Chronic illness combined with functional impairment often results in an increased need for medical care and supportive long-term care (LTC) services. Navigating the health care system is challenging and complex, and even more so for patients with complex needs. Traditional fee-for-service care does not support and facilitate coordination and collaboration between providers and service settings....

In 1995, combined Medicare and Medicaid spending in the last year of life for dually eligible beneficiaries was more than $40,000 per beneficiary. Medicaid's share, primarily for long-term care (LTC), constituted about 40 percent of the total. Beneficiaries under age 65, Black persons, and individuals who died in a hospital had higher than average expenditures. The vast majority (86 percent) re...

Social support is believed to be a universally valuable resource for combating stress, yet Asians and Asian Americans report that social support is not helpful to them, resist seeking it, and are underrepresented among recipients of supportive services. We distinguish between explicit social support (seeking and using advice and emotional solace) and implicit social support (focusing on valued ...

In 1995 California began its statewide effort to develop long-term planning strategies to care for a growing elderly population. With the enactment of AB1040, many counties, including Contra Costa and Santa Clara Counties, undertook the task of planning integration of: • Care and service delivery systems across medical, social, and supportive services. • Program administration within a framewor...

Before considering placement in a nursing home, you should explore the possibility of using alternative services or programs that permit the older person to receive the needed care in his or her own home or in a community setting. An increasing number and variety of communityased health, supportive services and specialized living arrangements have been created in communities throughout the nati...

PROBLEM BEING ADDRESSED Aboriginal and non-Aboriginal women in rural and remote settings struggle to access obstetric care close to home. Objective of the program: To deliver a full range of modern and safe obstetric care to 28 remote Aboriginal communities served by rural-based health care. PROGRAM DESCRIPTION Rural family physicians provide intrapartum, cesarean delivery and anesthesia serv...

Michael Hogan, chair of the President's New Freedom Commission on Mental Health, describes the commission's findings on the fragmentation of the public mental health services infrastructure and its effort to formulate strategies for improving the alignment of federal, state, and local policy and practice. Clinical treatment needs to be coordinated with supportive services such as housing, educa...