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Dive into the research topics where Larry Polivka is active.

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Featured researches published by Larry Polivka.


Journal of Aging and Identity | 2001

A Debate on the Ethics of Aging: Does the Concept of Autonomy Provide a Sufficient Framework for Aging Policy?

Larry Polivka; Harry R. Moody

This article presents a debate on the issue of autonomy in aging policy held at the 1994 annual meeting of the American Society on Aging held in San Francisco, California. Harry R. Moody, director of the Institute for Human Values in Aging at Hunter College, supports a reconceptualized notion of personal autonomy which focuses on issues of power, theory, and practice, and finds conflicts between autonomy and justice in the lived world of the elderly and disabled. In aging policy, he promotes an emphasis on social movements such as Hospice rather than on autonomy of individuals. He suggests alternatives to extreme paternalism or complete autonomy, such as a communicative ethics approach. Larry Polivka, director of the Florida Policy Exchange Center on Aging at the University of South Florida, affirms that policy for the aging and disabled should be based ona commitment to autonomy. He describes an integrated model for long-term care that places autonomy first and includes features of communicative ethics and the negotiated consent and virtues models of ethics.


Journal of Applied Gerontology | 2004

Who is Being Served? Program Eligibility and Home- and Community-Based Services Use

Evelinn A. Borrayo; Jennifer R. Salmon; Larry Polivka; Burton D. Dunlop

Functional and economic eligibility criteria for publicly funded programs are causal factors in the use of home- and community-based services (HCBS). Thus, the study’s overall hypothesis was that the main program eligibility criteria would determine the particular characteristics of consumers in three of Florida’s HCBS programs: Aged and Disabled Adult Medicaid Waiver (ADW), Community Care for the Elderly, and Home Care for the Elderly (HCE). Data on 464 consumers who were 60 years and older and receiving services in one of the three programs support the overall hypothesis but revealed important exceptions. The ADW program is not serving a more functionally impaired population than the other programs. The HCE program is serving elders who are more cognitively impaired. Consumer-directed long-term care programs like HCE have the potential to better serve frail older adults and their caregivers if more public funding is allocated and other policy modifications are made nationwide.


Health Care Management Review | 2004

Predictors of lawsuit activity against nursing homes in Hillsborough County, Florida

Christopher E. Johnson; Deborah K. Hedgecock; Oakley Ml; Aram Dobalian; Salmon; Kathryn Hyer; Larry Polivka

The objective of this study is to examine the litigation experience of twenty-eight nursing homes in Hillsborough County, Florida. Primary data were collected from Hillsborough County Circuit Courts Clerks Recording Computer System about lawsuit activity from 1996 to 2000 and linked to the Centers for Medicare and Medicaid Services Online Survey, Certification, and Reporting system. We found that registered nurse levels, size, and being part of a chain or system impacted litigation in Hillsborough County.


Journal of Aging and Identity | 2001

Globalization, Population, Aging, and Ethics

Larry Polivka

Many countries in the developing world have not benefited much from the emerging global economy. On the contrary, they have suffered substantial economic reversals. Through the imposition of structural adjustment policies imposed by the International Monetary Fund (IMF) and the World Bank, public sector capacities to meet the education and healthcare needs of their growing populations have been reduced. The fastest growing part of the population in many developing countries in Asia and Latin America is the elderly (60+) who have many economic and healthcare needs that the governments of these countries will not be able to meet without major changes in international and domestic economic policies and healthcare programs. These political and economic issues have major ethical implications that are rarely raised in discussions about the future of developing countries in a global economy. This article concludes with the description of two ethical frameworks within which more fruitful discussions might be conducted.


Gerontologist | 2017

Neoliberal Long-Term Care: From Community to Corporate Control

Larry Polivka; Baozhen Luo

Publicly (mainly Medicaid) funded long-term care (LTC) services have evolved from a nursing home dominated system of service to a much more balanced system including home- and community-based services (HCBS) programs over the last 30 years. The HCBS programs have been largely administered by the state and local level nonprofit aging networks (ANs) consisting of Area Agencies on Aging and thousands of service providers. Over the last decade, however, for-profit HMOs administered primarily by large insurance companies have begun to displace AN organizations. State policymakers have embraced for-profit privatizations under the rationale that this approach will generate greater savings, efficiencies, and higher quality outcomes than the traditional public or private nonprofit models of program administration. As we show here, there is very little evidence for this rationale; yet, this lack of evidence has not prevented the continuing growth of for-profit managed LTC programs supported more by an ideology of market fundamentalism than empirical evidence. We also describe six possible consequences of the trend toward corporate control of public LTC services in the years ahead.


Journal of Aging and Identity | 2002

Globalization, Population Aging, and Ethics, Part II: Toward a Just Global Society

Larry Polivka; Evelinn A. Borrayo

In “Globalization, Population Aging, and Ethics, Part I” (2001), we described how globalization, through the neoliberal policies imposed by international financial institutions (the International Monetary Fund, the World Bank) has substantially reduced the capacities of developing countries to meet the educational, economic, and healthcare needs of their growing populations. We also described how these needs will increase over the next several decades with the huge growth of the elderly population across Asia and Latin America. We concluded our analysis with a discussion of the ethical implications of this increasing discrepancy between resource capacity and human needs in the developing world and two perspectives (Rawlss theory of justice and liberation philosophy, 2000) that could help sharpen the debate over the ethics of globalization. In this article, we summarize our analysis and discussion of Part I and include new information from additional sources. We then extend our discussion of the ethical implications of this analysis by describing a range of political and policy options that we think are consistent with the ethical perspective suggested in Part I and that have the potential to help reduce the widening gap between resource capacity and human need in many developing countries.


Journal of Aging & Social Policy | 2008

Medicare Privatization and the Erosion of Retirement Security

Jung Kwak; Larry Polivka

ABSTRACT This paper describes initiatives to privatize the Medicare program over the last 10 years and the implications of these initiatives for the future of retirement security. Our analysis focuses on the privatization provisions of the Medicare Modernization Act, which is largely designed to benefit the corporate health care sector without containing costs or significantly reducing the threat of rising health care costs to the economic security of current and future retirees. In fact, as designed, the Medicare Modernization Act is likely to increase the threat to retirement security in the years ahead. We conclude with a series of policy alternatives to the neoliberal agenda for the privatization of Medicare.


Journal of Aging and Identity | 2000

Making Ethics Matter in Managed Care and Geriatrics: Challenges for Practitioners

Larry Polivka

The American healthcare system historically has suffered from society’s inability to decide whether healthcare is: (a) a right, (b) a good that each person is individually responsible for, or (c) a good that some people (the elderly and the poor) have a right to and others don’t (employees of a small firm without an insurance plan). We decree that the latter must be treated if they come to a hospital injured or sick—they just can’t be paid for in any direct way. In addition to the ethical dilemmas inherent in a healthcare system that recognizes the right to care for some and not others, we now have the ethical concerns raised by the involvement of managed care organizations in the doctor-patient relationship. The practical consequences of this new ethical dilemma are especially salient for the elderly with chronic illnesses. Research indicates that care for patients with chronic illnesses may be the most affected by managed care procedures designed to curb the use of services. There is a certain irony here, in that managed care strategies have theoretical advantages over the fee-for-service system in providing healthcare for the chronically ill elderly. Managed care reduces out-of-pocket spending for healthcare and has the potential to provide a more geriatrically oriented form of integrated care. In describing this potential, Webster and Feinglass (1997) note that:


Gerontologist | 2002

Utilization Across the Continuum of Long-Term Care Services

Evelinn A. Borrayo; Jennifer R. Salmon; Larry Polivka; Burton D. Dunlop


Gerontologist | 2006

The Relative Benefits and Cost of Medicaid Home- and Community-Based Services in Florida

Glenn Mitchell; Jennifer R. Salmon; Larry Polivka; Horacio Soberon-Ferrer

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Jennifer R. Salmon

University of South Florida

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Burton D. Dunlop

Florida International University

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Jung Kwak

University of Wisconsin–Milwaukee

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Kathryn Hyer

University of South Florida

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Aram Dobalian

University of California

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Baozhen Luo

Western Washington University

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