The evacuation of New Orleans in response to Hurricane Katrina was considered relatively successful for people with their own vehicles; approximately 1 million people evacuated Louisiana prior to landfall. In contrast, about 100,000 people were not evacuated prior to the storm—many of whom lacked access to a vehicle. Hurricane Katrina ultimately resulted in over 1,300 deaths. Among those who could not evacuate were some of society’s most vulnerable populations: the elderly, low-income individuals, and persons with disabilities. These populations often lack the ability to provide for their own transportation and may also have difficulty accessing conventional public transportation. As a result, evacuating these “transportation-disadvantaged” populations during emergencies has become an important topic of public policy discussion. Evacuations of varying scales are common in the United States and can be triggered by a variety of events, including natural disasters such as Hurricanes Katrina and Rita, wildfires, and terrorist attacks like those committed on September 11, 2001. In fact, emergency evacuations of more than 1,000 people occur more than three times a month.

Eurostat’s mission is to provide the European Union with a high-quality statistical information service. In addition to cooperating closely with international organisations such as the UN and OECD, Eurostat works with countries outside the EU. A key tasks for Eurostat is to coordinate the improvement of statistical systems in candidate and developing countries. Special programmes have been established with countries in Central and Eastern Europe (Phare) and the New Independent States of the former Soviet Union (Tacis). Eurostat also works closely with national statistical offices in Mediterranean countries and in many African countries.

This paper examines the role that Medicaid plays in addressing six populations with serious health needs resulting in high costs. For each population profiled, we describe the condition and the need for services and supports, as well as the role of Medicaid in meeting those needs. We also include profiles of real people with these conditions and descriptions of model programs or cutting edge practices designed to meet the needs of these high cost populations with exceptional needs. As these populations will show and as policy makers think about the type of health care system our nation needs, it is important to consider Medicaid’s role in anchoring the broader health system.

- Of the discharges for substance abuse treatment reported to SAMHSA's 2003 Treatment Episode Data Set (TEDS) with known reason for discharge, 28% (226,000) left against professional advice and 44% (361,000) completed treatment. Others were terminated by the facility (9%), transferred to another substance abuse treatment program or facility (11%), or discharged for other reasons (8%)
- Discharges who left against professional advice were more likely than those who completed treatment to have reported opiates (25% vs. 17%) and less likely to have reported alcohol (35% vs. 47%) as the primary substance of abuse.
- Discharges who left against professional advice were more likely than those who completed treatment to have have been in outpatient treatment (52% vs. 46%) or methadone treatment (9% vs. 2%) and less likely to have been in detoxification (25% vs. 30%) or residential treatment (14% vs 20%).
- Discharges who completed substance abuse treatment were more likely than those who left against professional advice to have been referred to treatment by the criminal justice system (39% vs. 29%) and less likely and to have been self or individually referred to treatment (34% vs. 40%).

The Social Care Institute for Excellence (SCIE) has established itself as an authoritative source of knowledge on good practice in social care. In 2005/06, twice as many people ordered our products or visited our website as the previous year. More importantly, more people are seeing the benefits of putting that knowledge into practice. We have forged strong relationships and key partnerships with the Commission for Social Care Inspection (CSCI) and the Care Services Improvement Partnership (CSIP) in England, with the Welsh Assembly Government and with the Department of Health, Social Services and Public Safety in Northern Ireland. Our work with these partners has focused on developing outcomesbased inspection standards, a common assessment framework and social care governance.

This statistical bulletin presents a range of information on obesity, physical activity and diet, which has been drawn together from a variety of sources. The bulletin is primarily concerned with body mass index (BMI) as a measurement of obesity unless otherwise specified. The data relate to England where possible. Where figures for England are not available, figures for Great Britain or the United Kingdom have been provided.

Medicaid today plays a critical role for people with long-term care needs. With expenditures of $86.3 billion in 2003, Medicaid is the single largest source of financing for long-term care, providing services to the elderly, working age adults and children with disabilities. Despite Medicaid’s importance to people who need long-term care, Medicaid also has significant limitations. Medicaid’s benefits are provided unevenly across the nation and stringent meanstesting forces people who need care to impoverish themselves to receive assistance. This paper provides a review of how Medicaid works for people with long-term care needs and describes the fiscal challenges that states currently face and that Medicaid may face in the future as the population ages.

The Statistical Abstract of the United States, published since 1878, is the authoritative and comprehensive summary of statistics on the social, political, and economic organization of the United States. Use the Abstract as a convenient volume for statistical reference, and as a guide to sources of more information both in print and on the Web. Sources of data include the Census Bureau, Bureau of Labor Statistics, Bureau of Economic Analysis, and many other Federal agencies and private organizations

This report is based upon the findings of focus groups and national surveys that the Economic Policy Institute conducted in 2005 and 2006 under the sponsorship of the Rockefeller Foundation's Economic Resiliency Group, as well as a study of the findings of public opinion research about American's attitudes about the economy over the past quarter century. The purpose of this research was not to take a snapshot of public opinion in 2006 but rather to paint a portrait of how Americans think about the economy, allowing for changing economic, social, and political conditions. We sought to uncover and analyze Americans' underlying attitudes about the economy—basic ways of thinking that persist in the midst of upturns, downturns, and administrations of both major parties. Beyond the anxiety of the first half of this decade and the prosperity of the second half of the last decade, these attitudes have been more profoundly influenced by the transformative impact of what has come to be called the "New Economy"—the new ways of working and doing business that have emerged in response to new technologies, international trade and investment, and the deregulation of many major industries. In many important ways, the utterances of political and governmental elites on both sides of the spectrum—conservatives and liberals—do not reflect the ways that everyday Americans think about the economy. Most Americans tend to be simultaneously pessimistic and optimistic about the economy.

While Hurricane Katrina was uniquely catastrophic, each year many lesser disasters can and do wreck personal property, cut access to financial resources, break off links to human services programs, interrupt employment, or result in sudden medical expenses. Any of these misfortunes may precipitate a crisis for low-income communities. In recognition of the need to assist low-income people in such precarious situations, the Food Stamp Act and the Robert T. Stafford Disaster Relief and Emergency Assistance Act grant the President and the U.S. Department of Agriculture Food and Nutrition Services (USDA FNS) broad authority to provide emergency food relief after disasters. The cornerstone of federal nutrition assistance in a disaster scenario is the Disaster Food Stamp Program (DFSP). The federal child nutrition programs and the distribution of commodity foods also play important roles. Advocates, service providers, public officials, business persons, and individuals should be aware of the potential of food stamps and other federal nutrition benefits to expedite and strengthen the response to disasters of various types.

The toolkits are handy all-in-one packets of ideas, templates, and resources for conducting effective food stamp outreach. The tool kits are divided into individual chapter files (.pdf) to make it easier for users to download sections of the kit, specific items within each section or the entire kit according to their needs. To use the electronic templates (.doc), right click on the documents, select “Save Target As”, browse to the directory you want to use, and save the document to your computer. Then simply input your information as you would with any Word document.

This report presents the first information from the 2005 National Survey on Drug Use and Health (NSDUH), an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years old or older. Prior to 2002, the survey name was the National Household Survey on Drug Abuse (NHSDA). This initial report on the 2005 data presents national estimates of rates of use, numbers of users, and other measures related to illicit drugs, alcohol, and tobacco products. Measures related to mental health problems also are presented, including data on depression and on the co-occurrence of substance use and mental health problems. Estimates from NSDUH for States and areas within States will be presented in separate reports. A major focus of this report is a comparison of substance use prevalence estimates between 2004 and 2005. Trends since 2002 also are discussed for some measures. Because of improvements to the survey in 2002, the 2002 data constitute a new baseline for tracking trends in substance use and other measures. Therefore, estimates from the 2002 through 2005 NSDUHs should not be compared with estimates from the 2001 and earlier surveys in the series to assess changes in substance use and mental health problems over time.

State lawmakers play a significant role in crafting legislation and policy that govern the safety and well-being of children in their states. The National Conference of State Legislatures (NCSL) tracks this activity through its State Child Welfare Legislation reports. This report documents significant state legislation enacted during calendar year 2005. Kinship care received a great deal of legislative attention in 2005. States promoted or enhanced the use of relatives as kinship care providers and established or amended guardianship laws to include relatives as important placement options. Another area of major legislative activity in 2005 concerned substance-exposed newborns and methamphetamine abuse.
In addition, legislatures addressed the following:
• Adoption, particularly adoption by relatives and post-adoption contact agreements;
• Parent and child involvement in case planning;
• Social worker loan forgiveness programs;
• Court handling of child welfare cases;
• Education of children in foster care;
• Behavioral health care for children in the child welfare system;
• Alternative response to reports of child maltreatment;
• Kinship care and guardianship;
• Children’s exposure to drug manufacturing;
• Extension of foster care beyond age 18; and
• Tribal issues.
Brief descriptions of significant state legislation appear below by issue area in alphabetical order. The appendix contains both citations and more extensive summaries of the laws discussed here.

• The National Childhood Obesity Database (NCOD) is the largest database of its kind in the world, with enormous potential as a tool both for tracking and analysing trends in childhood obesity, and for guiding evidence based interventions to tackle this major public health problem.
• The first year of data collection has been hampered by a number of
practical difficulties. These have had a significant impact on data quality and seriously limit the reliability of the results for this year, as a result of which many of the figures in this report need to be treated with considerable caution.
• There is anecdotal evidence of higher rates of opting out of the
measurement process among heavier children, which is supported by the
findings of this analysis. This means the figures obtained from the NCOD are likely systematically to underestimate the prevalence of overweight and obesity.
• Altogether, 538,400 children in Reception Year and Year 6 were measured – approximately 48% of those eligible.

Childhood schizophrenia is rare, affecting an estimated one in 40,000 children under the age of 13. During early teen years, the rate of schizophrenia onset in the general population begins to increase, and the peak rates of onset lie between the ages of 15 and 30. Males tend to experience the first signs and symptoms of schizophrenia at the younger end of this range, while onset in females is usually at the older end. While childhood schizophrenia is essentially the same brain disorder as schizophrenia in adults, the early age of onset presents special considerations for diagnosis, treatment, educational needs, emotional and social development, family relationships, and other factors. Although there's no cure for childhood schizophrenia, medications and well-coordinated mental health care services can help families manage the disease, learn strategies to cope with the effects of childhood schizophrenia, and address other child and adolescent developmental needs.

The Deficit Reduction Act of 2005 (DRA) was signed by the President in February 2006 and included major changes to the Medicaid program. This brief provides an overview of the changes to the rules and direction of Medicaid long-term care services as enacted in the DRA.

On March 16, 2006, a Notice announcing revised WIC Income Eligibility Guidelines was published in the Federal Register. The adjusted income eligibility guidelines are used by State agencies in determining the income eligibility of persons applying to participate in the WIC Program. WIC State agencies must implement the new guidelines on July 1, 2006. However, WIC State agencies may implement the revised income guidelines at the same time States implement revised income eligibility guidelines for the Medicaid Program. On January 24, 2006, the U.S. Department of Health and Human Services (HHS) published its annual update of the poverty guidelines. The HHS guidelines are used by a number of Federal programs, including WIC and the Medicaid Program, as the basis for determining and updating program income eligibility limits. To be eligible on the basis of income, applicants' gross income (i.e. before taxes are withheld) must fall at or below 185 percent of the U.S. Poverty Income Guidelines.

- Among adults who experienced a major depressive episode in the past year, 56.3% thought during their worst or most recent episode that it would be better if they were dead, 40.3% thought about committing suicide, 14.5% made a suicide plan, and 10.4% made a suicide attempt.
- Adults with a past year major depressive episode who reported past month binge alcohol or illicit drug use were more likely to report suicidal thoughts and suicide attempts than their counterparts with past year depression who had not did not binge drink or use an illicit drug in the past month.
- In 2004, an estimated 106,079 emergency department visits were the result of drug-related suicide attempts by persons aged 18 or older. A psychiatric condition was diagnosed in 41% (43,176) of the drug-related suicide attempts treated in the emergency departments. The most frequent psychiatric diagnosis was depression.

Developing home and community-based service (HCBS) alternatives to institutional care has been a priority for many state Medicaid programs over the last two decades and the focus of Medicaid policy debates recently. While the majority of Medicaid long-term care dollars go toward institutional care, the national percentage of Medicaid spending on HCBS has more than doubled from 1992 to 2003. This report presents a summary of the main trends to emerge from the data for the three Medicaid HCBS programs, and findings from the survey of policies used on 1915(c) waivers in 2005.

The ACT Action Plan for Mental Health Promotion Prevention and Early Intervention (PPEI) has been developed because of the recognised need to accompany clinical treatment of mental illness with actions which promote wellbeing and resilience across the community, and reduce the likelihood and severity of illness.

This report illustrates through case examples the experiences and challenges of low- and modest-income people who rely on Medicaid to pay for nursing home expenses. These case examples were developed through in-person interviews with nursing home residents and their families in three states: Georgia, Kansas and Virginia. The first section of the report summarizes the themes and issues shared across the interviews Kaiser conducted, while the second section presents the individual stories of a subset of those Kaiser interviewed.

This paper examines the role that Medicaid plays in addressing six populations (preterm birth babies, foster care children, individuals with spinal cord and traumatic brain injuries, individuals with mental illness, individuals with intellectual and developmental disabilities, and people with Alzheimer's disease) with serious health needs resulting in high costs. For each population profiled, the report describes the condition and the need for services and supports, as well as the role of Medicaid in meeting those needs. Profiles of real people with these conditions are also included with descriptions of model programs or cutting edge practices designed to meet the needs of these individuals.

Although states have primary responsibility for protecting children from abuse and neglect, they rely heavily on federal funding to fulfill this responsibility. Currently, about half of the cost of child welfare services nationally is paid with federal funds from a variety of sources. According to the Urban Institute’s latest child welfare financing survey, states spent a total of $23.3 billion from federal, state and local sources on child welfare in FY 2004, including $11.7 billion in federal funds.1 The extent of states’ reliance on federal funds in general—and any given funding stream in particular—varies widely over time and from state to state. Recent federal legislation will have the effect of shifting more of the cost of child welfare to the states and imposing additional limits on state flexibility to spend federal funds, trends that some child welfare experts say are at odds with the federal policy goal of improving the performance of state child welfare systems. This paper examines some of these changes in federal policy and their likely effect on states. It also briefly examines what are considered to be the major flaws in the current structure of federal child welfare financing and proposals for reform.

The Mental Health Peer Supported Hospital-to-Home Service is a unique project that uses the skills and experience of people with a lived experience of mental illness and currently living well with that mental illness to provide support to others with mental illness. It arose from lengthy consultation with mental health service consumers from across the SAHS region. They identified the first 2 weeks post discharge from hospital as a critical time when they often feel the most isolated and vulnerable to relapse and when they have the least energy to initiate follow-up with GPs for scripts for ongoing medication; hence when illness relapse are most likely to occur. This 3-month pilot project is part of the Department of Health/Mental Health Unit’s Mental Health Care Improvement Initiative (MHCII), recently developed and launched by the Director of Mental Services SA, to improve mental health services in SA.

- The most frequent reason for these ADHD stimulant medication related visits was nonmedical use (48%), followed by adverse reactions associated with medical use (34%), accidental ingestion (10%), and suicide attempts (8%).
- The rates of DAWN emergency department visits involving methylphenidate or amphetamine-dextroamphetamine for patients aged 12 to 17 were higher than the rates for patients aged 18 or older.
- About 68% of the DAWN emergency department visits involving nonmedical use of methylphenidate or amphetamine-dextroamphetamine also involved another substance (such as alcohol, an illicit drug, or a pharmaceutical).

Self-report offending surveys, such as the OCJS, are primarily designed to provide a better measure of the extent and nature of offending than can be obtained through official records. Data from the criminal justice agencies only provide a partial measure of offending because many offenders (and offences) are never formally processed. Moreover, most official data sources do not allow examination of the criminal careers of individual offenders. Two exceptions to this are the Home Office’s Offenders Index and the Police National Computer, both of which allow access to criminal conviction histories. Self report offending surveys ask people directly about their offending. Such surveys therefore include offenders and offences that are not dealt with by the criminal justice system and also enable patterns of offending and the factors associated with different forms of offending behaviour to be examined. However there are some limitations and key methodological issues that need to be considered in interpreting the findings presented in this report.

This fact sheet provides an overview of long-term care services, delivery of such services, and the large role Medicaid plays in financing long-term care.

This report focuses on three key issues in the services delivered by the mental health system in Victoria:
1. Insufficient access to clinical services, with around 50% of people with mental illness not receiving appropriate care for reasons including:
> Failure to seek care or navigate the complexities of the system;
> Under-capacity or poorly distributed capacity in both the State- and Commonwealth funded sectors;
> Gaps in service targeting and eligibility between sectors, which result in poor access for some groups, including vulnerable clients who have very complex needs (e.g., comorbidities), but do not match clinical criteria for specialist services; chronically ill people with a range of non-clinical support needs that vary in intensity over time; and children at risk of future mental illness who may or may not be involved in the child protection system.
2. Lack of connectedness between parts of the mental health system, with many individuals unable to navigate ‘siloed’ services such as housing and employment to obtain consistent, ongoing support; and
3. Limited investment in prevention and early intervention, with many children and young people in particular not receiving support designed to forestall or avoid the escalation of mental illness.

The reasons for cannabis use are broadly no different to those for other licit and illicit substances. Long term, sustainable improvements in mental health and substance abuse are likely, therefore, to rest on influencing factors that lie outside the traditional domains of both mental health and drug and alcohol treatment. The current responses for the prevention and treatment of cannabis use and mental illness are set out in several national policy frameworks – the National Drug Strategy, the National Mental Health Plan and most recently the COAG Mental Health Action Plan. Statements from the Federal Government to align these frameworks are welcome and may result in improved coordination at the strategy, policy and service levels and improved accountability. Given the early onset of both mental illness and initiation of cannabis use, it is clear that the bulk of the prevention and early intervention investment must be targeted at younger age groups. There are also very strong reasons for investment in treatment and harm reduction options for older age groups. Despite what we know about the early onset of mental illness and cannabis initiation, we also know people aged 25–44 years and 45–64 years are more than twice as likely as those aged under 25 years to receive an active treatment for a mental illness when seen in general practice. A similar pattern of delayed help seeking is seen in relation to problematic cannabis use, where the bulk of those seeking treatment are in the 30+ age group.

Regardless of size, employers completing our survey hired a small percentage of their employees through one-stops, and two-thirds of those they hired were low-skilled. About 80 employers who could provide estimates reported hiring about 9 percent of their new employees through the one-stops, roughly 1,300 of their 14,500 hires in 2005. They also reported that about two-thirds of those hired were low-skilled workers, in part because they thought the labor available from the one-stop centers was mostly low-skilled. Employers told us they would hire more job seekers from the one-stop labor pools if they had the skills for which they were looking.

- Among adults aged 18 or older, 13% (27.9 million persons) received treatment or counseling for mental health problems in the past 12 months.
- About 5.1% of all adults and 19.2% of adults who received treatment for mental health problems in the past year perceived an unmet need for treatment or counseling for mental health problems in the past year.
- Of those adults who perceived an unmet need for treatment for mental health problems in the past year, 48.1% reported cost or insurance issues as a barrier to treatment receipt.

Domestic violence

This guideline updates a previously released version: Domestic violence. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2004 Nov. 51 p.

In this monograph, instead of reviewing or meta-analyzing the literature in the field of adolescent risk, Reyna and Farley provide what the field needs much more—a metatheoretical reorientation. Two of their major metatheoretical choices are, I think, exactly right: the emphasis on a broad theory of rationality and the emphasis on dual-process models of cognition. Reyna and Farley rightly see that assumptions about rationality partly determine the scientific theories that dominate the field at any given point in time.

Significant number of public health and health care workers — referred to here as the frontline workforce — also deliver vital care and services, but are often underrepresented in current research and outreach initiatives within the health and health care system. This frontline workforce is a diverse group of professionals and paraprofessionals who provide a range of direct patient care and client services. The Robert Wood Johnson Foundation believes this fast-growing segment of the health and health care workforce, a group that plays a critical role in ensuring delivery of highquality care and services, warrants further research and outreach. This frontline workforce is growing rapidly; collectively it is growing faster (32.6%) than the growth rate of all health and health care occupations (28.3%), and significantly faster than the growth rate for all occupations (14.8%) in the United States workforce (Bureau of Labor Statistics Occupational Employment Statistics, 2003). Although we know the frontline workforce will continue to play a critically important role within public health and the health care delivery system, little has been known about who these workers are and what employment issues and needs they face. This chartbook attempts to fill this research gap by providing information about frontline occupations on both national and state levels.

1. The Child Support Agency was established in 1993 to assess, collect and enforce child maintenance payments from non-resident parents. From day one, however, the Child Support Agency has not delivered anywhere near what was expected of it.
2. The system has never recovered from this poor start and the Child Support Agency continues to be weighed down by the legacy of the past. For the sake of the children concerned, there is a clear need for fundamental reform of both child maintenance policy and its delivery. This has to be achieved by a clean break with the past. This means new arrangements should be put in place that work with parents to deliver the best outcomes for their children. Alongside this there must be a more effective process for assessing, collecting and enforcing maintenance that provides the people working to deliver child maintenance with the tools to do the job. In addition, there needs to be a new organisation that facilitates modern and innovative approaches to delivery.
3. This White Paper sets out the Government’s radical and far-reaching proposals for the wholesale reform of the child maintenance system so that much more money reaches the children who need it.

In 2002/03, there were 4,979,112 students enrolled in elementary or secondary schools across Canada. Between 2000/01 and 2002/03, enrollment declined by 0.5% overall. Some provinces and territories reported modest increases in elementary and secondary school enrollment. Between 2000/01 and 2002/03, Ontario’s enrollment rose by 1.1% and Alberta’s increased by 0.9%. The largest enrollment gains in were in the territories: Northwest Territories saw an increase of 1.4% and Nunavut reported the largest rise in enrollment, at 3.1%.

This study by Rebecca Tunstall and Alice Coulter of the London School of Economics is based on research carried out on 20 council estates in England over 25 years. The estates were tracked through visits and interviews in 1982, 1988, 1994 and 2005. In 1980, the estates were all unpopular, had serious management problems and many also had physical problems. The research has tracked their progress and this latest project comments on the whole period, with a focus on the last ten years.

A meeting of Canadian social planning organizations was convened by the Canadian Council on Social Development (CCSD) in Toronto, Ontario in early May 2006 with the support of Human Resources and Social Development Canada. The planning group for the meeting group included representatives from CCSD and social planning organizations from across Canada (See Appendix A). The following is a summary of discussion and next steps from this meeting. Representatives from more than thirty social planning organizations and regional networks across Canada participated in sessions to provide input on the development of a pan-Canadian network (see Appendix B for list of participants). Given the current social and economic context, and the recent federal budget, it was an opportune time to discuss the benefits and challenges of working together to address social development issues affecting communities across Canada.

In 2005, there were 109,323 registered marriages, representing a slight decrease of 1,635 (1.5%) from 2004. This decrease in registration numbers is consistent across all states and territories, with the exception of WA which rose by 4.9% (523) in 2005. NSW was the largest contributor to the decline in registrations at a national level, reporting a drop of 1,504 (-4%) marriages from 2004 to 2005. A similar pattern also occurred but to a lesser degree for both Vic. and SA with registration declines of 321 (-1.3%) and 253 (-3.2%) respectively. The number of registrations for Qld, Tas., NT and ACT remained steady when compared with 2004.

The U.S. Department of Health and Human Services estimates that the number of homeless and runaway youth ranges from 575,000 to 1.6 million per year. And, according to the National Runaway Switchboard, up to 42 percent identify as lesbian or gay. Additional research has found that homeless youth also disproportionately identify as bisexual and transgender. LGBT youth experience homelessness at a disproportionate rate, prompting the National Gay and Lesbian Task Force (the Task Force), in collaboration with the National Coalition for the Homeless (NCH), to produce this publication. Through a comprehensive review of the available academic research and professional literature, we answer some basic questions, including why so many LGBT youth are becoming and remaining homeless. We report on the harassment and violence that many of these youth experience in the shelter system and we summarize research on critical problems affecting them, including mental health issues, substance abuse and risky sexual behavior. We also analyze the federal government’s response to youth homelessness, including the specific impact on LGBT homeless youth of increased federal funding for faith-based service providers.

• Economic Consequences of Teen Birth, National Campaign to Prevent Teen Pregnancy
• Issue Trends: Child Care and Early Education
• TANF Update 1
• TANF Update 2
• TANF Update 3

If you are like most older people, you feel cold every now and then during the winter. What you may not know is that just being really cold can make you very sick. Older adults can lose body heat fast—faster than when they were young. A big chill can turn into a dangerous problem before an older person even knows what’s happening. Doctors call this serious problem hypothermia (hi-po-ther-mee-uh). Being outside in the cold, or even being in a very cold house, can lead to hypothermia. Hypothermia is what happens when your body temperature gets very low.

The federal government is on a “burning platform,” and the status quo way of doing business is unacceptable for a variety of reasons, including:
•Past fiscal trends and significant long-range challenges
•Rising public expectations for demonstrable results and enhanced responsiveness
•Selected trends and challenges having no boundaries
•Additional resource demands due to Iraq, Afghanistan, incremental homeland security needs, and recent natural disasters in the United States
•Numerous government performance/accountability and high risk challenges
•Outdated federal organizational structures, policies, and practices

An individual's health is influenced by everything from their genetic make-up, to living and working conditions, to the quality and availability of health services. This Stats & Facts Sheet tracks a number of influences that affect individual health and well-being, as well as key health outcomes. It also monitors health disparities. Canadians are among the healthiest people in the world, but some Canadians are not as healthy as others. Socio-economic status, Aboriginal identity, gender, and geographic location are significant factors associated with health disparities that can cause early deaths, disease, disability, and distress - at a significant cost to the individuals themselves and for Canadian society as a whole.

This UK-wide study by Peter Beresford, Lesley Adshead and Suzy Croft focused on service users' experience of specialist palliative care social work. Two groups use this service: people living with life-limiting illnesses and conditions and those facing bereavement. The participatory project explored service users' views of specialist palliative care social work practice as a basis for improving it by their involvement in its organisation, training, evaluation and review.

Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), beneficiaries seeking to take advantage of the new Medicare prescription drug coverage in 2006 can enroll either in a free-standing private prescription drug plan (PDP) or in a private Medicare Advantage (MA) plan that integrates prescription drug coverage with Medicare’s historical benefits and supplemental services. Under previous contracts from AARP’s Public Policy Institute (2004–2005) and The Commonwealth Fund (1999–2003), Mathematica Policy Research, Inc. (MPR) has analyzed trends in MA benefits and premiums. In this report, we expand on this work by analyzing in more detail how premiums and benefits are structured in MA plans in 2006. This report describes the analysis and documents the findings.

Since the November 1998 multi-state tobacco settlement, we have issued regular reports assessing whether the states are keeping their promise to use a significant portion of the settlement funds – expected to total $246 billion over the first 25 years – to attack the enormous public health problem posed by tobacco use in the United States. This year, we find that while the states have modestly increased total funding for tobacco prevention and cessation programs, the vast majority of states are still failing to keep the promise of the tobacco settlement and falling far short of funding such programs at even minimum levels recommended by the U.S. Centers for Disease Control and Prevention (CDC). The states’ failure to do more to prevent and reduce tobacco use is especially troubling in light of recent national surveys indicating that the remarkable progress the United States has made in reducing smoking has stalled among both youth and adults.

- Chairs, Chief Executives, Board Directors and Non-Executive Directors all have a responsibility for ensuring that the NHS organisation that they lead is compliant with equality and human rights legislation.
- Equality and human rights is as applicable to service issues as it is to employment, and as such is the responsibility of all parts of the organisation and of all Board members.
- There is a compelling synergy between legal compliance, aspiring to exemplar status, and the business imperative in relation to equality and human rights in NHS organisations.

This project developed a practical and comprehensive set of resources (a ‘toolkit’) for improving public neighbourhood play spaces and services for children and young people. The pilot process also aimed to develop each community’s own abilities and experience in planning and implementing such schemes. This report details:
- each stage of the process, including the initial development of the toolkit;
- the experiences of each of the five community groups in implementing the toolkit; and
- the impact this implementation had on the groups themselves.

Nearly 13 million American children live in families with incomes below the federal poverty level, which is $20,000 a year for a family of four. The number of children living in poverty increased by more than 11 percent between 2000 and 2005. There are 1.3 million more children living in poverty today than in 2000, despite indications of economic recovery and growth. Not only are these numbers dispiriting, the official poverty measure tells only part of the story—it is increasingly viewed as a flawed metric of economic hardship (see box). Research consistently shows that, on average, families need an income of about twice the federal poverty level to make ends meet. Children living in families with incomes below this level—for 2006, $40,000 for a family of four—are referred to as low income. Thirty-nine percent of the nation’s children—more than 28 million in 2005—live in low-income families.

View image of US Child Poverty Rates

Nonetheless, official poverty statistics continue to be used by researchers, policymakers, and the media to define economic disadvantage. In addition, eligibility for many public benefits is based on the official poverty measure. This fact sheet details some of the characteristics of American children who are considered poor by these official standards.

This discussion paper draws heavily upon the experiences and views of older people using social care about staying independent and taking risks. People tell CSCI that risk-taking is part of everyday life but that they want to be able to call upon the right support at the right time to help them deal with risks without losing or reducing their independence. However, rather than supporting them to live the way they want, poor quality services can create risks for older people which they cannot control. The key challenge for social care is to shift the balance towards supporting individuals who choose to take informed risks in order to improve the quality of their lives. The paper highlights some of the issues and challenges that this will entail in order for older people who call upon support from social care to have the best possible quality of life.

There were 8.4 million families in Canada in 2001. The majority of Canadian families are married households. In 2001, 70.4% of families were married couples, 13.8% were common-law relationships, and the remaining 15.6% were lone-parent families. Although married families are the most common family type in Canada, Quebec and the Northern Territories have a smaller percentage. In 2001, only 58.2% of families in Quebec were married families, while 25.2% were common-law. In the Yukon, Northwest Territories and Nunavut, common-law families ranged from 23% to 31%, higher than the Canadian average of 13.8%.

Research suggests that a lack of affordable, accessible childcare is the single most important barrier to work for lone parents on Income Support. The Extended Schools Childcare Pilot aims to address that barrier through providing "a virtual childcare guarantee" to lone parents that are not in work. In doing so, the pilot aims to help lone parents and partners of benefit recipients into work. The pilots commenced in October 2004 in two areas of Scotland, Aberdeenshire and Fife, and ran until March 2006. The pilots were co-ordinated by the Local Authority in close co-operation with other stakeholders (Jobcentre Plus and childcare providers). It was envisaged that a "virtual childcare guarantee" would be provided through existing childcare provision available in each area and through the development of additional childcare to meet identified gaps in provision.

This dissertation examines two issues related to obesity in older Europeans. First, it evaluates the effects of excessive body weight on health, utilization of medical care and labor force participation among older populations in Europe, and compares the effects across the different nations. Second, it analyzes risk factors for obesity and their interactions with environmental and societal variation across European countries. The dissertation concludes with a review of strategies and approaches for the prevention and management of obesity through public policy. Practices and experiences in different countries are examined along with an analysis of institutional structure, participants, functions, and areas of action in policymaking concerned with obesity control.

A motor vehicle crash is considered to be alcohol-related if at least one driver or nonoccupant (such as a pedestrian or pedalcyclist) involved in the crash is determined to have had a blood alcohol concentration (BAC) of .01 gram per deciliter (g/dL) or higher. Thus, any fatality that occurs in an alcohol-related crash is considered an alcohol-related fatality. The term “alcohol-related” does not indicate that a crash or fatality was caused by the presence of alcohol. Traffic fatalities in alcohol-related crashes fell by 0.2 percent, from 16,919 in 2004 to 16,885 in 2005. The 16,885 alcohol-related fatalities in 2005 (39% of total traffic fatalities for the year) represent a 5-percent reduction from the 17,732 alcoholrelated fatalities reported in 1995 (42% of the total). The 16,885 fatalities in alcohol-related crashes during 2005 represent an average of one alcohol-related fatality every 31 minutes.

The Western Australian Aboriginal Child Health Survey (WAACHS) was the first large-scale epidemiological survey of Indigenous children in Australia. It provides detailed information about the health, mental health, education and other socioeconomic outcomes for Indigenous children in Western Australia. Given that Queensland and the Northern Territory also have a substantial Indigenous population, these jurisdictions would find similar information to the WAACHS most useful in policy development and service provision. This paper examines the feasibility of using the WAACHS and other nationally available datasets to model key indicator variables for Queensland and the Northern Territory.

Homelessness acceptances during the July – September 2006 quarter were 22% lower than in the same period in 2005, and the lowest quarterly value since the early 1980s. A total of 42,590 decisions were made in respect of applications for accommodation that were considered by local authorities under the homelessness legislation. This is 24% lower than in the same period in 2005. Over half of all households accepted as owed a main homelessness duty are provided with temporary accommodation (TA) by local authorities, because a settled home is not available immediately. The latest statistics show that there were 93,090 households in TA on 30 September 2006, a reduction of 1% compared to the end of the previous quarter and 8% lower compared to 30 September 2005.

Government has a responsibility to protect its citizens against poverty and insecurity in retirement. The actions we have taken since 1997 – establishing Pension Credit, Winter Fuel Payments and real terms increases in the value of the basic State Pension – have helped pensioners escape from poverty. This Government introduced the Minimum Income Guarantee for pensioners, now part of the Pension Credit, which has raised the minimum income pensioners are entitled to from £68.80 a week in 1997 to over £114 today. More than 2 million pensioners have been lifted out of absolute poverty, and 1 million out of relative poverty. And we have seen sustained increases in pensioner incomes, with the poorest benefiting most. Pensioners are now less likely to be poor than younger people. In addition, the savings reward in Pension Credit has tackled the penalty of the 100 per cent marginal deduction rate that many savers faced, for the first time rewarding 1.9 million pensioner households who saved for retirement.

This report presents national-level information about crime and safety in U.S. public schools as reported by school principals, including the frequency of criminal incidents at school, the use of disciplinary actions, and efforts to prevent and reduce crime at school. Data come from the 2003–04 School Survey on Crime and Safety (SSOCS:2004). Eighteen percent of public schools reported at least one serious violent incident during the 2003–04 school year; two percent of public schools reported hate crimes; five percent of public schools reported gang-related crimes.

Social Security Represents an Important Source of Income for Women:
•88 percent of retirement-age women receive Social Security
•Most women receive benefits at least in part based on their spouse’s record. About 38 percent of women receive benefits solely on their own work record
•Social Security represents an average of 53 percent of total income for unmarried women over 65, versus 38 percent of total income for unmarried men and 33 percent of total income for married couples of the same age

In 2004, Canada's population reached 31.9 million. Since 2001, Canada's total population has grown by 3%, or 925,000 people. From a provincial perspective, population growth between 2001 and 2004 was greatest in Western Canada. The territory of Nunavut reported an increase of 5.3% in their population over this three-year period. The Northwest Territories followed closely behind with an increase of 4.9%. While many provinces experienced population increases between 2001 and 2004, the population fell in others. The most significant decreases were in Newfoundland, where the population decreased by 1.0%, and in Saskatchewan (0.5%).

Participation is on everyone's agenda at the moment, and statutory agencies are conscious of the need to hear a wide range of voices. Some voices, however, are more powerful than others. This research project carried out in Bradford supports the view that statutory agencies do not adequately hear minority voices within groups such as the South Asian community. Academics from Bradford University supported four community members to research participation issues in their communities, focusing on culture and place of origin, sexuality, mental health and disability.

Anti-social behaviour (ASB) is a costly and increasingly key topic of public concern in the UK. In response to this problem, the UK Government is introducing new legal instruments and policy initiatives to tackle ASB. These initiatives range from Anti-Social Behaviour Orders to cognitive behavioural programmes and parenting skills training for atrisk families. Despite growing interest in these measures, there is a paucity of rigorous evaluations of their effectiveness. Even more limited data exist on the cost-benefit implications of programmes. This review focuses on available UK and US literature on the effectiveness and cost-benefit analysis of interventions, and includes data from other countries where available.

The Common Assessment Framework (CAF) is a key part of delivering frontline services that are integrated and focused around the needs of children and young people. The CAF is a standardised approach to conducting an assessment of a child's additional needs and deciding how those needs should be met. It can be used by practitioners across children's services in England. The CAF will promote more effective, earlier identification of additional needs, particularly in universal services. It is intended to provide a simple process for a holistic assessment of a child's needs and strengths, taking account of the role of parents, carers and environmental factors on their development. Practitioners will then be better placed to agree, with the child and family, about what support is appropriate. The CAF will also help to improve integrated working by promoting co-ordinated service provision.

A brief that provides key questions for legislators and their staff to ask state child welfare agencies about child welfare system performance. It is designed to help legislators use the Child and Family Services Reviews (CFSRs), conducted jointly by the federal government and states, to engage with state child welfare agencies regarding child welfare reform and system improvement.

The purpose of this Handbook is to provide an update on the new CDW Interim Milestone and to answer those issues that need clarification in the light of experience in introducing and developing the CDW workforce. It does not replace or supersede the earlier guidance, rather it amplifies those “nitty gritty” points of detail which have arisen in practice.

Mental Health Policy Implementation Guide - Community Development: Workers for Black and Minority Ethnic Communities

Community development workers for Black and minority ethnic communities: Education and training – Supplementary guidance

The current 2006 report updates these social indicator indices from 2002 to 2004, the most recent year for which federal data is available. In 2004 Massachusetts’s rankings have improved from 39th, 30th, and 11th, to 36th, 29th, and 10th, respectively on the three indices, again if the District of Columbia is not included.
In addition, we present a fourth measure in this report that uses a new, and we believe more accurate, cost of living adjustment than that used by the third measure. This new (fourth) measure calculates the share of aggregate charitable giving in each state as a ratio of the share of aggregate after-tax household income, adjusted for cost of living, using the Center on Wealth and Philanthropy’s cost of living index. On this new measure Massachusetts ranks 8th, if Washington, D.C., is not included. In the 2004 rankings, Massachusetts moves up from 36th based on before-tax income to 8th based on after-tax income, adjusted for cost of living.

Stress related conditions and other mental disorders

Stress is the most common mental condition treated by occupational or primary care physicians and will be the focus of this guideline. References to additional mental disorders are found in the procedure summary in the original guideline document, although the more severe of those usually require referral to a specialist. Stress is not its own diagnosis but rather a combination of nonspecific emotional or physical symptoms varying in intensity and duration, which may or may not be related to a specific incident. The stress might also be associated with a particular disease or syndrome, but that is not always the case. A stressor is defined as anything that exerts a physical, emotional, or mental demand on an individual. Stress often occurs when the individual has anxiety because of a mismatch between perceived demands and resources, whether work-related or personal. The source of stress can be acute (such as an employee relocation) or chronic (such as consistently poor relations with a supervisor).

• Fathers of disabled children are fathers first, and fathers of a disabled child second. Many of the issues faced by fathers of disabled children are the same as fathers of non-disabled children
• Fathers and mothers of disabled children have many of the same needs and concerns, but there can also be real differences in how they respond to their child’s condition, what they do to cope, and what they find helpful
• Fathers can be greatly affected emotionally by a child’s disability impairment or illness
• Fathers want information about their child’s condition and development, what can be done to help, and what services are available to help their child and the family as a whole
• Fathers tend to rely heavily on their partners for emotional support

This publication presents information from the National Prisoner Census about persons held in Australian prisons on the night of 30 June 2006. The National Prisoner Census covers all prisoners in the legal custody of adult corrective services in adult prisons, including periodic detainees in New South Wales and the Australian Capital Territory, but excluding persons held in juvenile institutions, psychiatric custody and police custody. It is based on data extracted from administrative records held by the corrective services agencies in each Australian state and territory. These statistics provide a profile of the legal status and sentence details as well as demographic characteristics of Australian prisoners.

In the last two decades, the way we support frail older adults in the United States changed significantly with a large shift away from nursing homes, particularly among the oldest old. Consistent with the expressed desire of most older adults to continue to live in the community, this change in the mix of supports suggests continued change as the baby boom generation begins to need long term care. It also cautions policymakers and providers regarding their assumptions about the demand and supply for long term supports and suggests areas for further research. The National Nursing Home Survey (NNHS) indicates that the percent of older adults (age 65 and older) in nursing homes declined from 4.2 percent in 1985 to 3.6 percent in 2004 and other data sources suggest the decline continues through today. The use rate among the oldest old (age 85 and older) experienced the greatest decline falling from 21.1 percent in 1985 to 13.9 percent in 2004.

The policy community is increasingly focusing attention on alleviating the strain on low-income working families, particularly those with children. Research has examined the size and characteristics of low-income working families, the amounts and sources of income available to them, and, to a lesser extent, the expenses that these families face, such as housing or medical expenses. This paper seeks to unify discussions of income and expenses, to see if low-income working families are able to meet their expenses with the limited resources at their disposal. Relatively few data sets contain both detailed socioeconomic information and information on consumption expenditures for a large, nationally representative sample of low-income families. The National Survey of America’s Families (NSAF) is a notable exception.

This report provides a comprehensive summary of methodological research conducted on the National Survey on Drug Use and Health (NSDUH). Since its inception in 1971, considerable research has been conducted on the methods used in the survey. Studies have addressed sampling, counting and listing operations, questionnaire design, data collection procedures, editing and imputation procedures, nonresponse, and statistical analysis techniques associated with the survey. This research has been critical to the NSDUH project, providing information to identify and quantify survey errors, to guide redesign efforts, and to develop more efficient survey processes.

Gender equality is central to realizing the Millennium agenda, which risks failure without the full participation of all members of society. Within the Millennium Declaration and the Millennium Development Goals, and at the heart of the United Nations itself, is the acknowledgement that the vulnerable, especially children, require special care and attention. Gender equality will not only empower women to overcome poverty, but also their children, families, communities and countries. When seen in this light, gender equality is not only morally right – it is pivotal to human progress and sustainable development. Moreover, gender equality produces a double dividend: It benefits both women and children. Healthy, educated and empowered women have healthy, educated and confident daughters and sons. The amount of influence women have over the decisions in the household has been shown to positively impact the nutrition, health care and education of their children. But the benefits of gender equality go beyond their direct impact on children. Without it, it will be impossible to create a world of equity, tolerance and shared responsibility – a world that is fit for children.

Women Working, 1800 - 1930 focuses on women's role in the United States economy and provides access to digitized historical, manuscript, and image resources selected from Harvard University's library and museum collections. The collection features approximately 500,000 digitized pages and images including:
- 7,500 pages of manuscripts
- 3,500 books and pamphlets
- 1,200 photographs

This report builds upon a series of National Center for Education Statistics (NCES) reports on high school dropout and completion rates that began in 1988. It presents estimates of rates for 2004, and provides data about trends in dropout and completion rates over the last three decades (1972–2004), including characteristics of dropouts and completers in these years. Among other findings, the report shows that in students living in low-income families were approximately four times more likely to drop out of high school between 2003 and 2004 than were their peers from high-income families. Focusing on indicators of on-time graduation from public high schools, the averaged freshman graduation rate for the 3 most recent years for which data are available shows an increase from 72.6 percent for 2001–02 to 73.9 percent for 2002–03 to 74.3 percent for 2003–04.

- Among full time employed adults aged 18 to 64 in SAMHSA's National Survey on Drug Use and Health, 10.6% were classified as having a past year substance use disorder, 10.2% experienced serious psychological distress during the past year, and 2.4% had co-occurring serious psychological distress and a substance use disorder.
- Full time employed males in this age group were nearly twice as likely to have a past year substance use disorder than their female counterparts (13.2% vs. 6.9%). In contrast, females were nearly twice as likely to have experienced serious psychological distress during the past year than were the males (14.2% vs. 7.3%).
- Of the 2.9 million adults aged 18 to 64 employed full time who had co-occurring serious psychological distress and a substance use disorder, nearly 60% were not treated for either problem and less than 5% were treated for both problems.

This resource guide provides information about how the legislation on direct payments can successfully be applied to achieve positive outcomes for service users. It covers what we know is working well in practice and provides directions to more information.

This report draws on information obtained through multiple visits to each SafeFutures community during the five-year program period and the year following completion of the SafeFutures grants; followup discussions with selected informants to clarify specific aspects of program implementation; and analysis of secondary documents, including client indicator data provided by the local grantees. . . . This report is part of a series generated at the conclusion of the national evaluation of the SafeFutures Program conducted by the Urban Institute in Washington, DC. The series is comprised of six topical and six site-specific reports, as well as a final cross-site report, The SafeFutures Initiative: Key Findings From the Cross-Site Evaluation.

- The Substance Abuse and Mental Health Services Administration (SAMHSA) certifies Opioid Treatment Programs that provide medication-assisted therapy to treat addiction to opiates such as heroin, oxycodone, or hydrocodone. Currently, methadone and buprenorphine are the only opioid medications approved for treating opioid addiction.
- Of the 13,371 facilities responding to SAMHSA's 2005 National Survey of Substance Abuse Treatment Services, 8% (1,069) operated an Opioid Treatment Program certified by SAMHSA.
- About two thirds (67%) of all facilities operating Opioid Treatment Programs served opioid treatment program clients exclusively; these facilities accounted for 81% of all Opioid Treatment Program clients in 2005.

The Human Development Report continues to frame debates on some of the most pressing challenges facing humanity. Human Development Report 2006:
• Investigates the underlying causes and consequences of a crisis that leaves 1.2 billion people without access to safe water and 2.6 billion without access to sanitation
• Argues for a concerted drive to achieve water and sanitation for all through national strategies and a global plan of action
• Examines the social and economic forces that are driving water shortages and marginalizing the poor in agriculture

This document updates by a further year (to 1 August 2006) the health inequalities Public Service Agreement target and headline indicators that appeared in the Status Report on the Programme for Action published by the Department of Health in August 2005. It follows the style and format of the 2005 report. As expected, the report largely confirms the position set out in the earlier report with only minor changes.

The initial research found that neighbourhood concentrations of poverty and worklessness were strongly associated with low academic achievement; poor health, particularly in the form of high rates of depression and alcohol and drug abuse; high rates of crime victimisation and perpetration; low self esteem, limited ambitions and expectations; and high rates of family breakdown and reformation. Although on each estate those with 'no money and no work' were in a minority, the effect of deprivation on the estates was profound. The consistency of these results suggests that similar effects will be found elsewhere in Britain where similar proportions of people with 'no money and no work' exist.

SCIE aims to improve the experience of people who use social care by developing and promoting knowledge about good practice. Using knowledge gathered from diverse sources and a broad range of people and organisations, we develop resources that we share freely, supporting those working in social care and empowering service users. At the request of the Department of Health, we have produced this practice guide to the 2004 Act. It is easy to use and translates what is known from research and policy into recommendations for practice (practice points) and gives examples (ideas from practice). The guide is designed to answer any questions on the implementation of the Act, as well as provide food for thought.

- More than one million children live in housing in England that it considered sub-standard or unfit to live in
- On the whole, the research indicates that there is an association between homes with visible damp or mould and the prevalence of asthma or respiratory problems among children
- Dampness and mould has also been found to be associated with exacerbated symptoms among children with asthma or wheezing illness
- Poor quality housing can have an adverse effect on children's psychological well-being
- Parents and children both complain of the social stigma of living in bad housing
- Overcrowding and cooking with gas may cause respiratory infections in preterm infants
- Interventions such as installing or improving heating systems has been found to be effective in alleviating the potentially adverse effects of damp on the health on children

This fact sheet looks at trends in some of the most significant risks facing families today: child maltreatment, domestic violence, children’s disabilities, substance abuse, and parental mental illness. While these challenges can occur in families at all income levels, many -- such as depression, domestic violence, and child abuse -- are disproportionately frequent among low-income families. More than 28.5 million children live in low-income households, which have annual incomes up to twice the federal poverty level, or about $40,000 in 2005 for a family of four. Whether these challenges are associated with low income or a result of other factors, they are likely more difficult to cope with when a household has fewer resources. Also, because many of these risks occur in tandem, vulnerable families may require multiple services to achieve stability and security.

The following five issues have been highlighted as critical:
1) Macro-economic policies and their relationships to poverty reduction in general and urban poverty reduction in particular.
2) Processes and institutional arrangements that are conducive to mainstreaming citizens,especially the urban poor, into the planning and budgeting systems, both at the local and national level.
3) Citizens’ participation in monitoring, evaluation and audit of local government activities including service delivery.
4) Legal issues governing tenurial rights of the poor and slum dwellers.
5) Poverty/environment nexus that degrades the environment and exacerbates poverty in an inter-linking way.

Social exclusion remains a significant problem for people with mental health problems and continues to be an important issue. The National Social Inclusion Programme (NSIP) is a three year programme coordinating the cross-government implementation of the action points set out in the report of the Social Exclusion Unit (SEU), Mental Health and Social Exclusion, launched in June 2004. This report represented a landmark for mental health policy and practice in the UK. It provided, for the first time, a clear plan for action to reduce and remove the barriers to employment, mainstream services, and community participation for those with mental health problems.

Adult placement-type services (long- and short-term accommodation and / or support provided to a disabled or vulnerable person in an ordinary family home) have been in existence for a very long time. Perhaps the oldest formally constituted service is Geel, in Belgium, where for hundreds of years people with long-term mental illness and learning disabilities have lived and worked with families in the community, with support and back-up services from the local psychiatric hospital. In England, the Liverpool Personal Service Society has been providing family placements for about 30 years. Adult placements and small homes Despite its long history, adult placement (adult fostering / family placement) has not until recently been clearly defined and has had an uncertain legal status. The Registered Homes (Amendment) Act 1991 was enacted to give protection to people living in small homes (fewer than four residents), but did not separately define adult placements. Although guidance issued in 1992 introduced the idea of ‘lighter touch’ regulation for adult placements, the distinction between an ‘adult placement’ and a ‘small home’ remained unclear.

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) substantially changed the Medicare program by adding a prescription drug benefit and expanding the role of private health plans. The year 2006 was the first year of full implementation of many of the important changes enacted in the MMA. This issue paper offers an analysis of the benefits and premiums of Medicare Advantage MA) plans. Although several features of the prescription drug offerings of these plans are presented, it is beyond the scope of the study to assess the prescription drug benefit in detail. In establishing the MA program, Congress sought to contain growth in Medicare spending, improve the payment approach for private health plans, and provide people on Medicare, particularly those living in rural areas, with more choices as well as enhanced benefits. Marsha Gold, principal investigator, and her colleagues from Mathematica Policy Research, Inc., have drawn on their extensive expertise in analyzing the public databases available through the Centers for Medicare and Medicaid Services to describe the changes that have occurred in plan offerings by plan type. In addition, they estimate the degree of exposure to out-of-pocket costs Medicare beneficiaries are likely to have by plan type. Finally, the authors give special attention to the offerings of a particular model of MA, the Special Needs Plan, that was authorized to address the unique needs of people with multiple chronic conditions, dual eligibles, and those who live in long-term care facilities.

This Disability Equality Scheme shows what Communities and Local Government is doing to improve equality of opportunity for disabled people over the next three years. The Scheme was drawn up following widespread consultation with disabled people and their organisations, in order to find out what disabled people really wanted the department to do.

This study provides a range of analyses of the difficulties working households, aged 20 to 39, faced in buying a first home in every local authority area of Great Britain in 2005. It follows on from earlier studies conducted for the JRF in each year since 2002. It includes an assessment of the scope for 'intermediate housing market' products, to help working households which cannot afford to buy in the open market, and shows the impact of mobility in London as a means of coping with affordability problems.

• modernisation requires a research infrastructure capable of shifting the basis of social care towards evidence-based policy and practice
• the infrastructure should comprise a research workforce, funding and national, strategic priorities
• no such infrastructure exists to support social work and social care.
The report concludes that:
• an agency should be allocated the strategic role and resources to host an inquiry into and to develop, in collaboration with other stakeholders, a research infrastructure to support evidence-based policy and practice in social work and social care.

This discussion paper is intended as a catalyst for an exchange of information, experience and ideas about the contribution of social work to mental health services. This includes the development context for individual practitioners and the organisations in which they work and how the contribution of social work fits into the changes required in the wider system of mental health service provision. The development of social work as a discipline and as a profession has always taken place within a network of organisations and interest groups. In recent years these have included service user led groups. Contributors to this paper include ADSS, BASW, the GSCC, the NIMHE National Workforce Programme and the NIMHE/SCIE Social Care Fellows, SCIE, Skills for Care, and the SPN. The purpose of this discussion paper is to generate a debate with commissioners, employers and social workers in primary, secondary and tertiary mental health and social care services on the contribution that social workers can make to the support and recovery of people of all ages in mental distress, both now and in the future.

This document describes how clinical services for the management of substance misusers in prison should develop during the next two years as increasing resources permit. The aim is to address the current challenges facing the care and treatment of substance misusers in prisons. . . . In recent years, there has been substantial progress in the provision of non-clinical drug services across the prison estate. Clinical services have been slow to develop by comparison. Detoxification, of a pre-set duration, remains the solitary prescribing response to drug dependence in the majority of local prisons. . . . While detoxification may remain the preferred method of clinical management for some drug-dependent prisoners, it is now apparent that a range of clinical treatment options are required to manage the varied and complex needs of this patient group.

Immigration to the United States, 1789-1930, is a web-based collection of selected historical materials from Harvard's libraries, archives, and museums that documents voluntary immigration to the US from the signing of the Constitution to the onset of the Great Depression. Immigration has profoundly influenced the character and the growth of the United States. Its salient themes—including acculturation, nativism, racism and prejudice, homesteading, and industrialization—and the policies governing it are illustrated in the online collection. Concentrating heavily on the 19th century, Immigration to the United States, 1789-1930, includes approximately 1,800 books and pamphlets as well as 6,000 photographs, 200 maps, and 13,000 pages from manuscript and archival collections. By incorporating diaries, biographies, and other writings capturing diverse experiences, the collected material provides a window into the lives of ordinary immigrants.

The New Policy Institute has produced its 2006 edition of indicators of poverty and social exclusion in Scotland providing a comprehensive analysis of trends over time and differences between groups. It covers both devolved and non-devolved areas of responsibility. In summary, there has been substantial progress in poverty among children and pensioners but not among working-age adults. There remain substantial problems in Scotland's ill-health and low educational achievement by many children. . . . The researchers conclude that levels of poverty and social exclusion, trends over time, and the issues arising are largely similar in Scotland to most of the rest of Great Britain. Some are driven by the UK-wide tax and benefits system; others are clearly devolved responsibilities. The grey area, where Scotland-specific initiatives could potentially make a real difference, concerns work opportunities and low pay.

The National Committee for Quality Assurance's 2006 report on the performance of U.S. health plans found overall improvement in HEDIS clinical quality measures for those plans that collect and publicly report performance data. Improvements, moreover, were broad-based. There are several lessons for those pursuing high performance of the U.S. health system as a whole. Most importantly, the results show there is hope; performance on some HEDIS measures is now approaching 100 percent. Diffusion of measurement has been slow, but steady. The nation needs more and better measures of performance, mechanisms for setting standards of performance, and tools, such as performance-based contracts, for ensuring that improvement occurs.

The Child and Youth Well-Being Index (CWI) is an evidence-based composite measure of trends over time in the quality of life or well-being of America’s children and young people. It comprises several interrelated summary domains of annual time series of various social indicators of well-being. These seven domains have been found in numerous social science studies to be related to an overall sense of subjective well-being or satisfaction with life. Appendix A briefly describes the Methods of Index Construction and identifies both the seven domains of the CWI as well as the 28 Key Indicators that comprise them. Briefly, the seven domains include: Family Economic Well-Being, Health, Safety/Behavioral Concerns, Educational Attainment, Community Connectedness, Social Relationships, and Emotional/Spiritual Well-Being.

Services that support young children’s healthy mental development can reduce the prevalence of developmental and behavioral disorders that have high costs and long-term consequences for health, education, child welfare, and juvenile justice systems—and for children’s futures. States are interested in improving their support of young children’s healthy mental development and want to learn about ways to do so.

A concern for chronic poverty takes into account how long an individual or household experiences poverty. It helps highlight the differentiation within “the poor” in terms of income levels, and how they change; it also identifies those individuals or households who do not manage to move out of poverty. Chronic poverty in urban areas is underpinned by low wages or returns for those working in the informal economy, and high costs for daily needs such as accommodation, basic services and transport. It is compounded by health burdens linked to poor-quality housing, occupational risks and inadequate health care provision, and often by discrimination in access to jobs or services. The incidence of poverty (and within this of chronic poverty) in urban areas may be underestimated by poverty lines that take no account of the higher costs of many necessities; many urban households face serious deprivations, despite having incomes above the “US$ 1 a day” poverty line. “Poverty reduction” programmes rarely consider the needs of the chronically poor, and therefore fail to address these on a scale and with the diversity that is appropriate. Meanwhile, many city development programmes create or exacerbate poverty by reducing livelihood opportunities for low-income groups, or destroying their settlements.

In the AAUP Contingent Faculty Index 2006, the American Association of University Professors provides data to document the increasing predominance of non-tenure-track faculty in America’s colleges and universities. This report draws on figures submitted by institutions to the US Department of Education’s IPEDS database for fall 2005, and makes data on individual campuses easily accessible for the first time.

The Improving Opportunity, Strengthening Society strategy has two closely linked aims, to:
• increase equality between different races; and
• develop a better sense of community cohesionby helping people from different backgroundsdevelop a stronger sense of ‘togetherness’.
The strategy focuses on race equality and community cohesion together, recognising that we will only build strong communities if there is equality between people of different backgrounds, races and faiths. By the same token, efforts to promote equality are undermined in communities where people are suspicious of each other, do not
respect each others’ rights and do not have shared confidence in public institutions.

Toxic substances have the capacity to disrupt the development of all of the body’s organ systems. The nature and severity of that disruption depend upon the type of substance, the level and duration of exposure, and most important, on the timing during the developmental process. Early assaults can lead to a broad range of lifelong problems in both physical and mental health that impose devastating human and financial costs. This paper focuses on the effects of toxic exposures on the architecture of the developing brain. When it is relatively immature, the brain is particularly susceptible to adverse impacts on the formation of its basic circuits. During pregnancy, the developing brain is extremely sensitive to many chemicals. When certain substances reach dangerous levels at particularly sensitive points in time, they can disrupt that developmental process through toxic effects on the general health of brain cells as well as on their ability to perform specialized functions. These toxic influences can weaken the foundational structure of the brain and result in permanent impairment, thereby leading to a wide range of lifelong, adverse impacts on learning, behavior, and health.

The latest official figures on child poverty are for 2004/05, the Government's target year for its first milestone for abolishing child poverty, namely, reducing child poverty by a quarter compared with 1998/99. This target was not reached whichever measure of income poverty is used (the Government was ambiguous about which target it was using). On the more commonly used measure 'after deducting housing costs', the number of children in poverty in Britain fell by 700,000, or 17%, from 4.1 million in 1998/99 to 3.4 million in 2004/05. On the alternative 'before deducting housing costs'measure, the proportional fall was greater, at 23%, but still slightly short of the target. The only way to characterise what has been achieved so far has to be 'mixed': on the one hand, steady and solid progress, unequivocally reversing what had been a long upward trend in child poverty beginning at least as long ago as the end of the 1970s; on the other, equally unequivoca