Archived Research Projects Funded by the HHS Office of Disability, Aging and Long-Term Care Policy

This section gives basic information on many past research projects conducted by and/or for the Office of Disability, Aging and Long-Term Care Policy (DALTCP). This section's main function is for a user to see if more than one report was written for a particular project.

THIS SECTION IS CURRENTLY UNDER CONSTRUCTION AND DOES NOT YET CONTAIN ALL PAST PROJECTS.

Remember, the Site Index section includes an alphabetic list of keywords you can choose from to find information that is referenced throughout the DALTCP website.

Projects are Listed in This Section Alphabetically (by Title): A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Site Index

A

TITLE	Analyses of VISTA Marketing and Recruitment Activities
PURPOSE	The Office of the Assistant Secretary for Planning and Evaluation will conduct certain independent analyses of data gathered by an ACTION contractor concerning VISTA marketing and recruitment activities. These data were gathered as part of an assessment of the implementation of marketing and recruitment activities in the VISTA program that were designed to increase the number of recent college graduates who became volunteers under the VISTA program.
CONTRACTOR	ACTION, Washington, DC
COMPLETION DATE	October 1992
REPORT AVAILABLE	ACTION's 1991-92 VISTA Marketing Campaign: An Analysis [Report Abstract and Full Report available here] AUTHORS: Robert Clark and Michele Adler DATE: January 1993

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TITLE	Analysis and Comparison of State Board and Care Regulations and Their Effect on the Quality of Care in Board and Care Homes
PURPOSE	The primary objectives of this project were: (1) to determine the quality of care in board and care homes, and how it varies across states and programs and between licensed and unlicensed homes, and (2) to examine the effect of state regulations on the quality of care in board and care homes.
CONTRACTOR	Research Triangle Institute, Research Triangle Park, NC
REPORTS AVAILABLE	A Description of Board and Care Facilities, Operators, and Residents [Report Abstract available here] AUTHORS: Catherine Hawes, Linda Lux, Judith Wildfire, Rebecca Green, Vincent Mor, Angela Greene, Victoria Wilcox, Charles D. Phillips, Diana Spore and Vince Iannacchione DATE: December 1995
	Executive Summary: Analysis of the Effect of Regulation on the Quality of Care in Board and Care Homes [Report Abstract and Full PDF Report available here] AUTHORS: Catherine Hawes, Rebecca Green, Vincent Mor, Angela Greene, Judith Wildfire, Victoria Wilcox, Vince Iannacchione, Diana Spore, Linda Lux and Charles D. Phillips DATE: July 10, 1995
	Report on Study Methods: Analysis of the Effect of Regulation on the Quality of Care in Board and Care Homes [Report Abstract and Full Report available here] AUTHORS: Catherine Hawes, Judith Wildfire, Vince Iannacchione, Linda Lux, Angela Greene, Vincent Mor and Linda Laliberte DATE: January 19, 1996
	Report on the Effects of Regulation on Quality of Care: Analysis of the Effect of Regulation on the Quality of Care in Board and Care Homes [Report Abstract, Executive Summary and Full Report available here] AUTHORS: Charles Phillips, Judith Wildfire, Catherine Hawes, Vince Iannacchione, Rebecca Green, Linda Lux, Angela Green, George Dunteman, Vincent Mor and Diana Spore DATE: December 1995

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TITLE	Analysis of Eligibility Issues
PURPOSE	The purpose of this project was to analyze the 1989 National Long-Term Care Survey and the 1987 National Medical Expenditures Survey for purposes of assessing alternative measures of severity of impairment for use as eligibility criteria for home and community-based long-term care services.
CONTRACTOR	The MEDSTAT Group, Cambridge, MA
REPORT AVAILABLE	Use of the 1989 National Long-Term Care Survey for Examining Cognitive Impairment Eligibility Criteria [Report Abstract and Full Report available here] AUTHORS: Mary Elizabeth Jackson and Pamela Doty DATE: July 1995

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TITLE	Analysis of Existing Long-Term Care Data
CONTRACTOR	The Urban Institute, Washington, DC
START DATE	January 1980
COMPLETION DATE	December 1983
REPORT AVAILABLE	Private Capacity to Finance Long-Term Care [Report Abstract available here] AUTHORS: Marilyn Moon DATE: March 1983
REPORT AVAILABLE	Source Book on Long-Term Care Data [Report Abstract available here] AUTHORS: William G. Weissert (Editor) DATE: July 29, 1983

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TITLE	Analysis of Federal and State Policies Affecting Services to Mentally Retarded and Other Developmentally Disabled Persons: State Perspectives
PURPOSE	The purpose of this study was to analyze how federal policies and programs influence state policy choices with respect to expanding family and community care.
CONTRACTOR	Macro Systems, Inc.
COMPLETION DATE	December 1987
REPORT AVAILABLE	An Analysis of Federal and State Policies Affecting Services to Mentally Retarded and Other Developmentally Disabled Persons: State Perspectives Final Report [Report Abstract available here] AUTHORS: Tecla Jaskulski and Rebecca Weader DATE: July 1987

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TITLE	Analysis of Patterns of Post-Acute and Chronic Care Services Use Among Disabled and Non-Disabled Medicare Beneficiaries: 1989-1994
PURPOSE	This project looked at the change in home health and SNF utilization in 1989 through 1998.
FINDINGS/RESULTS	Use of Medicare home health agency (HHA) and skilled nursing facility (SNF) services among Medicare beneficiaries aged 65 and older is strongly related to chronic disability. Between 1989 and 1994, use of Medicare-covered HHA services increased among all Medicare beneficiaries aged 65 and older. However, increased use of post-acute services--HHA services, in particular--was greatest among chronically disabled elderly Medicare beneficiaries. In 1989, 3.4% of non-chronically disabled elderly used either SNF or HHA services; in 1994, the percentage rose to 4.9%. In contrast, 18.7% of chronically disabled elderly Medicare beneficiaries used SNF or HHA services in 1989 as compared to 29.2% in 1994.
CONTRACTOR	MEDSTAT Group, Inc., Cambridge, MA
START DATE	September 1, 1997
COMPLETION DATE	September 1998
REPORT AVAILABLE	Medicare Home Health Services 1989-1994: Patterns of Benefit Use Among Chronically Disabled Elders [Report Abstract available here] AUTHORS: Mary E. Jackson and Pamela Doty DATE: March 4, 1999

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TITLE	Assessing the Feasibility of Making State Level Estimates from National Surveys
PURPOSE	This project was a component of the Data Initiative--a broader HHS strategy to improve the Department's capacity to generate valid and reliable State level estimates, to measure the impact of social policy interventions, as HHS health and human services programs rapidly change their focus from the national to the State level. This project focused on three well known Federal surveys widely used for policy analysis: the Survey of Income Program Participation, the Current Population Survey, and the National Health Interview Survey. In relation to these surveys, this project: (1) closely evaluated statistical concerns to determine suitability and potential of using these surveys for State level estimates and to identify differences between States; (2) assessed the current capabilities of these surveys to provide State level data; and, (3) presented options for obtaining valid reliable State level data from relatively minimal enhancements and changes to the design of the surveys.
CONTRACTOR	The Lewin Group, Falls Church, VA
START DATE	October 1996
COMPLETION DATE	December 1997
REPORT AVAILABLE	Deriving State-Level Estimates from Three National Surveys: A Statistical Assessment and State Tabulations [Report Abstract, Executive Summary and Full Report available here] AUTHORS: Lisa Alecxih, John Corea and David Marker DATE: May 4, 1998

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TITLE	Assessment of the Policy Implications of Alternative Functional Definitions of Disability for Children
PURPOSE	This project used three different ways of measuring functional disability in three data sets.
CONTRACTOR	Albert Einstein College of Medicine
START DATE	June 1996
REPORT AVAILABLE	Assessment of the Policy Implications of Alternative Functional Definitions of Disability for Children: Final Report [Report Abstract, Executive Summary and Full Report available here] AUTHORS: Ruth E.K. Stein DATE: March 1997

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TITLE	Assistive Technology for the Frail Elderly
PURPOSE	This paper, prepared by an ASPE student intern, provides an overview of assistive technology for the frail elderly.
CONTRACTOR	University of Pennsylvania
START DATE	June 1991
COMPLETION DATE	February 1992
REPORT AVAILABLE	Assistive Technology for the Frail Elderly: An Introduction and Overview [Report Abstract and Full Report available here] AUTHORS: Robert Elliott DATE: April 28, 1992

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B

TITLE	Burden of Catastrophic Acute and Long-Term Care Costs
PURPOSE	This study used the National Long-Term Care Survey and other data sources to estimate the extent to which acute and long-term care service use cause disabled elderly persons to incur catastrophic costs.
CONTRACTOR	The Urban Institute, Washington, DC
COMPLETION DATE	February 1992
REPORT AVAILABLE	Catastrophic Acute and Long-Term Care Costs: Risks Faced by Disabled Elderly Persons [Report Abstract and Full Report available here] AUTHORS: Korbin Liu, Maria Perozek and Kenneth Manton DATE: June 1991

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C

TITLE	Caregiver Burden and Institutionalization, Hospital Use and Stability of Care
PURPOSE	This study assessed a variety of longitudinal models to examine the effect of different types of caregiver burden on outcomes important to policymakers: nursing home admissions, hospital use, and stability of the family and formal care networks.
CONTRACTOR	University of Illinois
COMPLETION DATE	November 1989
REPORT AVAILABLE	Caregiver Burden and Institutionalization, Hospital Use, and Stability of Care [Report Abstract and Executive Summary available here] AUTHORS: Baila Miller and Stephanie McFall DATE: November 1989

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TITLE	Caring for Frail Elderly People
PURPOSE	The Organization for Economic Cooperation and Development (OECD) is an international organization based in Paris, France, whose membership is comprised of advanced industrial nations--including the United States, Canada, Australia, New Zealand, Japan, and most of the countries of Western Europe. Since 1991, the OECD has been conducting comparative research on long-term care for the frail (i.e., functionally disabled) elderly across member countries. Three "expert" meetings have been held--in 1991, 1992, and 1994. In addition, DALTCP has contributed a "country report" (written by Pamela Doty) describing long-term care policy in the United States. OECD's cross-national study of care of the frail elderly is now nearing completion. A follow-up study examining the broader effects of population aging on OECD countries is planned.
FINDINGS/RESULTS	"Caring for Frail Elderly People: Policies in Evolution" was published by OECD, which compiles similar reports from each of the OECD member countries. Chapter 14 covers the United States.
CONTRACTOR	Organization for Economic Cooperation and Development, Paris, France
COMPLETION DATE	July 1995
REPORT AVAILABLE	Caring for Frail Elderly People: Policies in Evolution [Report Abstract and Chapter 14 available here] AUTHORS: Organization for Economic Cooperation and Development DATE: 1996

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TITLE	Characteristics of the Elderly Long-Term Care Population and Its Service Use
PURPOSE	Through an ASPE grant, the Center for Demographic Studies at Duke University has produced a series of studies covering the characteristics of the elderly long-term care population and its use of services.
CONTRACTOR	Duke University, Durham, NC
START DATE	September 1987
COMPLETION DATE	September 1990
REPORTS AVAILABLE	Recent Changes in Service Use Patterns of Disabled Medicare Beneficiaries [Report Abstract available here] AUTHORS: Kenneth G. Manton and Korbin Liu DATE: 1990
	Risks of Entering Nursing Homes for Long and Short Stays [Report Abstract, Full Report available here] AUTHORS: Korbin Liu, Carol DeVita, Kenneth G. Manton and Terri Coughlin DATE: 1988
	The Effect of Nursing Home Use on Medicaid Eligibility [Report Abstract available here] AUTHORS: Korbin Liu and Kenneth G. Manton DATE: 1989

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TITLE	Children's Disability Research Issues
PURPOSE	This project examined the costs, incentives, and outcomes for families, communities, and government for institutional care versus community care for children with disabilities.
FINDINGS/RESULTS	Study findings included the following: Families of medically fragile children with health insurance, either public or private, enjoy relatively comprehensive coverage while the uninsured have greater difficulty getting treatment. The majority of uninsured children have problems finding a pediatrician or other doctor to treat their special needs. Half of Medicaid recipients have a difficult time finding doctors to accept Medicaid payments. Children with private insurance are least likely to have trouble finding providers. Compared to the other two insurance groups, Medicaid recipients were more likely to report that services were well coordinated. However, parents providing in-home care were significantly more likely to view the service system as complex compared to those with children in nursing facilities. Families of uninsured children are more likely to delay care until high-cost emergency services are required. The majority of parents surveyed were pleased with their child's care, however, those with medically fragile children at home were significantly less likely to be "extremely" satisfied compared to those with children in institutions. Private insurance companies are much more likely to finance some of the costs of care if children remain in the community. Parents expressed a need for more information when faced with decisions about where to provide care: more information about available programs and services; how to meet qualifying criteria; how to get needed equipment; where to go for support groups or training. Parents also reported the need for various services including respite, home modification, and equipment.
CONTRACTOR	Texas A&M University, College Station, TX
START DATE	September 1994
COMPLETION DATE	March 1996
REPORT AVAILABLE	Health Policy for Medically Fragile Children: An Analysis of Factors Impacting Care in Texas [Report Abstract and Executive Summary available here] AUTHORS: Dottie J. Carmichael, Dena Stoner and Cheryl B. Silver DATE: March 1996

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TITLE	Client-Directed In-Home Care/Personal Assistance Services
PURPOSE	This survey of personal assistance services clients, workers, and case managers compared measures of quality of care, quality of life, client satisfaction and worker satisfaction across modes of service provision: client-directed modes (independent provider and supported independent provider) and professionally managed (agency-employed providers). The study was carried out in the context of California's In-Home Supportive Services (IHSS) program. Telephone or in-person interviews were conducted with approximately 1,250 IHSS consumers, 500 providers, and 50 social work case managers. The study also compared the outcomes associated with use of family, friends, and neighbors as independent providers as compared to services provided by aides previously unknown to the client.
FINDINGS/RESULTS	The study compared client and worker outcomes for clients receiving and workers providing personal assistance services through a consumer-directed model of service delivery as compared to a professional management model of service delivery. The consumer-directed model out-performed the professional management model on six of fourteen client outcome dimensions (summary measures) in the areas of empowerment, satisfaction with services, and quality of life. Within the client-directed service model, family providers out performed non-family providers on four of the fourteen client outcome dimensions. With respect to workers, workers in the professional management model experienced less stress and burden than consumer-directed workers on two of six dimensions; consumer-directed workers experienced less stress on one dimension. Consumer-directed workers had better interpersonal relationships with their clients than did workers in the professional management model. The same was true for non-family providers as compared to family providers in the consumer-directed model. Specifically, professional management model workers and non-family workers in the consumer-directed model worried less about client safety and had more positive emotional states; however, consumer-directed model workers and family providers in the consumer-directed model had better relationships with their clients. There were no differences between workers in the consumer-directed and professional management models in terms of the four measurement dimensions of job satisfaction; however, within the consumer-directed model of service delivery, non-family providers were more positive about the career benefits of being a home care worker than family providers.
CONTRACTOR	University of California, Los Angeles, CA
START DATE	September 1994
COMPLETION DATE	March 1998
REPORT AVAILABLE	In-Home Supportive Services for the Elderly and Disabled: A Comparison of Client-Directed and Professional Management Models of Service Delivery--Non-Technical Summary Report [Report Abstract, Executive Summary and Full Report available here] AUTHORS: Pamela Doty, A.E. Benjamin, Ruth E. Matthias and Todd Franke DATE: April 1999

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TITLE	Community Program Size and Quality
PURPOSE	This project examined the relationship between community residential size and quality of care for persons with developmental disabilities. It also examined the differences in cost among small facilities were of special interest.
CONTRACTOR	Temple University, Philadelphia, PA
REPORT AVAILABLE	Size and Quality in Residential Programs for People with Developmental Disabilities [Report Abstract available here] AUTHORS: James W. Conroy DATE: February 1992

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TITLE	Comparative Outcomes and Processes of Prepaid Managed Care for High-Risk Populations
PURPOSE	The purpose of this study is to learn more about the effects of managed care on persons with disabilities.
FINDINGS/RESULTS	Investigators have completed a major refinement of a disability diagnostic classification system and applied the system to claims form multiple plans. Service utilization and diagnostic profile data from Michigan and Colorado have been analyzed.
CONTRACTOR	University of California, La Jolla, CA
COMPLETION DATE	December 1996
REPORT AVAILABLE	Diagnostic Risk Adjustment for Medicaid: The Disability Payment System [Report Abstract and Executive Summary available here] AUTHORS: Richard Kronick, Tony Dreyfus, Lora Lee and Zhiyuan Zhou DATE: 1996

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TITLE	Conference on Successful Families
PURPOSE	At this conference, 13 of the leading researchers in the field came together to describe their work and define outstanding research issues. Discussions included issues of defining successful families and measures which can be used to identify them, methodological issues in research regarding families, and issues relevant to the application of findings.
CONTRACTOR	SysteMetrics/McGraw-Hill
REPORT AVAILABLE	Identifying Successful Families: An Overview of Constructs and Selected Measures [Report Abstract and Full Report available here] AUTHORS: Maria Krysan, Kristin A. Moore and Nicholas Zill DATE: May 10, 1990
REPORT AVAILABLE	Research on Successful Families [Report Abstract available here] AUTHORS: Maria Krysan, Kristin A. Moore and Nicholas Zill DATE: May 10, 1990

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TITLE	Consumer Direction in Home and Community-Based Care
PURPOSE	This project developed approaches and solutions for implementing consumer-directed service models for the delivery of home and community-based PAS for persons with disabilities. It addressed issues arising from regulatory compliance requirements as well as issues concerning potential tort liability faced by payers, consumers, and providers of these services. Many of these issues were identified in previous research sponsored by HHS (Flanagan, 1994) and by the Retirement Research Foundation (Sabatino and Litvak, 1995). Some of the tentative solutions proposed in that research were explored in this project. Work on the current project was divided into three main activities: (1) case studies of up to twenty programs that use a variety of "intermediaries" were conducted to determine how the intermediary assists consumers and their providers to comply with tax, labor law, and other regulatory requirements. The case studies also examined how the intermediaries provided other supportive services (e.g., training, supervision) that serve the interests of consumer-employers, public and private payers and the providers themselves; (2) meetings with Federal officials (e.g., IRS, DoL/FLSA and OSHA) to identify and discuss pertinent Federal tax and labor laws affecting PAS providers and consumers; and (3) development of up to three model contracts reflecting current Federal regulatory and other requirements in clear, simple and accurate terms for the benefit of all parties to these arrangements.
FINDINGS/RESULTS	The final report identifies key administrative, organization, labor and tax issues that must be addressed by State program adminstrators as they develop consumer-directed PAS programs. The report describes alternative models of intermediary services organizations (ISOs) that States can use to ensure that necessary employment-related tasks, such as paying and filing taxes for consumer-directed workers, are properly accomplished. Some ISO models also have the capacity to support self-directing clients with training and recruitment of workers. Examples of the various ISO models operating in the context of existing consumer-directed PAS are provided.
CONTRACTOR	The MEDSTAT Group, Inc., Cambridge, MA
START DATE	June 1995
COMPLETION DATE	October 1997
REPORT AVAILABLE	Consumer-Directed Personal Assistance Services: Key Operational Issues for State CD-PAS Programs Using Intermediary Service Organizations [Report Abstract, Executive Summary and Full PDF Report available here] AUTHORS: Susan A. Flanagan and Pamela S. Green DATE: October 24, 1997

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TITLE	Costs and Quality of Subacute Care
PURPOSE	This project was designed to provide an understanding of subacute care in select market areas.
CONTRACTOR	The Lewin Group, Fairfax, VA
REPORTS AVAILABLE	Subacute Care: Policy Synthesis and Market Area Analysis [Report Abstract and Full Report available here] AUTHORS: Lewin-VHI, Inc. DATE: November 1, 1995
REPORTS AVAILABLE	Subacute Care: Review of the Literature [Report Abstract and Full Report available here] AUTHORS: Lewin-VHI, Inc. DATE: December 1994

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D

TITLE	Design Study for a National Survey of People with Developmental Disabilities
PURPOSE	This study analyzed methods for collecting nationally representative data on people with mental retardation and other developmental disabilities living in the community.
CONTRACTOR	Mathematica Policy Research, Inc., Princeton, NJ
COMPLETION DATE	February 1990
REPORTS AVAILABLE	An Estimate of the Number of Persons with Developmental Disabilities Receiving Supplemental Security Income Benefits and Their Characteristics [Report Abstract and Full Report available here] AUTHORS: Brian O. Burwell DATE: December 1990
	Characteristics of Persons with Developmental Disabilities: Evidence from the Survey of Income and Program Participation [Report Abstract and Executive Summary available here] AUTHORS: Craig Thornton DATE: January 1990
	Design for a National Survey of Persons with Developmental Disabilities [Report Abstract and Executive Summary available here] AUTHORS: Craig Thornton, Susan A. Stephens, Brian O. Burwell, James W. Conroy, Bradley K. Hill and K. Charlie Lakin DATE: February 1990
	Persons With Mental Retardation and Related Conditions in Mental Retardation Facilities: Selected Findings from the 1987 National Medical Expenditure Survey [Report Abstract and Executive Summary available here] AUTHORS: K. Charlie Lakin, Bradley K. Hill, Tsuey-Haw Chen and Susan A. Stephens DATE: December 1989
	Summary of Recommendations for Survey Questions and Screening Criteria [Report Abstract available here] AUTHORS: Rita Stapulonis, Joy Gianolio, Susan A. Stephens and Craig V.D. Thornton DATE: November 29, 1989

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TITLE	Developing Integrated Managed Care Systems for Children with Disabilities
PURPOSE	The purposes of this study included: (1) documenting the state-of-the-art in developing managed care systems for children with disabilities; (2) learning how states are using the Medicaid and Title V sponsored managed care plans to serve low income children with disabilities; and (3) identifying lessons/best practices and managed care models from state experience.
CONTRACTOR	The MEDSTAT Group, Cambridge, MA
COMPLETION DATE	December 1996
REPORT AVAILABLE	Developing Integrated Managed Care Systems for Children with Disabilities: The State of the Art [Report Abstract and Executive Summary available here] AUTHORS: Sara S. Bachman, Mimi Bernardin and Brian Burwell DATE: December 1996

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TITLE	Disability Profiles and Policy Analyses
PURPOSE	To produce a series of analytical reports and policy analyses of the working-age disabled pouplation using data from the 1984 Panel of the Survey of Income and Program Participation.
CONTRACTOR	Mathematica Policy Research, Inc., Washington, DC
REPORTS AVAILABLE	A Labor Force Profile of Persons with Disabilities [Report Abstract and Executive Summary available here] AUTHORS: Alberto Martini DATE: March 19, 1990
	Federal Programs for Persons with Disabilities [Report Abstract and Executive Summary available here] AUTHORS: Brian O. Burwell DATE: January 1990
	Population Profile of Disability [Report Abstract and Executive Summary available here] AUTHORS: Pat Doyle DATE: October 1989
	Program Participation Patterns Among Persons with Disabilities [Report Abstract and Executive Summary available here] AUTHORS: Pat Doyle, Esther Miller and Jim Sears DATE: May 10, 1990

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TITLE	Disabled Children and the AFDC and SSI Programs
PURPOSE	This project examined the interaction of children with disabilities and public assistance programs, specifically: (1) factors responsibility for the rapid growth in the SSI rolls especially transitions from AFDC to SSI; (2) impact of care for a disabled child on the labor force participation, welfare receipt and earnings in AFDC families; and (3) additional costs for low income families with disabled children.
FINDINGS/RESULTS	Among the study's findings are the following: Over 40% of households had either a disabled mother or at least one child with special needs--30% of the others indicated that they had a physical or mental idsability which limited their ability to work; 21% report the presence of at least one child with a chronic health problem or disability. Respiratory diseases, especially asthma, were the most common chronic condition for children in AFDC, affecting 5.7% of children. Behavior and learning problems together formed the next most common category (2%); 0.7% were affected by other chronic diseases or physical impairments. In terms of severity, most conditions were mild to moderate; however, 44% of children's conditions were severe because the child required substantial help with daily activities, the condition interfered with the child's attendance at school, or the child received SSI. Eleven percent of all families cared for at least one child with a severe disability or illness; 7% of families received SSI for their children. Five percent of families were caring for more than one child with chronic conditions. Half of the families with one or more special needs children had average out-of-pocket expenses related to the child(ren)'s needs in the previous month. Expenses averaged approximately $131 with a range from $6.00 to $665. Expenditures were for medical care and medications that were not covered by insurance, special child care arrangements, and special food and diets. Mothers of special needs children were less likely to be working. Three-quarters of the families who received SSI still had incomes at or below 125% of poverty.
CONTRACTOR	Syracuse University
COMPLETION DATE	June 1996
REPORT AVAILABLE	Work, Welfare, and the Burden of Disability: Caring for Special Needs of Children in Poor Families [Report Abstract and Full Report available here] AUTHORS: Marcia K. Meyers, Anna Lukemeyer and Timothy M. Smeeding DATE: April 1996

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E

TITLE	Effects of Medicare's Hospital Prospective Payment System (PPS) on Disabled Medicare Beneficiaries
PURPOSE	The purpose of this study was to determine how PPS has affected the patterns of care received by Medicare beneficiaries with chronic disabling conditions.
CONTRACTOR	The Urban Institute, Washington, DC
COMPLETION DATE	1988
REPORT AVAILABLE	Effects of Medicare's Hospital Prospective Payment System (PPS) on Disabled Medicare Beneficiaries [Report Abstract available here] AUTHORS: Korbin Liu and Kenneth G. Manton DATE: February 1988

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TITLE	Estimates of Medicaid Asset Spend-Down in Connecticut
PURPOSE	This data set attempts to get at lifetime use, which is particularly important to Medicaid spend-down since over half of the persons admitted to nursing homes have multiple stays.
CONTRACTOR	The MEDSTAT Group, Cambridge, MA
COMPLETION DATE	February 1992
REPORTS AVAILABLE	An Analysis of the Impact of Spenddown on Medicaid Expenditures [Report Abstract and Executive Summary available here] AUTHORS: Leonard Gruenberg, Hillel Alpert and Brian Burwell DATE: January 1992
	Nursing Home Length of Stay and Spend-down: Connecticut, 1977-1985 [Report Abstract available here] AUTHORS: Korbin Liu and Kenneth Manton DATE: August 1990
	Nursing Home Stays and Spend Down in the State of Connecticut: 1978-1983 [Report Abstract available here] AUTHORS: Thomas W. Bice DATE: September 20, 1990
	Nursing Home Stays and Spend Down: State of Connecticut 1983-84 Admission Cohort [Report Abstract available here] AUTHORS: Thomas W. Bice DATE: June 1991

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TITLE	Evaluation of the Elderly Nutrition Program
PURPOSE	This project provided grants to State Agencies on Aging to support the provision of daily meals in either group or home settings to persons age 60 and older, specially targetting elders who have the greatest economic and social need.
FINDINGS/RESULTS	Key findings of the evaluation include the following: (a) people who receive ENP meals have higher daily intakes of key nutrients than similar nonparticipants; (b) ENP meals provide approximately 40-50% of participants' daily intakes of most nutrients; (c) participants have more social contacts per month than similar nonparticipants; and (d) most participants are satisfied with the services the ENP provides.
CONTRACTOR	Mathematica Policy Research, Inc., Princeton, NJ
COMPLETION DATE	July 1996
REPORT AVAILABLE	Serving Elders at Risk, The Older Americans Act Nutrition Programs: National Evaluation of the Elderly Nutrition Program 1993-1995--Volume I: Title III Evaluation Findings [Report Abstract and Executive Summary available here] AUTHORS: Michael Ponza, James C. Ohls, Barbara E. Millen, Audrey M. McCool, Karen E. Needels, Linda Rosenberg, Dexter Chu, Catherine Daly and Paula A. Quatromoni DATE: July 1996

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TITLE	Exploratory Study of Health Care Coverage and the Employment of People with Disabilities
PURPOSE	The purpose of this project was to review and analyze available information on how health insurance coverage and the particular provisions of health care policies are related to employment by people with disabilities. The review consisted of an examination of the available research literature on the relationship of health care coverage and employment among people with disabilities; the analysis of any additional information from states which extend health care coverage to people with disabilities through employer mandates or other provisions; an examination of employment rates and patterns among recipients of Veterans Administration disability benefits, and any other relevant available data such as national survey data.
CONTRACTOR	The Lewin Group, Fairfax, VA
START DATE	September 1996
COMPLETION DATE	June 1998
REPORT AVAILABLE	Exploratory Study of Health Care Coverage and Employment of People with Disabilities: Final Report [Report Abstract, Executive Summary, Full PDF Report available here] AUTHORS: David Stapleton, Gina Livermore, Scott Scrivner, Adam Tucker and David Wittenburg DATE: July 6, 1998
REPORT AVAILABLE	Exploratory Study of Health Care Coverage and Employment of People with Disabilities: Literature Review [Report Abstract, Executive Summary and Full Report available here] AUTHORS: David Stapleton, Gina Livermore, Scott Scrivner and Adam Tucker DATE: October 27, 1997

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TITLE	Exploratory Study of the Barriers and Incentives to be Addressed in Improving the Labor Force Participation of People with Disabilities
PURPOSE	The purpose of this project was to provide background information on barriers and incentives to improving the labor force participation of people with significant disabilities, particularly as related to HHS programs and policies.
CONTRACTOR	The Lewin Group, Falls Church, VA
START DATE	August 1994
COMPLETION DATE	June 1995
REPORT AVAILABLE	An Exploratory Study of Barriers and Incentives to Improving Labor Force Participation Among Persons with Significant Disabilities [Report Abstract and Executive Summary available here] AUTHORS: David Stapleton, Lisa Alecxih, Burt Barnow, Kevin Coleman, Gina Livermore, Gilbert Lo, Steve Lutzky and Andrea Zeuschner DATE: June 30, 1995

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F

TITLE	Factors Associated with a Breakdown in Caregiving Among Informal Caregivers to the Functionally and Cognitively Impaired Elderly Population
PURPOSE	This study investigated the reasons that principal informal caregivers of the activity of daily living dependent elderly decided to end caregiving.
CONTRACTOR	Johns Hopkins University, Baltimore, MD
COMPLETION DATE	February 1990
REPORT AVAILABLE	Factors Associated with Ending Caregiving Among Informal Caregivers to the Functionally and Cognitively Impaired Elderly Population [Report Abstract available here] AUTHORS: Judith D. Kasper, Ulrike Steinbach and Jane Andrews DATE: February 1990

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TITLE	Families with Disabilities in the United States
PURPOSE	The purpose of this project was to determine how disability is clustered in families, the extent of clustering, and the characteristics of such families.
CONTRACTOR	University of California
REPORT AVAILABLE	Families with Disabilities in the United States [Report Abstract and Executive Summary available here] AUTHORS: Mitchell P. LaPlante, Dawn Carolson, H. Stephen Kaye and Julia E. Bradsher DATE: September 1996

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TITLE	Financing of Long-Term Care
PURPOSE	In this project, four tasks were undertaken: (1) analysis of the causes of nursing home admission; (2) analysis of the correlation between nursing home entrance and income; (3) analysis of spend-down of assets to Medicaid eligibility; and, (4) model simulations.
CONTRACTOR	Lewin/ICF, Falls Church, VA
COMPLETION DATE	December 1988
REPORT AVAILABLE	Financing of Long-Term Care: Final Report [Report Abstract available here] AUTHORS: David L. Kennell, Lisa Alecxih, Polly Ericksen, Joshua M. Wiener and Raymond Hanley DATE: September 30, 1988

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TITLE	Financing Studies Using National Nursing Home Data
PURPOSE	x
FINDINGS/RESULTS	x
CONTRACTOR	Urban Institute, Washington, DC
COMPLETION DATE	February 1992
REPORT AVAILABLE	Effects of Multiple Admissions on Nursing Home Use: Implications for "Front-end" Policies [Report Abstract available here] AUTHORS: Korbin Liu and Maria Perozek DATE: September 1990

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TITLE	Future of Long-Term Care: Projections and Challenges
PURPOSE	This study used data from the Decennial Census of Population and Housing, the National Long-Term Care Survey, and the National Nursing Home Survey to develop projections of the need for long-term care among the elderly in the years 2000, 2020, and 2040.
CONTRACTOR	Miami University, Oxford, OH
COMPLETION DATE	February 1991
REPORTS AVAILABLE	Estimating the Prevalence of Long-Term Disability for an Aging Society [Report Abstract and Full Report available here] AUTHORS: Suzanne R. Kunkel and Robert A. Applebaum DATE: April 1991
REPORTS AVAILABLE	Long-Term Care for the Boomers: A Public Policy Challenge for the Twenty-First Century [Report Abstract and Full Report available here] AUTHORS: Robert Applebaum and Suzanne Kunkel DATE: February 1991

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H

TITLE	Health and Long-Term Care Expenditure Patterns of Children with Disabilities
PURPOSE	x
FINDINGS/RESULTS	x
CONTRACTOR	MEDSTAT Group, Cambridge, MA
START DATE	August 1994
COMPLETION DATE	November 1997
REPORT AVAILABLE	Children with Severe Chronic Conditions on Medicaid [Report Abstract, Executive Summary and Full Report available here] AUTHORS: Brian Burwell, Bill Crown and John Drabek DATE: November 1997

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I

TITLE	Inclusion of Board and Care Homes in 1991 National Health Provider Inventory
PURPOSE	x
FINDINGS/RESULTS	x
CONTRACTOR	Lewin/ICF, Falls Church, VA
COMPLETION DATE	June 1990
REPORT AVAILABLE	Descriptions of and Supplemental Information on Board and Care Homes included in the Update of the National Health Provider Inventory [Report Abstract available here] AUTHORS: Lewin-ICF and James Bell Associates DATE: August 8, 1990

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TITLE	Informal Care of the Disabled Elderly: A Research and Policy Initiative
PURPOSE	The purpose of this project was to provide necessary background information for policy relevant research and a national conference on informal caregiving of the disabled elderly.
CONTRACTOR	The MEDSTAT Group, Cambridge, MA
REPORTS AVAILABLE	Eldercare: The Impact of Family Caregivers' Employment on Formal and Informal Helper Hours [Report Abstract and Full Report available here] AUTHORS: Pamela Doty DATE: August 1995
	The Changing Face of Informal Caregiving--A National Conference on Policy Directions for the 1990s [Report Abstract available here] DATE: October 1992
	The Impact of Female Caregivers' Employment Status on Patterns of Formal and Informal Eldercare [Report Abstract and Full Report available here] AUTHORS: Pamela Doty, Mary E. Jackson and William Crown DATE: 1998

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TITLE	International Collaborative Effort (ICE) on Aging: Outcomes of Nursing Home Care in Five Countries
PURPOSE	The Outcomes of Nursing Home Care in Five Countries was one of a number of initiatives being conducted under the NCHS-sponsored International Collaborative Effort on Aging. The aging of the population worldwide reveals the urgency of the issue of long-term care. The establishment of nursing homes is one way in which several societies have tried to meet the needs of a proportion of the dependent elderly. An international study including Australia, Canada, the Netherlands, Norway and the United States, supported by NCHS, makes available comparable data on the number of persons in nursing homes and the characteristics of nursing home care in these counties. These data show how the different health care systems deal with the very dependent elderly receiving institutional care, including differences in nursing home outcomes using indicators like live versus dead discharges and place discharged to. Outcome indicators are related to characteristics of the patients prior to admission and to diagnosis on admission. Recommendations for strengthening comparable data across countries are discussed.
FINDINGS/RESULTS	Several articles were done by NCHS staff, which were included in the proceedings of 1988 International Symposium on Data on Aging. Meetings and presentations, including: a roundtable presentation at the World Congress of Gerontology, Budapest, Hungary, July 1993; a symposium at the 47th Annual Scientific meeting, Gerontological Society of America, Atlanta, Georgia, November 1994.
CONTRACTOR	This project was undertaken by representatives from several countries.
START DATE	January 1989
COMPLETION DATE	December 1997
REPORTS AVAILABLE	Home and Community-Based Care in the USA [Report Abstract and Full Report available here] AUTHORS: Robert F. Clark DATE: October 1991
	Home and Community-Based Care: The U.S. Example [Report Abstract and Full Report available here] AUTHORS: Robert F. Clark DATE: 1996
	Long-Term Care in Five Countries [Report Abstract available here] AUTHORS: Betty Havens and Francois Beland (Guest Editors) DATE: November 1996
	Nursing Home Care in Five Nations [Report Abstract and Full Report available here] AUTHORS: Joan Van Nostrand, Robert F. Clark and Tor Inge Romoren DATE: June 1993
	Overview of Long-Term Care in Five Nations: Australia, Canada, the Netherlands, Norway, and the United States [Report Abstract available here] AUTHORS: Joan F. Van Nostrand, Anna L. Howe, Betty Havens, David Bray, Wim J.A. van den Heuvel, Tor Inge Romoren and Robert Clark DATE: September 1995

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K

TITLE	Key Aspects of State/Local Administration of Home and Community-Based Care Services Programs
CONTRACTOR	National Association of Area Agencies on Aging
REPORT AVAILABLE	An Examination of Issues Related to How Home and Community-Based Services Programs Operate Within Fixed Budgets and to the Administrative Linkages Between Eligibility Determination, Needs Assessment and Care Planning Functions [Report Abstract and Full Report available here] AUTHORS: Brina B. Melemed DATE: December 1994

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L

TITLE	Long-Term Care Financing Policy Review
PURPOSE	In cooperation with the MEDSTAT Group (formerly known as SysteMetrics), the Office produced five monographs which review what we have learned about key long-term care problems and issues.
CONTRACTOR	SysteMetrics, Cambridge, MA
COMPLETION DATE	September 1994
REPORTS AVAILABLE	An Analysis of Long-Term Care Reform Proposals [Report Abstract and Full Report available here] AUTHORS: Brian Burwell, Mary Harahan, David Kennell, John Drabek and Lisa Alecxih DATE: February 1993
	The Disabled Elderly and Their Use of Long-Term Care [Report Abstract and Full Report available here] AUTHORS: Brian Burwell and Beth Jackson DATE: July 1994
	The Economic Impact of Long-Term Care on Individuals [Report Abstract and Full Report available here] AUTHORS: Lisa Alecxih and David Kennell DATE: October 1994
	The Emerging Private Financing System [Report Abstract and Full Report available here] AUTHORS: Lisa Alecxih and David Kennell DATE: October 1994

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TITLE	Long-Term Care Service Use: Longitudinal and Predictive Models
PURPOSE	Under an ASPE grant, the investigators examined a sample of 2,898 elderly persons living in the community in Massachusetts.
CONTRACTOR	Hebrew Rehabilitation Center for Aged, Boston, MA
COMPLETION DATE	February 1989
REPORT AVAILABLE	Long-Term Care Service Use: Longitudinal and Predictive Models Final Report [Report Abstract and Full Report available here] AUTHORS: John M. Morris, Claire E. Gutkin, Hirsch S. Ruchlin and Sylvia Sherwood DATE: March 1989

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M

TITLE	Measuring the Activities of Daily Living: Comparisons Among National Surveys
PURPOSE	x
FINDINGS/RESULTS	x
CONTRACTOR	Brookings Institution, Washington, DC
START DATE	October 1988
COMPLETION DATE	October 1989
REPORTS AVAILABLE	Measuring the Activities of Daily Living Among the Elderly: A Guide to National Surveys [Report Abstract, Executive Summary and Full Report available here] AUTHORS: Joshua M. Wiener and Raymond J. Hanley DATE: October 1989
REPORTS AVAILABLE	Measuring the Activities of Daily Living: Comparisons Across National Surveys [Report Abstract and Executive Summary available here] AUTHORS: Joshua M. Wiener, Raymond J. Hanley, Robert Clark and Joan F. Van Nostrand DATE: 1990

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TITLE	Monograph on Uninsured Children with Disabilities
PURPOSE	This project developed a brochure intended to familiarize state decision-makers with low-income uninsured children with disabilities so that they have essential information about these children as they develop and implement CHIP plans. It describes uninsured children with disabilities, their numbers, their needs, and how opportunities presented by CHIP can help.
FINDINGS/RESULTS	Highlights include: about 700,000 children with disabilities (12%) lack health insurance coverage and most (77% or 530,000) of these children live in low-income families; 70% of these families report that insurance is too expensive. To a lesser extent these families cite unemployment (2.9%) and lack of dependent coverage by employer plans (4.6%) as reasons their disabled children do not have insurance. Further, uninsured children with disabilities use certain health services less than those who are insured as indicated by number of doctor visits and receipt of therapy services. In general, children with disabilities have special needs that policy makers should consider in the design of CHIP programs, including appropriate and comprehensive coverage, appropriate utilization controls with gatekeepers familiar with the needs of children with disabilities, access to quality specialty care, cost sharing that is sensitive to the frequency of services that some children with disabilities may need, and program and access standards that comply with the ADA.
CONTRACTOR	Westat, Inc., Rockville, MD
START DATE	January 1998
COMPLETION DATE	July 1998
REPORT AVAILABLE	Considering Children with Disabilities and the State Children's Health Insurance Program [Report Abstract, Full PDF Report and Full HTML Report available here. You will need a copy of the Acrobat Reader in order to view this Portable Document Format (PDF) report.] AUTHORS: Lynn Elinson, Gavin Kennedy and Lois Verbrugge DATE: October 1998

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N

TITLE	National Conference on Managed Care for People with Disabilities
PURPOSE	x
FINDINGS/RESULTS	x
CONTRACTOR	MEDSTAT Group, Cambridge, MA
COMPLETION DATE	November 1996
REPORT AVAILABLE	Beyond the Water's Edge: Charting the Course of Managed Care for People with Disabilities--Conference Resource Book [Report Abstract available here] DATE: November 1996

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TITLE	National Institute on Consumer-Directed Home and Community-Based Care Services
PURPOSE	x
FINDINGS/RESULTS	x
CONTRACTOR	National Council on Aging
COMPLETION DATE	October 1998
REPORT AVAILABLE	Autonomy or Abandonment: Changing Perspectives on Delegation [Report Abstract and Full Report available here] AUTHORS: Donna Wagner, Pamela Nadash and Charles Sabatino DATE: July 1997

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TITLE	National Long-Term Care Channeling Demonstration
PURPOSE	x
FINDINGS/RESULTS	x
CONTRACTORS	Mathematica Policy Research, Princeton, NJ Temple University, Philadelphia, PA
START DATE	September 1980
COMPLETION DATE	July 1997
REPORTS AVAILABLE	Analysis of Channeling Project Costs [Report Abstract and Executive Summary available here] AUTHORS: Craig Thornton, Joanna Will and Mark Davies DATE: May 1986
	Analysis of Site-Specific Results [Report Abstract and Executive Summary available here] AUTHORS: Robert A. Applebaum, Randall Brown and Peter Kemper DATE: May 1986
	Analysis of the Benefits and Costs of Channeling [Report Abstract and Executive Summary available here] AUTHORS: Craig Thornton and Shari Miller Dunstan DATE: May 1986
	Assessment and Care Planning for the Frail Elderly: A Problem Specific Approach [Report Abstract available here] AUTHORS: Elizabeth Solen, Marilyn Grannemann, Elsie Carter, Helen Wells-Hunter, Patricia Decker, Suzanne Bulvanoski, Carol Coleman, Maryellen Kluxen and Tambria Johnson DATE: 1986
	Assessment Training for Case Managers: A Trainer's Guide [Report Abstract available here] DATE: 1985
	Case Management Training for Case Managers: A Trainer's Guide [Report Abstract available here] AUTHORS: Linda M. Sterthous DATE: 1985
	Channeling Case Management Manual [Report Abstract available here] AUTHORS: Barbara Schneider, Miriam Galper, Leonard E. Gottesman, Patricia F. Kohn, Betty Morrell, Linda Staroscik and Linda Sterthous DATE: 1986
	Channeling Effects for an Early Sample at 6-Month Followup [Report Abstract and Executive Summary available here] AUTHORS: Peter Kemper, Robert Applebaum, Randall S. Brown, George J. Carcagno, Jon B. Christianson, Thomas W. Grannemann, Margaret Harrigan, Nancy Holden, Barbara Phillips, Jennifer Schore, Craig Thornton and Judith Wooldridge DATE: May 1985
	Channeling Effects on Formal Community-Based Services and Housing [Report Abstract and Executive Summary available here] AUTHORS: Walter Corson, Thomas Grannemann, Nancy Holden and Craig Thornton DATE: May 1986
	Channeling Effects on Hospital, Nursing Home and Other Medical Services [Report Abstract and Executive Summary available here] AUTHORS: Judith Wooldridge and Jennifer Schore DATE: May 1986
	Channeling Effects on Informal Care [Report Abstract and Executive Summary available here] AUTHORS: Jon B. Christianson DATE: May 1986
	Channeling Effects on the Quality of Clients' Lives [Report Abstract and Executive Summary available here] AUTHORS: Robert A. Applebaum and Margaret Harrigan DATE: April 1986
	Channeling Financial Control System [Report Abstract available here] AUTHORS: Marilyn Grannemann DATE: 1985
	Community Services and Long-Term Care: Issues of Negligence and Liability [Report Abstract available here] AUTHORS: Elias S. Cohen and Linda S. Sterthous DATE: 1982
	Comparability of Treatment and Control Groups at Randomization [Report Abstract and Executive Summary available here] AUTHORS: Randall S. Brown and Margaret Harrigan DATE: October 27, 1983
	Differential Impacts Among Subgroups of Channeling Enrollees [Report Abstract and Executive Summary available here] AUTHORS: Thomas W. Grannemann and Jean Baldwin Grossman DATE: May 1986
	Differential Impacts Among Subgroups of Early Channeling Enrollees Six Months After Randomization [Report Abstract and Executive Summary available here] AUTHORS: Thomas W. Grannemann, Randall S. Brown and Shari Miller Dunstan DATE: July 1984
	Effects of Case Management and Community Services on the Impaired Elderly [Report Abstract and Executive Summary available here] AUTHORS: Randall Brown and Barbara Phillips DATE: February 1986
	Effects of Sample Attrition on Estimates of Channeling's Impacts for an Early Sample [Report Abstract and Executive Summary available here] AUTHORS: Peter A. Mossel and Randall S. Brown DATE: July 1984
	Evaluation of the National Long-Term Care Demonstration [Report Abstract and Executive Summary available here] AUTHORS: Peter Kemper, Randall S. Brown, George J. Carcagno, Robert A. Applebaum, Jon B. Christianson, Walter Corson, Shari Miller Dunstan, Thomas Grannemann, Margaret Harrigan, Nancy Holden, Barbara R. Phillips, Jennifer Schore, Craig Thornton, Judith Wooldridge and Felicity Skidmore DATE: April 1988
	Evaluation of the National Long-Term Care Demonstration: Final Report [Report Abstract, Executive Summary, Demonstration Summary and List of Reports/Data Tape Documentation available here] AUTHORS: Peter Kemper, Randall S. Brown, George J. Carcagno, Robert A. Applebaum, Jon B. Christianson, Walter Corson, Shari Miller Dunstan, Thomas Grannemann, Margaret Harrigan, Nancy Holden, Barbara Phillips, Jennifer Schore, Craig Thornton, Judith Wooldridge and Felicity Skidmore DATE: May 1986
	Examination of the Equivalence of Treatment and Control Groups and the Comparability of Baseline Data [Report Abstract and Executive Summary available here] AUTHORS: Randall S. Brown and Peter A. Mossel DATE: October 1984
	Final Report on the Effects of Sample Attrition on Estimates of Channeling's Impacts [Report Abstract and Executive Summary available here] AUTHORS: Randall S. Brown, Peter A. Mossel, Jennifer Schore, Nancy Holden and Judy Roberts DATE: January 13, 1986
	Guide to Memorandum of Understanding Negotiation and Development [Report Abstract available here] AUTHORS: Mary L. Johnson and Linda Sterthous DATE: 1982
	Informal Care to the Impaired Elderly: Report of the National Long-Term Care Demonstration Survey of Informal Caregivers [Report Abstract and Executive Summary available here] AUTHORS: Jon B. Christianson and Susan A. Stephens DATE: June 6, 1984
	Informal Services and Supports [Report Abstract available here] AUTHORS: Linda M. Sterthous DATE: 1985
	Methodological Issues in the Evaluation of the National Long-Term Care Demonstration [Report Abstract and Executive Summary available here] AUTHORS: Randall S. Brown DATE: July 1986
	National Long-Term Care Channeling Demonstration: Summary of Demonstration and Reports [Report Abstract, Demonstration Summary and List of Reports/Data Tape Documentation available here] DATE: March 1991
	Planning and Implementation of Channeling: Early Experiences of the National Long-Term Care Demonstration [Report Abstract and Executive Summary available here] AUTHORS: Raymond J. Baxter, Robert Applebaum, James J. Callahan Jr., Jon B. Christianson and Stephen L. Day DATE: April 15, 1983
	Planning and Operational Experience of the Channeling Projects [Report Abstract and Executive Summary available here] AUTHORS: George Carcagno, Robert Applebaum, Jon Christianson, Barbara Phillips, Craig Thornton and Joanna Will DATE: July 18, 1986
	Screening Training for Screeners: A Trainer's Guide [Report Abstract available here] AUTHORS: Miriam Galper Cohen, Mary L. Johnson, Barbara W. Schneider, Linda M. Sterthous, Linda Staroscik and Leonard E. Gottesman DATE: 1985
	Survey Data Collection Design and Procedures [Report Abstract and Executive Summary available here] AUTHORS: Barbara R. Phillips, Susan A. Stephens and Joanna J. Cerf DATE: March 7, 1986
	Tables Comparing Channeling to Other Community Care Demonstrations [Report Abstract and Full Report available here] AUTHORS: Robert A. Applebaum, Margaret N. Harrigan and Peter Kemper DATE: May 1986

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TITLE	National Survey Development: Asset and Health Dynamics of the Oldest Old
PURPOSE	x
FINDINGS/RESULTS	x
CONTRACTOR	University of Michigan
START DATE	March 1994
COMPLETION DATE	September 1994
REPORT AVAILABLE	Asset and Health Dynamics Among the Oldest Old (AHEAD): Initial Results From the Longitudinal Study [Report Abstract available here] AUTHORS: George C. Myers (Guest Editor) DATE: May 1997

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TITLE	National Survey of Special Care Units
PURPOSE	This survey was a census of special care units in licensed homes in the United States.
FINDINGS/RESULTS	Using data from the National Nursing Home Survey, approximately 17,000 nursing homes were identified. A screening instrument was developed to identify the characteristics of nursing homes that have developed SCUs and the nature of and populations served by those units. This instrument was mailed to all identified nursing homes. Approximately, 40% of nursing homes responded to the screener. A survey of a national representative sample of nursing homes was conducted in 1995. Findings include: almost 35% of nursing homes (predominately for-profit) report have at least one special care unit and 16% report having plans to develop such units. More nursing homes report having Alzheimer's units (22%) compared to facilities reporting subacute units (12%), rehabilitation units (10%), and special programs for persons with HIV/AIDS (2%). Nursing home specialization is projected to increase in the future.
CONTRACTOR	Project HOPE, Bethesda, MD
START DATE	March 1996
COMPLETION DATE	September 1996
REPORT AVAILABLE	Trends in Special Care: The 1995 National Nursing Census of Sub-Acute Units [Report Abstract, Executive Summary and Full Report available here] AUTHORS: Joel Leon, Michael Cheng and Jennifer Dunbar DATE: September 1997

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P

TITLE	Policy Synthesis on Assisted Living
PURPOSE	The purpose of this project was to: (1) examine the range of housing and service options available to the frail elderly; (2) identify critical public policy issues in the financing, delivery, and appropriateness of supportive housing alternatives; and (3) assist ASPE in developing a policy-relevant research agenda in supportive housing.
CONTRACTOR	Lewin Group, Falls Church, VA
START DATE	August 1991
COMPLETION DATE	December 1992
REPORT AVAILABLE	Policy Synthesis on Assisted Living for the Frail Elderly: Final Report [Report Abstract and Executive Summary available here] AUTHORS: Barbara Manard, William Altman, Nancy Bray, Lisa Kane and Andrea Zeuschner DATE: December 16, 1992

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TITLE	Pre Summit Experts Meeting on Productive Aging
PURPOSE	x
FINDINGS/RESULTS	x
START DATE	June 1997
COMPLETION DATE	July 1997
REPORT AVAILABLE	Active Aging: A Shift in the Paradigm [Full Report available here] DATE: June 1997

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TITLE	Prevalence Estimates of the Functionally Impaired Elderly
PURPOSE	This study operationalizes eligibility criteria invoked in these proposals, and offers estimates for the number who would be eligible under alternative functional and cognitive criteria.
CONTRACTOR	SysteMetrics, Cambridge, MA
START DATE	October 1988
COMPLETION DATE	December 1989
REPORTS AVAILABLE	Publicly-Financed Home Care for the Disabled Elderly: Who Would Be Eligible? [Report Abstract and Full Report available here] AUTHORS: Mary E. Jackson and Brian O. Burwell DATE: June 1992
REPORTS AVAILABLE	Use of Functional Criteria in Allocating Long-Term Care Benefits: What Are the Policy Implications? [Report Abstract and Full Report available here] AUTHORS: Mary E. Jackson and Brian O. Burwell DATE: November 1989

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R

TITLE	Resource Guide to Quality Assurance Measures
PURPOSE	This Resource Guide was designed to support efforts to measure and improve Medicaid managed care organization (MCO) performance for people with disabilities. It presents the results of an extensive search for existing performance measures that can be used for quality measurement and improvement by: state Medicaid agencies; MCOs; providers within MCOs; and people who advocate for the health care needs of those with disabilities. The purpose of the Resource Guide is threefold: (1) To provide an overview of the issues to be considered in measuring the performance of MCOs in services of people with disabilities; (2) To bring together in one volume key information about measures that now exist, or are about to be made available, that can be counted on to support efforts to measure and improve the care provided by MCOs to people with disabilities; and (3) To make clear the areas where technically strong measures do not exist, in order to encourage further measurement development in these areas. The Resource Guide was the result of a ten-month effort by the Center for Health Outcomes Improvement Research at the George Washington University Medical Center. This effort was supported by the Office of Disability, Aging and Long-Term Care Policy of the Office of the Assistant Secretary for Policy and Evaluation (ASPE) at the U.S. Department of Health and Human Services. ASPE commissioned the Resource Guide in response to numerous requests from the field to disseminate, sooner rather than later, the best available measures of performance in caring for people with disabilities.
FINDINGS/RESULTS	The Resource Guide sets up a typology for considering quality of managed care for persons with disabilities and lays current measures over the context of the typology.
CONTRACTOR	George Washington University, Washington, DC
START DATE	September 1997
COMPLETION DATE	July 1998
REPORT AVAILABLE	Meeting the Challenge of Serving People With Disabilities: A Resource Guide for Assessing the Performance of Managed Care Organizations [Report Abstract and Full Report available here] AUTHORS: Shoshanna Sofaer, Sabra F. Woolley, Kyle Ann Kenney, Barbara Kreling and D. Richard Mauery DATE: July 1998

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TITLE	Role of Home and Community-Based Services in Meeting the Health Care Needs of People with HIV/AIDS
PURPOSE	The purpose of this project was to consider the long-term care needs of people with HIV/AIDS (PWAs) and efficient and effective approaches for financing, organizing, and delivering long-term care services to this population. Specifically, the project considered the appropriate role of home and community-based services (HCBS) in meeting the health care needs of PWAs in an effective and efficient manner, the estimated demand for HCBS and factors likely to influence demand, and the strengths and limitations of various approaches to organizing, paying for, and delivering HCBS services to PWAs. The project included two major components: (1) case studies of community-based HIV/AIDS programs providing HCBS and (2) an analysis of data on health care service use and expenditures of PWAs enrolled in Medicaid in New Jersey, which maintains a statewide Medicaid utilization data, which is linked to a statewide HIV/AIDS registry.
FINDINGS/RESULTS	The primary finding of the case studies showed that the HCBS needs of the HIV population varies widely and deserves different considerations that models that serve the elderly and disabled populations. In addition, the case studies supported the need for ‘gap filling' programs such as the Ryan White Care Act but that coordination among Ryan White and Medicaid could be enhanced. The data from New Jersey Medicaid supports that nurse case management does positively affect access to home care services for persons with HIV/AIDS.
CONTRACTOR	Mathematica Policy Research, Princeton, NJ
START DATE	October 1996
COMPLETION DATE	April 1998
REPORT AVAILABLE	Role of Home and Community-Based Services in Meeting the Health Care Needs of People with AIDS: Final Report [Report Abstract, Executive Summary and Full Report available here] AUTHORS: Jennifer Schore, Mary Harrington and Stephen Crystal DATE: March 1998
	Role of Home and Community-Based Services in Meeting the Health Care Needs of People with AIDS: Literature Review [Report Abstract and Executive Summary available here] AUTHORS: Jennifer Schoff and Jennifer Schore DATE: January 17, 1997
	Serving A Changing Population: Home- and Community-Based Services for People With AIDS [Report Abstract and Full PDF Report available here. You will need a copy of the Acrobat Reader in order to view this Portable Document Format (PDF) report.] AUTHORS: Jennifer Schore, Mary Harrington and Stephen Crystal DATE: September 1998

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S

TITLE	Second Longitudinal Study of Aging (LSOA II): Health Care Financing Administration Data Linkage
PURPOSE	This is a joint project with the National Center for Health Statistics to assist in the development and preparation of data from the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services) (e.g., Medicare claims information, HMO enrollment) to be appended to the 1995 Second Supplement on Aging--the baseline for the Longitudinal Survey on Aging (LSOA II). As a result of the administrative data appended to the survey, researchers and public policy analysts will have important knowledge of respondents' health care utilization and HMO enrollment prior to entry into the study. These data can be used to better investigate changes in health care utilization among the elderly population.
CONTRACTOR	National Center for Health Statistics, Hyattsville, MD
START DATE	September 1997
COMPLETION DATE	September 1998

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TITLE	Service Utilization and the Individual, Family and Neighborhood Characteristics of Children with Disabilities in Illinois
PURPOSE	The objective of this project was to describe demographic and socio-economic characteristics and services for all children and adolescents who are identified as having a disability in Illinois, as well as to understand the stability of the care that they receive through childhood and adolescene.
FINDINGS/RESULTS	The study was based on an integrated database on all children in Illinois identified as having a disability by the Department of Public Aid, the State Board of Education, the Department of Mental Health and Developmental Disabilities, and Medicaid reimbursement files between 1989 and 1994. Some of the major findings include the following: the overall number of children identified as being disabled increased by 7% between FY 1990 and FY 1994. In FY 1994, 8% of all children in Illinois were identified as disabled from the combination of data sources. The number of children receiving SSI increased from 12, 184 in FY 1990 to 43,941 in FY 1994. The percentage of SSI children in special education decreased from 51% to 42% between FY 1990 and FY 1994. In each fiscal year, the majority of the children participating in both special education and SSI were mentally retarded. Over time, learning disabled and severely emotionally disturbed children were increasingly likely to participate in SSI and special education at the same time. In FY 1994, the majority of children participating in Medicaid reimbursed services and either special education or SSI were being treated for mental disorders. In each of the fiscal years, boys were more likely than girls to have been identified as disabled.
CONTRACTOR	University of Chicago, Chicago, IL
START DATE	September 1994
COMPLETION DATE	April 1996
REPORT AVAILABLE	Service Utilization and the Individual, Family, and Neighborhood Characteristics of Children with Disabilities in Illinois [Report Abstract, Executive Summary and Full Report available here] AUTHORS: Robert Goerge, Lucy Mackey-Bilaver, Bong Joo Lee, David Koepke and Allison Harris DATE: September 30, 1996

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TITLE	Study of Medicaid Financing for Disabled or High Cost Children
PURPOSE	This project used the Medicaid tape-to-tape and other data to estimate the numbers of children experiencing catastrophic health care expenses, the level of expenditures and sources of payment and their service utilization patterns.
CONTRACTOR	SysteMetrics, Cambridge, MA
COMPLETION DATE	December 1990
REPORTS AVAILABLE	Longitudinal Analysis of High Cost Medicaid Children in California [Report Abstract and Full Report available here] AUTHORS: Marilyn Rymer Ellwood and Elicia Herz DATE: October 1990
	SSI-Related Disabled Children and Medicaid [Report Abstract and Full Report available here] AUTHORS: Marilyn Rymer Ellwood DATE: June 1990
	Summary and Policy Implications: Analyses of Medicaid Financing for Disabled or High Cost Children [Report Abstract and Full Report available here] AUTHORS: Marilyn Rymer Ellwood and Leighton Ku DATE: December 1990
	Who is Paying the Big Bills? Very High Cost Pediatric Hospitalizations in California, 1987 [Report Abstract and Executive Summary available here] AUTHORS: Leighton Ku DATE: August 1990

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TITLE	Study of the Medically Uninsured, Mental Illness and Mental Retardation
PURPOSE	x
FINDINGS/RESULTS	x
CONTRACTOR	University of California
REPORT AVAILABLE	Disability, Health Insurance Coverage, and Utilization of Acute Health Services in the United States [Report Abstract and Executive Summary available here] AUTHORS: Mitchell P. LaPlante DATE: October 1993

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TITLE	Survey of Medicaid Personal Care Programs
PURPOSE	x
FINDINGS/RESULTS	x
CONTRACTOR	World Institute on Disability
COMPLETION DATE	April 1991
REPORT AVAILABLE	Case Studies of Six State Personal Assistance Service Programs Funded by the Medicaid Personal Care Option [Report Abstract and Full Report available here] AUTHORS: Jae Kennedy and Simi Litvak DATE: December 1991

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TITLE	Trends in Disability Rates Among the Elderly
PURPOSE	Analysis of survey data to examine trends in disability rates among persons aged 65 or over, both in the U.S. and in other countries.
FINDINGS/RESULTS	This project produced a report which provides a comprehensive review of the evidence, both domestic and international, on whether there is a decline in elderly disability rates. The most defensible conclusion is that there is such a decline. In the United States, some studies show smaller declines than others, but in a variety of research approaches using different surveys, different measures and different analytic methods there is no sign of any sustained increase in disability. On the contrary, several sources of data show statistically significant declines in elderly disability rates. Similarly, in much of the industrialized world outside the United States, available survey data point to an increase in the amount of time the elderly can expect to live without a disability. Cross-nationally, more comparable measures, survey field procedures and analytic strategies are needed to examine how fast disability rates are falling and to assess the implications for health and long-term care service use and expenditures.
CONTRACTOR	The Urban Institute, Washington, DC
START DATE	September 1997
COMPLETION DATE	September 1998
REPORT AVAILABLE	International Evidence on Disability Trends among the Elderly [Report Abstract, Executive Summary and Full Report available here] AUTHORS: Timothy A. Waidmann and Kenneth G. Manton DATE: June 18, 1998

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