September 2001
DHHS, Health Resources and Services Administration
This report details a comprehensive review of the cultural competence theoretical and methodological literature. It begins with a review of how cultural competence has been conceptualized. The identification and discussion of the areas in which cultural competence must be evidenced are presented as critical domains for measuring cultural competence. The report then presents and applies a measurement framework for the identification and review of specific performance indicators and measures of cultural competence that are garnered from the literature. The report identifies key challenges in measuring cultural competence and potential areas for further analysis are discussed. The conclusion section of this report highlights key themes raised throughout the report and presents considerations for next steps.
Client Area: Federal Government
September 2001
Social Security Administration
Lewin contact: Lisa Alecxih
SSA was mandated to conduct a demonstration to test outreach and application methods for enrollment in the Medicare Part B Buy-In program. In March 1999, SSA implemented four models in 11 sites around the country and the state of Massachusetts that involve different levels of SSA involvement. This report describes the demonstration, documents the implementation of the four models, and presents findings of the impact of each model on enrollment.
Client Area: Federal Government
Expertise Area: Medicare
September 2001
DHHS, Office of the Assistant Secretary for Planning and Evaluation (ASPE)
This report summarizes the findings from information collected during three sets of focus groups conducted for a study on employment supports for people with disabilities. The study was intended to increase the understanding of the role of various supports in helping people with disabilities find and maintain employment.
Client Area: Federal Government
Expertise Area: Employment, Training, and Workforce Development
September 2001
Office of National Drug Control Policy (ONDCP)
This report, developed for The Office of National Drug Control Policy, presents new estimates of the societal cost of drug abuse. The most recent previous estimates of drug abuse related costs are for 1995. In addition, the report provides annual estimates for 1992 through 1998 and projections for 1999 and 2000 that are consistently developed, so that trends in the overall societal cost and in component costs of drug abuse can be evaluated. In developing the report, p articular emphasis was placed on estimating the health-related consequences and costs of illicit drug abuse, including the costs of substance abuse treatment for comorbid health problems. Other major economic costs of drug abuse estimated include: premature mortality, victim loss from drug-related property and violent crime (and child abuse), social welfare services, criminal justice expenditures, workplace and household productivity impacts, and "crime career" costs.
Client Area: Federal Government
Expertise Area: Mental Health and Substance Abuse
August 2001
Social Security Administration
Lewin contact: Lisa Alecxih
SSA was mandated to conduct a demonstration to test outreach and application methods for enrollment in the Medicare Part B Buy-in program. This report provides information on the implementation and early outcomes of three of the six models implemented during fiscal year 2000. This report describes the demonstration, documents its implementation, and presents descriptive analyses of individuals targeted for the program.
Client Area: Federal Government
Expertise Area: Medicare
July 2001
DHHS, Center for Substance Abuse Treatment
This document introduces a new tool available to study the costs of substance abuse treatment: the Center for Substance Abuse Treatment (CSAT) Substance Abuse Treatment Cost Allocation and Analysis Template (SATCAAT). The particular purpose and strength of the SATCAAT is the development of cost estimates for defined components and units of service that combine (often in different proportions by different providers) to constitute substance abuse treatment. The SATCAAT should be considered an example of an important approach to studying the costs of substance abuse treatment. The method is described and actual data are presented from a sample of providers in order to demonstrate the output and potential use.
Client Area: Federal Government
Expertise Area: Mental Health and Substance Abuse
July 2001
DHHS, Center for Substance Abuse Treatment
This analytic report presents the results of an analysis of the relationship between the size of providers and the cost of delivering treatment services. It was found that large providers tend to have lower costs per unit of service than small providers, although it appears that this may be partially due to delivery of lower intensity services, with uncertain implications for the outcomes of care.
Client Area: Federal Government
Expertise Area: Mental Health and Substance Abuse
July 2001
DHHS, Substance Abuse and Mental Health Services Administration (SAMHSA)
Medicaid law and regulations require States to have a Preadmission Screening and Resident Review (PASRR) program to determine whether nursing facility applicants and residents require nursing facility services and specialized mental health care. This paper reviews the literature concerning PASRR and mental health services for persons in nursing facilities. It details the Federal laws and regulations concerning PASRR, reviews key policy issues from the literature, clarifies frequently asked questions regarding the process, and identifies additional policy questions to be studied.
Client Area: Federal Government
Expertise Area: Mental Health and Substance Abuse
April 2001
DHHS, Office of the Assistant Secretary for Planning and Evaluation (ASPE)
This report examines the impact of welfare reform on 12 rural and small metropolitan areas around the county. It identifies changes in wages and employment for the low-skill labor force over two periods - 1993 to 1996, and 1996 to 1998 - to determine the effect of the movement of welfare recipients to work.
Client Area: Federal Government
Expertise Area: Employment, Training, and Workforce Development
April 2001
DHHS, Office of the Assistant Secretary for Planning and Evaluation and Office of Child Support Enforcement
In recent years, federal and state governments have taken a number of actions to strengthen the nation's child support system. One chief policy concern is that child support awards, over time, may not keep pace with non-custodial parent earnings or the cost associated with raising a child. Given the cost and complexity of traditional review and adjustment procedures, a number of states are considering, or have implemented, one of the two new approaches authorized in the Personal Responsibilty and Work Opportunity Reconciliation Act (PRWORA) of 1996: Cost-of-living (COLA) adjustments that alter orders periodically without reviews, and An automated method to identify orders eligible for review and to apply the appropriate adjustment. This report focuses primarily on COLA adjustments and reviews the COLA policies in two states: Minnesota, and New York. The study reviewed the processes involved in passing COLA legislation, the stakeholders who were involved, the steps the states took to implement their COLA systems, the fiscal outcomes for both the parents and the states, and assessments of the pros and cons of a COLA system. In addition, the study examined a proposed automated method for reviewing and adjusting orders in Vermont.
Client Area: Federal Government
Expertise Area: Income Security
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