Margins and Dying – Does Profit Status Affect Hospice Quality and Cost? – Lori Gonzalez, Ph. D.
The most significant trend in hospice is the growth in the number of for-profit providers–which has tripled in the last 15 years. Until recently, hospices were run by non-profit or community groups, with extensive volunteer participation. Rising profits and increased Medicare expenditures raise questions about the effects on hospice quality and cost. This issue brief examines the research literature on hospice and profit status.
Special Care Units – Living With Dementia in Today’s LTC System – Lori Gonzalez, Ph.D.
“Dementia doesn’t rob someone of their dignity, it’s our reaction to them that does.” – Teepa Snow
The Older Americans Act of 1965 – 2018 Update – Lori Gonzalez, Ph.D.
The Older Americans Act has provided essential community services for older people for over 40 years. The program capacity, however, to meet the needs of older people for services like Meals on Wheels and caregiver support is declining as funding fails to keep pace with the growing population of older Americans. This growing gap between OAA resources and the need for them in communities across America threaten the quality of life of millions of older persons today and many more in the future.
What happens to older adult beneficiaries if the Affordable Care Act is repealed? – Lori Gonzalez, Ph.D.
Parts of the Affordable Care Act (ACA) or Obamacare recently faced repeal-leaving many including some older adults-unsure of what would become of their health benefits. The ACA covers about 20 million individuals through the Marketplace, Medicaid expansion, young adults staying on their parents’ plan, and other coverages. Among older adults (aged 55-64), 4.5 million gained coverage since ACA was enacted. This issue brief describes the ACA, how it may be repealed, and how its repeal could affect the health of millions of older adults.
Alternatives to Traditional Nursing Homes – Lori Gonzalez, Ph.D.
Sixty nine percent of Americans will need some form of Long-Term Care with 40 percent needing nursing home care (Mollot, 2015; SeniorCare.com), and yet, nursing homes are places that most people would like to avoid. Nursing homes tend to be more like hospitals than homes and are characterized by long hallways, nurses’ carts, overhead call systems, a lack of privacy, double occupancy rooms, unpleasant odors (sometimes) and impersonal treatment.
The Older Americans Act of 1965 – Lori Gonzalez, Ph.D.
The Older Americans Act of 1965 (OAA) is one of the nation’s most comprehensive set of programs aimed at improving the lives of older adults. This issue brief explains the goals of the OAA and its programs, describes funding formulas and gives recommendations for the future of the OAA.
The Greenhouse Project: New Research and Future of Small Homes – Lori, Gonzalez, Ph.D.
For over a decade, Green Houses have provided elders with person-centered elder care in a small, homelike environment. Today, 185 Green Houses operate in 27 states across the U.S. This issue brief describes the Green House Project and summarizes the latest research on the model.
The Future of the Program of All-Inclusive Care for the Elderly – Lori, Gonzalez, Ph. D.
The Program of All-Inclusive Care for the Elderly (PACE) has operated for decades and has proven itself to be a program that provides quality care that is also cost effective, but a recent shift to allow for-profit operators threatens the program’s effectiveness. PACE keeps those who would otherwise need a nursing home level of care in the community by providing comprehensive, cost effective care. This issue brief describes the PACE program, recent changes, and offers a comparison to for-profit hospice.
Older Americans Act Home-Delivered Nutrition Program – Lisa Rill, Ph. D.
Research has shown that many older adults prefer to age in place. Their ability to do so depends partly on the availability of home and community based-services provided by the federal government, and state and local agencies. This issue brief discusses the Older Americans Act Home-Delivered Nutrition Program (HDNP) with a focus on its effectiveness in providing services to home-bound older adults.
Florida’s Rapidly Aging Inmate Population – Lisa Rill, Ph. D.
Since 1980, the aging prison population in the U.S. has grown over 1,300 percent and the total annual prison spending has increased over tenfold. This issue brief focuses on the characteristics of the aging inmate population in Florida and compares the incarceration costs between the younger and older prisoners.
Assisted Living: Bill HB 1001 – Lisa Rill, Ph. D.
This issue brief describes the recent changes in Florida regarding the ALF regulations and compares it to the recommendations given by the Florida ALF workgroup.
CNA Training Requirements for LTC: The Root of Poor Quality of Care – Lisa Rill, Ph. D.
This issue brief illustrates the need for a new CNA program by comparing their educational and training requirements to other health care professionals. The concluding remarks provide recommendations for educational reform.
Assisted Living Facilities: Challenges and Concerns – Lisa Rill, Ph. D.
Over the past two decades, assisted living has become the fastest growing sector of long-term care, and with rapid growth comes many challenges. This issue brief presents some of the challenges that the ALFs face with particular focus on ALFs for the less affluent, function-focused care in ALFs, and aging in place.
Florida’s mental health system has remained significantly and chronically underfunded. This issue brief documents Florida’s mental health expenditures, in comparison with national expenditures, throughout the past decade.
The Challenge of Suicide in Older Adults – Kacey Heekin
Older adults experience a high rate of suicide. This issue brief includes information on risk factors and warnings signs of elder suicide and presents preventative interventions.
The Mental Health and Criminal Justice Systems: The Burden of Forcing One System’s Responsibilities onto Another – Kacey Heekin
Mental illness is a serious and prevalent condition in the United States, yet access to quality mental health services remains inadequate for far too many individuals in need. This issue brief focuses on why the condition of the mental health system has continued to deteriorate over the past 50 years and how this occurrence has placed tremendous burden on the criminal justice system.
Aging and Mental Health: The Troubles Facing the Current Geriatric Mental Health System – Kacey Heekin
A significant percentage of older adults in the United States experience mental illness, and it is expected that as the number of older adults continues to increase, so too will the number of older adults experiencing mental health issues. This issue brief explains why the existing U.S. geriatric mental health system is unprepared for this growth.
One of the most harmful misconceptions about mental illness is the exaggerated association of mental illness with violence. This issue brief provides information on the relationship between mental illness and violence and the negative consequences of the stigma of mental illness.
Florida’s Strained Mental Health System – Kacey Heekin
Florida has long struggled to provide adequate mental health care for its residents and to develop a stronger mental health system. This issue brief describes problems surrounding mental health care in Florida and includes recommendations for improvements.
Review of the Executive Actions – Kacey Heekin
The White House released a proposal of executive actions intended to reduce gun violence in the United States. This issue brief reviews these executive actions with regard to mental health issues and offers recommendations for continued mental health reform.