Archive

Archive for the ‘disabilities’ Category

The Future of Home Health Care: Workshop Summary (2015)

March 26, 2015 Comments off

The Future of Home Health Care: Workshop Summary (2015)
Source: Institute of Medicine/National Research Council

Individuals with disabilities, chronic conditions, and functional impairments need a range of services and supports to keep living independently. However, there often is not a strong link between medical care provided in the home and the necessary social services and supports for independent living. Home health agencies and others are rising to the challenges of meeting the needs and demands of these populations to stay at home by exploring alternative models of care and payment approaches, the best use of their workforces, and technologies that can enhance independent living. All of these challenges and opportunities lead to the consideration of how home health care fits into the future health care system overall.

On September 30 and October 1, 2014, the Institute of Medicine and the National Research Council convened a public workshop on the future of home health care. The workshop brought together a spectrum of public and private stakeholders and thought leaders to improve understanding of the current role of Medicare home health care in supporting aging in place and in helping high-risk, chronically ill, and disabled Americans receive health care in their communities. Through presentations and discussion, participants explored the evolving role of Medicare home health care in caring for Americans in the future, including how to integrate Medicare home health care into new models for the delivery of care and the future health care marketplace. The workshop also considered the key policy reforms and investments in workforces, technologies, and research needed to leverage the value of home health care to support older Americans, and research priorities that can help clarify the value of home health care. This summary captures important points raised by the individual speakers and workshop participants.

Disability insurance plans: trends in employee access and employer costs

March 4, 2015 Comments off

Disability insurance plans: trends in employee access and employer costs
Source: Bureau of Labor Statistics

Short- and long-term disability insurance programs replace some of the wages lost by people who cannot work because of a disabling injury or illness that is not work-related. Short-term disability insurance typically covers periods lasting less than 6 months, and long-term disability insurance lasts for the length of the disability or until retirement.

Those workers who are unable to work due to injury or illness and who do not have disability insurance coverage through their employers may seek benefits from Social Security Disability Insurance (SSDI). The number of SSDI claimants has grown over the past decade as younger workers and those in relatively low-skill, low-pay jobs have applied for benefits. This has prompted interest in the amount of coverage for workers in employer-provided disability insurance programs. This issue of Beyond the Numbers examines trends in employer-provided disability insurance coverage over time, explains the basic terms of coverage for typical plans, and estimates the costs to private employers.

Nondiscrimination on the Basis of Disability by Public Accommodations-Movie Theaters; Movie Captioning and Audio Description

March 3, 2015 Comments off

Nondiscrimination on the Basis of Disability by Public Accommodations-Movie Theaters; Movie Captioning and Audio Description
Source: Mercatus Center (George Mason University)

With this Notice of Proposed Rule Making (NPRM) the DOJ proposes amendments to Title III of the ADA concerning captioning and audio description services at movie theaters.1 Title III of the ADA applies to places of “public accommodation,” such as movie theaters, restaurants, schools, and doctors’ offices.2 These covered entities are prohibited from discriminating against any individual “on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation.”3

In particular, Title III of the ADA prohibits public accommodations, such as movie theaters, from affording unequal or lesser service to individuals with disabilities.4 As a result, these entities must “ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently . . . because of the absence of auxiliary aids and services.”5

Accessible Crowdwork? Understanding the Value in and Challenge of Microtask Employment for People with Disabilities

March 2, 2015 Comments off

Accessible Crowdwork? Understanding the Value in and Challenge of Microtask Employment for People with Disabilities
Source: Microsoft Research

We present the first formal study of crowdworkers who have disabilities via in-depth open-ended interviews of 17 people (disabled crowdworkers and job coaches for people with disabilities) and a survey of 631 adults with disabilities. Our findings establish that people with a variety of disabilities currently participate in the crowd labor marketplace, despite challenges such as crowdsourcing workflow designs that inadvertently prohibit participation by, and may negatively affect the worker reputations of, people with disabilities. Despite such challenges, we find that crowdwork potentially offers different opportunities for people with disabilities relative to the normative office environment, such as job flexibility and lack of a need to rely on public transit. We close by identifying several ways in which crowd labor platform operators and/or individual task requestors could improve the accessibility of this increasingly important form of employment.

Why Do SSI and SNAP Enrollments Rise in Good Economic Times and Bad?

February 25, 2015 Comments off

Why Do SSI and SNAP Enrollments Rise in Good Economic Times and Bad?
Source: Center for Retirement Research at Boston College

The number of participants in the Supplemental Security Income Program (SSI) and the Supplemental Nutrition Assistance Program (SNAP) skyrocketed during the Great Recession. But more surprising is that caseloads for both programs increased during the preceding expansion and during the nascent recovery period after the Great Recession. Using both administrative program data and the Survey of Income and Program Participation (SIPP), this project investigates the persistent growth in SSI and SNAP since 2000. Whereas the existing literature on program caseloads in the post-welfare reform era generally excludes the elderly from the analysis, this project is the first to investigate differences in elderly and non-elderly caseloads, allowing for differential responsiveness over time. Preliminary estimates suggest that the correlation between SSI and SNAP caseloads and economic well-being, and, separately, caseloads and health, grew stronger over this time. Coupled with a poverty rate that did not fall along with the unemployment rate, and with an increase in the share of the population reporting poor or fair health, these correlations helped lead to caseloads that remained roughly constant (SSI) or even increased (SNAP) during the most recent expansion, rather than falling as expected. The increases in caseloads stem both from increases in the entry rates among the newly eligible – particularly those in poor health – and from decreases in exit rates among low-income beneficiaries.

New Evidence on the Risk of Requiring Long-Term Care

February 23, 2015 Comments off

New Evidence on the Risk of Requiring Long-Term Care
Source: Center for Retirement Research at Boston College

Long-term care is one of the major expenses faced by many older Americans. Yet, we have only limited information about the risk of needing long-term care and the expected duration of care. The expectations of needing to receive home health care, live in an assisted living facility or live in a nursing home are essential inputs into models of optimal post-retirement saving and long-term care insurance purchase. Previous research has used the Robinson (1996) transition matrix, based on National Long Term Care Survey (NLTCS) data for 1982-89. The Robinson model predicts that men and women aged 65 have a 27 and 44 percent chance, respectively, of ever needing nursing home care. Recent evidence suggests that those earlier estimates may be extremely misleading in important dimensions. Using Health and Retirement Study (HRS) data from 1992-2010, Hurd, Michaud, and Rohwedder (2013) estimate that men and women aged 50 have a 50 and 65 percent chance, respectively, of ever needing care. But, they also estimate shorter average durations of care, resulting, as we show, from a greater chance of returning to the community, conditional on admission. If nursing home care is a high-probability but relatively low-cost occurrence, models that treat it as a lower-probability, high-cost occurrence may overstate the value of insurance.

We update and modify the Robinson model using more recent data from both the NLTCS and the HRS. We show that the low lifetime utilization rates and high conditional mean durations of stay in the Robinson model are artifacts of specific features of the statistical model that was fitted to the data. We also show that impairment and most use of care by age has declined and that the 2004 NLTCS and the 1996-2010 HRS yield similar cross-sectional patterns of care use. We revise and update the care transition model, and we show that use of the new transition matrix substantially reduces simulated values of willingness-to-pay in an optimal long-term care insurance model.

Lifetime Job Demands, Work Capacity at Older Ages, and Social Security Benefit Claiming Decisions

February 18, 2015 Comments off

Lifetime Job Demands, Work Capacity at Older Ages, and Social Security Benefit Claiming Decisions
Source: Center for Retirement Research at Boston College

We use Health and Retirement Study data linked to the Department of Labor’s O*Net classification system to examine the relationship between lifetime exposure to occupational demands and retirement behavior. We consistently found that both non-routine cognitive analytic and non-routine physical demands were associated with worse health, earlier labor force exit, and increased use of Social Security Disability Insurance. The growing share of workers in jobs with high levels of cognitive demand may contribute to growth in DI use.

Follow

Get every new post delivered to your Inbox.

Join 1,023 other followers