Governing IDFS's: the changing role of governing boards. One big board, or a board with sub-boards. Governance issues: today and tomorrow.
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Financial support strategies to assist informal caregivers of the elderly have been implemented and/or experimented with in several states. Little is known about how receptive caregiving families are to receiving financial support from the government to assist with in-home care, particularly whether they feel stigmatized. Few existing programs have assessed caregivers' views. In examining caregivers' reactions to receiving means-tested financial assistance, it is important to assess whether they consider support of the disabled a government responsibility as well as a possible stigma. Caregivers (N = 155) of disabled veterans aged 65 and older who receive Veterans' Administration disability allowances (Aid and Attendance) were surveyed. Results indicate that caregivers feel the government is primarily responsible for supporting the long-term disabled who are cared for at home. For the most part, these caregivers did not feel stigmatized or uncomfortable receiving means-tested government assistance to support in-home care. An important implication of this study is that financial support can be a workable component of an integrated service delivery system to support informal caregiving.
The Department of Labor is issuing these regulations pursuant to the requirements of the Office of Management and Budget (OMB) Circular No. A-110 (Revised), which provides standards for obtaining consistency and uniformity among Federal agencies in the administration of grants and agreements with institutions of higher education, hospitals, and other non-profit organizations. This rule also applies to the Department of Labor's grants to commercial organizations, foreign governments, organizations under the jurisdiction of foreign governments and international organizations. OMB issued Circular A-110 in 1976 and, except for a minor revision in February 1987, the Circular remained unchanged until revised in 1993. To update the Circular, OMB established an interagency task force to review the Circular. The task force solicited suggestions for changes to the Circular from university groups, non-profit organizations and other interested parties and compared for consistency the provisions of similar provisions applied to State and local governments. The revised Circular and these regulations reflect the results of these efforts.
The federal hospital system for veterans, established in the aftermath of World War I in a context of decentralization, privatization, and rejection of compulsory health insurance, seems an anomaly in health care policy-making. It is actually a good case of how the federal government achieves results in an area fraught with conflict: via normalization of crisis, containment of political decision making, and the association of the program with previously accepted goals (in this instance, workers' compensation). In the veterans' case, political judgments were transformed into scientific and bureaucratic decisions via the pragmatic use of experts. The system worked; the federal government governed.
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