Purpose: This study analyzed the effect of consumer-directed versus agency-directed home care on satisfaction with paid personal assistance services among Medicaid beneficiaries in Washington State. Design and Methods: The study analyzed a survey of 513 Medicaid beneficiaries receiving home- and community-based services. As part of a larger study,…

The nine articles of this special section focus on the role of evaluation in the reform of the mental health system in Washington. The reform process is described from its inception through its design to the dissemination and utilization of evaluation results. The final article considers implications for statewide evaluations. (SLD)

During 1974-1978, a six-week senior clerkship was completed by 234 students in six WAMI (Washington, Alaska, Montana, Idaho) family practices. The average student saw 56 percent of diagnoses common in family practice, and performed 26 percent of common procedures. Despite wide regional variation, few differences were seen among the sites. (MSE)

Describes an approach to combining health and social work services in a small community in a nontraditional setting through the use of a multidisciplinary student training project. Discusses professional relationships, service provision, patient use of services, and patient satisfaction. Provides suggestions for the establishment of similar…

Results are reported of a pilot study to determine the effectiveness of a tracking program to maintain high risk infants in continuing health care, determine health and developmental outcomes, and survey the use of community resources in this population. Subjects were 766 infants from six participating hospitals in two Washington counties, one of…

Until recently, teen pregnancy and birth rates had declined steadily in the United States in recent years. Despite these declines, the United States has the highest teen birth rate and one of the highest rates of sexually transmitted infections (STIs) among all industrialized nations. To help young people reduce their risk for pregnancy and STIs,…

Until recently, teen pregnancy and birth rates had declined in the United States. Despite these declines, U.S. teen birth and sexually transmitted infection (STI) rates remain among the highest in the industrialized world. Given the need to focus limited prevention resources on effective programs, Advocates for Youth undertook exhaustive reviews…

Presents an ethnographic analysis of the Puyallup Indian urban tribal health care system with emphasis on mental health issues. Merges anthropological theories and perspectives with the practical experience of providing culturally sensitive care within a multifaceted bureaucratic environment. Contains 146 references. (SV)

Purpose: Washington State's initiatives to increase the availability and quality of community residential care presented an opportunity to describe clients entering adult family homes, adult residential care, and assisted living and to identify outcomes of care. Design and Methods: We enrolled 349 residents, 243 informal caregivers, and 299…

The paper describes combined public education and community mental health in a preschool educational day treatment program for seriously emotionally disturbed children. The Developmental Therapy model on which the Tacoma, Washington, program is based is described as using five normal developmental stages to facilitate treatment which stresses the…

A study of the adjustment of migrant American Samoan families in five gateway cities (Honolulu, San Diego, Los Angeles, San Francisco and Seattle) was done with the objectives of learning about the transition experiences of the families, gaining information about the human services provided in these cities, and providing background cultural…