TOWARD A NATIONAL STRATEGY FOR LONG-TERM CARE OF THE ELDERLY -- Copyright -- Contents -- PREFACE -- OVERVIEW -- SECTION I BACKGROUND AND STUDY RATIONALE -- FUTURE GROWTH IN LONG-TERM CARE NEEDS -- The Elderly -- The Population Under Age 65 -- The Composite Picture -- LONG-TERM CARE COSTS -- Annual Costs and Personal Income -- Misconceptions About Insurance Coverage of Costs -- NATIONAL LONG-TERM CARE EXPENDITURES7 -- Nursing Home Expenditures -- Noninstitutional Care Expenditures -- FINANCING LONG-TERM CARE -- AVAILABILITY, APPROPRIATENESS, AND QUALITY OF LONG-TERM CARE -- SECTION II STUDY CONCEPT -- STUDY FOCUS -- Components of an Optimal Long-Term Care System -- Achieving Desirable Outcomes -- STUDY SCOPE -- Study Population -- Time Frame -- SECTION III STUDY APPROACH -- (1) DEFINING THE PROBLEM -- (2) NARROWING THE GAP BETWEEN THE DESIRABLE AND THE ACTUAL -- (3) FINANCING LONG-TERM CARE -- (4) MAKING LONG-TERM CARE AFFORDABLE -- (5) CROSS-NATIONAL COMPARISONS: LESSONS FOR THE U.S. -- (6) IMPLICATIONS FOR THE NONELDERLY DISABLED -- GENERAL ISSUES -- ANTICIPATED STUDY OUTCOMES -- SECTION IV PROPOSED BUDGET - LONG-TERM CARE STUDY -- ASSUMPTIONS -- Duration -- Staff -- Committee Meetings -- Subcontracts, Commissioned Papers, and Consultants -- Dissemination -- Other Costs -- REFERENCES AND NOTES -- EXHIBIT A-1 THE CHALLENGE: AN ACCELERATING GROWTH IN LONG-TERM CARE NEEDS -- THE ELDERLY -- THE UNDER AGE 65 POPULATION -- The Developmentally Disabled -- The Chronically Mentally Ill -- Other Disabled Persons Under Age 65 -- Future Needs of Under Age 65 Functionally Dependent -- ESTIMATED OVERALL GROWTH - 1980 TO 2000 -- EXHIBIT A-2 HEALTH STATUS, LIFE EXPECTANCY AND LONG-TERM CARE UTILIZATION BY THE ELDERLY -- THE CHANGING DEMOGRAPHICS -- Mortality -- Health Status and Use of Medical Care Services -- Expenditures for Medical Care.

Future Morbidity Patterns -- National Projections -- Regional Projections -- Conclusion -- REFERENCES -- EXHIBIT B-1 OVERVIEW OF MAJOR PROBLEMS AND ISSUES IN THE EXISTING LONG-TERM CARE SYSTEM -- INFORMAL CARE -- Costs and Financing -- State Initiatives -- FORMAL INSTITUTIONAL CARE -- Access and Quality -- Costs and Financing -- State Initiatives -- FORMAL COMMUNITY SERVICE PROGRAMS -- Access and Quality -- Costs and Financing -- Federal, State and Private Initiatives -- LONG-TERM CARE FOR THE UNDER AGE 65 POPULATION -- Chronically Mentally Ill -- Developmentally Disabled, Including Mentally Retarded -- Physically Disabled Adults -- RAPID CHANGES IN THE NATION'S HEALTH CARE STRUCTURE -- SUMMARY OF CRITICAL ISSUES -- FRAGMENTATION OF THE SYSTEM: A MAJOR CROSS-CUTTING PROBLEM -- PROPOSED NEW LONG-TERM CARE FINANCING ALTERNATIVES -- EXHIBIT B-2 INCREASING THE RANGE OF LONG-TERM CARE OPTIONS: OPPORTUNITIES AND ISSUES IN INTEGRATING EXISTING FUNDING STREAMS -- REFERENCES -- EXHIBIT B-3 HOUSING AND MOBILITY-IMPAIRED ELDERLY -- CURRENT CHARACTERISTICS -- Housing Programs Serving the Elderly -- Future Housing Needs of the Elderly -- EXHIBIT B-4 REFLECTIONS ON PUBLIC POLICY, ETHICS, HEALTH CARE, AND AN AGING POPULATION -- PUBLIC POLICY -- ETHICS -- THE NEW AGENDA -- A FUNDAMENTAL QUESTION -- THE MEASURING OF THE "THIRD AGE" -- THE FAMILY -- THE CORPORATE ETHIC -- SOCIETY AND RISKS -- A SUMMING UP -- EXHIBIT C-1 INCOME AND ASSETS OF THE ELDERLY: A BRIEF SURVEY OF EXISTING INFORMATION -- SURVEYS OF THE INCOME AND ASSETS OF TODAY'S ELDERLY -- Current Population Survey -- New Beneficiary Survey -- Survey of Consumer Finances -- OVERALL RESULTS -- Projected Data -- METHODOLOGY -- ASPE STUDY -- REFERENCES -- EXHIBIT C-2 OVERVIEW OF THE ADEQUACY OF EXISTING LONG-TERM CARE DATA SETS FOR POLICY-RELEVANT ANALYSES.

EXHIBIT C-3 INVENTORY OF SELECTED MAJOR PRIMARY DATA BASES AND ANALYTICAL STUDIES, EXISTING/CYCLICA AND NEW/COMING-ON-LINE -- PREFACE -- Acronyms -- I. ADULT DISABLED -- I. ADULT DISABLED -- I. ADULT DISABLED -- II. DEVELOPMENTALLY DISABLED -- III. GENERAL LTC/CROSSCUTTING & OTHER -- EXHIBIT C-4 RECENT ADDITIONS TO THE INFORMATION BASE -- Policy Oriented Books and Major Reports, 1980-1985 -- Journal Articles, Reports, and Policy-Related Statements, 1984-1985 -- REFERENCES -- EXHIBIT D-1 CRITICAL LONG-TERM CARE ISSUES FROM PERSPECTIVE OF INVOLVED PRIVATE SECTOR ORGANIZATIONS -- ANALYSIS OF COMMENTS PROVIDED TO PLANNING COMMITTEE -- The First Three Issues -- The Next Three Issues -- The Third Group -- Other Issues -- ATTACHMENT 1 -- ATTACHMENT 2 -- Financing Long Term Care -- Ensuring Continuity of Care -- Development of Community-based Services -- ATTACHMENT 3 -- Assessments of Needs -- Organization and Delivery of Services -- Organization and Management -- ATTACHMENT 4 -- EXHIBIT D-2 IOM COMMITTEE TO PLAN.