring health, or minimizing the effects of illness and disability.

community benefit agreement — a legal agreement between a developer and a coalition of community groups for a construction project that guarantees benefits to the community, such as local jobs, affordable housing and environmental improvements, in exchange for the community’s support for the project.

community clinic — an ambulatory health care program (defined under section 330 of the Public Health Service Act) usually serving an area that has scarce or nonexistent health services or a population with special health needs. It is also sometimes known as a neighborhood health center or a community health center. Community clinics attempt to coordinate federal, state and local resources in a single organization capable of delivering both health services and related social services to a defined population. While such a center may not directly provide all types of health care, it usually takes responsibility to arrange for all health care services needed by its patient population.

continuing medical education — formal education obtained by a health professional after completing his or her degree and full-time postgraduate training. 

coordination of benefits — procedures used by insurers to avoid duplicate payment for losses insured under more than one insurance policy. A COB, or "nonduplication," clause in a policy prevents double payment by making one insurer the primary payer and assuring that not more than 100 percent of the cost is covered. Standard rules determine which of two or more plans, each having COB provisions, pays its benefits in full and which becomes the supplementary payer on a claim.

copayment — a form of cost sharing in which a fixed amount of money is paid by the insured for each health care service provided.

core operating support — funding for an organization as a whole rather than for a specific project or program. Organizations who receive core operating support can make decisions about how to spend the money in ways that best support their missions.

cost-benefit analysis — an analytic method in which a program's cost is compared to the program's benefits for a period of time, expressed in dollars, as an aid in determining the best investment of resources. For example, the cost of establishing an immunization service might be compared with the total cost of medical care and lost productivity that will be eliminated as a result of more persons being immunized. Cost-benefit analysis can also be applied to specific medical tests and treatments.

Covered California — health insurance exchange run by the state of California.

covered services — health care services covered by an insurance plan.

credentialing — the recognition of professional or technical competence. The credentialing process may include registration, certification, licensure, professional association membership or the award of a degree in a field. Certification and licensure affect the supply of health care personnel by controlling entry into practice and influence the stability of the labor force by affecting geographic distribution, mobility and retention of workers. Credentialing also determines the quality of personnel by providing standards for evaluating competence and by defining the scope of functions and how personnel may be used.

culture of coverage — a widespread belief that everyone should have, and is entitled to, health insurance coverage and that systems should be in place to make health insurance accessible for all.

customary charge — one of the factors determining a physician's payment for a service under Medicare, which is calculated as the physician's median charge for that service over a prior 12-month period.

deductible — the amount of loss or expense that must be incurred by an insured or otherwise covered individual before an insurer will assume any liability for all or part of the remaining cost of covered services. Deductibles may be either fixed-dollar amounts or the value of specified services (such as two days of hospital care or one physician visit). Deductibles are usually tied to some reference period over which they must be incurred, e.g., $100 per calendar year, benefit period or spell of illness.

defined benefit — funding mechanisms for pension plans that can also be applied to health benefits. Typical pension approaches include: (1) pegging benefits to a percentage of an employee's average compensation over his/her entire service or over a particular number of years; (2) calculating a flat monthly payment; (3) setting benefits based upon a definite amount for each year of service, either as a percentage of compensation for each year of service or as a flat dollar amount for each year of service.

defined contribution — funding mechanism for pension plans that can also be applied to health benefits based on a specific dollar contribution, without defining the services to be provided.

deinstitutionalization — a policy that calls for the provision of supportive care and treatment for medically and socially dependent individuals in the community rather than in an institutional setting.

dementia — a brain disorder of unknown cause, characterized by insidious onset and progressive, irreversible loss of intellectual function. Alzheimer’s Disease is the most common form of dementia and, together with other dementias, is a major cause of disability among the elderly.

developmental disability — a severe, chronic disability that is attributable to a mental or physical impairment or combination of mental and physical impairments; is manifested before the person attains age 22; is likely to continue indefinitely; results in substantial functional limitations in three or more of the following areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living and economic self-sufficiency; and reflects the person's needs for a combination and sequence of special, interdisciplinary or generic treatments or services that are lifelong or of an extended duration and are individually planned and coordinated.

devolution — describes the dismantling or reduction of government supported social services.

digital divide — the disparity between those who have access to technology and those who do not. Low-income families, rural populations, certain minorities and those with lower levels of education make up large segments of society that are being passed by in the information age. Those without access to technology are at a disadvantage when it comes to attaining health-related benefits associated with higher education and quality employment. 

disability — any limitation of physical, mental or social activity of an individual as compared with other individuals of similar age, sex and occupation. Disability frequently refers to limitation of a person's usual or major activities, most commonly vocational. There are varying types (e.g., functional, vocational and learning), degrees (e.g., partial and total) and durations (e.g., temporary and permanent) of disability. Public programs often provide benefits for specific disabilities, such as those that are total and permanent.

disease — may be defined as a failure of the adaptive mechanisms of an organism to counteract adequately, normally or appropriately to stimuli and stresses to which it is subjected, resulting in a disturbance in the function or structure of some part of the organism. This definition emphasizes that disease is caused by a number of factors and may be prevented or treated by changing any or a combination of the factors. Disease is an elusive and difficult concept to define, being largely socially defined. For example, alcoholism and drug dependence are now often regarded as diseases, when they were previously considered to be moral or legal problems.

diversity in the health professions — the representation of diverse races and cultures among health professionals to ensure that all patients have access to health care providers who can communicate clearly and show understanding and respect for their patients’ cultures.

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