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Full-Text Articles in Social and Behavioral Sciences
Financial Security Scorecard: A State-By-State Analysis Of Economic Pressures Facing Future Retirees, Christian Weller, Nari Rhee, Carolyn Arcand
Financial Security Scorecard: A State-By-State Analysis Of Economic Pressures Facing Future Retirees, Christian Weller, Nari Rhee, Carolyn Arcand
Public Policy and Public Affairs Faculty Publication Series
As Americans increasingly worry about their retirement prospects, states play an important and growing role in retirement security policy. States already manage long-term care programs for the elderly through Medicaid. Concerned about the impact of future elder poverty on state and local budgets and their local economies, a number of states are exploring the creation of low-cost and low-risk retirement savings plans for private sector workers who lack access to pensions or 401(k)s on the job. Some states have developed programs to help older workers find work.
This report presents the Financial Security Scorecard, designed to inform state-level stakeholders and …
Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Rebalancing Long-Term Care Under The Affordable Care Act, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor
Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Rebalancing Long-Term Care Under The Affordable Care Act, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor
Gerontology Institute Publications
Federal approval of Rhode Island’s Global Consumer Choice Compact Global Waiver in 2009 provided Rhode Island with greater flexibility to modify its Medicaid program. Because 96% of long-term care expenditures in Rhode Island were directed toward institutional settings, a primary goal was to facilitate the state’s efforts to shift the locus of long-term care to non-institutional settings. This study draws lessons from Rhode Island’s experience with the Global Waiver for the long-term care rebalancing provisions of the Patient Protection and Affordable Care Act of 2010. Data derive from 325 archival sources and 26 semi-structured interviews. Results suggest that prospectively documenting …
Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Designing And Implementing State Health Reform, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor
Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Designing And Implementing State Health Reform, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor
Gerontology Institute Publications
Provisions in the Medicaid statute permit states to apply for waivers from traditional program requirements. On January 16, 2009, the federal government approved Rhode Island's Global Consumer Choice Compact Waiver. In exchange for a cap on combined federal and state spending of $12.075 billion through 2013, Rhode Island received greater flexibility to adopt certain Medicaid program changes. This study analyzes the design and implementation of the Global Waiver to draw general lessons for health reform at the state-level, a key concern given ongoing state discretion to improve their health care systems under the Patient Protection and Affordable Care Act. Data …
A Trade-Off Proposal For Funding Long-Term Care, Yung-Ping Chen
A Trade-Off Proposal For Funding Long-Term Care, Yung-Ping Chen
Gerontology Institute Publications
Long-term care can be a depressing subject. Most of us tend not to think about it. However, we cannot long avoid it as the 76 million baby boomers begin reaching older ages in a few short years. According to projections, in 40 years, those aged 65 to 84 (numbering 31.6 million in 2005) will more than double, and those 85 plus (about 5.1 million in 2005), who are more at risk of dependency, will more than triple (U.S. Census Bureau, 2004 and 2006). Heavy reliance on Medicaid, already the second largest budget item in most states, would not appear viable. …
Back To The Future: The Future Of Long-Term Care In Massachusetts, Deborah H. Thomson, John J. Ford
Back To The Future: The Future Of Long-Term Care In Massachusetts, Deborah H. Thomson, John J. Ford
Gerontology Institute Publications
The state of Massachusetts, like the rest of the United States, is facing an approaching crisis in long-term care. Over the next few decades the number of Massachusetts residents age 65 and older will soar. As these numbers increase, so will the need for long-term care.
Massachusetts is ill prepared to provide the services that will be needed. Our current system of health care benefits leaves many elders with gaps in coverage. Those individuals who need long-term services often impoverish themselves and their spouses before the state pays for their care. Others languish on waiting lists to receive services. Our …
Long-Term Care: Informed By Research, Francis G. Caro
Long-Term Care: Informed By Research, Francis G. Caro
Gerontology Institute Publications
Health services research has contributed to health policy and service developments that have led to major improvements in the quality of long-term care in the United States. This policy brief highlights a few areas in which publicly and privately funded research has informed the long-term care field.
Working Paper: Elders In Massachusetts Prefer Paid Caregivers, Francis G. Caro
Working Paper: Elders In Massachusetts Prefer Paid Caregivers, Francis G. Caro
Gerontology Institute Publications
Older Massachusetts residents would rather have paid professionals provide their long-term care than their own children, according to a recent UMass Poll of 461 Massachusetts residents.
Toward Improved Support For Research On Delivery Of Home- And Community-Based Long-Term Care, Francis G. Caro
Toward Improved Support For Research On Delivery Of Home- And Community-Based Long-Term Care, Francis G. Caro
Gerontology Institute Publications
Stronger and more consistent support is needed for research on long-term care. A greater investment in research will strengthen the ability of public and private organizations to provide effective and efficient assistance to people with disabilities and their informal caregivers. This paper provides a rationale for stronger research funding for the field and outlines several options to strengthen research.
Providing Low-Cost Assistive Equipment Through Home Care Services: The Massachusetts Assistive Equipment Demonstration, Alison S. Gottlieb, Francis G. Caro
Providing Low-Cost Assistive Equipment Through Home Care Services: The Massachusetts Assistive Equipment Demonstration, Alison S. Gottlieb, Francis G. Caro
Gerontology Institute Publications
This report describes the Massachusetts Assistive Equipment Demonstration, a collaborative project funded by the Robert Wood Johnson’s Home Care Research Initiative and carried out collaboratively by the Gerontology Institute at the University of Massachusetts Boston and the Executive Office of Elder Affairs (EOEA). The purpose of the demonstration was to systematically encourage the use of low-cost assistive equipment among elderly clients through existing case management resources, thereby extending the effectiveness of the Massachusetts home care program by supplementing formal services with expanded use of assistive equipment.
Nursing Home Ownership And Public Policy: An Historical Analysis, K. R. Kaffenberger
Nursing Home Ownership And Public Policy: An Historical Analysis, K. R. Kaffenberger
Graduate Doctoral Dissertations
In the early days of the United States, care of the disabled elderly outside the home meant the public almshouse. By the 1920s, private, nonprofit homes for the aged were prevalent. More recently, private, for-profit facilities have grown to dominate the field.
For-profit ownership has been controversial. Underlying the controversy is the concern that quality might be lowered in order to enhance profit.
This study asks why most nursing homes are privately owned and why most privately owned nursing homes are operated for profit. It does so with reference to The Nonprofit Economy, in which Burton Weisbrod describes a …
Long-Term Care Policy: Where Are We Going?, Gerontology Institute, University Of Massachusetts Boston, Omb Watch
Long-Term Care Policy: Where Are We Going?, Gerontology Institute, University Of Massachusetts Boston, Omb Watch
Gerontology Institute Publications
Millions of Americans suffer from physical or mental conditions that make it difficult for them to live fully independent lives. These are the frail elderly, disabled and chronically ill persons of all ages, and many mentally ill or mentally retarded persons. They need help to manage daily activities, whether they live in their own homes or in nursing homes.
Such care can be extremely expensive, since it often must be provided for many years, even a lifetime. Today, those costs are met largely by the individuals themselves or by their families and by public programs for low-income persons.
For many …