In a society that is diverse in culture, language, and ethnicity, HHS manages an array of programs that aim to eliminate disparities in health status and access to health services and that increase opportunities for disadvantaged individuals to work and lead productive lives. These programs have strong foundations in basic and applied science, and
In 1997, HHS published its first strategic plan in response to the Government Performance and Results Act (GPRA). Since that time, the Department has successfully implemented the remaining GPRA requirements and now is working to continually improve the quality of its GPRA submissions. Part of that quality improvement effort has focused on updating
Market Barriers to the Development of Pharmacotherapies for the Treatment of Cocaine Abuse and Addiction: Final Report. Market Analysis for a Prospective Cocaine Medication
The market analysis estimates how costs and revenues accrue over time in the development and commercialization of a prospective cocaine medication, and presents plausible scenarios of prospective pharmaceutical companies and their drug development decisionmaking process. For pharmaceutical companies, the risk associated with developing and marketi
 In addition to the reforms noted, as per the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), all health insurance contracts for employer-groups of 2-50 employees must be issued on a guarantee-issue basis.
The nongroup (individual) health insurance market provides access to coverage for persons who cannot obtain health insurance coverage through their employer or do not qualify for public programs. For some persons it provides a temporary source of coverage while between jobs or for early retirees who are not yet eligible for Medicare.
States, in their actions, can and do make very different decisions about how to regulate the individual health insurance market. These actions reflect different values, political climates, and expectations. They also are designed to achieve specific policy goals, such as expanding access, with most states having considered laws and/or regulati
While almost all health insurance policies cover the usual medical expenses associated with hospital, surgical and out-patient care received from licensed facilities and medical personnel, other requirements for coverage can be implemented through state regulations. One way to spread the cost of a medical condition or treatment among a broad pop
States have sought to improve access to insurance policies through several regulatory approaches.
MEMORANDUM FROM THE SECRETARY August 26, 1998 TO: Heads of Operating Divisions Heads of Staff Divisions SUBJECT: HHS Policy for Changing the Population Standard for Age Adjusting Death Rates
ABA (American Bar Association). 1983. Board and Care Report: An Analysis of State Laws and Programs Serving Elderly Persons and Disabled Adults . Report to the Department of Health and Human Services. Washington, DC. Avorn, J., P. Dreyer, K. Connely, and S.B. Soumerai. 1989. Use of psychoactive medication and the quality of care in rest homes.
A Description of Board and Care Facilities, Operators, and Residents. 6.9 the “Niche” Served by Board and Care Homes
It seems clear that board and care residents fall somewhere between nursing home residents and residents of other residential settings with fewer services. In general, board and care home residents are more impaired than residents of congregate apartments, for example (Griffith, personal communication, 1995); however, on average, they are less imp
Approximately 43 percent of board and care residents were prescribed and 41 percent used at least one psychotropic agent, primarily on a routinely scheduled basis. On average, residents were prescribed 0.64 (SE = 0.06) and used 0.59 (SE = 0.05) different psychotropic drugs. While some residents used no psychotropics, others use as many as six. Fiv
Most board and care residents seemed to feel that they are safe and that their needs are adequately met. Overwhelmingly residents who were able to respond for themselves reported that they rarely or never went without needed assistance with activities of daily living ( Exhibit 6-12 ). Less than 5 percent of residents felt that they could use more
A Description of Board and Care Facilities, Operators, and Residents. 6.5 Health Status and Health Care Use
Over one-third of all board and care residents self-report poor or fair health. As shown in Exhibit 6-6 , the most prevalent health problem was arthritis/rheumatism, reported by 42 percent of residents. High blood pressure (28 percent), diabetes (11 percent), and asthma, emphysema, or chronic bronchitis (11 percent) were other frequently mentione
A Description of Board and Care Facilities, Operators, and Residents. 6.4 Cognitive and Functional Status
6.4.1 Cognitive Impairment In the early 1980s, Dittmar and Smith (1983) found 30 percent of the residents were “confused,” while Sherwood and colleagues (1981) found 24 percent were cognitively impaired ( Exhibit 6-4 ). A prevalence rate of 40 percent with moderate to severe cognitive impairment in this study indicates a significant increase
Disability levels in the area of psychiatric conditions, other than Alzheimer’s and other dementias, were about the same as in the 1980s, with one-third of the residents in the DRI study, as in this study, reporting a mental, emotional, or nervous condition. Similarly, as shown in Exhibit 6-4 , the percentage of residents with a diagnosis of me
Residents use varying sources of funds to pay for board and care and the services they receive, with many residents having more than one payment source ( Exhibit 6-3 ). Because SSI is widely thought to be one of the primary sources of income for residents in board and care facilities, it is surprising that less than one-third of the residents were
A Description of Board and Care Facilities, Operators, and Residents. 6.1 Demographic Characteristics
6.1.1 Age As show in Exhibit 6-1 , most residents were among the “old old,” with approximately one-third age 85 and older and another 30 percent age 75 to 84 years. Indeed, the average age of the residents was 75 years. Residents residing in the extensively regulated States tended to be older (77 years) than those living in homes in States
State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Sustainability and Lessons Learned
Participants did not indicate any plans to change the behavioral consultation visits, although some recommended that expanding the program would be advantageous. Current budget constraints limit any plans in this direction. The survey respondent stated that any additional funds would most likely to be used to hire more surveyors.