Elderly long -term care: A historical comparative analysis of *policy decisions and "policy lags"

This research project analyzes four policy decisions: the Kerr-Mills Act of 1960, The Omnibus Budget Reconciliation Act of 1981, the 1999 United States Supreme Court decision in Olmstead v. L.C., and the Older Americans Act Amendments of 2000. The issue of long-term care for the elderly is examined in relation to these four policy decisions. The Kerr-Mills Act of 1960 constitutes a benchmark in policy because it legislated federal and state matching funding for the assistance of community-based home care for the elderly. The Omnibus Budget Reconciliation Act of 1981 resulted in broadening community-based services in the form of the social services block grant and the home and community-based services waiver program. The 1999 United States Supreme Court decision in Olmstead v. L.C. was a landmark case for institutionalized disabled persons. The Older Americans Act Amendments of 2000 (amendments of a law originally enacted in 1965) brought forth the National Family Caregiver Support Program which marks another benchmark in policy legislation: the first time that the Federal government has officially recognized the role of informal, unpaid family caregivers. The historical comparative research method is used to examine these four policy decisions. Primary and secondary archival data and historical documents are used to analyze the policies. Five research questions are posed regarding each policy decision. The concept of the social construction of aging is used to analyze the influence it had on policy outcomes. During the time frame of 1960 to 2000, other policies were enacted that impacted the lives of the elderly but were not the subject of this investigation. A paucity of policies were enacted that attempted to ameliorate the plight of the elderly in seeking the provision of community-based long-term care. There was a mismatch between needs and the policies intended to ameliorate the situation, ultimately resulting in policy lags. New comprehensive policies are called for that will resolve the community-based long-term care needs of the elderly.