Peer Reviewed Journal Articles
AIDS Patient Care, Vol. 8(3), 1994. "Providing Long-Term Care for Persons with AIDS." Dan Gentry, Toni E. Fogarty, and Susan Lehrman. Abstract.
AIDS and Public Policy Journal, Vol. 9(4), 1995. "The Organization and Availability of HIV-related Services in Baltimore, Maryland and Oakland, California." Katherine Marconi, Thomas Rundall, Dan Gentry, Jennafer Kwait, David Celentano, and Paul Stolley. Abstract.
HSR: Health Services Research, Vol. 32(6), 1998.
"Predictors of California Nursing Facilities' Acceptance of People
with HIV/AIDS." Susan Elizabeth Lehrman, Dan Gentry, and Toni E.
Fogarty. Abstract.
Journal of Health and Human Services Administration, Vol. 18(2), 1995. "Staffing Patterns in AIDS Service Organizations: The Volunteer Contributions." Dan Gentry and Thomas Rundall. Abstract.
Journal of Aging & Social Policy, Vol. 9(1), 1997. "Defining the Challenges of Providing Long-Term Care: The Case of the Nursing Home Industry's Response to the AIDS Epidemic." Toni E. Fogarty, Dan Gentry, and Susan Elizabeth Lehrman. Abstract.
Commissioned Paper
For the Agency for Health Care Policy and Research and the Health Resources and Services Administration, 1995. "Evaluating the Impact of HIV/AIDS Case Management: Research Issues and Limitations." Susan E. Lehrman, Dan Gentry, and Edward C. Waltz. (Executive Summary available soon).
Book
For the U.S. Department of Health & Human Services, Health Resources & Services Administration (HRSA), 1997. "Self-Assessment Module for Ryan White CARE Act Title I HIV Health Services Planning Councils and Title II HIV Care Consortia." Dan Gentry and Susan Lehrman. Book Summary.
Project Report
For Metropolitan St. Louis AIDS Program, St. Louis City Department of Health and Hospital, 1996. "Case Management Assessment Report." Dan Gentry and Susan Lehrman. (Introduction to the Case Management Assessment Report available soon).
Peer Reviewed Journal Articles
AIDS Patient Care, Vol. 8(3), 1994. "Providing Long-Term Care for Persons with AIDS." Authors: Dan Gentry, Toni E. Fogarty, and Susan Lehrman.
In this pilot study, a random sample of 50 nursing homes located in each of the five U.S. cities with the highest AIDS incidence were surveyed (total N=250) to determine: (1) the frequency of admission inquiries by, and actual admissions of PWAs, (2) the frequency of adoption of formal AIDS admission policies, (3) the industry's concerns regarding provision of care in traditional nursing homes, and (4) the industry's preferred way of delivering long-term care (LTC) to PWAs. The majority of the facilities cited ability to meet special care needs, the costs of this care, and inadequate reimbursement as important admission policy issues. The majority indicated a preference for either special care units for AIDS or AIDS-specific skilled nursing facilities as the most appropriate setting for the provision of LTC to persons living with AIDS. While almost half (48.2 percent) of the facilities had been approached, at least informally, about admitting a PWA, only 15.4 percent of the nursing homes had admitted a resident with AIDS.
AIDS and Public Policy Journal, Vol. 9(4), 1995. "The Organization and Availability of HIV-related Services in Baltimore, Maryland and Oakland, California." Authors: Katherine Marconi, Thomas Rundall, Dan Gentry, Jennafer Kwait, David Celentano, and Paul Stolley.
This article examines the study of HIV-related organizations in two communities, Baltimore, Maryland, and Oakland, as they entered the second decade of the AIDS epidemic. Based on an examination of HIV medical and support services, which included satisfaction ratings by providers with their own services and with the availability of referrals for additional services, the authors identified HIV-related services that may need significant financial support in the two EMAs, and provided a methodology for assessing how organizational leaders perceived HIV services. The authors also describe the configuration of HIV care in Baltimore and Oakland based on the following parameters: What were the characteristics of organizations that provided HIV-related services? Which HIV-related services were provided by these organizations? How many different organizations provided each type of service? Which features did these organizations incorporate that were specifically designed to reduce barriers to access? To what extent were leaders of ASOs satisfied with their organization's ability to deliver HIV-related services? TO what extent were leaders of HIV-related organizations satisfied with he availability of referral resources in their community? With which service referrals was there the greatest amount of dissatisfaction?
HSR: Health Services Research, Vol. 32(6), February 1998. "Predictors of California Nursing Facilities' Acceptance of People with HIV/AIDS." Authors: Susan Elizabeth Lehrman, Dan Gentry, and Toni E. Fogarty.
This article examines factors that predict the provision of HIV/AIDS care among California nursing facilities (NFs) in 1990. The study uses logistic regression to examine the probability that a NF had admitted a person with AIDS/HIV (PWA/H). Independent variables of key interest included whether the facility was hospital-based; whether it sustained a financial loss in FY 1990; whether it had a hospice; the percentage of its residents on Medicare; the percentage of its residents on MediCal; the number of PWA/Hs per elderly in the county where the facility was located; the ratio of home-based hospices to elderly in the county; and the ratio of NF beds to elderly in the county. Of the 902 facilities examined, 7.65 percent served AIDS residents. The financial loss variable was not significant. The community-based hospice variable was significant and negative. All other key variables were significant and positive. The study: (1) suggests that NFs respond to external pressures to provide AIDS care even in the absence of financial incentives or a positive financial margin; (2) supports concerns that competition may exist between the elderly and PWA/H for NF beds; (3) shows that NFs are less likely to provide care if substitute services are available; and (4) demonstrates that facilities capable of providing a higher level of clinical and psychosocial care may be particularly willing, perhaps able, to provide AIDS care.
Journal of Health and Human Services Administration, Vol. 18(2), 1995. "Staffing Patterns in AIDS Service Organizations: The Volunteer Contributions." Authors: Dan Gentry and Thomas Rundall.
This article reports results from a survey of AIDS service organizations (ASOs) that provide medical and social services to people with AIDS in the Oakland, California, area. The survey was designed to assess organizational and staffing characteristics of ASOs. Forty two of sixty-seven (62.7% response rate) ASOs responded, providing detailed data on their staffing patterns. ASOs that provided social services reported 48.5 percent of their total full-time equivalents (FTEs) as volunteers while medical organizations reported only 9.5 percent of their total FTEs as volunteers. Among the social service providers, ASOs that self-identified as private, non-profit community-based organizations (CBOs) reported greater than half (50.8%) of their total FTEs as volunteer staff. All CBOs that reported utilizing more than five volunteer FTEs were AIDS-specific providers and had designated a full-time, paid staff position as volunteer coordinator/director.
Journal of Aging & Social Policy, Vol. 9(1), 1997. "Defining the Challenges of Providing Long-Term Care: The Case of the Nursing Home Industry's Response to the AIDS Epidemic." Authors: Toni E. Fogarty, Dan Gentry, and Susan Elizabeth Lehrman.
AIDS is now viewed as a chronic disease requiring long-term management. As a result, more persons with AIDS (PWAs) are seeking long-term care in facilities that have primarily served the elderly. In some regions, however, the nursing home market into which PWAs may introduce new demand is a market already characterized by excess demand. In light of this, competition for limited long-term care resources may develop between the frail elderly and PWAs. The nursing home industry has raised many issues regarding the feasibility of admitting AIDS patients as residents, but little is known about how important these issues are in deciding admissions policy. How the industry perceives and resolves the concerns it has regarding delivery of care to PWAs can affect the overall long-term care system and thus affect the traditional users - the frail elderly. Knowing the concerns and preferences of the industry may help guide and anticipate future changes in the system. In this pilot study, a random sample of 250 nursing home administrators in the five highest AIDS-incidence areas in the U.S. was surveyed to determine (1) the industry's concerns and issues regarding AIDS care, (2) data regarding requests for admission by PWAs to nursing homes, and (3) data concerning the industry's preferred way of delivering AIDS care. Important Admissions policy issues cited by the respondents included the ability to meet special care needs, costs of care, and inadequate reimbursement. The majority also believed the most appropriate methods of providing care were special care units for AIDS within nursing homes or dedicated HIV/AIDS nursing facilities.
Book
For the U.S. Department of Health & Human Services, Health Resources & Services Administration (HRSA), 1997. "Self-Assessment Module for Ryan White CARE Act Title I HIV Health Services Planning Councils and Title II HIV Care Consortia." Dan Gentry and Susan Lehrman.
The Ryan White CARE Act is designed to provide health and support services to people living with HIV disease and AIDS (PLWH). Title I Planning Councils and Title II Consortia are planning bodies with responsibility for ensuring that PLWH have access to needed services that are delivered within a planned coordinated continuum of care. This module is designed to help planning councils and consortia assess how the continuum of care was developed and maintained, and what specific services are included in it.
Access to care can be enhanced by providing a coordinated set of services and linking mechanisms. There are additional logistical, financial, cultural, and quality assurance considerations to improve access to care, however, the module does not assess them.
Specifically, this module examines:
After completing this module, the council or consortium's capacity to provide a thoughtfully developed continuum of care to PLWH will be strengthened. The council or consortium will have better information about whether its existing continuum meets the service needs of PLWH and how to make further improvements.
The self-assessment questions are divided into three sections. The definition questions ask how the council or consortium defined both the services and the linking mechanisms essential to the continuum of care. The establishment and integration of services section is divided into two parts: questions concerning the services contained in the continuum of care, and questions about the linking mechanisms contained in the continuum of care. The last section on coordination asks questions about the council or consortium's efforts to integrate Title I or Tile II services with other health and social services in the community, especially other Ryan White-funded services.
