Reports

HHS-DoL Symposium Summary The Lewin Group  

Content Findings from Existing Research Options for Future Research  

This document is the information package given to the attendees of the conference “Pathway to the Future: How Workforce Development and Quality Jobs Can Promote Quality Care.” The held in Washington, D.C. on May 23-25, 2004, and was sponsored by the U.S. Department of Health and Human Services and the U.S. Department of Labor.

This paper provides the fundamental context of both the long-term care sector and the workforce investment system in order to build understanding among members of each system. It is not intended to be comprehensive but to provide enough information to stimulate dialogue. Section II briefly describes the characteristics of the long-term care paraprofessional workforce.

The purpose of the synthesis paper is to review, summarize, and discuss the significance of available research findings on the frontline long-term care (LTC) workforce since 1999, in both home and community-based and nursing home settings. This paper provides an updated review of the status of empirical findings, focusing on what has been learned between 1999 and 2003.

The traditional system of providing Medicaid personal care services (PCS) through home care agencies gives consumers few choices about how and when their care is provided. Because some agencies do not provide care on weekends or outside business hours, consumers may not receive care when they need it.

Despite the TANF program's emphasis on employment, the policies, practices and attitudes of the employers of TANF recipients have received limited attention.

This package--distributed at a national symposium held at the Wyndham Hotel, Washington, D.C. on May 23-25, 2004--was prepared by the Office of Disability, Aging and Long-Term Care Policy (DALTCP) with the U.S. Department of Health and Human Services (HHS) under Contract #HHS-100-03-0009 with the Lewin Group.

U.S. Department of Health and Human Services

Recruiting and Retaining a Quality Paraprofessional Long-Term Care Workforce: Building Collaboratives with the Nation's Workforce Investment System Michael E.

U.S. Department of Health and Human Services The Effect of Consumer Direction of Personal Assistance Received in Arkansas Stacy Dale, Randall Brown, Barbara Phillips, Jennifer Schore and Barbara Carlson Mathematica Policy Research, Inc. May 2004 PDF Version

Contents Research Questions Data Sources Study Limitations Characteristics of the Study States Key Findings Potential Next Steps The 1996 Personal Responsibility and Work Opport

Content Key Research Questions Data and Methods Key Findings Conclusions Endnotes

With the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), policymakers and researchers have recognized the importance of understanding the dynamics of the low-wage labor market and the economic opportunities in it.

This report examines the implementation of TANF sanctions in three states, looking at the ways that case managers used sanctions to promote compliance with work requirements. They found that case managers often exercised discretion in deciding whether and when to initiate a sanction, especially when a client partially met participation requirements.

By: LaDonna Pavetti, Michelle K. Derr, Gretchen Kirby, Robert G. Wood, and Melissa A. Clark Submitted to:U.S. Department of Health and Human ServicesOffice of the Assistant Secretary for Planning and Evaluation

By: Peter Schochet and Anu Rangarajan Submitted to:U.S. Department of Health and Human ServicesOffice of the Assistant Secretary for Planning and Evaluation Project Officer: Susan Hauan

By: Fredrik Andersson, Julia Lane, Erika McEntarfer  

Content The Value of Hardship Measures Defining and Measuring Hardship Material Hardship Indexes Measuring Hardship Using the SIPP Unanswered Questions for Future Research  

This report analyzes the experiences of welfare "cyclers," a group that has received relatively little attention in previous research on welfare dynamics. For this study, "cycling" is defined as receipt of welfare benefits during three or more discrete spells during a four-year "observation" period.

By: Fredrik Andersson, Julia Lane, Erika McEntarfer   Research Brief (in PDF format) Executive Summary

The report analyzes the experiences of welfare "cyclers" (those who received welfare benefits during three or more discrete spells during a four-year observation period) using five MDRC studies of welfare reform initiatives during the mid- to late-1990s. Overall, cyclers constituted a relatively small portion of the welfare caseload (9 percent).

This report summarizes what is known about the measurement of material hardship and its application to research with low-income families with children. It discusses challenges in defining and measuring material hardship, reviews how such measures have been in recent research, and presents analyses of data from the Survey of Income and Program Participation (SIPP).

This literature review summarizes what is known about falls and fall prevention and identifies the components of effective strategies for reducing falls. Intertwined in the discussion are the results of interviews conducted with individuals representing nine fall prevention programs that have been identified as particularly successful.

This report provides an overview of prevention efforts under the Steps to a HealthierUS initiative. First, it highlights the problems and challenges in preventing chronic disease.

Prepared for: Julia IsaacsU.S. Department of Health and Human ServicesOffice of the Assistant Secretary for Planning and Evaluation

By: Lashawn Richburg-Hayes and Stephen Freedman MDRC April 2004 Submitted to:U.S. Department of Health and Human ServicesOffice of the Assistant Secretary for Planning and Evaluation

FRONT COVER MESSAGE FROM THE SECRETARY

U.S. Department of Health and Human Services The Effect of Reducing Falls on Long-Term Care Expenses: Literature Review Abt Associates, Inc., Center for Health and Long Term Care Research April 8, 2004 PDF Version

This report provides an overview of past research and develops a preliminary classification framework for maternity group homes. The report is the first deliverable to come from the Maternity Groups Homes Evaluation Design and Site Selection Task Order, under contract to Mathematica Policy Research.

Prepared by: Lara Hulsey Mathematica Policy Research ASPE Project Officer: Brenda Benesch Contract No: 233-02-0086

Delivery Order 27 Under Contract No. HHS-100-97-0017 Authors: Kathryn Langwell Cynthia Helba Jo Ann Kauffman Revised:  March 3, 2004 Prepared for:

By Martha J. Zaslow, Sharon M. McGroder, and Kristin A. Moore

The $3 billion Welfare-to-Work (WtW) grants program established by Congress as part of the Balanced Budget Act (BBA) of 1997 provided funds to over 700 state and local grantees.

This report is the second of two reports to Congress from HHS' congressionally mandated evaluation of the US Dept. of Labor's Welfare-to-Work (WtW) Grants Program. The report presents findings from the outcomes analysis component of the evaluation, and describes the characteristics and subsequent experiences of enrollees in WtW programs in 11 study sites.

This study of Maryland's Temporary Assistance to Needy Families (TANF) caseload was undertaken to provide policy makers and program managers with empirical data on the characteristics, circumstances, and prospects of the adults and children who currently receive cash assistance.

By: Thomas M. Fraker, Dan M. Levy, Robert B. Olsen, Rita A. Stapulonis Submitted to:U.S. Department of Health and Human ServicesOffice of the Assistant Secretary for Planning and Evaluation

  U.S. Department of Health and Human Services

Jennifer Schore and Barbara Phillips

U.S. Department of Health and Human Services

National welfare reform legislation in 1996 created the Temporary Assistance for Needy Families (TANF) Program, which imposed time limits on cash assistance receipt and broadened and strengthened mandates for clients to work or engage in work-related activities.

Past studies by federal agencies examined the impact of the Balanced Budget Act of 1997 policies on beneficiaries and providers. While documenting changes in the supply of home health agencies (HHAs), these studies concluded that agency closings did not cause a shortage of Medicare home health providers and that beneficiaries' access to services were not generally affected.

This report describes the implementation of IndependentChoices by synthesizing information from in-person interviews with program staff, a mail survey of program counselors, and telephone interviews with consumers who had the opportunity to receive the program allowance.

This report addresses the liability issues that may arise in government-sponsored consumer-directed personal assistance programs (CDPAS).

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 services for other Medicaid beneficiaries.

ASPE initiated a study of WIA and TANF coordination to understand better and assess the degree to which TANF and WIA programs work together to further their mutual policy goals at a time when both programs were undergoing congressional reauthorization.

Jennifer Schore and Barbara Phillips Mathematica Policy Research, Inc.

By Kerry Kemp,Health Systems Research, Inc.