Research / Journal abstracts

Despite more than $428 billion in spending in FY2008 to assist working-age people with disabilities, services provided are often fragmented, confusing, & less effective than they could be. This brief explains how the government serves a caretaker role. Authors point out that this model runs contrary to the goal of maximizing self-sufficiency embraced by the Americans with Disabilities Act & fails to direct funds to help those with disabilities join, remain in, or return to the workforce.

A review of 36 studies of outcomes for nearly 5,000 people with intellectual & developmental disabilities moving from large institutions to community living arrangements found high consistency in positive change in daily living skills. Studies specifically addressing social skill development, language & communication skills development, self-care & domestic skill development & community living skill development also showed positive outcomes associated with leaving large institutions.

Detailed data on community-based residential services providers indicated a high worker turnover for long-term care costs. The findings indicated that providers were unlikely to reduce turnover on their own, since its associated costs were either tolerably small or borne by others. An analysis indicated that it was socially beneficial for the government to reduce turnover through wage subsidization in this sector.

Nursing home use declined among older adults (65+) in more than 2/3 of states but increased among older working-age adults (31-64) in all but 2 states. This article examines the associations between programmatic characteristics and rates of use. Although greater investment in Medicaid HCBS coupled with reduced nursing home capacity was associated with reduced rates of nursing home care for adults aged 65+, neither characteristic was associated among older working-age adults.

This study explores the perceived value of workplace accommodations from the perspective of the individual users of PAS who had contacted the Job Accommodation Network (JAN). A follow-up survey assessed their perspective on the impact of PAS and other accommodations. The findings indicate that people who have considered or implemented PAS accommodations perception of work ability increases from being "Substantially Limited" with no accommodation to "Not Limited at All" with accommodiation.

Disability measures recently introduced into the U.S. Current Population Survey offer an unprecedented opportunity to track, month by month, the labor force status of working-age adults with disabilities in the midst of a major economic downturn. Over a one-year period, the number of employed workers with disabilities declined at a rate more than three times that of workers without disabilities, and the unemployment rate rose dramatically to levels far exceeding that of other workers.

This article presents an overview of the direct-care workforce, touching upon training requirements, demographics, wages and benefits, and employment settings. It notes that, despite the U.S. needing more direct-care workers than ever, job quality in the field remains extremely low. The article proceeds to list several ways that policymakers and employer practices can improve the quality of direct-care jobs. The article was written by PHI Director of Policy Research, Dorie Seavey.

This latest installment of Health Affairs' new series The Care Span, supported by The SCAN Foundation, identifies several ways to strengthen transitional care processes through health reform provisions. Most of the interventions led to reductions in readmissions through at least thirty days after discharge. To learn about the recommendations and proposed strategies, peruse this publication.

To learn more about long-term services and supports, the key characteristics of a high-performing system, and new options and incentives in the Affordable Care Act that can support cost-effective programs to help people with disabilities remain in their homes and communities, access this article. This paper outlines the five key characteristics of a high-performing system of long-term services and supports and describes an emerging “scorecard” that could help measure states’ progress.

The new issue of Generations, the quarterly journal of the American Society on Aging, is devoted entirely to the eldercare workforce. The Winter 2010-11 issue covers: the current state of the nation’s eldercare workforce; the eldercare workforce’s makeup, deficiencies, and strengths; and strategies for much-needed workforce recruitment, training and management, policy development, and fostering of cultural competencies.