Research / Journal abstracts

A study was conducted to identify current definitions, issues and strategies related to the use of PAS in the workplace. Participants were employees with disabilities who used PAS in the workplace as well as employers. More than 30 articles were reviewed and a comprehensive search of bibliographic resources was conducted. The study revealed an increasing need for PAS, and highlighted fiscal and societal barriers to the full implementation of PAS at work.

Find out about a pilot program at four affordable housing properties for older adults in Washington, DC. With input from service coordinators, residents, and family caregivers, a two-part workshop was designed to increase caregiver capacity while strengthening the coordination between caregivers and service staff. Caregivers who participated in the workshops reported feeling more confident in their roles as well as more knowledgeable of resources.

Health Affairs has published a special issue devoted entirely to long-term care. Review articles on providers, issues related to Medicare and Medicaid, transition and diversion programs, new state strategies to meet LTC needs, quality of care, demographic issues, policy and financing, health spending, caregivers and the workforce, and palliative care and end-of-life.

Explore the use of social marketing principles to enhance enrollment in the C&C Demonstration and Evaluation (CCDE). In this study, focus groups were conducted in Arkansas and Florida. Several lessons emerged from the findings including the importance of conducting process evaluation activities early during program implementation, carefully selecting and training personnel to conduct outreach and enrollment activities, and developing specific messages to include in marketing the cash option.

Predictors of service use was examined among four in-home and two community-based services. Results showed that race did not have a significant effect on service use, but gender had a significant effect for some services. The results indicated the importance of social supports and structural factors in predicting use. Implications for policies and practice to improve community outreach, access and utilization of services by different racial groups of elders are discussed.

Examine factors associated with the use of personal care services (PCS) and the amount of authorized hours in California in 2004-2005. Of those Medicaid-eligible individuals with developmental disabilities living at home, 31% received PCS. When this study controlled for client need, gender, and age, those who were Asian/Pacific Islanders, African Americans, Hispanics, and other races had higher odds of receiving PCS than Whites but were authorized between 16 and 39 hours fewer than Whites.

Review this article addressing family policy questions that are often asked about consumer-directed services. Issues such as quality, suitability, and fraud and abuse are examined. Elder consumers and their caregivers who participated in the Arkansas Cash and Counseling program were interviewed. Analysis of responses demonstrates how this model can address both the needs of consumers with diverse disabilities and policy makers.

Review recommendations offered for maximizing the new Center for Medicare and Medicaid Innovation’s effectiveness in promoting reforms to improve the quality and value of care, while helping achieve health reform’s goals of more efficient, coordinated, and effective services. Suggestions include implementing a variety of payment reform initiatives, including global and bundled payment, and encouraging the implementation of innovative models developed by states and the private-sector.

To inform long-term care reform efforts, a web-based survey of over 1,000 LTC specialists nationwide was conducted. Findings included the need for LTC to be rebalanced toward HCBS settings, though few supported doing so by limiting nursing home bed supply. Although virtually all felt that the federal government was doing a poor job regulating LTC providers, most believed that the approaches used to oversee nursing homes should also be applied to assisted living.

An expert explores patterns in services and spending under long-term care programs and examines the rise in HCBS, the existence of waivers from federal and state coverage requirements, and the changing populations who use long-term care services. He concludes with a discussion on the need to reduce the fragmentation and lack of coordination in LTC services by removing the divide between Medicare and Medicaid programs. Listen to the recorded webinar and find Mr. Ng’s published paper.