Other Free Encyclopedias » Medicine Encyclopedia » Aging Healthy - Part 1 » Board and Care Homes - Defining Board And Care, Estimated Numbers Of Beds, Resident Characteristics, Services, Funding And Regulation

Board and Care Homes - Funding And Regulation

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The topics of funding and regulation are typically discussed together, since they are related. For much of its history, board and care has operated as a "grassroots" option, out of view of public funding and regulation (Morgan et al., 1993; Nolin and Mollica, 2001). While public sources of funding have been unavailable throughout most of this history, board and care homes have also, until recently, been largely unregulated, especially if they are small (Morgan et al., 1995). Given that public funding has focused on medical needs of older adults via Medicare, and nursing homes via Medicaid, the nonmedical housing and support provided by board and care homes has been privately paid by most residents or their families. In some cases, state programs have provided support to the poorest elders living in board and care homes (Dobkin, 1989).

That situation has been changed by the utilization of Medicaid waiver monies and funds to support community-based care, thus providing public monies to support the care of older adults residing in board and care homes in some states. This change has been motivated by the generally lower costs for board and care than for nursing homes, with the expectation that public costs overall would remain lower for individuals able to remain in board and care facilities rather than nursing homes (Nolin and Mollica, 2001).

At the same time that funding is beginning to flow from federal sources, states are moving rapidly in the direction of regulating smaller, non-nursing home facilities, driven both by the boom in assisted living and by the earlier reports of poor care in board and care homes (GAO, 1992). State regulations include size requirements, staffing, services, whether units may be shared, transfer policy, and resident rights (see Mollica, 2001). It is unclear whether board and care will flourish, change, or disappear under the dual thrusts of state regulation and the growth in private-pay assisted living facilities.

J. KEVIN ECKERT LESLIE A. MORGAN

BIBLIOGRAPHY

DITTMAR, N., and SMITH, G. P. Evaluation of Board and Care Homes: Summary of Survey Procedures and Findings. Denver, Colo.: Denver Research Institute, 1983.

DOBKIN, L. The Board and Care System: A Regulatory Jungle. Washington, D.C.: American Association of Retired Persons, 1989.

ECKERT, J. K., and LYON, S. "Regulation of Board and Care Homes: Research to Guide Public Policy." Journal of Aging and Social Policy 3, no. 3/4 (1991): 147–162.

General Accounting Office (GAO). Board and Care Homes: Elderly at Risk from Mishandled Medications. House Select Committee on Aging, HRD 92-45. Washington D.C.: U.S. Government Printing Office, 1992.

General Accounting Office (GAO). Assisted Living: Quality-of-Care and Consumer Protection Issues in Four States. GAO/HEHS-99-27. Washington, D.C.: U.S. Government Printing Office, 1999.

KANE, R.; WILSON, K. B.; and CLEMMER, E. Assisted Living in the United States: A New Paradigm for Residential Care for Frail Older Persons. Washington, D.C.: American Association of Retired Persons, 1993.

MCCOY, J., and CONLEY, R. "Surveying Board and Care Homes: Issues and Data Collection Problems." The Gerontologist 30 (1990): 147–153.

MOLLICA, R. L. "State Policy and Regulations." In Assisted Living: Residential Care in Transition. Edited by Sheryl I. Zimmerman, Philip D. Sloane, and J. Kevin Eckert. Baltimore: Johns Hopkins University Press, 2001.

MORGAN, L. A.; ECKERT, J. K.; and LYON, S. M. "Social Marginality: The Case of Small Board and Care Homes." Journal of Aging Studies 7, no. 4 (1993): 383–394.

MORGAN, L. A.; ECKERT, K. J.; and LYON, S. M. Small Board-and-Care Homes: Residential Care in Transition. Baltimore: Johns Hopkins University Press, 1995.

MORGAN, L. A.; GRUBER-BALDINI, A. L.; and MAGAZINER, J. "Resident Characteristics." In Assisted Living: Residential Care in Transition. Edited by Sheryl I. Zimmerman, Philip D. Sloane, and J. Kevin Eckert. Baltimore: Johns Hopkins University Press, 2001.

NOLIN, M., and MOLLICA, R. In Assisted Living: Residential Care in Transition. Edited by Sheryl I. Zimmerman, Philip D. Sloan, and J. Kevin Eckert. Baltimore: Johns Hopkins University Press, In press.

NOLIN, M. A., and MOLLICA, R. L. "Residential Care/Assisted Living in the Changing Health Care Environment." In Assisted Living: Needs, Policies in Residential Care for the Elderly. Edited by Sheryl Zimmerman, Philip D. Sloane, and J. Kevin Ekert. Baltimore: John Hopkins University Press, 2001.

RUBINSTEIN, R. L. "Long Term Care in Special Community Settings." In Long Term Care. Edited by Z. Harel and R. Dunkle. New York: Springer, 1995.

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