Mental Health Services for Nursing Home Residents: What Will It Cost?

The Nursing Home Reform Act of 1987 requires nursing homes to provide basic mental health services for all residents and to give active mental health treatment, a set of specialized mental health services, to those residents who are admitted with a serious mental illness. This article examines the potential size of the nursing home population who will require mental health services, its demographic composition, and the facilities in which these individuals reside using the Institutional Population Component of the National Medical Expenditure Survey. Estimates of the potential costs of providing monthly psychotherapy and pharmacological management to this population in nursing homes indicate that the mandate will have significant financial effects on nursing facilities. Conclusions about how the requirements for maintaining the mental and psychosocial well-being of nursing home residents may affect the future of nursing home care and mental health care are considered.

Explaining the Growth in Municipal Recycling Programs: The Role of Market and Non-Market Factors

The implementation of thousands of municipal recycling programs in the United States has increased recycling’s portion of solid waste from 10% to 30% over the past decade. But the lack of accurate data has spurred a debate over whether the growth in recycling can be attributed to market or nonmarket factors. To address this issue, this article conducts a benefit-cost analysis of a municipal recycling program. Results suggest recycling is costly. So why, then, does it remain popular? This article suggests that local governments could be responding to households that perceive a benefit from recycling services. These benefits are estimated with a contingent valuation survey.

Estimates of Use of Research-Based Instructional Strategies in Core Electrical or Computer Engineering Courses

Many research-based instruction strategies (RBISs) have been developed; their superior efficacy with respect to student learning has been demonstrated in many studies. Collecting and interpreting evidence about: 1) the extent to which electrical and computer engineering (ECE) faculty members are using RBISs in core, required engineering science courses, and 2) concerns that they express about using them, are important aspects of understanding how engineering education is evolving. The authors surveyed ECE faculty members, asking about their awareness and use of selected RBISs. The survey also asked what concerns ECE faculty members had about using RBISs. Respondent data showed that awareness of RBISs was very high, but estimates of use of RBISs, based on survey data, varied from 10% to 70%, depending on characteristics of the strategy. The most significant concern was the amount of class time that using an RBIS might take; efforts to increase use of RBISs must address this.

State-Level Pharmaceutical Assistance Programs for the Elderly: A national survey.

In order to put Pennsylvania's Pharmaceutical Assistance Contract for the Elderly (PACE) Program in a national context, a nationwide mail survey and telephone follow-up to each of the 58 State Unit Directors on Aging in the United States and its territories identified 10 programs. The results reported in this article are specific to the seven state-level pharmaceutical assistance programs which were in operation during the fiscal year 1984-85. In general, the programs varied on select program characteristics and on their efforts to address major policy issues. Data from the non-program states indicated support, legislative efforts, and a high interest in fiscal concerns. The findings reflect a lack of program uniformity and have implications for program development and implementation. Suggestions on how to identify the "optimum" or best combination of program and policy options are discussed.

The Provision and Use of Mental Health Services in Nursing Homes: Results from the National Medical Expenditure Survey

Data from the Institutional Population Component of the National Medical Expenditure Survey were used to provide national estimates of annual mental health service provision and use in nursing homes. In addition, the relationship between service provision and setting characteristics such as ownership, size, Medicaid certification, and chain status was examined. Although more than three quarters of residents with a mental disorder resided at a nursing home that provided counseling services, fewer than one fifth actually received any mental health services within the year.