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SECTION IV PROPOSED BUDGET - LONG-TERM CARE STUDY ASSUMPTIONS Duration The budget assumes a two-year study with the final draft completed by the committee at the end of month 20. The remaining time is for review of the report, publication, and dissemination. Staff The budget assumes a three person full-time professional staff consisting of a study director, an associate study director, and research assistant, plus support staff. Committee Meetings Five or six committee meetings (depending on how the first meetings are organized) of an 18-person committee, with six additional four-person subcommittee meetings to monitor the work of subcontractors and commissioned paper authors. Subcontracts' Commissioned Papered and Consultants The bulk of the extensive analytical agenda for the study would be conducted through subcontracts, commissioned papers and the use of consultants. The subcontracts would be for those tasks where a considerable amount of secondary data analysis would be carried out. Commissioned papers are more modest efforts where the study would be drawing on the existing knowledge and expertise of a single individual. Consultants would be used to augment the staff capacity as necessary. -25-

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Dissemination Travel costs for committee members are built in for dissemination activities following release of the report. In addition a small invitational conference is budgeted with travel costs for 30 persons. During this conference there could be a structured presentation and discussion of the committee findings and of various policy options. Invitations would be extended to both policymakers and policy analysts, interested organizations such as the AARP, and the press. Other Costs Other costs include the usual administrative expenses based on experience with other similar studies. -26-

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LONG-TERM CARE (24 months) 1. SALARIES and WAGES Professional Staff Support Staff 2. FRINGE BENEFITS OVERHEAD (63% of wages & benefits) 4. CONSULTANTS (100 days) 5. COMMISSIONED PAPERS 6. SUBCONTRACTS - Analytical Studies 7. TRAVEL Committee Meetings Staff Dissemination 8. OTHER DIRECT COSTS 9. G & A COSTS (10.0%) -27- $ 291,062 61,878 $ 59,820 1,860 17,580 TOTAL $ 352,940 77,647 313,336 25,000 15,000 240,000 79,260 48,264 138,173 $1,289,620

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REFERENCES AND NOTES 1. Doty, Pamela, Korbin Liu, and Joshua Wiener. "An Overview of Long-Term Care." Health Care Financing Review, Spring 1985, 6(3):74. 2. U.S. House of Representatives, Select Committee on Aging, "America's Elderly at Risk: A Report Presented by the Chairman." Committee publication #99-508 July 1985, p. 18. 3. See exhibit C-1, Table 1. 4. Doty, Liu, and Wiener, op. cit., p. 74. American Association of Retired Persons, Long-TErm Care Research Study, January 30, 1984 (survey performed for the AARP by the Gallup Organization). 6. Detailed data on sources of support for long-term care are found in exhibit B-2. 7. Detailed data on expenditures are found in exhibit B-2. 8. Levit, Katharine R., Helen Lazenby, Daniel R. Waldo, and Lawrence M. Davidaff, "National Health Expenditures, 1984." Health Care Financing Review, Fall 1985, 7~1~:12. 9. See exhibit C-1. 10. Levit, et. al., op. cit., page 20; also Robert M. Gibson, "National Health Expenditures, 1978," Health Care Financing Review, Summer 1979, 1~1~:31. 11. Doty, Liu, and Wiener, pot cit., p. 74. 12. Institute of Medicine, "Improving the Quality of Care in Nursing Homes." National Academy Press, 1986, p. 8. 13. Detailed findings and recommendations concerning the quality of care in nursing homes are found in the Institute of Medicine report, "Improving the Quality of Care in Nursing Homes." 14. For example, TOM report cited above and see discussion in exhibit B-1, page 56. 15. For example, The Brookings Institution is carrying out a major study of the organization and financing of long-term care. 16. See discussion in exhibit B-2. 17. See discussion of model programs in exhibit B-1. 18. See discussion of relationship of housing to long-term care in exhibit B-3. 19. Information presented to the planning committee by Robert Kane. -28-