State discretion and medicaid program variation in long-term care: when is enough, enough?

Although federal statutes and regulations establish the broad parameters within which state Medicaid programs operate, the federal government grants states substantial discretion over Medicaid and Medicaid-funded long-term care. An appreciation of resulting cross-state variation in Medicaid program characteristics, however, has been lacking in the ongoing debate over whether the federal government should further devolve responsibility for caring for the poor and disabled elderly to the states. To better inform this discussion, therefore, this article documents considerable variation, not only in terms of Medicaid program spending and recipients, but also in terms of strategies chosen to reform long-term care services and financing. Since there is little doubt that states take full advantage of current levels of discretion, advocates of devolution may want to reassess their views to consider whether existing variation has resulted in inequities addressable only through more, not less, federal involvement.     

FROM MEDIA POLITICS TO E-PROTEST

New forms of political expression are often taken as further evidence of the 'cultural turn' within contemporary societies. Taking two recent cases - the use of popular culture in the election campaigns of British political parties (and particularly the Labour Party) and the so-called 'Carnival Against Capital' of June 18th 1999 - this article argues for caution in assuming that such cultural modi vivendi necessarily require culturalist forms of explanation and analysis. Weargue that both established political parties and extra-parliamentary social movements have found new opportunities for political communication and mobilization through media and information technology (particularly the Internet). However, the resource and organizational problems they confront remain the same, as does the familiar instrumental rationality of their actions. Rather than leading us to abandon established analytical tools such as political intermediation, political opportunity structures or resource mobilization, shifting opportunities and conditions require the adaptation and extension of such concepts. In this spirit, we attempt to offer an analysis of the cultural mode adopted by parties and movements without losing sight of their broader goals and motivations.     

Biosocial Perspectives on the Family

New theoretical models conceptualize families as systems affected by, and effecting change in, reciprocal influences among social, behavioral, and biological processes. Technological breakthroughs make noninvasive assessment of many biological processes available to family researchers. These theoretical and measurement advances have resulted in significant increases in research on family processes and relationships that integrate knowledge from the fields of behavioral endocrinology, behavior genetics, and, to a lesser degree, evolutionary psychology. This review covers a broad spectrum, including the topics of parenthood, early child development, adolescent and middle child development, parent‐child relations, courtship and mate selection, and the quality and stability of marital and intimate relations. Our intention is to introduce, by example, the relevance of the biosocial approach, encourage family researchers to consider the application of these ideas to their interests, and increase the participation of family researchers in the next generation of studies.     

Inter‐professional collaboration and conceptualisations of practice

This article discusses the inter‐professional collaborative experiences of professionals working with children and their families in two areas of high social need. The findings suggest that, although the way that professionals conceptualise their practice may hinder attempts to collaborate effectively, a complex interplay of several factors is involved. A typology of the various collaborations reported is then constructed. Finally, integrating this work with the findings of other studies, an explanatory model is developed. These have particular relevance given the current rhetoric of ‘joined‐up government’. The project was funded by the Economic and Social Research Council (Ref. R000221542). Copyright © 2000 John Wiley & Sons, Ltd.     

Disability, Dependency and the New Deal for Disabled People

The emergence of the 'New Deal' and its attendant claim to be part of a new political and social future based on the 'third way' seems to offer formerly excluded people new horizons for social inclusion. This paper provides a critical exploration of the likely impact of the 'New Deal' for disabled people. The paper contextualises the 'New Deal' in the wider ideology and rhetoric of 'Welfare to Work'. In doing so, it highlights similarities between 'New Deal', 'Welfare to Work' and the victim blaming ideas which characterised discussions of a growing 'social underclass' in the 1980s. By looking at the way the disability problem is framed within the 'New Deal' and 'Welfare to Work', it will be argued that it is unlikely to address the nature of employment barriers, indeed risks seriously misrepresenting the causes of disabled people's economic and social exclusion. In this way, its ideological underpinnings may simply reaffirm disabled people's economic and social dependency.     

The Abative Effect: A New Term to Describe the Action of Antecedents that Reduce Operant Responding

The Analysis of Verbal Behavior - Behavior-analytic terminology concerning the so-called inhibitory effect of operant antecedents lacks precision. The present paper describes the problem with...     

Poverty, Welfare, and Patriarchy: How Macro-Level Changes in Social Policy Can Help Low-Income Women

A critical review of the current status of low-income women reveals how patriarchy, violence, and discrimination mitigates against their employment and contributes to their poverty. Myths that fuel prejudice against the poor have led to public policy and welfare legislation based on individualistic rather than structural assumptions about the causes of poverty. Research on the effects of welfare reform reinforces the conclusion that changes in social welfare and policy are necessary for income parity and improvement in the employment opportunities, access, and status of low-income women. A human-capital model and recommendations for macro-level changes in public policy and programming that address the systemic causes of women's poverty are presented.     

Mental health and educational difficulties in children in contact with Children's Social Services

The British Child Mental Health Survey 1999 collected data from 10 438 children aged 5–15 years, selected at random from the child benefit register. At 2 and 3 years, all those with a psychiatric disorder and a random third without were followed up with further detailed interviews about the services contacted if parents reported service contact or if parents expressed concern about their child's mental health at baseline and follow‐up, but reported no service use. We compared children in contact with Children's Social Services with children in contact with Child and Adolescent Mental Health Services (CAMHS) or no services. The children in contact with Children's Social Services had a high level of psychopathology and considerable educational difficulties. Despite this, they often had no contact with CAMHS or access to provision for special educational needs. It also became clear that parents were often using Children's Social Services as a first‐line service, i.e. a way of trying to access help. The results provide us with an interesting insight into the level of need of those children in contact with Children's Social Services and we hope to stimulate discussion about how liaison between all the services children access can better provide for their needs.