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Board and care homes are non-medical community-based facilities that provide at least two meals a day and routine protective oversight to one or more residents with functional limitations. Unweighted data from the 1991 National Health Provider Inventory (NHPI) indicate that there were about 30,000 licensed board and care homes in the United States serving over half a million persons.
The purpose of this paper is to describe the diverse strategies that have been proposed for long-term care reform (for persons age 65+), and to present a balanced discussion of the points that have been made in support of, and in opposition to, each proposal. What the authors believe is "balanced" may not be perceived to be so by those who advocate a particular proposal, but so be it.
Barbara Manard, William Altman, Nancy Bray, Lisa Kane and Andrea Zeuschner
Lewin-VHI, Inc.
December 16, 1992
This report was prepared under contract #HHS-100-89-0032 between the U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and the Lewin Group.
This booklet of long-term care and disability research has been prepared by the Division of Long-Term Care and Aging Policy, Office of Family, Community and Long-Term Care Policy, Office of the Assistant Secretary for Planning and Evaluation. It summarizes the results of the Division's research projects from 1989 through the present and highlights future plans.
The 1982 and 1984 National Long-Term Care Surveys (NLTCS) are household surveys of functionally impaired Medicare beneficiaries age 65+. The 1989 NTLCS is a resurveying of this population.
This report discusses the parameters of the model and provides examples of how these parameters can be changed to simulate alternative scenarios of the utilization and financing of nursing home and home care by elderly persons for the period 1986-2020. [94 PDF pages]
This report provides pertinent details about the variables, data, and equations on which the Brookings/ICF Long Term Care Financing Model is based. It is designed for those interested in learning precisely how the model generates its results.
The Brookings/ICF Long Term Care Financing Model is available to interested researchers. However, access to a mainframe computer and significant amounts of computer time are required. The computer tape containing the code of the model and associated input data can be purchased through NTIS.
A generally consistent finding of community-based long-term care demonstrations, including Channeling, is that these programs do not lead to net reductions in long-term care expenditures. Even though reducing nursing home costs was a goal of these demonstrations, none involved systematic managerial and resource allocation strategies specifically designed to research this goal.