Purpose: States are increasingly using the Medicaid 1915c waiver program to provide community-based long-term care. A substantially greater share of long-term-care dollars supports community-based care for individuals with intellectual and developmental disabilities, relative to older and working-age persons with primarily physical disabilities.…

Purpose: This article describes early efforts of four community partnerships in Boston, El Paso, Houston, and Milwaukee to address governance and management structures in ways that promote the sustainability of innovative community-based long-term care system improvements. The four communities are grantees of the Community Partnerships for Older…

Purpose: This study analyzed the effect of consumer-directed versus agency-directed home care on satisfaction with paid personal assistance services among Medicaid beneficiaries in Washington State. Design and Methods: The study analyzed a survey of 513 Medicaid beneficiaries receiving home- and community-based services. As part of a larger study,…

The paper discusses two reforms in Ontario's long-term care. The first is the commercialization of home care as a result of the implementation of a "managed competition" delivery model. The second is the Ministry of Health and Long-Term Care's privileging of "health care" over "social care" through changes to which…

Context: Multiple national agencies and organizations recommend that women age 40 years and older have an annual screening mammogram. Women who are poor, less educated, lack a usual source of care, and reside in rural Appalachia are less likely to have had a recent mammogram. Purpose: To increase use of mammography among a rural Appalachian…

Context: Migrant and seasonal farmworkers are recognized as a medically underserved population, yet little information on need, access, and services is available--particularly with regard to oral health care. Purpose: This study describes the facilities, services, staffing, and patient characteristics of US dental clinics serving migrant and…

In 1982 California eliminated 250,000 "medically indigent adults" (MIAs) from the Medi-Cal program and transferred responsibility for their care to the counties, along with about 70% of what the state would have spent on their care had they remained in the Medi-Cal program. There is far greater variability among the counties in benefits,…

In an increasingly cost-conscious health care environment, average length of hospital stay has decreased. Although psychiatric inpatient treatment is largely exempt from the constraints of the Medicare diagnosis related groups (DRG's), length of stay for geropsychiatric hospital services has decreased also. A trend toward higher rates of early…

THIS PUBLICATION DISCUSSES IN DEPTH THE PROBLEM OF WATER POLLUTION AS SEEN BY THE FLORIDA STATE BOARD OF HEALTH. DOMESTIC SEWAGE, INDUSTRIAL WASTES, AND ALLEVIATION ACTIVITIES OF THE STATE BOARD OF HEALTH AND COUNTY HEALTH DEPARTMENTS ARE DESCRIBED. SIX APPENDIXES PRESENT CORRESPONDENCE AND REPORTS REGARDING THE PROBLEM. THIS IS AN ISSUE OF…

In 1969, the Medical School of the University of Puerto Rico (UPR) received a grant from the National Center for Health Services Research and Development (Public Health Service, HEW) to plan and conduct--as a demonstration project--a special retraining program for physicians who had failed to approve the licensure examinations of the Puerto Rico…

The report of a team project concerned with idea development for community mental health centers includes--(1) concept description, (2) development of facility and resource requirements, (3) conceptual diagrams, (4) schematic plans, and (5) model photographs. (MH)

Describes the Children's Health Program, designed to provide screening and follow up services to isolated rural families. A staff of physicians, nurses, teachers, and nutritionists work at traveling well-child clinics and individually visit isolated families. (SB)

Discusses the development of crisis centers in the community and their role in organizing and coordinating community services for more optimal usage by people experiencing distress. (Author/RK)

Percentage and frequency information are presented pertaining to the responses of participating health center administrators concerning student access to contraceptive services through the student health center, local family planning agencies, and local private physicians. (MB)