This document presents Congressman Claude Pepper's report on the Medicare Home Care Benefit. Section I traces the history of home health care in the United States. Section II offers statistics and general background information about older Americans and Medicare. The beginning of the Medicare home care benefit and its present operation are…

Florida's District 12 Veterans Administration (VA) wanted to deliver medical case-management services to veterans not receiving home-based services due to the geographic restrictions of the VA's Hospital-Based Home Care Program. The Florida Department of Health and Rehabilitative Services (HRS) desired to demonstrate the effectiveness of nurse…

The mental health policies of the past 20 years and the evidence of unserved populations suffering from serious mental illness constitute a public health crisis. Currently there are at least 3,000,000 people in the United States suffering from mental disorders. A fully developed continuum of care is needed to respond effectively to the diverse…

The delivery of services in a health maintenance organization (HMO) provides many opportunities for innovation. There is a growing awareness that many outpatient medical visits are related to psychological or social needs. Because of the economic incentive for HMO's to reduce inappropriate utilization, psychologists and psychotherapists will play…

For certain groups of the mentally ill, most notably individuals with serious mental disabilities, the community-based mental health system can be more of a "non-system." Unforeseen problems have plagued both the dream of deinstitutionalization and the effectiveness of community mental health centers during the last 20 years. Uncoordinated…

Historically, the financial responsibility for caring for those with mental illness has shifted back and forth from the local community, to the state, to the federal government. Today states provide the vast majority of the funds to the state mental health agencies and oversee local governments and most private resources for mental health funding.…