Leveraging the PASRR process to divert and transition elders with mental illness from nursing facilities

This study examines how some states use Pre-Admission Screening and Resident Review (PASRR) processes to provide opportunities for nursing facility diversion and/or transition for elders with mental illness and highlights potential promising practices from selected states. Document reviews and interviews were conducted with key informants across 13 states. Key themes presented are 1) philosophies of diversion/transition embedded into PASRR processes, 2) questions on screening tools used to promote diversion/transition, 3) PASRR authorities' collaboration with other initiatives to promote diversion/transition, and 4) the extent to which states used PASRR to help identify mental health supports needed by nursing facility residents. Findings provide policy-relevant information to help states consider enhancement of their PASRR processes to further support nursing facility diversion and transition for persons with mental illness and improved mental health services for those in nursing facilities.     

Customer service competencies: a global look

The purpose of the study was to identify competencies needed by those providing service to today's customers. A total of 460 service providers were interviewed from thirty-two different organizations in North America and twenty-six organizations in Asia and Europe. Based on 2.825 critical incidents, five major factors were identified to create the SERVE model: See the ‘big picture’ and how customer service fits into it; Establish an authentic human connection with each customer; Render timely, accurate and thorough service; Value and respond to unique customer needs; and Extend a hand to repair and strengthen relationships with customers who are upset or angry. Similarities and differences among the different geographic regions and among the different respondent types were noted. Implications for HRD practice and future research were discussed.     

Critical Thinking and the Web

TechNotes is designed to bring to readers’ attention new developments in technology of relevance to social work education. In this second column, the authors recommend strategies for teaching students to critically evaluate online sources.     

An Ethnography of an AIDS Hospice: Toward a Theory of Organizational Pastiche

This article describes everyday life at a hospice that provides terminal, residential care to persons with AIDS. Data were gathered over 12 months of participant observation and a series of formal interviews. The hospice is a nonprofit organization that receives most of its financial support from local community churches and agencies. The philosophy of the hospice is common to its genre—that is, care for dying patients should be holistic, personal, and palliative. The hospice staff largely adheres to this philosophy yet also organizes its everyday activities to meet the practical needs of everyone involved. Some of the more interesting staff practices include the use of touch for healing and communicating, and stress management techniques. The essence of everyday life in the hospice, though, is the relationship between the staff member and the resident. The study identifies three types of relationships—caring, pastoral, and intimate. The conclusion focuses on the value of integrating traditional interactionist ethnography and postmodernist social theory for conducting qualitative research on emerging health care phenomena like the AIDS hospice. The concept of organizational pastiche is offered to interpret the distinctive ways health care organizations specializing in HIV/AIDS care must adapt to the unprecedented cultural and biological features of the epidemic.     

Welcoming America: A Case Study of Municipal Immigrant Integration,Receptivity, and Community Practice

A growing number of leaders in towns and cities across the United States have embraced policies encouraging receptivity and integration of immigrant populations. This article examines this phenomenon and how communities are seeking greater immigrant integration. To do this, we describe immigration federalism and how it influences receptivity. A discussion of the organizational networks that facilitate greater immigrant integration follows. We consider Welcoming America, a nonprofit organization that serves as a convener for dialogue and policy change, as a case study among these larger organizational networks. The article concludes with a broader examination of implications for receptivity and integration in community practice work.     

Effect of Environmental Risk and Externalizing Comorbidity on Internalizing Problems Among Economically Disadvantaged African American Youth

This study examined the effects of racial discrimination, community violence, and stressful life events on internalizing problems among African American youth from high‐poverty neighborhoods (N = 607; 293 boys; M_age = 16.0 years, SD = 1.44 years). Mediated effects via externalizing problems on these relations were also examined, given the high comorbidity rate between internalizing and externalizing problems. Externalizing problems partially mediated the effect of stressful life events on internalizing problems and fully mediated the effect of racial discrimination for boys but not for girls. Exposure to violence had a significant indirect effect on internalizing problems via externalizing problems. The findings call for greater attention to internalizing problems among African American youth and pathways to internalizing problems via externalizing problems.     

A test of the utility of social indicators for behavioral health service planning

Given current imperatives for more effective, responsive, and economical government, policy planners and administrators are seeking increasing assistance from social scientists. Here the usefulness of social indicators to the processes of policy planning and implementation in the delivery of mental health, alcohol and drug abuse services is investigated to determine whether social indicator data can contribute to more effective policy planning. In a two part study, the relationship between social indicators and Specific sources of these data were: population total, subdivided by geographic area and race (Caucasian, Black, and Other, which in Arizona is virtually all Native Americans) from the 1975 special census; population by age and ratio of dissolutions to marriages from the Arizona Statistical Review for 1977; crime rates from the Arizona State Justice Planning Agency for 1975; and cause of death rates from the Bureau of Vital Statistics, Arizona Department of Health Services for 1975. Subjective measures of psychological well-being were not available for the internal validational component of the study. state wide service utilization rates and The Negative Affect Scale measures the individual's level of anxiety, worry, loneliness, and sadness, and is associated with other measures that have been used in epidemiological studies to identify persons with psychological difficulties. The Psychiatric Screening Inventory assesses an individual's level of psychiatric impairment as evidenced by the frequency with which he or she reports having experienced each of the 22 psychological and psychosomatic symptoms on the scale. It has also been used in numerous epidemiological studies to investigated levels of impairment among various populations. The Positive Affect Scale reflects the degree to which the person is involved with, interested in, and experiences control over his or her physical and social environment. Active involvement with the world and frequent social participation are considered to be conducive to the experience of positive affect. The Perceived Quality of Life Scale measures the degree to which the persons is satisfied with the quality of his or her life. The score on this scale is a composite of the respondent's level of satisfaction in different areas of life such as standard of living, health, personal functioning, and family life. The greater the satisfaction in these separate areas, the higher will be the individual's overall evaluation of the quality of his or her life. psychological well-being in the community is examined. Both objective and subjective social indicators were studied. Both types of indicators were found to be useful and complementary in identifying service needs and states of well-being in the community.