Licensure status and the extensiveness of regulation in the two groups of States were the independent variables against which facility and resident quality measures were compared. Consistent with the sample design and original study power calculations, we used a probability level of 0.05 as the determination of statistical significance.
The development of instruments to describe residents, homes, operators, and staff and to capture key elements of quality was another major task. We developed three basic types of measures: (1) those used to describe homes and residents, (2) those used as covariates in the analysis of the effect of regulation and licensure on quality, and (3) tho
A Description of Board and Care Facilities, Operators, and Residents. 2.3 Definition of Licensed and Unlicensed Board and Care Homes
Each study State had different definitions or criteria for licensure of board and care homes, and, even within States, there were multiple categories of homes and multiple agencies that licensed homes. Because of this variation, we adopted decision rules about inclusion and exclusion for both licensed and unlicensed homes.
The objective of this study was to determine whether regulation affects the quality of care in licensed and unlicensed board and care homes. Specifically, the study was designed to determine whether an extensive regulatory system is associated with better quality of care and, if such an association is found, to determine whether regulation affects
A Description of Board and Care Facilities, Operators, and Residents. Section 2: Overview of Study Methods
The goals of this project were to describe the quality of care in board and care homes and how it varies across licensure and regulatory systems. Accomplishment of these objectives required a study design that incorporated several activities, including a major collection of new data. The study design included:
A variety of demographic factors and policy initiatives have increased demand for residential facilities that offer supportive services for the aged and disabled. These factors include
The Commission considered several ways in which its medical-record recommendations might be implemented and enforced. The alternatives considered ranged from a wholly voluntary approach to Federal legislation which, like the 1974 Drug Abuse and Alcoholism statutes, 49 would make compliance with the recommendations a requirement attached to the di
Persons With Mental Retardation and Related Conditions in Mental Retardation Facilities: Selected Findings from the 1987 National Medical Expenditure Survey. Overview
Part I of this report noted a number of significant limitations in the sample frame for the Institutional Population Component of NMES. It was noted that there is strong evidence that this caused substantial underrepresentation of smaller community-based residential facilities and their residents in the National Medical Expenditure Survey.
Standards for Privacy of Individually Identifiable Health Information. Final Privacy Rule Preamble.. Current law and practice
The issue that drew the most comments overall is the question of when individuals' permission should be obtained prior to use or disclosure of their health information. We learned that individuals' views and the legal view of 'consent' for use and disclosure of health information are different and in many ways incompatible. Comments from individua
Background/Objectives We interviewed the following individuals during our site visit to Washington State: Dorothy Canavan, Lab Manager, Dynacare Jon Counts, Dr.P.H., Director, Public Health Laboratories Jac Davies, Health Services Administrator, Public Health Laboratories Daniel Jernigan, Medical Epidemiologist, Public Health Laborator
Public Health Laboratories and Health System Change . Shape the Delivery System Through Dialogue / Collaboration
We uncovered some innovative models to stimulate dialogue and collaboration among laboratory stakeholders, often originating with, and guided by, forward-looking PHL directors. These models hold promise for ensuring private sector awareness and understanding of key public sector functions in laboratory testing. The most advanced example of this ap
In the State of Washington, a public-private venue called the Clinical Lab Advisory Council (CLAC) is shaping the laboratory delivery system. The CLAC was created by the PHL director in cooperation with the Office of Laboratory Quality Assurance and a range of private laboratory interests in the state. The CLAC was initially conceived as a respons
The PHL is a central part of the public health infrastructure. PHLs support the public health infrastructure in each of the three core public health functions. Descriptions of PHL activities within these core functions have been previously described by the CDC and the ASTPHLD: 3, 4, 5
Public Health Laboratories and Health System Change . Policy Context and Background: Environmental Scan
The purpose of this environmental scan is to provide some general context on public health laboratories and the laboratory services marketplace. In this section, we report on the components that constitute the laboratory services marketplace. We describe the PHL's role as part of the public health infrastructure; provide an overview of PHL activit
Public Health Laboratories and Health System Change: Executive Summary. Competition from large commercial labs
The laboratory industry is rapidly consolidating, with the historical dominance of hospital-based labs giving way to increasing market power of large, national reference labs. These labs take advantage of scale, quick turn-around, powerful IT systems, and full service packages to garner exclusive contracts from MCOs and their associated providers.
As part of its ongoing research program in public health infrastructure, The Office of the Assistant Secretary for Planning and Evaluation (ASPE) of the Department of Health and Human Services (DHHS) commissioned The Lewin Group to study the relationship between public health laboratories (PHLs) and managed care organizations (MCOs). As the study
Overview Adult day care facilities in Wyoming are licensed by the state Department of Health. Adult day care is provided under the long-term care waiver program. Medicaid providers do not have to meet requirements other than licensure. Licensure and Certification Requirements