The purpose of this study is to explore the extent to which changes in medication use account for improvements in functioning among older Americans. Using several waves of the Health and Retirement Study, a nationally representative survey of non-institutionalized Americans ages 51-61, the authors examine changes between 1992 and 1998 and between
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Many children with special health care needs depend on the health and supportive services provided by Medicaid. It is important that policymakers have a sound understanding of these children's patterns of health care use, especially given the shift to managed care. Previous studies of children on Medicaid with severe disability and/or chronic illn
Report from the Working Group on Improving Public Policies and Programs Affecting Persons with Mental Retardation and Other Developmental Disabilities
This report analyzes the impact of current federal policies and programs on the growth of community living arrangements and supportive services for people with mental retardation and other developmental disabilities (MR/DD).
The activities of daily living (ADLs) are the basic tasks of everyday life. Reported estimates of the size of the elderly population with ADL disabilities differ substantially across national surveys. Differences in which ADL items are being measured and in what constitutes a disability account for much of the variation. Other likely explanations
This report looks at the changing nature of the caseload by examining the characteristics and circumstances of three groups: people who leave welfare and stay off for at least a year (leavers), people who stay on welfare persistently (stayers), and people who cycle on and off the rolls (cyclers). The report uses a unique data set consisting of ove
The study of family strengths has been pursued by researchers from a variety of disciplines, including psychiatry, sociology, psychology, and family/marriage counseling. This paper will present an overview of this growing literature, focusing on four topics: the definition of strong families; the characteristics of strong families as identified by
Are today's elderly healthier than previous generations or does increased longevity come with increased risk of disability and reduced quality of life? In the ongoing search for a definitive answer, this paper provides a comprehensive review of the evidence, both for the United States and internationally. The basic conclusion is that disability ra
Development of an Assistive Technology and Environmental Assessment Instrument for National Surveys: Final Report - Part I
The purpose of this project was to develop, pilot, and disseminate a set of instruments for national surveys to measure the use of assistive technology and the environments in which they are used. The project focused on older adults living in the community. The instruments have been designed as a series of modules that can be adopted in whole or p
This study analyzes data from the 1985 National Nursing Home Survey to examine the phenomenon of multiple nursing home admissions. This is done in order to determine the number of individuals who would be fully covered if "front-end" nursing home coverage options were enacted. Analysis of nursing home stays indicates that 51% of admissions would b
Do Consumer-Directed Medicaid Supportive Services Work for Children with Developmental Disabilities?
The evaluation of Cash and Counseling is the first to use a randomized design to compare service use and quality under traditional versus consumer-directed approaches to Medicaid supportive services. As part of the evaluation, this paper presents results for the children and parents who participated in Florida's Cash and Counseling demonstration
The purpose of this paper is to demonstrate the variability in estimates of disability in the U.S. elderly population as a function of differing definitions of physical disability and cognitive impairment. Differing cut-off points along the disability continuum are employed, in conjunction with the varied definitions of disability, in order to dem
The Congress, HHS, and other federal agencies have expressed considerable interest in the adequacy of current programs and policies affecting severely disabled children, particularly those who are technology dependent and whose health and medical care place catastrophic financing and caregiving burdens on their families. Medicaid tape-to-tape and
This project developed an inventory of Quality Improvement Program (QIO) activities and then proposed methodologies to evaluate Medicare's QIO in the future. The contractor gathered information from publicly available sources, from CMS data when available, and from nine site visits to a variety of QIOs. Based on the findings, NORC developed a list
This paper looks at programmatic definitions of disability for federal disability programs by: (1) reviewing and examining major programmatic definitions of disability, and (2) describing complex eligibility processes by using the Social Security Disability Insurance program as an example. Programmatic definitions are critical from a federal polic