Christy M. Nishita

The Cost and Financing of Home Modifications in the United States

Home modifications can aid in the performance of tasks and support independent living. However, obtaining funding in the United States is difficult for both individuals and home modification programs. For individuals, cost is an important factor in the decision of whether to obtain home modifications, along with the perceived need and perceived effectiveness of the modifications. Home modification programs face budget limitations and a lack of stable sources of funding. The public and private sources of financing are far from comprehensive and have confusing eligibility requirements. Several action steps by policymakers and practitioners will increase the availability of home modifications. Ideally, the future would bring a housing stock that incorporates visitability and universal design concepts.

Building an infrastructure to prevent falls in older Californians: the Fall Prevention Center of Excellence.

Abstract:  The Fall Prevention Center of Excellence (Center), a consortium of federal, state, and private organizations, was established in 2005 to guide the implementation of a statewide initiative to prevent falls among older Californians. The process began with the convening of a representative group of recognized leaders in Californias health and human services in 2003. This group engaged in a 2‐day strategic planning process that culminated in the development of the California Blueprint for Fall Prevention. The overarching goal of the Blueprint is to build a statewide infrastructure for fall prevention services and programs that will serve as a model for the rest of the country. The specific goals of the Center are to establish fall prevention as a key public health priority in California; create, test, and evaluate effective and sustainable fall prevention programs; and build a comprehensive and sustainable fall prevention system in California. To accomplish these goals, the Center is currently engaged in developing and disseminating fall prevention tools and informational resources directed at the needs of both consumer and professional audiences; linking organizations involved in fall prevention while increasing awareness of fall prevention as an important public health issue; and helping communities build their capacity to effectively address falls in older adults through the delivery of integrated fall prevention services and “best practice” programs.

Building Integrated Information Systems for Chronic Care: The California Experience

ABSTRACT For over three decades, chronic-care services have been described as fragmented, complex, difficult to access, overlapping, and duplicative in function. Although a number of remedies have been implemented to improve service delivery, little has been written about the potential of integrated information systems (IIS) to serve as a remedy to fragmentation. We begin to address this gap by comparing and contrasting three unique models of chronic-care IIS developed in California to improve service delivery. To analyze the current status of each IIS, we apply six design criteria: (1) the information on programs and services is comprehensive, (2) the system has the capacity to serve the needs of diverse users, (3) the system integrates multiple layers and levels of information, (4) information from multiple sources is standardized and uniform, (5) information can be accessed in a timely manner, and (6) provisions are adequate to meet all requirements for privacy and confidentiality. Although much work remains to be done, there is reason to be optimistic that innovative IIS can contribute to the development of more effective chronic-care delivery systems.