This chapter helps the reader to understand what a needs assessment is and be acquainted with a framework within which to conduct a needs assessment. and to be familiar with the core concepts of a needs assessment. It helps the reader to be familiar with strategies that encompass a needs assessment. Needs assessments can be carried out by a wide cast of people. Social workers and public health workers, as well as city planners, can carry out needs assessments, as can government organizations. Local citizens or groups of people can also be responsible for carrying out a needs assessment. The chapter provides an overview of strategies to develop a needs assessment. When used in combination with a health behavior framework, a needs assessment can help one determine the needs of a community and attempt to build community support for this resource or policy change through media advocacy and coalition building.
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This chapter provides a backdrop to our current social security program and an overview of some models for social security programs in Europe and Canada. It explores the genesis of the social program in the United States. The chapter also explores contents of the original social security act (SSA) and compares the titles and programs mandated through the current SSA. It offers some guidelines for the current administration of the program, examines the debate around current proposals for revision, and reviews why these proposals are current issues for consideration. The chapter then presents the current social security system, which provides for older adults, but has also grown to cover dependent women and children. Although many people have argued for their vision to privatize the system, the reality is that there is much more political support to maintain the program as a safety net program rather than a means-tested program.
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Social, Political, Economic, and Demographic Factors and Historical Landmarks Impacting Aging and Disability Public Policy
This chapter helps the reader to be familiar with the demographic and social factors that influence and shape aging and disability policy over time and to be aware of policy changes over the past century within disability and aging public policy. It explains the contrast between advances in science and technology and public policy related to people growing older and people with disabilities. Landmarks serve as essential tools to help us recall specific historical events in time. Historical landmarks, science, and technology have played significant roles in the evolution of social policies; however, aging and disability policies may not have made as many strides as other areas throughout history. The chapter briefly discusses: the role of historical landmarks in shaping social trends and public policies; the relationship between historical landmarks and aging and disability-related policies; and trends in policy, social, and political influences and landmarks in the United States.
This chapter discusses the history of the Medicare in the United States; specific components of Medicare Parts A, B, C, and D; and how Medicare provides healthcare resources to older adults and people with disabilities. Medicare, a healthcare program perceived to be a universal program rather than one based upon a needs test, currently provides healthcare to people who reach the age of 64. Comprised of four parts, it can provide hospital care, general healthcare, hospice care, home healthcare, and prescription drug coverage. The chapter provides an overview of the Medicare program, its various components, and aspects of healthcare that are covered through its component parts. Although there are currently no needs tests or limitations as to who qualifies for services, the chapter concludes with some dilemmas for the future of healthcare coverage, including “an empty pot at the end of the rainbow” and rationing of healthcare services and procedures.
This chapter helps the reader to understand the history of housing and long-term care for older adults and people with disabilities and specific components of the Long-Term Care Reconciliation Act. The chapter discusses how legislation related to housing and long-term care provides resources to older adults and people with disabilities. It explains community-based care options such as home health, seniors congregate living, assisted living options, skilled nursing facilities, and long-term care facilities. Although differences may exist from state to state relative to who qualifies for these options and when they qualify, these will be discussed in some detail specifically providing an overview of these as options for care management of older adults. The chapter describes different residential models of care for people as they require community-based settings or settings with supports and examines issues that will face the long-term and community-based care settings in the future.