Almost home : reforming home and community care in Ontario / / Patricia M. Baranek, Raisa B. Deber, A. Paul Williams

• Record Nr.: UNINA9910818671103321
• Autore: Baranek Patricia M.
• Pubbl/distr/stampa: Toronto, [Ontario] ; ; Buffalo, [New York] ; ; London, [England] : , : University of Toronto Press, , 2004; ©2004
• ISBN: 0-8020-8639-X; 1-281-99267-4; 9786611992675; 1-4426-7075-4
• Descrizione fisica: 1 online resource (357 p.)
• Disciplina: 362.1/4/0971309049
• Soggetti: Home care services - Government policy - Ontario - History - 20th century; Long-term care of the sick - Government policy - Ontario - History - 20th century; Home care services - Government policy - Ontario; Long-term care of the sick - Government policy - Ontario; History; Ontario
• Lingua di pubblicazione: Inglese
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Note generali: Description based upon print version of record.
• Nota di bibliografia: Includes bibliographical references and index.
• Nota di contenuto: 1. Introduction and overview -- 1.1 From hospital to home and community -- 1.1.1 The medicare mainstream -- 1.1.2 Outside the mainstream: community-based long-term care -- 1.1.3 Policy content: financing, delivery, and allocation -- 1.2 The case of Ontario's reform of community-based long-term care -- 1.2.1 Factors pushinh towards reform -- 1.2.2 Models for reform -- 1.3 Looking ahead: the making and meaning of LTC reform in Ontario -- 2. Conceptual framework -- 2.1 Introduction -- 2.2 Neo-institutionalism and policy communities -- 2.2.1 Ideas -- 2.2.2 Insitutions -- 2.2.3 Interests -- 2.3 Policy outcomes: design decisions -- 2.3.1 The public/private mix -- 2.3.2 Financing -- 2.3.3 Delivery -- 2.3.4 Allocation -- 2.4 Summary and ; conclusions: policy legacy -- 3. Research methodology: the case study approach -- 3.1 Qualitative research and case studies -- 3.2 Data sources -- 3.2.1 Documents -- 3.2.2 Interviews -- 3.3 Determination of the policy community -- 3.4 The community-based LTC policy community -- 3.5 Analytical strategies -- 3.5.1 Historical review -- 3.5.2 Policy analysis -- 3.5.3 Content analysis -- 4. Long-term care reform in the Liberal period, 1985-1990 -- 4.1 Long-term care reform under the Liberal goverments -- 4.2 Liberal minority government, 1985-1987: one-stop shopping -- 4.2.1 Institutional changes and underlying government interests -- 4.2.2 A new agenda -- 4.2.3 Societal interests and influence on reform -- 4.2.4 Assessment of one-stop access by members of the policy community -- 4.3 Liberal majority government, 1987-1990: service access organizations -- 4.3.1 Paradigm shift through institutional change -- 4.3.2 MCSS takes charge -- 4.4 Rationale for and scope of the reform -- 4.4.1 Strategies for cange and the service access organizations -- 4.4.2 Service access organizations -- 4.4.3 Integration of services through institutional change -- 4.4.4 Influence of societal interests on the development of the SAO model -- 4.4.5 The mobilization of interests -- 4.4.6 Assessment of SAO by the LTC policy community -- 4.4.7 Beginning of the implementation process for strategies for change -- 4.5 Conclusions.; 5. Long-term care reform under the New Democratic Party, 1990-1993 -- 5.1 The first attempt at long-term care reform under the New Democratic Party -- 5.2 The early days of the NDP government, 1990-1992: delay, then more of the same -- 5.2.1 Redirection and the service coordination agency model -- 5.2.2 Service coordination agency: a Liberal model in NDP clothing? -- 5.2.3 Consultation with the community -- 5.2.4 Mobilization of interests -- 5.2.5 The coalitions propose a new mocel -- 5.2.6 Institutional changes within government: the shift from MCSS to MOH -- 5.2.7 A new model begins to emerge -- 5.3 The NDP and the multi-service agency model -- 5.3.1 The recession and the social contract -- 5.3.2 The locus of policy development shifts -- 5.3.3 The partnership documents -- 5.3.4 Anticipating objections -- 5.4 Conclusions -- 6. The New Democratic government and the multi-service agency, 1994-1995 -- 6.1 The New Democrats and the multi-service agency -- 6.2 Bill 173, an Act respecting long-term care -- 6.3 Government interests -- 6.3.1 Direct delivery -- 6.3.2 Human resource issues: unionization and protection of collective agreements -- 6.3.3 For-profit versus non-for-profit delivery -- 6.3.4 External purchase of services -- 6.3.5 Mandated basket of services -- 6.3.6 Entitlement to home care -- 6.3.7 User fees -- 6.4 Policy interests of societal gropus -- 6.4.1 'Consumers' -- 6.4.2 Providers -- 6.4.3 Labour -- 6.4.4 Volunteers -- 6.4.5 Other interests -- 6.4.6 Activities of the provider coalition -- 6.5 A babel of values -- 6.6 Amendments to Bill 173 -- 6.7 Perceived influence of societal interest groups -- 6.8 Conclusions -- 7. The Progressive Conservatives implement long-term care, 1995-1996 -- 7.1 The Progressive conservatives -- 7.2 The Progressive Conservatives on campaign -- 7.3 The Progressive Conservatives and the community care access centres -- 7.3.1 The PC consultation -- 7.3.2 The consultation report -- 7.3.3 Assessment of the consultations -- 7.3.4 The CCAC model -- 7.3.5 Assessment of CCACs -- 7.4 Governmen interests in the development of the CCAC model -- 7.5 Societal interets -- 7.5.1 Changing structure of societal groups -- 7.5.2 Interests advanced by societal groups at the consultation -- 7.6 Influence of interests -- 7.7 Conclusions -- 8. Moving towards home: policy change and policy stasis beyond the medicare mainstream -- 8.1 Reforming community -based long-term ; care in Ontario -- 8.2 Summary: policy content and process under successive governments -- 8.2.1 One-stop shopping/access (Liberal, 1987) -- 8.2.2 Service access organizations (Liberal, 1990) -- 8.2.3 Service coordination agency (NDP, 1991) -- 8.2.4 Multiservice agencies (NDP, 1993) -- 8.2.5 Community care access centres (PC, 1996) -- 8.2.6 Summary of the reform models -- 8.3 Ideas, interests, and institutions -- 8.3.1 Ideas -- 8.3.2 Interests -- 8.3.3 Institutions -- 8.4 Epilogue: Reining in the community care access centres -- 8.4.1 Romanow and the future of medicare -- 8.5 Whither the state in health care? -- References -- Index.
• Sommario/riassunto: "Almost Home is a comprehensive study of the policy questions underlying the shift in medical care from hospitals to homes and communities, a change that is reshaping Canadian health care policy and politics. Using document analysis and interviews with government officials and other key stakeholders in the policy community, the authors analyse the policy content and process of five different attempts to reform home and community care in Ontario between 1985 and 1996, as introduced by Liberal, New Democratic, and Conservative governments."--Jacket