The Home Care Research Initiative supported primary research projects to improve knowledge about home care health policy and practice.

Home and community-based services — ranging from skilled nursing and physical therapy to help with daily activities such as bathing and dressing — are vital to many people with chronic illness or disability.

By 1995, these services had become the fastest-growing component of U.S. health care spending, according to the Visiting Nurse Service of New York. Demand for home care was increasing while, at the same time, financial and political forces were pushing for cuts in spending growth.

Key Results
According to the national program director, Penny Hollander Feldman, Ph.D., at the Visiting Nurse Service of New York, the program substantially contributed to current knowledge about spending on home and community-based services and options for expanding managed long-term care and assisted living. The Home Care Research Initiative:

• Addressed gaps in knowledge that are relevant to policy by funding nine primary research projects.
• Synthesized existing research, worked to develop consensus on home and community-based service goals and successes and advanced new concepts and paradigms by commissioning 26 papers (20 of which were completed) to inform policy-makers, practitioners and researchers.
• Worked with policy-makers and long-term care opinion leaders to:
  • Identify relevant long-term care research issues.
  • Understand how to communicate research results in ways that are responsive to their needs through meetings and publications.

Several projects influenced long-term care policy or have the potential to do so, according to Feldman. These include:

• Two projects where staff worked with state decision-makers to install and test new mechanisms for assessing needs and targeting long-term care services in Michigan and New Hampshire.
• One project where staff worked with officials in the Massachusetts home care system to identify the obstacles that must be overcome to facilitate the purchase and use of assistive devices.
• An analysis of national survey data that showed that the use of inexpensive assistive devices results in less use of long-term care services by people who are disabled. See Lessons Learned for lessons from this project.

See Project List for reports on the individual projects.

Program Management
The Visiting Nurse Service of New York in New York City, through its Center for Home Care Policy and Research (a nonprofit institute), served as the national program office.

Funding
The Board of Trustees of the Robert Wood Johnson Foundation (RWJF) authorized the program in July 1995 for $4.8 million. Total authorizations through June 2002 were $6.64 million.