Black Adoption Placement and Research Center at 25: placing African-American children in permanent homes (1983-2008)

The Black Adoption Research and Placement Center is a nonprofit organization delivering culturally specific adoption and foster care services. The organization developed as a response to concerns in the African-American community about the high numbers of African-American children entering and not exiting the public foster care system. The organization has undergone significant transformations over its 25-year history in relation to social, political, and economic changes that have altered the ways that the agency finances and delivers services. The history of Black Adoption Research and Placement Center presents an organization that has weathered many challenges because of its strong leadership, its committed governing body, its external relationships, and its internal operations.     

CompassPoint Nonprofit Services: strengthening the capacities of nonprofits (1971-2008)

CompassPoint Nonprofit Services is a nonprofit organization that delivers cutting-edge research and support services to the nonprofit community. Over its 30-year history, CompassPoint has transitioned from a small management support agency into a nationally-recognized leader in nonprofit capacity building and nonprofit management research. Through its strong internal operations and external connections, the agency has been able to stay current on the multiple challenges facing the local and national nonprofit community. CompassPoint has been a valuable resource for the nonprofit sector as it has struggled to retain its identity over the past 30 years, in relation to political and economic changes that have altered the functioning of the sector as a whole.     

Asian Community Mental Health Services at 35: a pioneering ethnic organization (1973-2008)

Asian Community Mental Health Services is a nonprofit organization that delivers mental health services to primarily Asian and Pacific Islander communities. From its early beginnings and over its 35-year history, the agency has had to overcome numerous challenges, including gaining legitimacy as a culturally specific nonprofit, combating stigma surrounding mental health issues within the Asian Pacific Islander community, building resources to fund service delivery, and developing an educated and culturally sensitive workforce. The history of the organization highlights the multiple challenges and rewards of developing a culturally specific nonprofit in an urban area as well as the important role that internal operations play in relation to nonprofit expansion and growth.     

The Bayview Hunters Point Foundation for Community Improvement: a pioneering multi-ethnic human service organization (1971-2008)

The Bayview Hunters Point Foundation for Community Improvement is a nonprofit organization established in 1971 to defend the legal rights of African-Americans living in its community. Over the years, the agency diversified its services to include mental health and substance abuse treatment, violence prevention, youth programming, and HIV services. The organization has overcome multiple challenges during its 37-year history in relation to social, political, and economic changes that have influenced the way the organization has financed and delivered its services. The history of the organization presents a collaborative approach to community problem-solving and exemplifies the important role that external relationships play in relationship to nonprofit growth and survival.     

Shelter Network: serving homeless families and individuals (1987-2007)

Shelter Network is a nonprofit organization that delivers a range of services that meet the needs of homeless families and individuals in order to help them achieve stable housing and self-sufficiency. The agency began as a grassroots community effort to respond to the growing problem of homelessness and its relationship with its external community continues to play an important role in its financing, growth, and development. Over its 20-year history, Shelter Network has overcome multiple challenges related to leadership, finance, and community support and has grown from a grassroots agency into an organization with a budget of $7 million.     

The Unity Council at 40: a pioneering community development and service organization (1967-2007)

The Spanish Speaking Unity Council (Unity Council) is a community development nonprofit organization that was established in 1964, during the civil rights movement, by a group of community members who wanted to ensure the political representation of the Latino community. Over its 45-year history, the Unity Council has grown into a $12 million community development organization that delivers a range of programming, including social services and employment training as well as facilitating the development and support of local businesses, low-income housing, and neighborhood improvement activities. The history of the agency presents the multiple challenges and rewards associated with development in an underserved community and an example of the important role that leadership plays in the growth of a nonprofit.     

Larkin Street Youth Services: helping kids get off the street for good (1982-2007)

Larkin Street Youth Services is a pioneering nonprofit organization that was established in 1981 to serve the growing urban homeless and runaway youth population. What began as a neighborhood effort has evolved into a $12 million organization over the course of its 25-year history. Larkin Street Youth Services delivers a continuum of services to homeless youth including counseling, housing, education, employment, and HIV services. The agency has received significant local and national attention for the success of its targeted program model and continuum of care services. The history of Larkin Street Youth Services provides an example of the important role of internal operations in an agency's ability to re-invent itself and respond to a larger community need.     

BANANAS: providing child care services to a multi-ethnic community

BANANAS, Inc. is a nonprofit organization that has provided child care resource and referral services for over 35 years. BANANAS emerged as a grassroots effort initiated by a group of female volunteers who sought to build a network of women with children who needed childcare. As the organization developed, its leaders recognized and responded to additional needs, including resource and information sharing, workshops and classes, and political advocacy. Beginning as a collective, BANANAS has grown into a multifaceted service delivery and advocacy nonprofit operating with an annual budget of $12 million. This history of the agency reflects the development of a unique community-based effort, its challenges and rewards, and the multiple successes that this pioneering nonprofit has experienced.     

Jewish Family and Children's Services: a pioneering human service organization (1850-2008)

Jewish Family and Children's Services of San Francisco, the Peninsula, Marin, and Sonoma Counties is a pioneering nonprofit human service organization that has delivered services for 157 years. Over the course of its history, the organization has transformed itself from an all-volunteer agency delivering aid to immigrant families during the Gold Rush era to a $30 million nonprofit human service organization offering a full-range of services to adults, children, and families. The history of Jewish Family and Children's Services sheds light on the importance of strong leadership, strategic planning, external relationships, and strong donor support.     

Forecasting service needs for the year 2000: implications for state government

This article is based upon research in Florida of the older population and its projected need for services. It includes discussion of the method and findings of the study. The focus, however, is on the policy implications for state government that emerged from the research. The data has enabled Florida to examine the experience of its own community care programs in order to help develop a strategic plan for expanding resources, reforming its organization, and improving its performance. In addition to funding and organization of the state's long-term care system, the issue of targeting limited community resources to severely frail elders emerged as a major concern of this research. Although the various states differ widely in history, demographics, and structure, these policy issues should be of immediate concern to each of them.     

Girls Incorporated of Alameda County at 50: a voice for girls (1958-2008)

Girls Incorporated of Alameda County is nonprofit human service organization that has delivered education, counseling, and advocacy services to girls aged 6 to 18 for 50 years. The organization began as a small, local girls club and has grown into a large multi-faceted service delivery organization attached to a national governing body. The history of Girls Incorporated of Alameda County introduces struggles in relation to external and internal factors that altered the way that the agency financed and managed and exemplifies the important role of nonprofit leadership. The organization's many accomplishments have also presented multiple challenges, particularly related to the changing roles of women in American society.     

The Program of All-Inclusive Care for the Elderly (PACE): an innovative long-term care model in the United States

This article examines the long-term care service system in the United States, its problems, and an improved long-term care model. Problematic quality of care in institutional settings and fragmentation of service coordination in community-based settings are two major issues in the traditional long-term care system. The Program of All-Inclusive Care for the Elderly (PACE) has been emerging since the 1970s to address these issues, particularly because most frail elders prefer community-based to institutional care. The Balanced Budget Act of 1997 made PACE a permanent provider type under Medicare and granted states the option of paying a capitation rate for PACE services under Medicaid. The PACE model is a managed long-term care system that provides frail elders alternatives to nursing home life. The PACE program's primary goals are to maximize each frail elderly participant's autonomy and continued community residence, and to provide quality care at a lower cost than Medicare, Medicaid, and private-pay participants, who pay in the traditional fee-for-service system. In exchange for Medicare and Medicaid fixed monthly payments for each participating frail elder, PACE service systems provide a continuum of long-term care services, including hospital and nursing home care, and bear full financial risk. Integration of acute and long-term care services in the PACE model allows care of frail elders with multiple problems by a single service organization that can provide a full range of services. PACE's range of services and organizational features are discussed.     

The Program of All-Inclusive Care for the Elderly (PACE)

Summary

This article examines the long-term care service system in the United States, its problems, and an improved long-term care model. Problematic quality of care in institutional settings and fragmentation of service coordination in community-based settings are two major issues in the traditional long-term care system. The Program of All-Inclusive Care for the Elderly (PACE) has been emerging since the 1970s to address these issues, particularly because most frail elders prefer community-based to institutional care. The Balanced Budget Act of 1997 made PACE a permanent provider type under Medicare and granted states the option of paying a capitation rate for PACE services under Medicaid. The PACE model is a managed long-term care system that provides frail elders alternatives to nursing home life. The PACE program's primary goals are to maximize each frail elderly participant's autonomy and continued community residence, and to provide quality care at a lower cost than Medicare, Medicaid, and private-pay participants, who pay in the traditional fee-for-service system. In exchange for Medicare and Medicaid fixed monthly payments for each participating frail elder, PACE service systems provide a continuum of long-term care services, including hospital and nursing home care, and bear full financial risk. Integration of acute and long-term care services in the PACE model allows care of frail elders with multiple problems by a single service organization that can provide a full range of services. PACE's range of services and organizational features are discussed.     

Nonprofit and for-profit home care in Israel: clients' assessments

Clients' assessments of differences between nonprofit and for-profit organizations delivering home care services to Israel's frail elderly were studied. No significant differences were found between nonprofit and for-profit providers with respect to organizational efficiency; speed of placement and replacement of home care workers; responsiveness to clients' complaints; and supervision of care plans, schedules, and service delivery. Systematic differences were found, however, in clients' perceptions of workers employed by nonprofit versus for-profit service providers. The differences related to the home care workers' adaptation to clients' needs and wants; how well workers delivered services; and how satisfied clients were with the services received. Indications are that the relatively high efficiency of nonprofit organizations can largely be attributed to the performance of their home care workers.     

Nonprofit and For-Profit Home Care in Israel

Clients' assessments of differences between nonprofit and for-profit organizations delivering home care services to Israel's frail elderly were studied. No significant differences were found between nonprofit and for-profit providers with respect to organizational efficiency; speed of placement and replacement of home care workers; responsiveness to clients' complaints; and supervision of care plans, schedules, and service delivery. Systematic differences were found, however, in clients' perceptions of workers employed by nonprofit versus for-profit service providers. The differences related to the home care workers' adaptation to clients' needs and wants; how well workers delivered services; and how satisfied clients were with the services received. Indications are that the relatively high efficiency of nonprofit organizations can largely be attributed to the performance of their home care workers.     

Staffing,retention, and government funding: A case study

This study analyzes the implications of government‐contract funding on the staffing pattern of a nonprofit agency, the Canadian Red Cross, Toronto Region. Furthermore, the study explains the implications of the staffing pattern on services and on the agency's organization. Staffing is one area that the literature on nonprofit organizations has not adequately addressed. The findings indicate that contract‐based funding leads to the hiring of temporary staff and affects the retention of employees. Although contract funding has some benefits, temporary staffing is detrimental to the agency's services. It affects not only employee recruitment and retention but also training. The results highlight how change in government funding from grants to contracts resulted in the agency's new staffing strategy and ultimately reduced the effectiveness of the services the agency provided to the community.     

Facility Ownership and Resident Satisfaction with Assisted Living

Abstract

Although the majority of assisted living facilities operate as for-profit organizations and serve increasingly frail elderly populations, little is known about the impact of ownership on the quality of care in assisted living. This study examines the relationship between facility ownership and the quality of care in assisted living, using resident satisfaction as a quality indicator. The assessed aspects of satisfaction include health care, housekeeping, physical environment, relationships with staff, and social life/activities. The relationship of facility ownership to resident satisfaction is examined controlling for resident psychological well-being, functional ability, facility size, and staff resources. Data were collected in personal interviews with 156 residents, including 96 residents in eight for-profit facilities and 60 residents in five nonprofit facilities in Maryland. Residents in the sampled nonprofit facilities were more satisfied with assisted living than were residents in the for-profit facilities. In particular, residents in nonprofit facilities were more satisfied with health care, physical environment, and social life/activities in the facility. Better understanding of the relationship between facility ownership and resident satisfaction can help administrators create environments that maximize resident satisfaction in both nonprofit and for-profit facilities.     

Telemedicine,rural elderly,and policy issues

Historically, rural America has had a difficult time providing health care to its residents, particularly its frail elderly population. Rural health care is often faced with a shortage of health care specialists, facilities with inferior equipment, and insufficient resources compared to health care in more urban areas. It is anticipated that the use of telemedicine will help address many of the problems facing the delivery of health care services to rural elderly. This paper reviews some innovative projects delivering services to the elderly. Also, the paper discusses several issues that need to be addressed before telemedicine can reach its full potential in improving access to health care, including reimbursement policies, patient and provider liability and confidentiality, and the infrastructure supporting telemedicine. Although telecommunications has tremendous potential to address the care needs of frail isolated elderly, without comprehensive reimbursement policies, guidelines for ethical conduct of a teleconsultation, acceptable security measures of patient records, and adequate as well as compatible infrastructure, that potential cannot be completely realized.     

The Collaborative Research Education Partnership

Abstract

This article discusses the founding and operation of the Emmett J. and Mary Martha Doerr Center for Social Justice Education and Research, an endowed nonprofit organization located within the School of Social Service at Saint Louis University. The nonprofit Center provides a creative mechanism for facilitating university-community agency research. The Research Education Partnership (REP) model creates a partnership among students, community agency personnel, and faculty in funded practice research and program evaluation. Four collaborations, their benefits and challenges, are described. Students are prepared to integrate research into practice. The Center promotes and supports faculty-community partnerships for social justice.     

Caregiving and long-term health care in the People's Republic of China

The growing proportion of frail elderly in the People's Republic of China has necessitated policy of the state toward their long-term care. In this decade, there has been an increase in the amount of data available on the care and needs of Chinese frail elders. This article synthesizes these data and traces the patterns of care of frail elders. It distinguishes between urban and rural patterns, and identifies the increasing role of the family and community in the caregiving of elders. State policy, evident from the data, suggests that the state's role in direct care of elders is minor but that it continues to influence and support eldercare as part of its policy of promoting the one-child per couple policy. This process can be seen in support programs for the childless elder, who symbolizes the expected condition of a large number of future elders under the one-child policy. The article identifies four factors that are influencing the changing patterns of long-term care of elders in China: (1) economic reform programs; (2) the political agenda of the Chinese Communist Party; (3) differences in urban and rural economic conditions; and (4) policy directed at long-term investment in health care technology.