Delivering services to the rural elderly. A study of policy implementation

B. Foster, J. Susman, K. Mueller, A. Bowman, K. Lunt

Research output: Contribution to journalArticlepeer-review


This article presents an analysis of two demonstration projects designed to improve delivery of services to elderly residents of rural Nebraska. One project employs a statewide system of care management focused on individual clients. In the other, local agencies in four communities coordinate services by using the local senior center as a focal point. This article uses established theory of policy implementation to illustrate problems encountered in starting new social programs that require state-local cooperation. Four guidelines are suggested for policymakers: (a) if local agencies are responsible for implementation, local managers must be involved in all the planning activities for new programs; (b) clear guidelines are needed to be sure that there is consensus concerning the details of implementation; (c) all health care providers should be involved in implementation when health care services are being coordinated; and (d) community coordinating councils can be effective.

Original languageEnglish (US)
Pages (from-to)13-20
Number of pages8
JournalJournal of Case Management
Issue number1
StatePublished - 1994
Externally publishedYes

ASJC Scopus subject areas

  • Leadership and Management


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