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Biomedical subjects

R Hemp

Publications and source records attributed to R Hemp.

13 recordsLinked to original sources
PubMed1997

Toward family and community mental retardation services in Massachusetts, New England, and the United States.

Current trends in mental retardation services in the Commonwealth of Massachusetts were investigated using the New England region, the state of Michigan, and the United States as comparative frames of reference. Our goal was to analyze recent structural, financial, and programmatic trends in Massachusetts and the New England region to close state institutions and implement community and family support services. Massachusetts in particular illustrates the policy choices and challenges facing many American states engaged in restructuring their service delivery systems. New England is an extremely dynamic and innovative region that is providing significant national leadership in the provision of alternatives to institutional care.

Community Mental Health Services↗
PubMed1991

Current and future trends in state-operated mental retardation institutions in the United States.

Results of a national study of state-operated institutional care in the United States were presented. The relations among census reduction, staffing level, and resident cost were explored. Resident cost escalated dramatically in recent years, primarily because staffing levels in the states remained relatively stable, whereas the institutional census continued to decline. Econometric projections suggest that by the year 2000, the institutional census will fall below 55,000 persons, cost per resident will rise to more than $113,000 per year, and 28 to 51 institutions will close.

Budgets↗
PubMed1990

Synthesis of research on the costs of institutional and community-based care.

Cost studies in the long-term care field are reviewed, with emphasis on those relating to people with developmental disabilities. Studies frequently stressed the cost-effectiveness of community programs but often had significant methodological problems. Among the predominant findings in the literature were: 1) the generally lower average costs per client in community programs versus institutional programs; 2) unexplained wide cost ranges in similar community programs; and 3) significant cost shifts among federal, state, and local governments associated with deinstitutionalization initiatives. The implications of these findings for public officials and the advocacy community are discussed.

Community Mental Health Services↗
PubMed1987

National study of public spending for mental retardation and developmental disabilities.

Results of a nationwide study of public mental retardation/developmental disabilities (MR/DD) spending in the states during Fiscal Years 1977 through 1986 were summarized. Trends identified included: (a) continuing growth in spending for community services, (b) contraction of total spending for institutional operations, and (c) predominance of ICF/MR support in large (16+ beds) congregate care settings. Periodic replication of the study was recommended as was additional research to identify the political and economic determinants of state MR/DD spending.

Budgets↗
PubMed1986

Governmental spending for mental retardation and developmental disabilities, 1977-1984.

A study of public spending for mental retardation and developmental disabilities in fiscal years 1977 through 1984 reveals that combined state and federal government spending grew by 23 percent despite diminished growth in federal spending after passage of the Omnibus Budget Reconciliation Act of 1981. Combined state and federal expenditures for community services grew by 40 percent, primarily because of an unprecedented rise in state spending. Total state and federal spending for institutional services plateaued, as a 26 percent drop in state appropriations was offset by an infusion of federal dollars, mostly through the Intermediate Care Facilities for the Mentally Retarded program. Federal, state, and local expenditures in fiscal 1984, estimated to total $16.49 billion, are assessed, and future trends in the financing of institutional and community services in the U.S. are discussed.

Child↗