Community-based long term care: The experience of the living at home programs

Through the Living at Home Program (LAHP) 20 communities across the United States have developed cooperative networks involving multiple health and social services providers. The LAHP networks have sought to increase access to care, reduce duplication of services, and identify and fill service gaps. The LAHP national evaluation is examining the inter-organizational linkages that have been implemented by the networks and the characteristics of 1500 clients enrolled for care. Preliminary findings at the midpoint of the evaluation indicate that the networks have moved from a reliance on informal communication and coordination mechanisms at baseline to the use of more formal structural mechanisms over time. Despite the lack of formal targeting criteria, the networks have enrolled a quite frail elderly population. Future analyses will examine variability across the networks in client targeting and service utilization, in order to shed light on the need for utilization review of community based long term care.