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Results for “Community Financing”

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At least 1,261 records · Page 70Linked to original sources
PubMed1979

Staff reactions to the closing of a community mental health center.

Many community mental health centers face seriuos financial problems as they near the end of the federal funding period. The author describes the developments surrounding an extended financial crisis at an inner-city mental health center that eventually was forced to close. Using a crisis theory framework, she examines staff reactions to the crisis and proposes an intervention model in which a consultant is employed to help staff identify and avoid maladaptive coping behavior.

Adaptation, Psychological↗
PubMed1985

The mental health commissionership: major changes over a decade.

During the past decade major changes have occurred in the role of the state mental health program director. Those changes have made that position more complex, more administrative, and less medical. The author discusses four themes in particular: the growing belief in the desirability of employing professional managers, the increasing requirements for quantitative information, the loss of confidence in the overriding treatment ideology of deinstitutionalization, and managerial constraints imposed by consent decrees. Such changes make the role of the commissioner more important, yet more difficult.

Community Mental Health Services↗
PubMed1989

Treatment of homosexual alcoholics in government-funded agencies: provider training and attitudes.

Alcoholism treatment providers in 36 government-funded agencies in New York City were surveyed for information about their training for and attitudes toward the treatment of homosexual patients. The 164 respondents had limited knowledge about how to evaluate and treat homosexual alcoholics and frequently did not discuss sexual orientation with their clients even though they considered it important. The training and supervision of most providers in the treatment of alcoholic homosexual clients was substandard or nonexistent. About half of the providers believed that treatment programs would benefit from having openly gay staff and felt that being openly gay carried little professional risk. Respondents also reported that development of programs for homosexual alcoholics had little priority in their facilities. Many believed that homosexual alcoholics are less likely to seek help and may have more difficulty achieving sobriety.

Adolescent↗
PubMed2003

Evaluating the California Wellness Foundation's Health Improvement Initiative: a logic model approach.

The difficulties of conducting randomized trials to evaluate community-based initiatives have led some researchers to argue in favor of a case study "logic model" approach to evaluation. This article describes a case study logic approach adopted for the evaluation of one community initiative, the Health Improvement Initiative (HII) funded by the California Wellness Foundation (TCWF). The HII is a comprehensive, community-based initiative designed to improve population health by implementing and sustaining community-level systems changes. Nine communities received funding to create broad-based community coalitions (Health Partnerships) that were charged with developing and implementing action plans around systems change. The HII is being evaluated using a case-study logic-model approach that uses quantitative and qualitative data to construct indicators of coalition functioning, systems changes, and population health. By examining the relationship between these indicators over time, it should be possible to determine if any changes in intermediate or long-term outcomes are associated with Health Partnership activities.

California↗
PubMed2005

State strategies to support community based long term care for the elderly.

States play a principal role in designing and implementing publicly funded long term care programs. They are in a key position to determine what setting, from whom, and under what philosophy of care individuals can access long term care. State long term care systems have evolved over the past 25 years to support increased availability of community based care for older individuals. States have pursued three broad strategies to increase availability. One set of strategies aims to increase capacity through expanding the supply, public funding and eligibility for a wide array of home and community based services (HCBS). A second set of strategies seeks to constrain institutional growth in order to increase the dollars available for HCBS. Managed/capitated long term care is a third strategy that is a hybrid of the other two approaches. Empirically, increased capacity through use of Medicaid and Medicare resources and growth in the supply of community based care providers, combined with moderation of institutional bed supply, are associated with enhanced access and expenditures for community based long term care. The effectiveness of capitated or managed systems of care varies by model and in some cases is still under study. State fiscal resources are key to the ability to support community based care for the elderly. Targeted federal support may be critical to the continued expansion of community based care, given heterogeneity in state resources, coupled with an increasing demand for long term care.

Aged↗
PubMed1996

Do nonprofit hospitals pay their way?

Using 1988 and 1991 data from nonprofit voluntary hospitals in California, we find that the vast majority of nonprofit hospitals provide community dividends in excess of the tax subsidies they receive. However, nearly 20 percent of nonprofit hospitals do not meet this standard. Further, those hospitals that do not meet the standard tend to not meet the standard over time. We recommend more explicit identification of the community dividends expected in return for special tax treatment and more explicit accounting on the part of nonprofit hospitals.

California↗
PubMedDate not supplied

The Pfizer Foundation's Community Health Ventures program: providing models for community health partnerships.

In response to its concern for the future of community health centers (CHCs) and those who receive care in these centers, in 1997 the Pfizer Foundation created and funded Community Health Ventures (CHV), a four-year, $3.6 million grant-making program. It was designed to increase the capacity of centers to adjust to a changing health care environment. This descriptive special report discusses the outcomes of the program, including its impact on CHCs and their patients, and offers recommendations for funders on how to establish effective partnerships with CHCs.

Chronic Disease↗
PubMedDate not supplied

The quality of chronic disease care in U.S. community health centers.

Community health centers (CHCs) are responsible for providing care for more than fifteen million Americans, many of whom are members of groups who have been documented to receive low-quality care. This study examines the quality of care for patients with chronic disease in a nationally representative sample of federally funded CHCs. Fewer than half of eligible patients received appropriate care for the majority of indicators measured, and uninsured patients received poorer care than insured patients. Although the quality of chronic disease care in CHCs compares favorably with that of care received in other settings, gaps in quality were observed for the uninsured.

Chronic Disease↗
PubMedDate not supplied

[The prelude to psychiatric reform in Brazil: the contradictions of the 1970s].

The article provides a historical reconstruction of the period leading up to what has become known as Brazil's Movement for Psychiatric Reform, which runs from the 1967 creation of the national social welfare system (INPS) to 1978, when the Mental Health Workers Movement gained prominence. Focusing on technical criteria influenced by the U.S. prevention model, our discussion examines the contradictions in Brazil's official mental health policy and also looks at the practice of financing and strengthening private psychiatric institutions, to the detriment of community action. Although most official documents from the 1970s contain proposals clearly aimed at community actions, what we observe is the crystallization of a model under which the government purchases psychiatric beds in private hospitals.

Brazil↗
PubMed2006

Impact of the CDC's Section 317 Immunization Grants Program funding on childhood vaccination coverage.

The Centers for Disease Control and Prevention's Section 317 Grants Program is the main source of funding for state and jurisdictional immunization programs, yet no study has evaluated its direct impact on vaccination coverage rates. Therefore, we used a fixed-effects model and data collected from 56 US jurisdictions to estimate the impact of Section 317 financial assistance immunization grants on childhood vaccination coverage rates from 1997 to 2003. Our results showed that increases in Section 317 funding were significantly and meaningfully associated with higher rates of vaccination coverage; a 10 dollars increase in per capita funding corresponded with a 1.6-percentage-point increase in vaccination coverage. Policymakers charged with funding public health programs should consider this study's findings, which indicate that money allocated to vaccine activities translates directly into higher vaccine coverage rates.

Centers for Disease Control and Prevention, U.S.↗