Guided by the welfare initiative under the Supreme Court's Olmstead Decision in 1999, and a New Freedom Initiative (NFI) in 2001, all American States are expected are modify their respective long term care (LTC) policies to provide comprehensive health care services dedicated to the needs of older Americans. This framework is expected to reform the following areas to increase well being of older Americans:Using the Systems Change Framework as a guide, this paper examines reform in the State of Oregon and how reform efforts have affected them. In Oregon, LTC services are administered on a local level, so as to increase the number of options available to seniors citizens.About 7% of Oregon's population are less than 5 years old, 25% under 18, and 13% are 65 or older. Women constitute 51% of the population. Of these, most settlers originally came from Europe. Others like Mexican Americans, Hispanics, Asians form a large part. The Asian community forms slightly less than 5% of the population.Program information was obtained through interviews with people over 65 years of age, health care professionals and health service providers about each of the four component areas of the LTC Systems and Change Framework. Interviewees provided details regarding the impact of services across available services, satisfaction with services, and future plans for reforms.Unrelated to governmental policy changes though, a technical experts meeting held during April 2000 had underscored the fact that the issue of older population is currently under-addressed, is poorly understood and widely unrecognized. It said that not many organizations are taking into account the comprehensive health issues, medical systems and reimbursement, environmental issues, and education that are necessary to help older Americans live better.
To utilize available funds effectively, resources must be tailored to the needs of the aged. The 25% of the population who are over age 50 today control 70% of the total net worth of U.S. households and are seasoned consumers (Dychtwald 1990).
Baby Boomers, already in there 60s, are already pushing the market to produce goods and services that are relevant to their needs. They do not like to be thought of as old. Many of these goods and services will increasingly be health-related such as gyms, ski slopes, and dating services for older adults. Since they have resources to spend, the market will respond to meet their demands.
To meet the needs of the elders, the government has framed Older Americans Act (OAA). The OAA aids state agencies to cover their social service needs. All people over age 60 are eligible, regardless of need or income. Further the State Units on Aging establish local Area Agencies on Aging (AAA) to develop and administer service plans within local areas. These provide referral services, case management, transportation, home services, day care, nutritional information, community meals, legal services, senior centers, employment programs, and protective services.
Access is the most important concept to remember when planning services for the aged. They will try to avoid services that they perceive are inappropriate, too expensive, or