Healthcare Safety Net

Pertaining to The Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L. 104-191)

This paper presents some preliminary findings on board and care at the national level. The data indicate that there were about 34,000 licensed board and care homes in 1991. Over three fifths were run on a for profit basis. Non profits and government sponsored board and care homes were more likely than for profits to serve the mentally ill and MR/DD populations.

Board and care homes are non-medical community-based facilities that provide at least two meals a day and routine protective oversight to one or more residents with functional limitations. Unweighted data from the 1991 National Health Provider Inventory (NHPI) indicate that there were about 30,000 licensed board and care homes in the United States serving over half a million persons.

Three studies sponsored by HHS confirm previous research linking health impairment levels, advanced age, and various indicators of caregivers' physical burden and emotional stress with individual caregivers' decisions to stop giving care and increased likelihood of nursing home placement.

Sandra Newman, Michelle Rice and Raymond Struyk The Urban Institute This report was prepared under contract between the U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and the Urban Institute.

Concern about inappropriate nursing home placement and rising long-term care costs led to a series of government-financed demonstrations to study whether substituting care at home for care in nursing homes could reduce costs and improve the quality of life for the frail elderly.

Over the past decade and a half, a series of demonstrations prior to the National Long-Term Care Channeling Demonstration have been fielded to test some form of case managed, community-based long-term care. Fourteen community care demonstrations funded through Federal Government waivers and similar to Channeling were identified.