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This report to Congress responds to a mandate of the Orphan Drug Act (P.L.97-414, January 4, 1983), which called for the Secretary of HHS to conduct demonstration projects to test methods for identifying individuals at risk of institutional placement who could be treated more cost-effectively with home health and other non-institutional services.
The purpose of this paper is to describe the diverse strategies that have been proposed for long-term care reform (for persons age 65+), and to present a balanced discussion of the points that have been made in support of, and in opposition to, each proposal. What the authors believe is "balanced" may not be perceived to be so by those who advocat
These Papers describe the current state of knowledge about long-term care in the U.S., and serve as a knowledge base for the difficult analytic tasks that lie ahead. They are based on the work of HHS's Task Force on Long-Term Care up to January 1981 and contain data that have not been available before. Five Papers make up this document: (1) an ove
Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities
This report summarizes the insights and conclusions drawn from a project to asses unmet needs for supply-side information on the health system. The project focused on identifying how information needs associated with a changing health care system are perceived by providers, insurers, purchasers, consumers, and government at various levels. The pro
High Service or High Privacy Assisted Living Facilities, Their Residents and Staff: Results from a National Survey
This report gives a description of the policies and practices, residents, and staff in the segment of the assisted living facility (ALF) industry that provides the highest level of services and privacy. It reports data on a nationally representative sample of residents and staff in ALFs classified as providing relatively high services or offering
Using MSIS Data to Analyze Mental Health Service Use and Expenditures for Medicaid Beneficiaries with Mental Illness in New Jersey in 1999
In the study described in this report, the authors used the Medicaid Statistical Information System (MSIS) files to examine the use and costs of Medicaid services for beneficiaries with mental illness in one state (New Jersey). This report includes an overview of findings on service use and costs for beneficiaries with mental illness compared with
Prepared by: R. William Thomas Abt Associates Prepared for: Office of the Assistant Secretary for Planning and Evaluation Department of Health, Education, and Welfare Contract: HEW-100-76-0179 Each chapter of the Report is in PDF format. Download a copy of the reader .
This paper explains the cost estimates for the long-term care provisions of the Health Security Act. [44 PDF pages]
The privatization of welfare services has increased significantly and expanded into new services since passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) gave states additional flexibility to design and operate their Temporary Assistance for Needy Families (TANF) programs. Despite its increasing popular
The objective of this report is to summarize the findings from the quantitative and qualitative methods used to answer the key study questions. The report provides a description of the states, agencies, and patients that participated in the study. Quantitative data are used to (1) examine the influence of patient, provider, agency, and market/regu
The evaluation of the 2001 OPM policy of parity for mental health and substance abuse (MH/SA) health care insurance benefits in the FEHB Program was conducted primarily to assess the impact of this policy on utilization and cost. Would increases be within reasonable limits or would the increase to utilization and cost render MH/SA parity unafforda
The activities of daily living (ADLs) are the basic task of everyday life: eating, bathing, dressing, toileting, and transferring. Although persons of all ages may have problems performing ADLs, disability prevalence rates are much higher for the elderly rising steeply with advancing age. When an effort is made to standardize ADL items for com
This paper discusses the policy implications of allocating long-term care benefits to the elderly on the basis of objective functional criteria, particularly functioning in the activities of daily living (ADLs). Although research has documented the link between measures of ADL performance and the need for services, developing a long-term care prog
An analysis was made of the pre and post-patterns of Medicare Part A service use using the samples of the 1982 and 1984 National Long-Term Care Surveys linked to the Medicare Part A bill files and mortality reports. The analysis was conducted both for the total elderly Medicare beneficiary population and for the community resident disabled populat
Factors Associated with Ending Caregiving Among Informal Caregivers to the Functionally and Cognitively Impaired Elderly Population
This study investigated factors associated with the decisions of principal informal caregivers of the activity of daily living (ADL) dependent elderly living in the community to end caregiving. Data were from the 1982 National Long-Term Care Survey (NLTCS), the 1982 Informal Caregiver Survey and 1984 NLTCS Longitudinal Follow-up.