title: Analysis and advocacy in home- and community-based care: an approach in three parts.
abstract: A new chapter in health policy presents both challenges and opportunities for aging policy analysts and advocates concerned with long-term care. Millions of long-term care recipients and providers live today in a pubic policy netherworld, one principally associated with Medicaid. I suggest here that moving policy forward will entail three key steps: (a) to overcome structural lag in key home and community-based care (HCBC) policy arenas; (b) to reverse a contemporary pattern of risk-shifting from institutions to individuals; and (c) to inform and empower caregivers to have their own pressing needs recognized. Recent developments in Washington provide new optimism on these fronts. Voluntary long-term care and community-based care (LTC/HCBC) proposals are on the table within the broad context of health care reform. Whether they remain will be, in large, part a function of how far we have moved along the fronts described: modernizing policies, recognizing risks, and activating neglected policy constituencies.
authors.affiliation: School of Social Work, Boston University, Boston, Massachusetts, USA. rhudson@bu.edu
authors.forename: Robert B
authors.initials: RB
authors.lastname: Hudson
mesh_terms: D000375:Aging; D017028:Caregivers; D002908:Chronic Disease / Q000191:economics / Q000628:therapy; D003153:Community Health Services / Q000458:organization & administration*; D005853:Geriatrics; D006291:Health Policy; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D057187:Independent Living; D008134:Long-Term Care / Q000458:organization & administration*; D008484:Medicaid / Q000458:organization & administration; D006278:Medicare / Q000458:organization & administration; D011057:Politics; D012306:Risk; D012947:Social Work / Q000458:organization & administration; D014481:United States