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Public Policy and Administration


Anne J. Hacker


As the U.S. population ages, the need for public policies regarding long-term care increases, as the need is unequal to demand. The purpose of this qualitative study was to explore and describe the role of senior service providers (SSPs) who have dealt with health policies from being responsible for the decision-making processes of implementing federal and state guidelines in Michigan on access and wait-listing of older adults for home and community-based services (HCBS). The theoretical foundation for this study was the social construction and policy design theory. The central research question sought perceptions of SSPs as to their ability to impact the social construction for their targeted population. Data were collected via open-ended surveys that were distributed to SSPs in Michigan (n = 10). Codes and themes emerged from the manually analyzed data. Findings included the importance of getting medical help for older adults needing HCBC. Additionally, participants indicated enrollment policies should be equally applied across HCBS providers to decrease waitlists and increase access, and extended waitlist periods may not provide the services required or preferred, a problem likely to worsen as more baby boomers reach retirement age. Improving HCBS policy implementation may result in positive social change for this expanding population, baby boomers, and the remaining members of the generation that precedes them, a cohort of people that will likely double in 12 years.