State Implementation of Collaborative Aging and Disability Policy
Type of DegreeDissertation
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This research examines aging and disability collaborative arrangements at the state level. The focus is on how states design their collaborative long-term care service delivery programs through the Aging and Disability Resource Center grants. This study uses state determinant theory to isolate factors that influence the variation in program design. The primary concepts of interest are; fragmentation of policy decision making, state commitment to public welfare spending, and state spending on long-term care infrastructure. Based on the unique development of the aging and disability networks, the following research questions were derived: Question 1: Does the bureaucratic arrangement of state aging and disability agencies influence the adoption of coordinated referral systems? Question 2: Does a state's financing for public welfare programs influence the adoption of coordinated referral systems? Question 3: Does the pattern of state’s long-term care spending influence the adoption of coordinated referral systems? This paper investigates the Aging and Disability Resource Center program to assess how specific structural and budgetary policies within each state may influence how states chose to implement their collaborative programs. This was accomplished through a mixed methods approach that first implements a quantitative analysis of secondary data on state program design, state government structure, public welfare spending, long-term care infrastructure, and several social, economic and political control variables. This was followed by a semi-structured interview of state program directors that analyzes grant processes and outcomes. This study found no relationship between state government structure and long-term care infrastructure and the ADRC program design models. It found limited support for the positive relationship between increase in public welfare spending and the adoption of a decentralized ADRC model. It found that the key factors influencing aging and disability collaboration were state ADRC advisory councils, where states ‘housed’ their programs and federal incentives.