Each year, substance abuse treatment programs in the United States record approximately 150,000 admissions of youths under the age of 18. Nevertheless, little is known about the effectiveness of the types of community-based services typically available to youths and their families. Researchers interviewed youths treated in 11 adolescent programs that had been identified as having suggestive evidence of effectiveness, in order to learn whether they had better outcomes a year after treatment admission than they would have had at other facilities. The study failed to find strong and persuasive evidence of greater treatment effectiveness at the facilities studied. Relative effectiveness may be difficult to measure because facilities serve different populations, because the study examined relative rather than absolute treatment effects, or because large and significant treatment effects might exist for each evaluated treatment program but might be no longer detectable a year after admission. However, there were consistently small positive effects for direct measures of substance use.

This document sets out a programme of work to equip services and professionals to identify and respond to the health and mental health needs of individuals affected by domestic violence, childhood sexual abuse, rape, oblique sexual assault and sexual exploitation, including children, adolescents, and adults, both victims and abusers, male and female.

As an employee of a school or other education institution, you may sometimes access individual student records while performing your official duties. Under the Family Educational Rights and Privacy Act (FERPA), you are legally and ethically obliged to safeguard the confidentiality of any information they contain. This guide provides a general overview of the legal and related issues you may encounter while carrying out your duties. The Forum Guide to the Privacy of Student Information: A Resource for Schools was written to help school and local education agency staff better understand and apply FERPA, a federal law that protects privacy interests of parents and students in student education records. The Forum has developed full reports on student (and staff ) privacy guidance, but a shorter document was needed to provide a quick overview and links to other resources when more information is needed. This guide defines terms such as “education records” and “directory information”; and offers guidance for developing appropriate privacy policies and information disclosure procedures related to military recruiting, parental rights and annual notification, videotaping, online information, media releases, surveillance cameras, and confidentiality concerns related specifically to health-related information.

A snapshot of mental health services in NSW in 2006
> There were approximately 1.1 million people who experienced a mental illness in NSW in 2005-06.
> About 170,000 or two to three per cent had a severe mental illness.
> Mental health units in NSW hospitals managed approximately 26,000 overnight admissions in 2004-05.
> Community mental health services in NSW made 2.3 million clinical interventions each in 2004-05.
> The suicide rate was 8.6 per 100,000 in 2004 – the lowest in 50 years.
> In 2005-06, the dedicated mental health recurrent budget was $854 million. Almost half the budget is dedicated to community mental health services.

The reform of mental health services outlined in this strategic plan rely fundamentally on partnerships and the participation of the broader community. Its success depends on MHS and its staff listening to consumers, their families and carers, and our other partners, and working closely with them to build a service framework that we are all confident in, and which delivers the necessary services to all Tasmanians. A central component of our plan for the future is a model of care for mental health that is centred on consumers, promotes their recovery, and is provided equitably and efficiently. We have built our model of care on best practice based on evidence, using the full range of experience and expertise within our own organisation, and across Australia and the world.

How do you actually do a recovery-oriented service system? ... The following document answers this question by identifying eight domains of a recovery-oriented service system ranging from degree of participation of persons in recovery in the recovery planning and system development process to ”Identifying and Addressing Barriers to Recovery.” It then lists a dozen or so concrete, practical and well-researched action steps or guidelines in each domain. It answers questions like: “You will know when you are placing primacy on the participation of people in recovery when…” The document gives examples, identifies potential barriers, and uses the words of people in recovery to explain what each domain means and what they can expect in that domain.

Petrol sniffing causes devastation in Indigenous communities. The health impacts include chronic disability and the social impacts include violence, crime and the breakdown of community structures. Tragically, young Indigenous people are dying as a result of petrol sniffing. For over twenty years petrol sniffing has been the subject of many reports, reviews, coronial inquiries and research projects. The reasons why young Indigenous people sniff petrol, the disruptive impact on Indigenous communities, and the severe health implications for individuals are well known and have been repeatedly addressed in all of the reports. In fact, the evidence received by the Committee echoed the research already undertaken and again pointed to the multiple causes of petrol sniffing including hunger and poverty, boredom and a lack of meaningful employment opportunities. The lack of progress in implementing recommendations contained in these reports has created much frustration and despair in communities. Evidence from Indigenous community members indicates persistent unsafe conditions for adults and children. The Committee believes that petrol sniffing in Indigenous communities has become so destructive and the need to find effective solutions is so urgent that the Council of Australian Governments must take responsibility for initiatives that address petrol sniffing.

Australia's health 2006 is the tenth biennial health report of the Australian Institute of Health and Welfare. It is the nation's authoritative source of information on patterns of health and illness, determinants of health, the supply and use of health services, and health services expenditure. Australia's Health 2006 is an essential reference and information resource for all Australians with an interest in health.

This site provides:
- Access to online and print-based resources
- Australian statistics
- National and state/territory government policies
- Information about Australia's National Advisory Council for Suicide Prevention
- Information about suicide prevention projects in all states and territories funded through the National Suicide Prevention Strategy
- Resources related to the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples
- Links to related sites
- Conference information

Changing Lives, the report of the 21st Century Social Work Review, set out a compelling and challenging vision for the future direction of social work services. In the Executive’s immediate response to the report, Ministers welcomed the findings of the review, accepted all 13 recommendations and gave a commitment to act upon them. This implementation plan sets out proposals to do that. The aspirations of Changing Lives represent major cultural change and will be achieved only by a concerted effort at national and local levels over an extended period. Implementation will therefore be both a collaborative
process, with a strong emphasis on shared learning, and a progressive
process, where plans for the next stage build upon the successes of the one before. A process which recognises that there is no one blueprint for future services that meets every need in every circumstance. This plan sets out the processes we intend to put in place to support a five year change programme. It also sets out detailed milestones and funding proposals for the first two years of that programme. New funding of £15M will be available for the first two years – £4M for the remainder of this year to get work underway, building to £11M next year. Further funding will follow in the subsequent three financial years, building on the early foundations of the change programme. The scale of the final three years’ funding will be influenced by progress with the change programme and the extent of engagement of organisations in transforming the delivery of services.

Despite the general perception that it is no longer an important public health problem, lead poisoning remains a serious, preventable environmental health threat to young children that affects neurodevelopmental, intellectual, and cognitive outcomes. One of the key goals of current U.S. public health policy is the elimination of childhood lead poisoning, which will require improvements in lead poisoning prevention; screening, reporting, and surveillance of childhood blood lead levels; and treatment of childhood lead poisoning. The focus of this report is on screening, reporting, and surveillance, which are critical for eliminating lead poisoning, as well as for its prevention and treatment. In pursuit of this goal at the community level, Healthy Home Resources commissioned the RAND Corporation and the University of Pittsburgh Office of Child Development to examine the current status of childhood blood lead level screening, reporting, and surveillance in Allegheny County, Pennsylvania, and to offer recommendations for improving these processes. The findings and recommendations presented in this report are the result of a background study of the relevant literature, a review of existing blood lead level reporting and surveillance databases for Pennsylvania and Allegheny County, and interviews and focus groups.

Drug Consumption Rooms (DCRs) are places where dependent drug users are allowed to bring their illegally obtained drugs and take them in supervised, hygienic conditions. There are approximately 65 DCRs in operation in eight countries around the world but there are none in the UK. The Independent Working Group (IWG) on Drug Consumption Rooms was set up to address the question of whether DCRs would have a significant impact on drug-related problems in the UK and whether they should be trialled in this country. Over a 20-month period, the IWG reviewed the growing body of evidence, commissioned research where there were significant gaps, visited DCRs abroad and heard from relevant witnesses. The IWG has concluded that DCRs are a rational and overdue extension to the harm reduction policy that has produced substantial individual and public benefits in the UK over the last two decades. DCRs offer a unique and promising way to work with the most problematic users, in order to reduce the risk of overdose, improve their health and lessen the damage and costs to society. The IWG therefore recommends that pilot DCRs are set up and evaluated in the UK.

The Swiss drug-treatment policy of offering heroin addicts substitution treatment with methadone or buprenorphine has led to fewer new users, according to a study. The investigators found little merit to allegations that the liberal injectable-drug policy—particularly the use of harm-reduction measures such as low-dose methadone programs, heroin-assisted treatment, and needle-exchange programs—would prove counterproductive, Carlos Nordt, Ph.D., and Rudolf Stohler, M.D., of Psychiatric University Hospital here wrote in the June 3 issue of The Lancet.

Among the resolutions at the recent fifth White House Conference on Aging was the decision to “attain adequate numbers of healthcare providers who are skilled and culturally competent in geriatrics.” Much needs to be done to recruit and retain social service professionals who have expertise in working with older adults, and to educate the public and other professionals as to the value of social work interventions with the elderly.The Social Work Leadership Institute (SWLI) at the New York Academy of Medicine and The Institute for Geriatric Social Work (IGSW) at Boston University, both funded by The Atlantic Philanthropies, are working to address these concerns. SWLI’s Center on Aging
Policy (CAP) provides a range of services and products to practitioners, as well as legislators and public officials, to advance public policy strategies ensuring a qualified workforce caring for older adults. IGSW has created a wide range of initiatives to improve the quality of social work practice with older adults through the latest in educational design, evaluation of training effectiveness, and policy-relevant research.

The swelling ranks of Americans age 65-plus have increased the demand for skilled caregivers who can address the increasingly complex and diverse healthcare and psychosocial needs of older adults. Social workers are uniquely prepared to care for older adults in a wide range of acute- and long-term-care settings by helping older adults and their families choose among, gain access to, and navigate a bewildering array of health and social services, among other important functions. According to government data, opportunities for geriatric social workers are expected to grow significantly. But, a number of barriers currently prevent them from providing optimal care to elders. Reimbursement and training policies that fail to support social work services deter individual practitioners from specializing in gerontology.The result is a shortage of professionals trained to care for the elderly. Identifying the barriers, and promoting realistic efforts to minimize or eliminate them, is the current
challenge. Meeting this challenge is crucial for the future social work labor force and for an aging population that increasingly needs their services.

TRANSFORMING MEDICAID requires a bold shift in focus — from an emphasis on controlling costs in the short-term to a focus on investments in quality that will improve health outcomes and enhance the long-term viability of the nation’s health care safety net.
IT REQUIRES INNOVATIVE THINKERS willing to roll up their sleeves, forge new partnerships, design and test novel programs, relentlessly measure results, learn from mistakes, and press on.
IT REQUIRES LEADERS who truly believe that improving the quality of heath care services can both deliver better outcomes and lower costs, particularly for people with chronic health needs.
MEDICAID’S TRANSFORMATION IS UNDERWAY. And the Center for Health Care Strategies (CHCS) is fortunate to be partnering with states, health care organizations, physicians, and consumer groups across the country that are committed to providing the best possible, most cost-effective care for the millions of Americans served by Medicaid and other publicly financed programs. Together we are creating opportunities to lead improvements in the national health care system.

U.S. Surgeon General Richard H. Carmona today issued a comprehensive scientific report which concludes that there is no risk-free level of exposure to secondhand smoke. Nonsmokers exposed to secondhand smoke at home or work increase their risk of developing heart disease by 25 to 30 percent and lung cancer by 20 to 30 percent. The finding is of major public health concern due to the fact that nearly half of all nonsmoking Americans are still regularly exposed to secondhand smoke. The report, The Health Consequences of Involuntary Exposure to Tobacco Smoke, finds that even brief secondhand smoke exposure can cause immediate harm. The report says the only way to protect nonsmokers from the dangerous chemicals in secondhand smoke is to eliminate smoking indoors.

Hurricane Katrina dealt a severe blow to over a million people in Louisiana and the coastal regions of Mississippi and had repercussions throughout the Gulf region.1 Low-income families and individuals in particular bore the brunt of the storm and flooding, losing their homes, jobs, and resources for recovery. Public programs had served many of these people before the hurricane hit, and many others became newly eligible as a result of it. But the impact of Katrina strained the essential components of these programs, including their funding arrangements and eligibility and benefit standards. It raised critical questions about the programs' ability to respond swiftly and fairly to families and individuals affected by the storm, and about state and local governments' incentives to respond effectively to victims' needs.

'Co-production' has emerged as a general description of the process whereby clients work alongside professionals as partners in the delivery of services. This research, from the New Economics Foundation, examines 'co-production', its definition, effects and prospects. It looks at how public service institutions and government might better recognise the contribution to their neighbourhoods played by people outside paid work and the relationship between such activities and welfare and public services.

Violence against women in Jamaica persists because the state is failing to tackle discrimination against women, allowing social and cultural attitudes which encourage discrimination and violence. This violates the government’s most basic treaty obligations under the UN Convention for the Elimination of Violence against Women (CEDAW), among others. Shortcomings in national legislation do not deal adequately with marital rape, incest or sexual harassment, thereby encouraging impunity and leaving women without the protection of the law. Discrimination is entrenched and often exacerbated in the police and criminal justice system. Women and adolescent girls are rarely believed by the police, so have little confidence in reporting crimes against them. Evidence is often not sought effectively or professionally, and witnesses are rarely protected. In court, women’s testimony is explicitly given less weight than men’s, thereby depriving women of the right to equality before the law. In Jamaica, entrenched discrimination against women means many individuals fail to appreciate that forced sex carried out by an acquaintance or family member is a serious crime.

Join Together convened this panel to address two realities: state governments pay dearly for the nation’s failure to effectively prevent and treat alcohol and drug problems. They also have enormous potential because state governments are the primary funders of prevention and treatment services. The panel met four times, held public hearings, received written testimony, and reviewed research and existing models. The panel heard from experts, clients, providers, government officials, community and reflected on their own experiences in state government.

Clinicians should encourage parents to limit sedentary activity and make physical activity and sport recommendations to parents and caregivers that are consistent with the developmental level of the child (Harris, 2000).

Under the Bush Administration, the “shadow government” of private companies working under federal contract has exploded in size. Between 2000 and 2005, procurement spending increased by over $175 billion dollars, making federal contracts the fastest growing component of federal discretionary spending. This growth in federal procurement has enriched private contractors. But it has also come at a steep cost for federal taxpayers. Overcharging has been frequent, and billions of dollars of taxpayer money have been squandered. At the request of Rep. Henry A. Waxman, this report is the first comprehensive assessment of federal contracting under the Bush Administration. The report reaches three primary conclusions:
- Procurement Spending Is Accelerating Rapidly. Between 2000 and 2005, procurement spending rose by 86% to $377.5 billion annually. Spending on federal contracts grew over twice as fast as other discretionary federal spending. Under President Bush, the federal government is now spending nearly 40 cents of every discretionary dollar on contracts with private companies, a record level.
- Contract Mismanagement Is Widespread. The growth in federal contracts has been accompanied by pervasive mismanagement. Mistakes have been made in virtually every step of the contracting process: from pre-contract planning through contract award and oversight to recovery of contract overcharges.
- The Costs to the Taxpayer Are Enormous. The report identifies 118 federal contracts worth $745.5 billion that have been found by government officials to include significant waste, fraud, abuse, or mismanagement. Each of the Bush Administration’s three signature initiatives — homeland security, the war and reconstruction in Iraq, and Hurricane Katrina recovery — has been characterized by wasteful contract spending.

Presents data on citizen complaints about police use of force received by large, general purpose State and local law enforcement agencies as well as on complaint dispositions. Findings presented are from new questions on formal citizen complaints about police use of force added to the Law Enforcement Management and Administrative Statistics survey. Detail is presented on the policies and procedures of large municipal police departments relating to the processing of citizen complaints and other administrative features. The report also discusses the limitations of complaints' data and the use of sustained complaints as a measure of police use of excessive force.
Highlights include the following:
- During 2002 large State and local law enforcement agencies, representing 5% of agencies and 59% of officers, received a total of 26,556 citizen complaints about police use of force.
- About a third of all force complaints in 2002 were not sustained (34%). Twenty-five percent were unfounded, 23% resulted in officers being exonerated, and 8% were sustained.
- Using sustained force complaints as an indicator of excessive force results in an estimate of about 2,000 incident of police use of excessive force among large agencies in 2002.

This report summarizes child abuse statistics submitted by states to the National Child Abuse and Neglect Data System (NCANDS) during 2004. See a list of all Child Maltreatment Reports. The data are presented in aggregate and by state, and trends are reported when available. Topics include sources of reports; time for response; victimization rates; types of maltreatment; age, race and gender of victims; age and gender of perpetrators; relationship of perpetrators to the victim; number of child fatalities; types of services provided; and additional research related to child maltreatment.

The records of child abuse and neglect reports are maintained by State child protection or social services agencies to aid in the investigation, treatment, and prevention of child abuse cases and to maintain statistical information for staffing and funding purposes. In many States, these records and the results of investigations are maintained in databases, often known as central registries. The type of information contained in registry and department records varies from State to State, as does access to the information maintained.

Child care subsidies have the potential to support parents’ employment and children’s development. A growing body of research tells us what parent employment outcomes are associated with the use of child care subsidies, how employment patterns and decisions differ for various subgroups of parents, and whether child care subsidies appear to make more difference for certain subgroups. The issue is explored in a Research Brief, a Literature Review, and a Table of Methods and Findings. This is the second package in a series on child care subsidies that also includes an Introduction to the field.

This second Project THRIVE describes the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program of Medicaid with a focus on young children ages birth to 5 and offers tips for using the program in state Early Childhood Comprehensive Systems to improve early childhood health and development, state performance rates on child health, and collaborative efforts with other federal and state programs and services. Through EPSDT, Medicaid can finance services that promote child health, child development, and healthy mental development such as regular checkups, interperiodic screenings, and treatment. While in theory EPSDT guarantees children coverage for a full range of services, in practice, screening and referral rates fall short of the 80 percent screening benchmark set in 1989. State ECCS initiatives can use interagency coollaboration to improve EPSDT performance and child health access.

This brief seeks to inform policymakers and others about the difficulties faced by low-income working parents as they strive to make progress in the workforce. Using data from NCCP’s Family Resource Simulator, it highlights ways in which the current structure of work support policies often leads to unintended consequences. As low-wage workers increase their earnings above the federal poverty level, their families begin to lose eligibility for government work supports. Given that some of these benefits drop off quickly, earning more does not always improve a family’s financial bottom line.

Respect is about central government, local agencies, local communities and ultimately every citizen working together to build a society in which we can respect one another – where anti-social behaviour is rare and tackled effectively, and communities can live in peace together. It’s not about going back to the past or returning to the days of ‘knowing your place’.
- It’s about nurturing and, where needed, enforcing a modern culture of respect, which the majority of people want.
- It’s about showing tolerance, acceptance and common decency towards the people around us – our family, friends and peers, people who are older or younger than us, people from different walks of life or who follow different cultures or religions.
- It’s about being considerate of the consequences of our behaviour for others.

This information packet includes fact sheets about child maltreatment and the services available from the Child Welfare Information Gateway. The fact sheets review the definitions of maltreatment, child abuse and neglect prevention, and provide statistical information about the prevalence of child abuse and neglect and the characteristics of victims and offenders. Directories of federal clearinghouses, hotlines, state agencies, and other organizations that disseminate information about family and domestsic violence and substance abuse are also inserted.

This study documents that nonresident fathers of children in foster care are not often involved in case planning efforts and nearly half are never contacted by the child welfare agency during their child's stay in foster care. By not reaching out to fathers, caseworkers may overlook potential social connections and resources that could help to achieve permanency for the child. A total of 1,222 local agency caseworkers were interviewed by phone about 1,958 specific cases between October 2004 and February 2005 to examine front-line practices related to nonresident fathers. Interviewers achieved an 83% response rate to the survey.

This report continues the dropout rate report series. The report is based on several sources of data and provides details on high school dropouts and high school completers for 2002 and 2003. Apart from provide characteristics of dropouts and completers in these years, the report also provides information about trends in high school dropout and completion rates going back to the 1970s. Among other findings, the report shows that young people (16-24 year olds) of Hispanic origin have been more likely to be out of high school without a high school credential than young White- and Black, non-Hispanics over the past 30 years.

Countries of the World Map
This map of the world uses the Robinson Projection, which shows distortions in areas and distances that results in a more natural visualization of the globe on a flat surface. The projection was created by Arthur H. Robinson (1915-2004). Robinson, under commission from Rand McNally, was a renowned scholar of geography and cartography at the University of Wisconsin-Madison. The National Geographic Society adopted the projection in 1988 and was used for their world maps for ten years. Robinson's equal-area projection has been widely used in textbooks and atlases over the past several decades.

Drug courts emerged in the late 1980s in response to rapidly increasing felony drug caseloads that strained the Nation's courts and overflowed its jails and prisons. Their goal is to reduce substance abuse and criminal behavior and free the court and correctional systems to handle other cases. By providing a structure that links supervision and treatment as an alternative to incarceration, drug courts exert legal pressure on defendants to enter and remain in treatment long enough to realize benefits. As of December 2005, more than 1,500 drug courts were operating in the United States and another 391 were being planned. As part of the evaluation of these courts, researchers have begun to look at their inner workings and to investigate how key functional components, singly and in combination, affect outcomes. This NIJ Special Report presents findings from several recent studies that speak to the concerns of policymakers and practitioners about "what works" in drug courts. Topics addressed include how target populations and participant attributes affect program outcomes, the judge's role in the success of drug court participants, treatment issues, drug court interventions for juveniles, and cost-benefit analyses of drug courts.

The mental ill health of women in custody is a serious issue. Studies have shown high levels of mental distress among women offenders, with the illness or its symptoms, often manifested in drug and alcohol abuse, being factors in their criminal behaviour. This is then compounded by being held in custody as a result of their crimes, leading to a further deterioration in their mental
well-being. This report sets out the key findings and recommendations of the work and in particular the role of the NHS when responsibility for the health of those in custody is fully transferred to PCTs in April 2006. This report is intended to be read by all those concerned with the effects and after-effects of custody on the mental health of women, and not just the organisations to whom the recommendations are directly addressed. Two key messages underpinning all the recommendations is the need for partnership working within establishments, between government departments, and between statutory and voluntary organisations in the community, and the need to make interventions at an early stage of a woman’s contact with the criminal justice system.

It is difficult to find an all-inclusive definition for ‘mental illness’. Cultural and societal norms mean that there is no clear consensus as to what it means. In addition, further confusion often surrounds the ways and contexts in which terms like ‘mental health problems’, ‘mental illness’ and ‘mental health’ are used.
Mental Illness
According to the charity, The Mental Health Foundation: ‘When someone experiences severe and or enduring mental health problems they are sometimes described as mentally ill’ [1]. This is the definition used in this factsheet. However, there are many problems associated with the term. These include: the lack of any universal agreement as to the point at which normal behaviour becomes mental illness; the stigma attached to the label ‘mental illness’; the fact that the existing ways of categorising mental illnesses do not always match people’s experiences; and the fact that some people think the term implies that all mental health problems are the result of underlying biological causes, when most are caused by a combination of factors, and are often triggered by situations in a person’s life.

Development and implementation of the Common Core for Line Workers and Common Core for Supervisors was mandated by the Program Improvement Plan (PIP), part of the 2003 federal Child and Family Services Review (CFSR). Although in-service core training had historically been provided by the Regional Training Academies, the Inter-University Consortium, and county staff development departments, the introduction in 2005 of the common core curricula is significant: it marks the dissemination of new worker training that is standardized for the entire state. The aim of statewide standardization of Common Core Curricula is to provide consistency and equity in the application of best and evidence-based practice in all 58 California counties.

The child welfare system is a group of services designed to promote the well-being of children by ensuring safety, achieving permanency, and strengthening families to successfully care for their children. Most families first become involved with the child welfare system due to a report of suspected child abuse or neglect (sometimes called "child maltreatment"). Child maltreatment is defined by Federal law1 as serious harm (neglect, physical abuse, sexual abuse, and emotional abuse or neglect) caused to children by parents or primary caregivers, such as extended family members or babysitters. Child maltreatment can also include harm that a caregiver allows to happen (or does not prevent from happening) to a child. In general, child welfare agencies do not intervene in cases of harm to children caused by acquaintances or strangers. These cases are the responsibility of law enforcement. The child welfare system is not a single entity. Many organizations in each community work together to strengthen families and keep children safe. Public agencies (departments of social services, child and family services, etc.) often contract and collaborate with private child welfare agencies and community-based organizations to provide services to families, such as in-home ("family preservation") services, foster care, residential treatment, mental health care, substance abuse treatment, parenting skills classes, employment assistance, and financial or housing assistance.

To date, every state in the country has implemented the first round of the Childand Family Service Review (CFSR), the U.S. Children’s Bureau outcome-based performance review. The performance review was designed to build a new degree of accountability for the safety, permanency, and well-being of children and their families. While the results of the reviews reflect the unique culture and circumstances of each participating state, the findings are fairly consistent. Two of the findings are especially significant:(1) State child welfare systems need to improve the practice of effectively engaging families to participate meaningfully in ensuring good outcomes for their children. (2) Improved outcomes for vulnerable children and their families cannot be real-ized in the absence of strong working relationships between child welfare agencystaff and a full range of partners involved in contributing to familysuccess and well-being.

We’ve all forgotten a name, where we put our keys, or if we locked the front door. It’s normal to forget things once in a while. However, forgetting how to make change, use the telephone, or find your way home may be signs of a more serious memory problem. We have written this booklet to help you know:
1. The difference between mild forgetfulness and more serious memory problems.
2. The medical causes of memory problems and how they can be treated.
3. How to cope with serious memory problems.

The study included several dimensions: a review of service rates and the rate methodologies for four specific community-based services; an assessment of workforce capacity needed to provide services in the future; and observations and recommendations regarding the potential to restructure the State’s funding, across different programs, to support assisted living, home care, respite care, and adult day care.

Alzheimer’s disease is an illness of the brain. It causes large numbers of nerve cells in the brain to die. This affects your ability to remember things and think clearly. Doctors don’t know what causes the disease. They do know that it usually begins after age 60 and nearly half of people age 85 and older may have Alzheimer’s. However,
it is not a normal part of aging.

Policies promoting home- and community-based services and disease management models implicitly rely on family care, still the bedrock of long-term and chronic care in the United States. The United Hospital Fund studied family caregivers of stroke and brain injury patients when home care cases were opened and closed and found that even with short-term formal services, family caregivers provided three-quarters of the care. Patients’ mobility impairments and Medicaid eligibility were the main factors in determining the amount and duration of formal services. Between one-third and one-half of family caregivers reported being inadequately prepared for the case closing. At all stages, family caregivers expressed significant isolation, anxiety, and depression. Therefore, home care agency practice and public policies should provide better education, support, and services for family caregivers.

When people work longer, they produce additional goods and services for the economy. They also earn more income, usually save some of that income, allow their assets to grow, and increase their annual Social Security benefit by withdrawing money over a shorter period of time. At the same time, they lower Social Security deficits by delaying receipt of government benefits and, quite importantly, pay more taxes-which bolster other government programs. The broader positive ramifications of additional work have yet to be fully examined. For instance, the Social Security Administration does not report effects of proposed policy reforms on general revenues. To examine these complex interactions, we estimate the effect of increased work using the Urban Institute's Dynamic Simulation of Income Model (DYNASIM3). Among other items, DYNASIM calculates retirement wealth from earnings, pensions, and Social Security. It also calculates payroll tax and federal and state income tax at the individual and family level from 1992 to 2050. These projections account for the dramatic heterogeneity of individual demographic and economic circumstances and how they evolve over time. At the individual level, we calculate the change in net wealth and annual future consumption made possible by additional work. At the macro level, we calculate the change in total earnings and in the Social Security deficit due to additional work. We also look at the changes in general revenue that could be used to support other government spending (including spending on the elderly).

The first wave of the baby boom generation turns 65 in 2011, old enough to begin drawing on Medicare coverage. Over the decade to follow, tens of millions more will become eligible for the nation's largest public health care program, testing the resiliency and solvency of the four-decade-old system. The panel reviewed the central themes of Marilyn Moon's new book, Medicare: A Policy Primer (Urban Institute Press). The book stresses that policymakers need to stay focused on beneficiaries, given their modest economic resources, the high costs of health care, and the Medicare population's diversity.

Child protection agencies provide a safety net for abused and neglected children and those at risk of maltreatment. Panelists examined strategies to transform the child welfare system into well-honed operation that keeps children safe and actively advances their well-being.

Washington State's Unemployment Insurance (UI) program has undergone a number of important changes since 2003, the result of three major legislative enactments and increasingly proactive program administration. Second Engrossed Senate Bill (2ESB) 6097 of 2003 made fundamental changes in the method of financing UI and included a number of restrictions on UI benefits. As the benefit provisions became fully operative in early 2005, there was a particularly strong reaction to the reduction in benefits caused by the use of average earnings during all four-quarters of the base period for setting the weekly benefit amount (WBA). Prior to 2004 the WBA had been determined using the average of the high two quarters of the base period. The change reduced the average WBA by some $40-$50 with some claimants experiencing much larger reductions, e g., six percent with reductions of $150 and above.

- In 2004, among persons aged 12 or older, 2.4 million initiated nonmedical use of prescription pain relievers within the past year
- There were 615,000 new nonmedical users of OxyContin® in 2004
- Three fourths (73.8 percent) of past year initiates of nonmedical pain reliever use had used another illicit drug prior to using pain relievers nonmedically
- Nearly all (99.1 percent) past year initiates of nonmedical OxyContin® use had used another illicit drug prior to using OxyContin® nonmedically

- In 2004, there were almost 390,000 admissions to substance abuse treatment among young adults aged 18-25
- Young adults aged 18-25 were less likely than youths aged 12-17 to be admitted for primary abuse of marijuana (27 vs. 64 percent)
- The criminal justice system was the principal source of referral to treatment for 47 percent of young adult admissions compared to 52 percent of youth admissions

- In 2002 to 2004, a majority (58.3 percent) of past year marijuana users aged 18 to 25 obtained their most recently used marijuana for free or shared someone else's, while 40.0 percent in this age group bought their marijuana
- Three fourths (75.3 percent) of daily marijuana users aged 18 to 25 obtained marijuana the last time by buying it compared with one third (33.8 percent) of nondaily users
- More than three fourths (78.2 percent) of the past year marijuana users aged 18 to 25 who bought their most recently used marijuana bought it from a friend

- In the six States that participate in the mortality component of the Drug Abuse Warning Network (DAWN)—Maine, New Hampshire, Vermont, Maryland, Utah, and New Mexico—the rates of opiate-related drug misuse deaths in 2003 ranged from 7.2 per 100,000 population in New Hampshire to 11.6 per 100,000 population in New Mexico.
- In each of these six States, most opiate-related drug misuse deaths involved multiple drugs.
- In five of the six States, adults aged 35 to 54 had the highest rates of opiate misuse deaths. In the remaining State (Maine), the highest rate was for adults aged 21 to 34.

The British Medical Association has long been concerned with the health of children and young people. The BMA’s Board of Science has produced a number of health promotion publications on this group, including 'Growing up in Britain' (1999), 'Eating disorders, body image and the media' (2000), 'Adolescent health' (2003) and 'Preventing childhood obesity'(2005). Mental health problems in children and young people are of great significance to public health. Children and young people make up about 25 per cent of the total population of England. . . Not only do mental health problems impact on the lives of the individual concerned, limiting their ability to cope with life and fulfil their potential, they also have a considerable effect on their families and carers. Further, psychiatric disorders in childhood may persist, increasing the risk of problems in adult life. . . Research has shown that of those with mental health problems at the age of 26, half had met the criteria for a disorder by age 15. It should, however, be noted that a mental health problem in childhood does not necessarily lead to an adult disorder: the majority of children with anxiety or depression will not have mood disorders in adult life. . . Certain groups of children and adolescents are at greater risk of suffering mental health problems. As this report highlights, socio economic factors play a significant role, and there is a higher prevalence of mental health problems among children from deprived backgrounds. Looked after children (ie children brought in the care of local authorities) are at particular risk, as are refugee and asylum seeker children, and young offenders.

This report sets out findings from a survey to investigate schools' and other education and care providers' systems for checking the staff they appoint. It identifies confusion about procedures and problems with record-keeping and guidance, but also includes examples of good practice. It will be of particular interest to schools, colleges, local authorities, parents and governors.

This study considers the baseline against which the development of the policy of free personal and nursing care in Scotland can be evaluated. It considers a range of statistical data, systematically reviews relevant research on care and support for older people and sets free personal care within the broader policy context.

Depression that occurs during pregnancy or within a year after delivery is called perinatal depression. The exact number of women with depression during this time is unknown. But researchers believe that depression is one of the most common complications during and after pregnancy. Often, the depression is not recognized or treated, because some normal pregnancy changes cause similar symptoms and are happening at the same time. Tiredness, problems sleeping, stronger emotional reactions, and changes in body weight may occur during pregnancy and after pregnancy. But these symptoms may also be signs of depression.

Fatherhood is at a turning point. Fifty years ago the common image of paternity was of a distant, disciplinarian father whose value to children lay squarely in the size of his pay packet. Today, 21st century dad wants a closer relationship with his children and is willing to re-order his priorities to achieve it.

This study brings together the findings from two surveys commissioned by the Equal Opportunities Commission investigating the use of leave by fathers from the perspectives of both mothers and fathers.

In many ways, the struggles adoptive families face in accessing adoption-competent mental health services mirror the challenges other families face in accessing competent mental health services. All families seeking mental health services for their children confront a patchwork of underfunded services and supports, guided by an often-bewildering mix of theories, philosophies, and treatment interventions. The vast majority of families – adoptive or otherwise – inevitably rely on publicly funded services or services available through private health insurance programs. Thus, they routinely face limitations in the availability, intensity, and duration of mental health services. The challenge of finding competent mental health services is even more complex when adoption-related issues are a component of mental health needs. Audience. This paper is written for state adoption program managers, child welfare directors, mental health and Medicaid managers, advocates, and adoptive families who can make these promising practices a reality in each state. It is our hope that these nuggets of creative practices can be adapted, evaluated and, eventually, sustained in communities across this country. For without the availability of, and accessibility to, quality, adoption-competent and family-centered mental health supports and services, many of these newly created adoptive families may not thrive. It is our hope that this paper will be useful in advancing local, state and national efforts to support adopted families so they can reach their hopes and dreams.

The Casey Commitment to Post-Adoption Services. Casey Family Services, the direct service arm of the Annie E. Casey Foundation, recognizes that adoption is a lifelong process and that adopted children’s special needs for ongoing services and supports do not end when their adoptions are finalized. Since 1991, Casey Family Services has been providing comprehensive post-adoption services to families that have come together through adoption, regardless of the circumstances of that adoption. Again and again, adoptive families report that post-adoption services have been their lifeline. Yet, there is not one federal funding stream devoted to post-adoption services. Nationally, as the numbers of children adopted through state child welfare systems continue to grow, the need for a comprehensive array of post-adoption services and supports becomes both critical and urgent.

This White Paper addresses the critical need for policy and practice aimed at achieving and sustaining stability and permanence for children through adoption. The focus on the needs of adoptive families at this time is an important one, given current public policy initiatives which, since 1996, have led to significant increases in the number of children adopted and available for adoption. This paper reviews trends and issues in adoption today; identifies the needs of children waiting for adoption; describes the growing importance of post-adoption services for children and families; highlights
elements of responsive post-adoption services programs; and presents a set of post-adoption principles to guide the development of policy and practice recommendations that support systems change and enhance quality service delivery.

Government has set out an ambitious vision – that by 2025 disabled people should have full opportunities and choices to improve their quality of life, and will be respected and included as equal members of society. The public sector has a key role in enabling all citizens to play a full part in society. Whether delivering services such as education and healthcare directly, or shaping the country through investment and regulation, public authorities play a
major part in tackling disadvantage, and releasing potential. Effective implementation of the Disability Discrimination Act (DDA) is not, therefore, merely a question of legal compliance, but a policy imperative for the public sector.

Methamphetamine is a dangerous drug that represents a substantial challenge to policymakers, health care professionals, social service providers, and the law enforcement community. Over time, methamphetamine abuse can result in the deterioration of physical and mental capacities, the dissolving of family ties, diminished employment prospects, and a lifetime spent cycling through the criminal justice system. The consequences of irresponsible drug abuse harm not only the individual, but his or her family and the larger community. Thus, it is important that our public resources be effectively directed to both prevent the development of such a habit as well as treat those individuals before the proverbial die has been cast. . . . This report examines the development of methamphetamine as the “next big thing” in drug threats by analyzing drug use rates through a series of
different measures, investigating the role of the media in perpetuating the “epidemic” language, and assessing the state-of-the-art in methamphetamine treatment options.

Community Links set out to establish a picture of employees in low-paid informal work in the London Borough of Newham. The interviews explored personal and family circumstances and motivations for engaging in informal paid work. Respondents were also asked about the wages they earned informally, their benefit situations, barriers to formal employment and their aspirations for the future. Informal paid work is that which "involves the paid production and sale of goods or services which are unregistered by, or hidden from the state for tax, benefit and/or labour law purposes, but which are legal in all other respects" (Small Business Council, 2004).

Total federal expenditures to help states pay for the costs of administering the Foster Care and Adoption Assistance Programs increased 7 percent from fiscal years 2000 to 2004, from approximately $2.5 to $2.6 billion,5 but analysis of changes in the types of costs incurred was limited due to inconsistencies in how states tracked and reported data over time. While over a third of the states received greater federal reimbursements of administrative costs in fiscal year 2004 than in fiscal year 2000, six states accounted for over 80 percent of the increase. California alone was responsible for approximately 31 percent of the total increase. Nearly all of the federal expenditures—89 percent in fiscal year 2004—were for costs related to child placement services such as managing cases as children progress through the child welfare system and finding appropriate foster and adoptive homes. We were unable to use the data to analyze changes at a more detailed level because not all states complied with the criteria for reporting costs or interpreted the criteria the same. For example, at least one region did not require states to report costs as instructed on the reporting form. Some federal and state officials told us, however, that caseworker costs such as developing and reviewing case plans accounted for the bulk of the increase during this time period and were primarily associated with the salaries and benefits of caseworkers.

We are a nonpartisan, nonprofit, "consumer advocate" for voters that aims to reduce the level of deception and confusion in U.S. politics. We monitor the factual accuracy of what is said by major U.S. political players in the form of TV ads, debates, speeches, interviews, and news releases. Our goal is to apply the best practices of both journalism and scholarship, and to increase public knowledge and understanding.

CampusHealthandSafety.org is an online resource for higher education administrators, students, parents, and other professionals who are seeking information about creating healthier and safer living and learning environments for college and university students, both on campus and in the surrounding community. This Web site emphasizes a comprehensive public health-based approach to addressing alcohol and other drug use and violence and in promoting mental health wellness among students. On this site, you will find an overview of this approach, termed environmental management, and how it may be applied to alcohol and other drug prevention, violence prevention, and mental health promotion on campus. This site also presents the latest data on the scope of these problems, information on how students and campuses are affected by them, and examples of prevention approaches that professionals and concerned citizens can implement on their own campuses and neighboring communities.

Child welfare agencies provide a safety net for abused and neglected children and children at risk of abuse and neglect. Federal, state, and local government funding supports all services provided by the state child welfare agencies. However, the amount of funding from federal, state, or local sources varies greatly by state and can be affected by both national and state-specific events. Our findings document the amount states spent on child welfare activities in state fiscal year (SFY) 2004, the funding sources they used, how child welfare spending changed since SFY 2002, and why we see such state variation in child welfare spending. This survey was the fifth in a series analyzing states' financing of child welfare activities. The methodology was the same as previous rounds of the survey. In April 2005, we mailed the survey to each state child welfare director. Urban Institute staff conducted extensive phone, facsimile, and e-mail follow-up with each state to ensure data were properly interpreted. We received survey responses from 48 states and the District of Columbia.

No issue has stumped policymakers more than how to provide healthcare to its citizens in an efficient and fair manner. Healthcare costs spiral out of control, usurping other vital government functions. Those rising costs also lead to increased numbers of uninsured, as employers and employees both decide to avoid costs simply by neglecting health insurance altogether. Every recent health "fix" has involved trying to buy health reform by devoting even more dollars to it. Do we lack adequate drug care? Then spend more through a drug bill. Do tax breaks tend to discourage consumer involvement in their healthcare? Then spend more on health savings accounts. Yet each of those enactments adds cost to a system that already is unsustainable. Yes, they might get at some particular imbalance in the system — removing some bias against drugs or against spending out of pocket — but in simply throwing more money into the system, they add to, rather than subtract from, the fundamental problem that someone, somewhere, somehow has to decide what health spending is worthwhile and what is not.

This bulletin looks in depth at the reasons certain services are failing to meet national minimum standards. It is primarily designed to assist the responsible person in charge of a care service and registered care services' managers to improve their recruitment policies and procedures and vetting practices.

Alcohol use is closely tied to the three leading causes of death among African-American youth ages 12 to 20: unintentional injuries (including motor vehicle crashes), homicides and suicides. Yet, despite years of protest from African-American communities, African-American youth continue to be inundated with more alcohol advertising than youth in the United States
in general, even though African-American youth have tended to drink less than youth from other racial and ethnic groups. In 2003, the Center on Alcohol Marketing and Youth (CAMY)issued a report detailing the exposure of African-American youth to alcohol advertising in magazines and on radio and television in 2002. That report provided the first-ever comprehensive review of African-American youth exposure to alcohol advertising. This current report analyzes such exposure in 2003 and 2004.

If one were to judge solely from popular TV shows, the nation’s emergency care system is in fine shape. Its doctors, nurses, and ambulance personnel are dedicated and competent professionals who save lives with their expertise and state-of-the-art equipment and can always be trusted to come through in a crunch. And, indeed, there is a great deal of truth to this picture: Our emergency and trauma care system has made tremendous strides over the past few decades, and today it manages to save many lives that just ten or twenty years ago would have been inevitably lost. But underneath the surface, a national crisis in emergency care has been brewing and is now beginning to come into full view.

The National Association of Hispanic Journalists has produced a Network Brownout Report for more than 10 years, analyzing the way Hispanics are portrayed on national newscasts. We have long wanted to develop a companion to that report that examines print media, but it has always been a major challenge. Would we only look at the top 10 newspapers in terms of circulation? Would we randomly select one week for extensive review? And most importantly, would we be telling a national story? It wasn’t until last year that we took the idea and decided to apply it to the three major national news magazines.

This User Guide provides information on the Panel Study of Income Dynamics (PSID). The 2003 PSID is a nationally representative sample of over 7,000 families. The PSID began in 1968 with a sample of 4,800 families and re-interviewed these families on an annual basis from 1968-1997. Since then, it has re-interviewed them biennially. Following the same families and individuals since 1968, the PSID collects data on economic, health, and social behavior. . . . Initially, the PSID identified disability by asking the head of the household whether he, or she when no adult male is present, had a physical or nervous condition that limits his or her ability to work. In 1981 the PSID began asking the head this question with respect to his spouse. Additional questions that provide an opportunity to expand this definition of disability were included in 2003. The User Guide makes use of these new questions to estimate the size of the population with disabilities and the prevalence rate of disability in the population, as well as the employment rate and level of economic well-being.

While the new Medicare drug benefit has helped alleviate concerns about prescription drug access for elderly and disabled Americans, many low-income, uninsured people under age 65 continue to rely on community safety nets to get needed medications. As the number of uninsured Americans increases, safety net providers are stretching limited resources to meet growing prescription drug needs, according to findings from the Center for Studying Health System Change’s (HSC) 2005 site visits to 12 nationally representative communities. Despite redoubled efforts—centered on obtaining discounted drugs and donated medications—to make affordable drugs available to needy patients, safety net providers and community advocates report that many low-income, uninsured people continue to face major barriers to obtaining prescription drugs.

The Mental Capacity Act 2005 provides a statutory framework for people who may not be able to make their own decisions, for example because of learning difficulties, an illness such as dementia or brain injury or mental health problems. The Department of Health is consulting on draft research regulations under the Act to provide detailed policy on a number of issues where broad outlines were given in the primary

Conclusion: The Committee believes that the policy of free personal care for the elderly introduced by the Community Care and Health Act has been a success, and has been widely welcomed. . . . The Committee proposes that the policy of providing free personal care for those over 65 continues to be pursued and developed. . . . The Committee has heard evidence that would suggest that there have however been some major problems with the implementation of free personal care for the elderly. These could undermine the policy if not addressed. . . . .The Committee supports the principle that everyone who has a right to free personal care under the legislation and is assessed as requiring it should have it provided without undue delay.

Scotland's first ever action plan aimed at reducing the proportion of young people not in education, employment or training (NEET) was launched today. First Minister Jack McConnell and Deputy First Minister Nicol Stephen said it was crucial to rescue the unacceptable waste of potential represented by the 20,000 young Scots identified as NEET who will need support in order to access opportunities.

This consultation proposes a metrics-based research assessment and funding system to replace the research assessment exercise after 2008.

Although mental health trusts perform better than trusts in the acute sector in terms of financial standing, there are still areas of financial management in which they need to improve. This report considers how they currently function, as well as methods of improvement and best practice that they need to employ.

Waiting for Health Care in Canada: What we know and what we don't know provides a snapshot of wait times for various health conditions, including waits in the five priority areas set by First Ministers (cancer, cardiac, joint replacement, sight restoration and diagnostic imaging). Drawing on surveys, provincial wait times data, CIHI analyses and other sources, the report takes a pan-Canadian look at wait times across the spectrum of care, from access to family physicians to waits for surgery and beyond.

On the following state profile pages, TFAH has highlighted a number of key CDC and HRSA programs and has documented the support each state receives for programs which provide essential services that help reduce illness and help save lives. Highlighted programs include bioterrorism preparedness, cancer prevention, chronic disease prevention and health promotion, diabetes control, environmental health,
HIV prevention, immunization, infectious disease prevention, the preventive health and health services block grant, tobacco law suit settlement dollars, Ryan White CARE Act (Titles I and II) grants, the maternal
and child health block grant, primary health care grants, and health professions grants.

The United States, the third most populous country globally, accounts for about 4.6% of the world’s population. Within the next few years, the U.S. population — currently estimated at 299 million persons — is expected to reach twice its 1950 level of 152 million. More than just being double in size, the population has become qualitatively different from what it was in 1950. As noted by the Population Reference Bureau, “The U.S. is getting bigger, older, and more diverse.” The objective of this report is to highlight some of the demographic changes that have already occurred since 1950 and to illustrate how these and future trends will reshape the nation in the decades to come (through 2050).

Preliminary figures indicate that, as a whole, law enforcement agencies throughout the Nation reported an increase of 2.5 percent in the number of violent crimes brought to their attention in 2005 when compared to figures reported for 2004. The violent crime category includes murder, forcible rape, robbery, and aggravated assault. The number of property crimes in the United States from January to December of 2005 decreased 1.6 percent when compared to data from the same time period in 2004. Property crimes include burglary, larceny-theft, and motor vehicle theft. Arson is also a property crime, but data for arson are not included in property crime totals. Figures for 2005 indicated that arson decreased 2.2 percent when compared to 2004 figures.

In the United States, 71% of all deaths among persons aged 10–24 years result from four causes: motorvehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2005 national Youth Risk Behavior Survey (YRBS) indicated that, during the 30 days preceding the survey, many high school students engaged in behaviors that increased their likelihood of death from these four causes: 9.9% had driven a car or other vehicle when they had been drinking alcohol; 18.5% had carried a weapon; 43.3% had drunk alcohol; and 20.2% had used marijuana. In addition, during the 12 months preceding the survey, 35.9% of high school students had been in a physical fight and 8.4% had attempted suicide. Substantial morbidity and social problems among youth also result from unintended pregnancies and STDs, including HIV infection. During 2005, a total of 46.8% of high school students had ever had sexual intercourse; 37.2% of sexually active high school students had not used a condom at last sexual intercourse; and 2.1% had ever injected an illegal drug. Among adults aged >25 years, 61% of all deaths result from two causes: cardiovascular disease and cancer. Results from the 2005 national YRBS indicated that risk behaviors associated with these two causes of death were initiated during adolescence. During 2005, a total of 23.0% of high school students had smoked cigarettes during the 30 days preceding the survey; 79.9% had not eaten >5 times/day of fruits and vegetables during the 7 days preceding the survey; 67.0% did not attend physical education classes daily; and 13.1% were overweight.

Volunteering in America: State Trends and Rankings is a powerful new tool to assist organizations in developing a strategy and setting goals to increase volunteering in their organization and build the national service and volunteer infrastructure in their states. The Corporation for National and Community Service is committed to working with the nonprofit sector to reach the goal of 10 million more volunteers by the year 2010.

This report is about the views of young parents who are living with their own children in residential family centres. These are centres where parents stay with their children for a while, for the staff to assess how well the parents are looking after their children, and to give the parents what help they need in how to look after them.

This consultation document proposes introducing new legislation to give NHS health bodies new powers to deal with individuals causing a nuisance or disturbance on NHS premises. The paper seeks comments on the need for such legislation and all aspects of its formulation and use.

This is a good practice guide to inform delivery of homelessness prevention services. The two main objectives of the guide are to: summarise what is meant by 'homelessness prevention' and its implications for the ways that local authorities deliver relevant services; and show how the homelessness prevention ethos can be delivered in practice.

This summary accompanies the good practice guide on homelessness prevention, providing key findings from an evaluation of homelessness prevention across 10 local authorities.

In the late 1970s, practitioners began to recognize that the presence of substance abuse in combination with mental disorders had profound and troubling implications for treatment outcomes. This growing awareness has culminated in today's emphasis on the need to recognize and address the interrelationship of these disorders through new approaches and appropriate adaptations of traditional treatment. In the decades from the 1970s to the present, substance abuse treatment programs typically reported that 50 to 75 percent of their clients had COD, while corresponding mental-health settings cited proportions of 20 to 50 percent. During the same period of time, a body of knowledge has evolved that clarifies the treatment challenges presented by the combination of substance use and mental disorders and illuminates the likelihood of poorer outcomes for such clients in the absence of targeted treatment efforts.

This technical assistance document is a case example of a state-level systems change initiative to develop integrated services for individuals with co-occurring psychiatric and substance use disorders (hereinafter termed "co-occurring disorders") defined as any combination of psychiatric and substance disorder of any level of severity, including both seriously mentally ill (SMI) and non-SMI populations. ("Integrated" service is defined to mean simultaneous attention to both mental health and substance abuse treatment needs in any service setting, appropriate to the mission of that setting and the population served in that setting). The process described was designed and implemented by the State of New Mexico Department of Health/Behavioral Health Services Division within the adult (ages 18 and over) indigent (non-Medicaid) public service system. This case example is presented to help policy makers, systems planners, program managers, and service providers in the behavioral health (defined to include both mental health and substance abuse) field better understand the processes that support the implementation of "no wrong door" access to integrated services utilizing existing funding resources and existing service system structures within a public system of care.

This publication looks at how the work of housing associations in tackling homelessness contributes to the wider efficiency agenda of ensuring that best use is made of limited resources by helping people who have satisfactory accommodation to stay in it.

This publication gives guidance and offers practical ideas for small housing associations on how to develop race equality as part of their efforts to achieve equality and diversity. It emphasises the importance of flexibility and suggests approaches that can be interpreted and customised to individual housing associations' needs and capabilities. It also addresses small housing associations' concerns over why they need to tackle race equality specifically and the potential extra paperwork that it could involve.

This statistical first release provides information on the percentages of 16, 17 and 18-year-olds in education and training and those who are not in education, employment or training for 2004. Key analyses are by age, gender, type of learning, institution, labour market status, and highest qualification being studied.

The Commission is planning to give adult care homes and services a rating on the quality of their service. It is seeking views on its draft guidelines on what a good and bad service would look like.

This details the Commission's new approach to managing concerns and complaints about care homes and services. It focuses on the service provider maintaining the quality of their service.

The Department of State is required by law to submit a Report each year to the U.S. Congress on foreign governments’ efforts to eliminate severe forms of trafficking in persons. This Report is the sixth annual TIP Report. It is intended to raise global awareness, to highlight the growing efforts of the international community to combat human trafficking, and to encourage foreign governments to take effective actions to counter all forms of trafficking in persons. The Report has increasingly focused the efforts of a growing community of nations on sharing information and partnering in new and important ways. A country that fails to make significant efforts to bring itself into compliance with the minimum standards for the elimination of trafficking in persons, per U.S. law, receives a "Tier 3" assessment in this Report. Such an assessment could trigger the withholding of non-humanitarian, non-trade-related assistance from the United States to that country. In assessing foreign governments’ efforts, the TIP Report highlights the "three P’s"— prosecution, protection, and prevention. But a victim-centered approach to trafficking requires us equally to address the "three R’s"— rescue, rehabilitation, and reintegration. The U.S. law that guides these efforts, the Trafficking Victims Protection Act (TVPA) of 2000, as amended, makes clear from the outset that the purpose of combating human trafficking is to ensure just and effective punishment of traffickers, to protect their victims, and to prevent trafficking from occurring.

Across the nation, methamphetamine (or “meth”) is a destructive force that is having tragic consequences for an increasing number of children, the child welfare systems that protect them, and America’s families. This report examines the deleterious impact of meth on children, families, communities and the child welfare system. It identifies some promising strategies to prevent meth use, keep children safe, and help parents with addictions complete treatment. However, to truly combat meth abuse and the many other serious problems confronting families today, national changes are desperately needed to bring about more flexibility in child welfare policy, funding, and practice while ensuring a reliable funding stream. The report provides a comprehensive set of recommendations that, taken together, will significantly improve the child welfare system’s ability to combat the impact of meth and many of the other serious issues facing children and families.

Americans weaned on post-war affluence have come to expect an extended period of leisure at the end of their work life. And, indeed, the majority of today’s retirees are able to afford a decent retirement. However, this group is living in a “golden age” that will fade as Baby Boomers and Generation Xers reach traditional retirement ages in the coming decades. This gloomy prediction reflects the trend towards longer retirements and likely declines in retirement incomes relative to pre-retirement earnings — known as replacement rates. Because many Americans appear unaware of these disquieting trends, the Center for Retirement Research at Boston College has developed the National Retirement Risk Index. The Index measures the share of working-age households who are at risk of being unable to maintain their pre-retirement standard of living in retirement. The Index shows that, even if people retire at age 65 and households annuitize all their wealth including the receipts from reverse mortgages on their homes, 43 percent will be at risk. But the situation is not hopeless — if people choose to work longer — even just two years — and save 3 percent more, they can substantially improve the outlook for their retirement security.

In October 2005, RAND Corporation researchers traveled to Mississippi to assist the Governor’s Commission on Recovery, Rebuilding, and Renewal and, more specifically, to provide assistance to the Affordable Housing Subcommittee of the Infrastructure Issues Committee. RAND researchers provided support in identifying and developing a list of policy and implementation options that could be useful to local communities in considering how to address affordable-housing issues. In developing this list of options, RAND researchers considered how affordable housing is defined, what affordable-housing issues different U.S. regions face, what the critical challenges are in providing affordable housing, and what strategies are available to deal with those challenges. They investigated how affordable-housing issues have been addressed in the wake of other natural disasters in this country, what lessons have been learned, and what best practices can be taken away from previous natural disaster experiences. They examined the extent and scope of damage to affordable housing that Mississippi sustained, what types of affordable-housing needs that Mississippi might consider addressing during rebuilding, and on what scale. Finally, they studied options available to deal with affordable-housing issues. This report describes affordable-housing issues and myriad rebuilding options.

The Government is committed to the abolition of child poverty by 2020. This study investigates the prevalence and characteristics of poor children in large families (three/four or more children) in the UK and how we compare with other countries. It also explores how the tax and benefit system has varied by family size over recent years and how this compares with other countries. It discusses how the tax and benefit system might be adapted in favour of large families so that the child poverty target might be achieved.

The Deficit Reduction Act of 2005 (DRA) changes to Medicaid affect health access and coverage for children, starting with those ages birth to 5 years. State policymakers and family advocates working to develop Early Childhood Comprehensive Systems (ECCS) and those implementing ECCS plans will need to use their tools and knowledge wisely to ensure a positive impact from the DRA on young children. This first Project THRIVE Short Take highlights opportunities and cautions for states concerning:
- Eligibility for children with disabilities
- Family cost sharing
- Benefits and benchmark plans
- Case management
- Proof of citizenship

A significant proportion of affordable housing provision is delivered through the land use planning system using Section 106 (S106) agreements. However, little is known about whether such agreements are being fully implemented. As government statements suggest the increasing importance of S106, this research seeks to address current knowledge gaps regarding the outcomes of S106 planning agreements. Through detailed analysis of a range of evidence and a sample of sites, this report:
- examines whether the affordable housing element in S106 agreements is being delivered, and the reasons for any delay or non-delivery;
- assesses whether negotiated changes to initial agreements and non take-up of planning permission result in the loss or modification of plans for affordable housing;
- identifies common patterns in the delivery of the affordable housing through S106 agreements.

The growing number of boomers reaching retirement age over the next 20 years offers an unprecedented chance to tap into a large base of potential volunteers. It makes good sense to consider ways to encourage boomers’ volunteerism. Benefits would accrue to society directly through the contributions of unpaid work, to older adults as volunteering improves health and well being, and potentially to government, as healthier older adults require fewer health care dollars. In fact, numerous studies document that active and engaged older people remain in better health. For example, a recent small-scale experiment shows that low-income minority seniors volunteering in public elementary schools outscored their nonparticipating counterparts in both physical strength and cognitive ability (Fried et al. 2004). Other studies find older adults who volunteer live longer and with better physical and mental health than counterparts who do not volunteer (Lum and Lightfoot 2005; Murrow-Howell et al. 2003). Glass and his colleagues (1999) show that productive activities like volunteering and work can lower the risk of mortality as much as fitness activities can.

At the heart of the nation's child support enforcement system are children and families. In its 2005-2009 Strategic Plan, the federal Office of Child Support Enforcement (OCSE) explains that "child support is no longer primarily a welfare reimbursement, revenue-producing device for the Federal and State governments; it is a family-first program, intended to ensure families’ selfsufficiency by making child support a more reliable source of income" (U.S. Department of Health and Human Services 2005, p.1, emphasis added). Among OCSE’s guiding principles are that child support services are most effective when cultural differences are respected, and child support enforcement programs have an obligation to provide public education and outreach to all families in need. Specific strategies OCSE has identified include customizing their approach to service delivery by, for example, "deliver(ing) culturally-appropriate services to clients who are tribal members or members of minority groups, ? address(ing) perceived obstacles to payment, including access to children, matters of procedural justice, and affordability of orders, and ? "develop(ing) targeted, specific initiatives to deal with special populations" (U.S. Department of Health and Human Services 2005).

The Washington, DC, metropolitan area is home to over 1 million immigrants, who composed one-fifth of the area’s total population in 2004. The metropolitan area is relatively affluent and boasts a strong economy that attracts large numbers of immigrants for jobs at both the high- and low-skilled ends of the labor market. Immigrants in the Washington area come from more diverse countries of origin than is the case nationally, and a relatively high share come from origins with above average incomes. Whether higher or lower skilled, immigrants contribute strongly to the region’s economy, purchasing power, and tax base. Immigrant households in the Washington, D.C., metropolitan area had a total income of $29.5 billion in 1999–2000, and they paid $9.8 billion in taxes. This represents 19 percent of the region’s total household income and 18 percent of all taxes paid. Our estimate of the amount of taxes paid by immigrants is an underestimate, because it is based on 1999–2000 data, and the number of immigrants in the region has grown from 850,000 to at least 1.2 million since that time.

This is a transcript of the speech made by Secretary of State for Commun