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Demonstration Program (demonstration + program)
Selected AbstractsThe Growing Pains of Integrated Health Care for the Elderly: Lessons from the Expansion of PACETHE MILBANK QUARTERLY, Issue 2 2004DIANE L. GROSS The early success of the demonstration Program of All-Inclusive Care for the Elderly (PACE) led to its designation as a permanent Medicare program in 1997. But the growth in the number of programs and enrollment has lagged and does not meet expectations. This article offers insights into the mechanisms influencing the expansion of PACE, from information obtained in interviews and surveys of administrators, medical directors, and financial officers in 27 PACE programs. Sixteen barriers to expansion were found, including competition, PACE model characteristics, poor understanding of the program among referral sources, and a lack of financing for expansion. This experience offers important lessons for providing integrated health care to the frail elderly. [source] Partnering Managed Care and Community-Based Services for Frail Elders: The Care Advocate ProgramJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2003Kathleen H. Wilber PhD OBJECTIVES: To describe a demonstration program that uses master's-level care managers (care advocates) to link Medicare managed care enrollees to home- and community-based services, testing whether referrals to noninsured services can reduce service usage and increase member satisfaction and retention. DESIGN: Using an algorithm designed to target frail, high-cost users of Medicare insured healthcare services, the program partners PacifiCare's Secure Horizons and four of its medical groups with two social service organizations. SETTING: Three care advocates located in two community-based social services agencies using telephone interviews to interact with targeted elders living in the community. PARTICIPANTS: Three hundred ninety PacifiCare members aged 69 to 96 receiving care from four PacifiCare-contracted medical groups. INTERVENTION: The 12-month intervention provides telephone assessment, links to eight types of home- and community-based services, and monthly follow-up contacts. MEASUREMENTS: Sociodemographic characteristics of intervention participants, types of service referrals, and acceptance rates. RESULTS: Lessons learned included the importance of building a shared vision among partners, building on existing relationships between members and providers, and building trust without face-to-face interactions. CONCLUSION: The program builds on current insured case management services and offers a practical bridge to community-based services. [source] A rhythm recognition computer program to advocate interactivist perceptionCOGNITIVE SCIENCE - A MULTIDISCIPLINARY JOURNAL, Issue 1 2004Jean-Christophe Buisson Abstract This paper advocates the main ideas of the interactive model of representation of Mark Bickhard and the assimilation/accommodation framework of Jean Piaget, through a rhythm recognition demonstration program. Although completely unsupervised, the program progressively learns to recognize more and more complex rhythms struck on the user's keyboard. It does so without any recording of the input flow, and without any pattern matching in the usual sense. On the contrary, internal processes are dynamically constructed to follow and anticipate the user's actions. We show that these processes are representations of the rhythms in the interactivist sense, and that they emerge from non representational grounds, avoiding the symbol-grounding problem. They are not copies or transductions of reality, but ideal internal constructions of the agent, avoiding the circularity pointed out by Piaget. In practice, the active nature of this recognition process allows it to work even with noisy and complex input flows. [source] The end of public housing as we know it: public housing policy, labor regulation and the US cityINTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 1 2003Jeff R. Crump In this article I argue that the US public housing policy, as codified by the Quality Housing and Work Responsibility Act of 1998 (QHWRA), is helping to reconfigure the racial and class structure of many inner cities. By promoting the demolition of public housing projects and replacement with mixed-income housing developments, public housing policy is producing a gentrified inner-city landscape designed to attract middle and upper-class people back to the inner city. The goals of public housing policy are also broadly consonant with those of welfare reform wherein the ,workfare' system helps to bolster and produce the emergence of contingent low-wage urban labor markets. In a similar manner, I argue that public housing demonstration programs, such as the ,Welfare-to-Work' initiative, encourage public housing residents to join the lowwage labor market. Although the rhetoric surrounding the demolition of public housing emphasizes the economic opportunities made available by residential mobility, I argue that former public housing residents are simply being relocated into private housing within urban ghettos. Such a spatial fix to the problems of unemployment and poverty will not solve the problems of inner-city poverty. Will it take another round of urban riots before we seriously address the legacy of racism and discrimination that has shaped the US city? Cet article démontre que la politique du logement public américaine, telle que la réglemente la Loi de 1998, Quality Housing and Work Responsibility Act, contribue à remodeler la structure par races et classes de nombreux quartiers déshérités des centres-villes. En favorisant la démolition d'ensembles de logements sociaux et leur remplacement par des complexes urbanisés à loyers variés, la politique publique génère un embourgeoisement des centres-villes destinéà y ramener les classes moyennes et supérieures. Les objectifs de la politique du logement rejoignent largement ceux de la réforme sociale où le système de ,l'allocation conditionnelle' facilite et nourrit la création de marchés contingents du travail à bas salaires. De même, les programmes expérimentaux de logements publics, telle l'initiative Welfare-to-Work (De l'aide sociale au travail) poussent les habitants des logements sociaux à rejoindre le marchéde la main d',uvre à bas salaires. Bien que les discours autour de la démolition des logements sociaux mettent en avant les ouvertures économiques créées par la mobilité résidentielle, leurs anciens habitants sont simplement en train d'être déplacés vers des logements privés situés dans des ghettos urbains. Ce genre de solution spatiale aux problèmes du chômage et de la pauvreté ne viendra pas à bout du dénuement des quartiers déshérités du centre. Faudra-t-il une autre série d'émeutes urbaines pour que l'on aborde sérieusement l'héritage de racisme et de discrimination qui a façonné les villes américaines? [source] Rejoinder: Alex Schwartz's critique of ,The end of public housing as we know it'INTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 1 2003Jeff R. Crump In this article I argue that the US public housing policy, as codified by the Quality Housing and Work Responsibility Act of 1998 (QHWRA), is helping to reconfigure the racial and class structure of many inner cities. By promoting the demolition of public housing projects and replacement with mixed-income housing developments, public housing policy is producing a gentrified inner-city landscape designed to attract middle and upper-class people back to the inner city. The goals of public housing policy are also broadly consonant with those of welfare reform wherein the ,workfare' system helps to bolster and produce the emergence of contingent low-wage urban labor markets. In a similar manner, I argue that public housing demonstration programs, such as the ,Welfare-to-Work' initiative, encourage public housing residents to join the lowwage labor market. Although the rhetoric surrounding the demolition of public housing emphasizes the economic opportunities made available by residential mobility, I argue that former public housing residents are simply being relocated into private housing within urban ghettos. Such a spatial fix to the problems of unemployment and poverty will not solve the problems of inner-city poverty. Will it take another round of urban riots before we seriously address the legacy of racism and discrimination that has shaped the US city? Cet article démontre que la politique du logement public américaine, telle que la réglemente la Loi de 1998, Quality Housing and Work Responsibility Act, contribue à remodeler la structure par races et classes de nombreux quartiers déshérités des centres-villes. En favorisant la démolition d'ensembles de logements sociaux et leur remplacement par des complexes urbanisés à loyers variés, la politique publique génère un embourgeoisement des centres-villes destinéà y ramener les classes moyennes et supérieures. Les objectifs de la politique du logement rejoignent largement ceux de la réforme sociale oú le système de ,l'allocation conditionnelle' facilite et nourrit la création de marchés contingents du travail à bas salaires. De même, les programmes expérimentaux de logements publics, telle l'initiative Welfare-to-Work (De l'aide sociale au travail) poussent les habitants des logements sociaux à rejoindre le marchéde la main d',uvre à bas salaires. Bien que les discours autour de la démolition des logements sociaux mettent en avant les ouvertures économiques créées par la mobilité résidentielle, leurs anciens habitants sont simplement en train d'être déplacés vers des logements privés situés dans des ghettos urbains. Ce genre de solution spatiale aux problèmes du chômage et de la pauvreté ne viendra pas à bout du dénuement des quartiers déshérités du centre. Faudra-t-il une autre série d'émeutes urbaines pour que l'on aborde sérieusement l'héritage de racisme et de discrimination qui a façonné les villes américaines? [source] | ||||||||||