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This report presents the results of an evaluability assessment of discharge/transition planning as a homeless prevention strategy in four types of institutional and custodial settings including: adult in-patient psychiatric hospitals, foster care independent living programs, residential treatment programs for adults with substance abuse disorders,

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. Analyses were carried out on the 1982 National Long-Term Care Survey (NLTCS) and the 1984 NLTCS Longitu

This report summarizes ASPE's analysis of the effect of regulation and licensure on the quality of care in board and care homes. Study purpose and methodology are described, major findings are presented, and implications of the study findings are discussed. [48 PDF pages]

This literature review examines empirical evidence on health care coverage, employment, and public program participation among people with disabilities. The review is part of a larger project investigating the relationship between health care coverage and the employment of people with disabilities contracted for by the Office of Disability, Aging

This collection of brief issue papers uses diverse data to describe 15 major problems facing American children and families. Each paper summarizes the state of knowledge about the scope of the problem, trends, current government expenditures, costs per case, effectiveness of current intervention strategies and public attitudes about the problem ar

This comparative study first identifies and describes two cohorts of nursing facility decedents, those that did and did not elect Medicare hospice. Then, using data for up to one year prior to death, the study characterizes utilization and quality of care for these two cohorts. The influence of Medicare hospice on hospital utilization and symptom

This paper was requested as part of the National Academy of Sciences, Committee on National Statistics Panel to Evaluate the Survey of Income and Program Participation (SIPP). SIPP is sponsored by the Bureau of the Census and has been an ongoing longitudinal survey of the civilian non-institutionalized population since 1983.

In 1992, Lewin-VHI produced the report Policy Synthesis on Assisted Living for the Frail Elderly in order to address: the policy concerns generated by a growing frail elderly population, rapid increases in costs of care, and growing interest in various types of supportive housing for the elderly. The 1992 Policy Synthesis was based on a review and

This paper addresses issues which arise at the juncture of welfare and disability policies. Using preliminary data from a recent survey of current and recent AFDC recipients in California, we find that disabilities and chronic health problems affect the mothers or children in 43% of all households in the AFDC system. The presence of one or more ch

This is the second in a series of four reports that summarize study findings and methods. This report presents descriptive findings on the characteristics of board and care facilities, operators, staff, and residents. Section 2 briefly describes the study design and sampling and analytic methodology; more detailed discussion is presented in the Te

This report analyzed data on all pediatric hospitalizations of $25,000 or more in California to determine the relationship between source of payment and various characteristics, including age and diagnosis. [39 PDF pages]

This study examines the impact of changes in Medicare home health policy mandated by the Balanced Budget Act (BBA) of 1997 on satisfaction with care for disabled Medicare beneficiaries. The BBA mandated major changes in home health payment requiring the implementation of a Prospective Payment System (PPS) and an Interim Payment System (IPS) prior

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.

This report describes the design and implementation of the Consumer-Directed Care Research Project (CDC), Florida's model of Cash and Counseling, and draws lessons from the state's experience. The report is based primarily on in-person interviews conducted in January 2002, about 18 months after the project began enrolling beneficiaries. Intervie

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

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