Planning and Implementation of Channeling: Early Experiences of the National Long Term Care Demonstration

摘要

This document describes the development and first year's operations of the National Long Term Care Demonstration, a channeling demonstration to test two models of community - based care as alternatives to the current institutionally oriented system. Both models offer a central intake point, systematic assessment of individual needs, and ongoing case management. However, the case management model is designed to manage services currently available to long - term care clients, while the financial control approach is to expand the range of publicly financed services, informal caregivers, and add cost control features. Data sources include interviews with selected participants in the 10 demonstration sites and project records and reports for 1980 to 1982. The initial chapters provide background information on the demonstration, covering its design, characteristics of the State lead agencies and local host agencies responsible for channeling, and characteristics of participating States and sites. Implementation of the three important elements of channeling -- referral sources, service providers, and reimbursement mechanisms -- are discussed in detail. Subsequent chapters describe the channeling process itself, beginning with casefinding, referral, and screening processes and characteristics of the population recruited by channeling. Also reviewed are assessment, care planning, service initiation, and ongoing case management. The report presents data on the development and maintenance of the caseload and on the time required to complete each of the client level channeling functions. The final section explores the experience of the 10 channeling projects to date, particularly factors influencing implementation and early operations. The appendices detail sources of eligible referrals by site and model. Tables, 1 figure, and almost 30 references are supplied.