Abstracts of DALTCP REPORTS--"S" Titles

This section gives abstracts for reports produced through DALTCP-funded research or through research done by DALTCP staff. Links to Executive Summaries and/or Full Reports immediately follow most descriptions, as well to Project Descriptions (if available). (We are working towards putting ALL Full Reports online.) Reports can be ordered from the Office of Disability, Aging and Long-Term Care Policy, unless stated otherwise. Requests can be made by Fax (202-401-7733) or through email (webmaster.DALTCP@hhs.gov).

NOTE: Because of the large number of DALTCP reports, abstracts are divided into several files.

Remember, the Site Index section includes an alphabetic list of keywords you can choose to find information that is referenced throughout the DALTCP website.

SCREENING AND ASSESSMENT IN TANF/WELFARE-TO-WORK: LOCAL ANSWERS TO DIFFICULT QUESTIONS

ABSTRACT: In 1999, HHS contracted with Urban Institute to conduct the Study of Screening and Assessment in TANF/Welfare-to-Work. The second phase of the study involved case studies of a limited number of localities to further explore how these agencies and their partners responded to the issues and challenges identified during phase one. This report presents the findings from the case studies.

SCREENING AND ASSESSMENT IN TANF/WELFARE-TO-WORK: TEN IMPORTANT QUESTIONS TANF AGENCIES AND THEIR PARTNERS SHOULD CONSIDER

ABSTRACT: This report discusses issues related to the development and use of screening and assessment practices to assist in the identification of disabilities and barriers to employment among TANF recipients. It is organized to address key questions that should be considered as states and localities grapple with the challenge of identifying the unobserved barriers to employment facing TANF recipients remaining on welfare.

SCREENING TRAINING FOR SCREENERS: A TRAINER'S GUIDE

ABSTRACT: A standardized instrument was used to screen applicants to the National Long-Term Care Channeling Demonstration according to specific criteria thought to contribute to being "at risk" of institutionalization. The screen was usually conducted over the telephone beginning with the person referring the applicant. Completion of the screen generally took 15-25 minutes. This Trainer's Guide contains all the materials needed to train staff members of a long-term care program to conduct the screening process using the Channeling Applicant Screen. Included is a detailed lesson plan for a two-day training program, lecture notes, handouts, scripts and the Applicant Screen Set (1982), which contains blank forms and the manual for screeners (screen set available separately). [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB86-241593]

SEARCHING FOR A NEEDLE IN A HAYSTACK: CREATIVE USE OF THE DECENNIAL CENSUS DRESS REHEARSAL DATA TO FIND BOARD AND CARE PLACES IN CENTRAL MISSOURI

ABSTRACT: The purpose of this survey was to determine: (1) whether the Census provides a suitable frame for selecting board and care places; and (2) whether the questionnaire would elicit sufficient information to identify such places. Board and care places are housing units or group quarters which provide room, meals and one or more services to dependent persons. The services center on activities of daily living or instrumental activities of daily living. They can be as concrete as assisting the dependent person with eating or as abstract as providing protective oversight. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB93-151991]

SERVICE UTILIZATION AND THE INDIVIDUAL, FAMILY, AND NEIGHBORHOOD CHARACTERISTICS OF CHILDREN WITH DISABILITIES IN ILLINOIS

ABSTRACT: This report describes the demographic characteristics and human services utilization of all children and adolescents who are identified as having a disability in Illinois. It also seeks to understand the stability of care that these children receive through childhood and adolescence. The data base used for the study, the Integrated Database on Children's Services in Illinois, was developed from state-wide service data which came from a set of agencies including the Department of Public Aid, the Illinois State Board of Education, and the Department of Mental Health and Developmental Disabilities. The study focuses on those children identified as having a disability from July 1, 1989 through June 30, 1994. The report finds that the population of children served by public programs for disabilities in Illinois grew and changed dramatically between FY 1990 and FY 1994: the Supreme Court's Zebley decision allowed more children with emotional disorders to receive services and the Medicaid program expanded to address the needs of children with extreme emotional disturbances; (2) the new population of children receiving Supplemental Security Income (SSI) is slow to use additional services; (3) the population of children receiving special education services is dropping as mainstreaming disabled children into regular classrooms becomes more prevalent; and (4) children with less severe conditions, such as language disorders or learning disabilities, are less likely to participate in multiple programs than children with more severe or chronic disabilities, like severe emotional disturbance. The report concludes that this study could be used as a baseline against which to measure changes occurring as a result of 1996 changes to SSI eligibility criteria and future changes in Medicaid and welfare programs. It notes that a possible addition to the analysis would examine new early intervention programs. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov]

SERVING A CHANGING POPULATION: HOME- AND COMMUNITY-BASED SERVICES FOR PEOPLE WITH AIDS

ABSTRACT: This publication summarizes the results of a study, conducted by Mathematica Policy Research, Inc., for ASPE, to examine the availability of and funding for home and community-based services for people with AIDS. The study, which also helped develop a research agenda, had three components: (1) a literature review; (2) case studies; and (3) an analysis of use and reimbursement patterns for New Jersey Medicaid beneficiaries with AIDS. [Order this report from Mathematica Policy Research, Inc., P.O. Box 2393, Princeton, NJ 08543-2393, 609-275-2334, Website http://www.mathematica-mpr.com, 11 pages]

SERVING ELDERS AT RISK, THE OLDER AMERICANS ACT NUTRITION PROGRAMS: NATIONAL EVALUATION OF THE ELDERLY NUTRITION PROGRAM 1993-1995--VOLUME I: TITLE III EVALUATION FINDINGS

ABSTRACT: The Elderly Nutrition Program provides grants to state Agencies on Aging to support the provision of daily meals in either group or home settings to persons age 60 and older, specifically targeting elders who have the greatest economic and social need. This study is an evaluation of the Nutrition Program and was designed to accomplish the following: (a) describe the demographic, functional, health, and service use characteristics of participants; (b) compare the characteristics of congregate meal and home-delivered meal program participants, and assess how well the program is reaching special elderly populations, such as low income and minority elderly; (c) provide estimates of the impact of the program's nutritional components on the nutrition and social well-being of participants; (d) include a thorough "process" analysis of how the program is administered and operated and the quality and effectiveness of those components; and (e) examine funding amounts, sources, and uses, and assess the adequacy of funding. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB97-106447, 313 pages]

SIZE AND QUALITY IN RESIDENTIAL PROGRAMS FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES

ABSTRACT: No abstract available at this time. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB93-147056]

SMALL AREA ESTIMATION OF DEPENDENCY

ABSTRACT: Health planning efforts for the elderly have been hampered by the lack of reliable estimates of the non-institutionalized long-term care population. Until recently national estimates were virtually non-existent, and reliable local estimates remain unavailable. With the recent publication of several national surveys, however, synthetic estimates can be made for states and counties by using multivariate methods to model functional dependency at the national level, and then applying the predicted probability to corresponding state and county demographic and contextual data. Using the 1984 National Health Interview Survey's Supplement on Aging and the 1986 Area Health Resources File System, the authors produced log-linear regressions models that included demographic and contextual variables as predictors of functional dependency among the non-institutionalized elderly. The authors found race, sex, age, and the percent of the elderly population in the community who reside in poverty to be significant predictors of functional dependency. Applying these models to 1986 Medicare Enrollment Statistics, the authors produced estimates of two levels of functional dependency for all states and a sample of counties. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB93-152007, 28 pages]

SOURCE BOOK ON LONG-TERM CARE DATA

ABSTRACT: This volume is a compendium of tables available, not an inventory of answers. While an effort was made to group tables into a structure which reflects common policy themes such as size and characteristics of the population, supply of services, utilization, etc., the tables included are those which were available from the research papers produced for this project. As such, no section is exhaustive or even complete on a topic, and the level of detail provided on topics and subtopics varies as a function of what was available. Thus, a quick review of the table of contents will demonstrate that data are considerably more available on institutional than non-institutional care, formal as compared to informal care, and utilization as compared to demand, costs, and outcomes. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov]

SSI ENROLLEES IN TENNCARE: ROOM FOR IMPROVEMENT

ABSTRACT: This report uses TennCare as a case study to learn whether mainstreaming people with disabilities in Medicaid managed care meets their needs. It compares the experiences of children and adults; people with diverse disabling conditions, including physical/sensory disabilities, mental illness, and mental retardation; people living in urban and rural areas of the state; and people in different managed care plans. The report seeks to answer the key questions: (1) Do SSI recipients have better or worse experiences in TennCare than do other TennCare enrollees? (2) Do SSI adults and children and SSI recipients with different types of disabling conditions have different experiences? (3) Do SSI recipients enrolled in different managed care plans have different experiences? Which managed care plan characteristics might be associated with any differences? (4) Do SSI recipients residing in urban and rural areas have different experiences? The authors use these comparisons to suggest lessons for states that are considering implementing managed care for their SSI populations and for the managed care plans that serve people with disabilities.

SSI-RELATED DISABLED CHILDREN AND MEDICAID

ABSTRACT: This report analyzed the 1984 Medicaid experience of all children passing the Supplemental Security Income (SSI) disability test in California, Georgia and Michigan in order to determine the enrollment, utilization and expenditure patterns of these children. The study estimated the proportion of Medicaid expenditures attributable to SSI-related disabled children. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov]

STATE ASSISTED LIVING POLICY: 1996

ABSTRACT: Assisted living facilities are an expanding source of supportive housing and services, and represent a new model of long-term care. Consumer choice and control are central to assisted living models, which seek to allow consumers to control both key features of their living environments and to direct their own receipt of services. This study reviews the assisted living and board and care policies in each of the 50 states. Fifteen states have existing licensure regulations for assisted living facilities and an additional nine states are developing regulations. Twenty-two states reimburse or plan to reimburse assisted living as a Medicaid service and six states provide Medicaid payments for services in board and care settings. Thirteen states have created a task force or a process within a state agency to make recommendations for the development of assisted living rules. One of the major difficulties associated with assisted living is the lack of a common or standard definition of this kind of care. However, state approaches share common components, including: (1) assisted living is characterized as residential, rather than institutional; (2) health or medical services are provided, either by facility staff or through contracts with community agencies; (3) state undertaking that assisted living is a model emphasizing consumer or resident independence, autonomy, dignity, privacy, and decisionmaking; (4) many states attempt to combine minimum standards of safety and quality of care while also allowing market forces to shape quality. State policies generally address three major issues: (1) the requirement for a living unit; (2) admission and retention criteria; and (3) the level of services to be provided. The report provides specific information about policies in each state. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov]

STATE ASSISTED LIVING POLICY: 1998

ABSTRACT: As part of DALTCP's National Study of Assisted Living for the Frail Elderly, the National Academy for State Health Policy has been conducting annual surveys of all state licensing and housing finance agencies involved in assisted living, as well as of Medicaid agencies that provide funding for assisted living. This report summarizes the assisted living and board and care policies of each of the 50 states. Twenty-two states have licensing regulations using the term "assisted living" and draft regulations have been developed by nine other states. Thirty-five states reimburse or plan to reimburse assisted living or board and care facilities as a Medicaid service. While there is great variation across states, overall assisted living is developing as a residential rather than an institutional model. The major issues addressed by state policies concern requirements for the living unit, for residential admission and retention, for allowable services and for staff training. The report gives an overview of state assisted living trends, summarizes each state's licensing rules and financing policies, and provides a state agency contact list. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #]

STATE CHILD WELFARE ABSTRACTS: 1980-1985

ABSTRACT: This document provides individual state profiles of information related to the status of children, as well as national summary profiles and graphs displaying national trends. The information is drawn from an integrated data base on foster care, adoption, child maltreatment, and related sociodemographic data developed for the HHS Office of Social Services Policy. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB88-243761]

STATE LONG-TERM CARE REFORM: DEVELOPMENT OF COMMUNITY CARE SYSTEMS IN SIX STATES

ABSTRACT: This study examined the approaches used in six states (Arkansas, Illinois, Maine, Maryland, Oregon and Wisconsin) to make their long-term care systems more responsive to the needs of older people. According to the study, each of the states was able to expand community-based care services without generating runaway costs in total long-term care spending. Experiences in these states also demonstrated that some aspects of community care systems can be tightly structured and uniform state-wide, without compromising the flexibility necessary for responding to individual service needs. Non-medical supportive services were also found to form the core of state long-term care programs. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov]

STATE LONG-TERM CARE: RECENT DEVELOPMENTS AND POLICY DIRECTIONS

ABSTRACT: This report provides a thumbnail sketch of long-term care budgets, legislation and planning in the 50 states and the District of Columbia. The focus of this report is mainly on state legislation, expenditures and policy activity in FY 2001 to provide the most current perspective possible in fast-changing state environments. It also previews FY 2002 (when the data were available and appropriate). In some cases, reference is made to prior years to provide context for review and analysis. [140 pages]

STATE LTC PROFILES REPORT, 1996

ABSTRACT: This report, a revision of a 1992 report, attempts to describe how each state is progressing toward balancing its long-term care system for the elderly and physically disabled. This report is based on the assumption that states are moving, or want to move, toward a more balanced long-term care system, where less dollars are spent on nursing facility care and more dollars are spent on HCBS alternative care. Unless otherwise noted, the data used in this report addresses the long-term care of older persons. Long-term care services for children are not directly considered here. The methodology used to aggregate data ranking of the states in this report is based on this assumption that work toward promoting home and community care includes reducing efforts spent on nursing homes.

STATE WAGE PASS-THROUGH LEGISLATION: AN ANALYSIS

ABSTRACT: Twenty-one states have implemented "wage pass-through" programs with the stated expectation that doing so will help address the shortage of direct-care workers employed by long-term care providers in their states. A wage pass-through is an additional allocation of funds provided through Medicaid reimbursement for the express purpose of increasing compensation for direct-care workers. The purpose of this issue brief is to: describe the structure of wage pass-through programs in selected states; summarize what is known about the impact of these programs on the recruitment and retention of direct-care workers; and identify key design elements that states should consider if they choose to implement a wage pass-through.

STATE WELFARE-TO-WORK POLICIES FOR PEOPLE WITH DISABILITIES: CHANGES SINCE WELFARE REFORM

ABSTRACT: The overview presented in this report focuses on state policy responses to two key aspects of the recent federal welfare reform law that hold important ramifications for recipients with disabilities and caregivers--work participation and time limit requirements--and state flexibility to exempt recipients from one or both of these requirements. Findings are based on two primary data sources--written policy documents and conversations with state welfare agency staff in each of the 50 states and the District of Columbia--and reflect state policies at a single point in time (April-May 1998). Although this point in time review provides essential baseline information, it is important to note that states are likely to revisit these policies and may use the increased flexibility provided under federal welfare reform to change policies over time. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #]

STATE WELFARE-TO-WORK POLICIES FOR PEOPLE WITH DISABILITIES: IMPLEMENTATION CHALLENGES AND CONSIDERATIONS

ABSTRACT: This report examines key operational issues and implementation challenges associated with serving welfare recipients with disabilities. The term "disabilities" is used broadly in this report and includes limiting physical conditions, substance abuse and mental health problems, and learning disabilities. These are sometimes referred to as "hidden disabilities" and are generally considered to be a subset of a broader range of barriers faced by "hard-to-serve" TANF recipients. In order to serve this population, the two primary issues that TANF agencies must address are: (1) how to identify disabilities among TANF recipients, and (2) how to create the structure services to assist in their transition from welfare to work. These issues provide the conceptual framework for our study.

SUBACUTE CARE: POLICY SYNTHESIS AND MARKET AREA ANALYSIS

ABSTRACT: Between 1985 and 1991, Medicare spending for post-acute care services provided by rehabilitation hospitals, long-term hospitals, skilled nursing facilities, and home health providers grew from $3.4 billion to over $12.1 billion (a 25% annual increase), while Medicare spending for acute care services grew by only 6% per year. To combat these rising costs, the concept of subacute care is being promoted as a cost-effective alternative to inpatient acute hospital care. This report addresses questions related to the definition of subacute care, incentives and barriers to its growth, and the current and potential size of the market for this kind of care. A literature review, consultation with a Technical Advisory Group, site visits to 19 institutional providers, interviews with seven home health care providers and others were used to develop this report. The report concludes that: (1) the emerging concept of subacute care brings needed attention to some types of patients and to certain types of programs envisioned in the ideal; (2) subacute providers are currently applying elements of this new concept successfully; (3) many providers of subacute care are simply using a new term for existing practices; (4) there are substantial challenges to realizing the promise of subacute care, including clarification of Medicare managed care rules in regard to subacute care and producing better value, not just cheaper care; and (5) more information on subacute care is needed. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB97-104517, 369 pages]

SUBACUTE CARE: REVIEW OF THE LITERATURE

ABSTRACT: For this report, "literature" was defined very broadly to include published articles in both the academic and trade press, as well as relevant unpublished documents prepared by trade associations, investment analysts, providers and others. In brief, they identified a large body of work, primarily produced over the last few years, as can be seen from the accompanying bibliography; however, they found very little well-documented, reliable information about the basics of subacute care--who is providing it, what types of patients (and how many) are being served, who is paying for it, how much it costs, whether it saves money and what types of outcomes are produced. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov]

SUMMARY AND POLICY IMPLICATIONS: ANALYSES OF MEDICAID FINANCING FOR DISABLED OR HIGH COST CHILDREN

ABSTRACT: The Congress, HHS, and other federal agencies have expressed considerable interest in the adequacy of current programs and policies affecting severely disabled children, particularly those who are technology dependent and whose health and medical care place catastrophic financing and caregiving burdens on their families. Medicaid tape-to-tape and other data were used to estimate the numbers of children experiencing catastrophic health care expenses, the level of expenditures and sources of payment, and their service utilization patterns. This report summarizes the various analyses that were performed with data from California, Georgia, Michigan, and Tennessee. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, 21 pages]

SUMMARY OF LONG-TERM CARE PROVISIONS UNDER THE HEALTH SECURITY ACT

ABSTRACT: The long-term care component of the Health Security Act encompasses six key elements: (1) a new home and community-based services program; (2) improvements in long-term care coverage under Medicaid; (3) private long-term care insurance standards and tax incentives; (4) tax incentives that help individuals with disabilities to work; (5) a demonstration study of acute and long-term care integration; and (6) a long-term care system performance review. This paper offers a comprehensive summary of these long-term care provisions.

SUMMARY OF RECOMMENDATIONS FOR SURVEY QUESTIONS AND SCREENING CRITERIA

ABSTRACT: This document contains brief summaries of recommendations for survey items to be included in the Survey of Persons with Mental Retardation and Developmental Disabilities. The domains covered by these recommendations are based on the core set identified in consultation with the Technical Advisory Group and HHS. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov]

SUPPORTIVE HEALTH SERVICE NEEDS OF CHILDREN WITH DISABILITIES

ABSTRACT: To sharpen the focus on the differential need of children with disabilities, this paper focuses on a subset of health-related services that are used almost exclusively by children with disabilities--supportive services. The basic finding is that policies focused on low-income children will reach the majority of children with disabilities who have unmet supportive service needs. These needs range widely across types of services, however, making the effectiveness of public health insurance policies in reaching these children dependent also on how comprehensive the service coverage is. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov]

SURVEY DATA COLLECTION DESIGN AND PROCEDURES

ABSTRACT: This report documents the design and implementation of the surveys which collected data for the evaluation of the National Long-Term Care Channeling Demonstration. The report addresses the manner in which elderly sample member survey data were linked to other data sources, such as service use and cost data, death records, and the survey of informal caregivers. The organization and management of the survey process by the evaluation contractor are also described. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB86-235330]

SURVEY OF EMPLOYERS OFFERING GROUP LONG-TERM CARE INSURANCE TO THEIR EMPLOYEES

ABSTRACT: The primary purpose of this research is to inform employers' (including the Federal Government's) decision about how to structure and market a long-term care insurance offering to employees. This final report provides information about current and best practices in the employer group long-term care insurance market that can inform federal policymakers and employers in deciding how to construct a group long-term care insurance offering. Current practices were collected from a random and select sample of employers and best practices were compiled from the select sample (similar to government agencies, innovative, or successful in enrollment) of employers. The random sample survey generated a response rate of 58%, which is in line with response rates achieved with other employer surveys. The total sample included 93 employers. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov]

SYNTHESIS AND ANALYSIS OF MEDICARE'S HOSPICE BENEFIT: EXECUTIVE SUMMARY AND RECOMMENDATIONS

ABSTRACT: The goal of this study was to inform policymakers about the role of Medicare's hospice benefit in general, and its contribution to end-of-life care for institutionalized beneficiaries in particular. The study provides an overview of Medicare's hospice program which pays for almost four-fifths of all hospice in the U.S., a discussion of Medicaid's hospice benefit, including issues specific to the dually eligible, and a description of alternative benefit design options as offered under employer-sponsored benefit packages. Also included are claims analyses of hospice use by three populations: (1) all Medicare hospice enrollees, (2) a subset of Medicare hospice users in nursing facilities in five states, and (3) a younger subset of hospice users in employer-based or other private insurance plans.

SYNTHESIS AND CRITIQUE OF STUDIES ON MEDICAID ASSET SPENDDOWN

ABSTRACT: The purpose of this paper is to provide a synthesis and critique of current research on Medicaid spenddown. The primary goal was to ask what these studies can tell us about the extent to which persons incurred catastrophic expenses in nursing homes. A corollary goal was to examine how the data and research methods used in the various studies affected the "results" reported. The authors believe that results of Medicaid spenddown studies are frequently quoted in the media and by policymakers, without an adequate explanation of what these results actually mean. As a consequence, the public may have been influenced that spenddown is alternatively a smaller (or larger) problem than it really is, depending on which study is quoted. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov]

SYNTHESIS OF COST STUDIES ON THE LONG-TERM CARE OF DISABLED AND IMPAIRED PERSONS FINAL REPORT

ABSTRACT: The focus of this project was research which included an assessment of the cost of care in institutional versus community-based settings. This report presents a discussion of what has been learned to date, based on a review of representative recent studies; an analysis of recurring methodological issues affecting study results; and implications for research management. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB86-116381 Volume I; #PB86-116399 Volume 2]

SYNTHESIS OF RESEARCH ON CHILD CARE UTILIZATION PATTERNS

ABSTRACT: This paper synthesizes findings on current and future trends in child care usage patterns among employed mothers of preschoolers (less than 6 years old). It summarizes the types, duration, and expenditures on arrangements using the Current Population Surveys (1958, 1965, 1977 and 1982), the National Survey of Family Growth (1982), and the Survey of Income and Program Participation (Winter 1984-1985). [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB91-151811, 32 pages]

SYSTEMATIC COMPARISON OF COMMUNITY CARE DEMONSTRATIONS

ABSTRACT: Concern about inappropriate nursing home placement and rising long-term care costs led to a series of government-financed demonstrations to study whether substituting care at home for care in nursing homes could reduce costs and improve the quality of life for the frail elderly. Based on the evaluation of these demonstrations, the authors conclude that expanding public financing of community services beyond what already exists under the current system does not reduce costs. Small nursing home cost reductions are more than offset by increased costs of providing expanded community services to those who would not enter nursing homes even without the expanded services. Although they do not reduce costs, expanded community services appear to make people better off. Moreover, the expanded services do not appear to cause substantial reductions in care by family and friends. The research and policy debate should move beyond the question of whether expanded public financing of community care will reduce costs to the problems of how much community care society is willing to pay for, who should receive it, and how it can be delivered efficiently. (University of Wisconsin-Madison, Institute for Research on Poverty, Special Report Series, SR#45) [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB91-106948]

SYSTEMATIC REVIEW: AN INNOVATIVE APPROACH TO REVIEWING RESEARCH

ABSTRACT: Standard research literature reviews are the usual means of summing up and interpreting the accumulated findings of research studies in a given research field. Review results generally serve as the best guide for further research. Review results can also provide an up-to-date description of the strengths, weaknesses, and findings in a research field, and, therefore, can be used to inform makers of opinion, policy, and law. [Order this report from National Technical Information Service (NTIS), Department of Commerce, 5285 Port Royal Road, Springfield, VA 22161, Website http://www.ntis.gov, Accession #PB92-179423, 17 pages]

Last revised: February 25, 2003

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