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National policy diffusion of cost sh...

Moone, Rajean P.

National policy diffusion of cost sharing in the 2000 reauthorization of the Older Americans Act.

紀錄類型:	書目-電子資源 : 單行本
正題名/作者:	National policy diffusion of cost sharing in the 2000 reauthorization of the Older Americans Act./
作者:	Moone, Rajean P.
面頁冊數:	267 p.
附註:	Source: Dissertation Abstracts International, Volume: 69-01, Section: A, page: 0381.
Contained By:	Dissertation Abstracts International69-01A.
標題:	Gerontology. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3295694
ISBN:	9780549405405

National policy diffusion of cost sharing in the 2000 reauthorization of the Older Americans Act.
Moone, Rajean P.

National policy diffusion of cost sharing in the 2000 reauthorization of the Older Americans Act. - 267 p.

Source: Dissertation Abstracts International, Volume: 69-01, Section: A, page: 0381.

Thesis (Ph.D.)--University of Minnesota, 2008.

The population is not only aging, but also remaining more independent. As the number of older adults increase, more consumers will inevitably utilize home and community based services that support independence. Since 1965, the Older Americans Act has supported an infrastructure of home and community based services for adults 60 years old and older by providing funding for service development at the local level. While the Act has received support through 14 reauthorizations, funding has not kept pace with increases in service utilization, inflation, and cost of services.

ISBN: 9780549405405Subjects--Topical Terms:

168436
Gerontology.

National policy diffusion of cost sharing in the 2000 reauthorization of the Older Americans Act.
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245 1 0 $a National policy diffusion of cost sharing in the 2000 reauthorization of the Older Americans Act.
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500 $a Source: Dissertation Abstracts International, Volume: 69-01, Section: A, page: 0381.
502 $a Thesis (Ph.D.)--University of Minnesota, 2008.
520 $a The population is not only aging, but also remaining more independent. As the number of older adults increase, more consumers will inevitably utilize home and community based services that support independence. Since 1965, the Older Americans Act has supported an infrastructure of home and community based services for adults 60 years old and older by providing funding for service development at the local level. While the Act has received support through 14 reauthorizations, funding has not kept pace with increases in service utilization, inflation, and cost of services.
520 $a Until 2000, states could request a voluntary contribution to offset the cost of providing services. In 2000, the Older Americans Act expanded the definition of the voluntary contribution policy to include not only solicitation of donations, but also an optional sliding-fee scale system, called cost sharing. Theoretically, this will increase participant contribution in services. Cost sharing has also raised a philosophical debate about introducing a sliding fee scale to a social welfare program. The participant contributions collected from fees are utilized to expand services for other consumers. Each state unit on aging has the authority to adopt or not adopt cost sharing. Previous policy diffusion research suggests that a number of factors influence the adoption of policy, including regional influences, advocacy networks, internal state characteristics, and market characteristics.
520 $a This study investigated factors that influenced the decision of the state units on aging to adopt or not adopt cost sharing under Older Americans Act funded services. The research question answered in this study was: What factors influence a state's decision to adopt or not adopt the voluntary policy of cost sharing in the Older Americans Act? Each state and territory designates a state unit on aging (N=57) to administer the Older Americans Act. The state units on aging served as the primary source of information regarding the diffusion of cost sharing. To answer the research question, this study utilized a mixed methods approach. First, key informant interviews with stakeholders at state units on aging (N=40) occurred via telephone in 2007. Interviews were transcribed and coded through NVIVO qualitative analysis software. Next, secondary data was analyzed utilizing the inferential statistics chi-square and Independent Samples t-tests. Data on individual states' proportion of older adults, poverty rate of older adults, number of area agencies on aging, per capita income, and contribution rates was analyzed utilizing the Statistical Package for the Social Sciences analysis software.
520 $a Results from the study depict the importance of internal determinants and perceived financial gain in diffusion of the cost sharing policy of the Older Americans Act. While other factors including national advocacy groups and philosophical ideologies also provided insight into cost sharing, none were as influential as internal determinants and perceived financial gain. Specifically the area agencies on aging within a state were influential in the discussions, decision and subsequent policy relating to cost sharing. In addition states that adopted cost sharing perceived it as a method to increase program income from service recipients.
520 $a This study added to the limited research on the Older Americans Act and social welfare diffusion. In addition it serves as a practice method for social workers charged with implementing federal policies. Local advocates need to become more aware of influential factors in the decision to adopt voluntary social welfare policies in a time of increased federal policy devolution. Further research is needed to delve deeper into policy diffusion of the Older Americans Act.
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