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Experience Counts: Chapter 6 - Planning and Development of Services

DEVELOPING MASTER PLANS FOR SERVICES
FOR THE ELDERLY AT THE LOCAL LEVEL

Objective: to promote comprehensive long-term planning in services for the elderly in Israel

Description:

In order to systematically address the needs of the elderly at the municipal level, a major initiative was undertaken to develop a more comprehensive and long-term approach to service development for the elderly. To this end, the concept of municipal master plans for the elderly was developed and implemented. Master plans have been developed in Israel's three largest cities (Jerusalem — 1983; Tel Aviv-Jaffa — 1988; and Haifa — 1989), and in a medium-sized city (Rishon Lezion — 1991); plans are currently being developed in three other municipalities. Local authorities have taken responsibility for developing the plans with the cooperation and professional assistance of the JDC-Brookdale Institute and JDC-ESHEL (The Association for the Planning and Development of Services for the Aged in Israel).

Four main principles underlie the planning process:

— an integrated and comprehensive view of the elderly's needs at the local level

— the development of a database to evaluate services and unmet needs

— a long-range approach to service development to facilitate timely response to needs and suit resource allocation to expected needs

— the promotion of inter-organizational and inter-professional cooperation for planning and developing services for the aged

The process includes a city-wide steering committee whose role is to formulate the overall terms of reference, monitor the process, approve the final recommendations and be part of the implementation. The steering committee is composed of representatives of organizations from both the public and voluntary sectors responsible for the provision and financing of services for the elderly as well as local groups of senior citizens. In addition, there is a smaller planning committee that has direct responsibility for developing the recommendations and that meets on a regular and intensive basis. The process is facilitated by professional consultants who also play a major role in developing the database and in linking the local planning process to national databanks, policies and standards. Citizen participation is invited through public hearings that are held as a complement to the process.

The recommendations relate to both quantitative needs and qualitative and organizational improvements in the system and include a broad range of areas, such as:

— social services in the community (day care, social clubs, voluntarism)

— home-delivered services (personal care, housekeeping, meals-on-wheels, laundry service)

— medical, nursing and rehabilitative services (hospitalization, community medical and nursing services, preventive care, psychogeriatric care, dental care)

— information and referral

— institutional care and sheltered housing

In order to provide a base for decisionmaking and facilitate the formulation of the recommendations for the present and future development of services, a database is created encompassing all the service areas and including information on the existing services, assessments of present and future needs, assessment of organizational and operational difficulties, and evaluation of gaps in the service system. The database is targetted to the specific emphasis in each city and maximum use is made of any local surveys which are available. The process of developing a master plan may take up to two years.

In order to disseminate this planning model to other local authorities to assist them in developing master plans in a more independent way, a manual has now been published. The manual, published in 1994, is designed primarily for use by service directors, decisionmakers, professionals and policymakers involved in the provision of services for the elderly at the local level. The approach developed is now being applied to other target populations, including an effort to develop municipal plans for children-at-risk in two cities in Israel.

Research and Evaluation:

The cities that have developed the plans have been very satisfied with the process and feel it has made a major contribution to advancing services for the elderly. The implementation in the cities of Jerusalem, Haifa and Tel Aviv was evaluated and was found to be in accordance with the recommendations which had been made.

Sponsor: JDC-ESHEL

JDC-Brookdale Institute

Financing: JDC-ESHEL and local municipalities

Bibliography:

Korazim, Malka (ed.). 1994. Guide for the Preparation of a Master Plan for the Development of Services for the Elderly at the Local Level. JDC-Brookdale Institute and JDC-ESHEL, Jerusalem, Israel. (Hebrew)

Trajtenberg, S.; Korazim, M.; and Rotem, D. 1989. A Preliminary Evaluation of Master Plans for the Development of Services for the Elderly in Three Large Cities — Jeursalem, Tel Aviv and Haifa. JDC-Brookdale and JDC-ESHEL, Jerusalem. (Hebrew)

For Further Information:

JDC-ESHEL (The Association for the Planning and Development of Services for the Aged in Israel)
POB 3489
Jerusalem
Israel
Tel. 972-2-6557128; Fax 972-2-5662716.

COORDINATION IN THE PLANNING AND DEVELOPMENT OF SERVICES AT THE
NATIONAL AND LOCAL LEVEL:
A PARTNERSHIP BETWEEN THE
GOVERNMENTAL AND VOLUNTARY SECTORS

Objective: To coordinate service planning and development for the elderly at the national and local level

To promote a creative partnership between the voluntary and governmental sectors

Description:

National Level: JDC-ESHEL (The Association for the Planning and Development of Services in Israel):

In order to promote cooperation between the voluntary sector and the government and promote coordination among the various governmental agencies involved in planning services for the elderly, JDC-ESHEL was established in 1969. JDC-ESHEL, a partnership of a consortium of government ministries and the American Joint Jewish Distribution Committee (AJJDC)(*), has become a major framework for coordinating service development decisions among the participating organizations. Its board includes representatives of the Ministries of Finance, Health, and Labor and Social Affairs and the National Insurance Institute (Social Security Administration). In addition, JDC-ESHEL operates on the basis of nine subcommittees, which include an even broader range of representation from the public, voluntary and academic sectors. A large percentage of the total service development budget for the elderly in Israel is channeled through this organization.

Local Associations for the Elderly:

In order to promote a similar degree of cooperation at the local level, the concept of local associations was introduced by JDC-ESHEL. The first local association was established in 1971; over 100 associations for the elderly have now been established.

The Associations are nonprofit organizations which determine their goals and areas of activity independently, based on the specific needs in their communities. Each association is governed by a council, approximately one-third of whom are public officials; one-third, professional representatives of organizations serving the elderly; and one-third, senior citizens, one of whom serves as the voluntary chairman of the association. Each association includes an executive committee of from 7-9 persons responsible for the legal, financial and ongoing managerial functions of the association. In addition, subcommittees fulfill a number of functions on a range of issues.

The special roles of the Associations include:

— interorganizational coordination — The associations serve as an umbrella framework for all the agencies providing services to the elderly at the local level. Under its auspices, cooperative planning and development occurs through discussions with representatives of relevant organizations.

— strengthening the involvement of the public

— initiating new services and developing new and innovative programs appropriate to the conditions in the local communities

— advocacy to influence local policies

— mobilizing and pooling resources from a broad variety of sources

Over time, the responsibilities of the associations have expanded and in many communities they have been designated to manage and operate services, including home care, day care and other services lacking in the community.

A national association of local associations has been established to strengthen the local associations and to serve as an advocacy group on national issues.

JDC-ESHEL assists the local associations in the following areas: advice and professional consultation on setting up and operating local associations; consultation and professional assistance in planning and implementing various service programs; and financial assistance in implementing various service programs. The development of a database of all the associations is underway and training modules for managers as well as the volunteer board members are being developed. A guide on how to establish a local association was published in 1992 by JDC-ESHEL.

Special Features:

— provides an ongoing forum to coordinate ongoing service development at the local level between governmental and voluntary organizations

— provides a forum for direct participation and leadership by the elderly in planning and developing services

— provides a mechanism by which local input and feedback influence national decisionmaking

— provides an important opportunity for high-level volunteer leadership

— promotes voluntarism by and on behalf of the elderly

— provides for flexibility in decisionmaking and service development at the local level

Sponsor: Incorporated nonprofit associations

Financing: Funds and contributions are recruited from local municipalities, national ministries, JDC-ESHEL, as well as other sources

Bibliography:

Eran, Y. 1992. A Guide for the Establishment of Local Associations. JDC-ESHEL, Jerusalem. (Hebrew)

For More Information Contact:

JDC-ESHEL (The Association for the Planning and Development of Services for the Aged in Israel)
POB 3489
Jerusalem
Israel
Tel. 972-2-6557128; Fax 972-2-5662716.

LINKING POLICYMAKING AND RESEARCH ON AGING: THE JDC-BROOKDALE INSTITUTE,
A PARTNERSHIP BETWEEN GOVERNMENT AND THE VOLUNTARY SECTOR

Objective: To strengthen the link between applied research in aging and policymaking and professional practice

To promote a creative partnership between the voluntary and governmental sectors

Description:

There has been a significant development of policy-related research on aging in Israel over the last 20 years. Indeed, in many respects the field of aging has become a leading sector in pioneering the development of policy-relevant research and in linking that research with the development of policy and practice.

As the Israeli population rapidly aged and the interest in aging increased, it was only natural that more attention should be devoted to expanding the knowledge base required to help develop an effective response. Legislative initiatives focused on expanding entitlements for services to the elderly played an important role in spurring research of a policy-relevant nature that could assist in developing this legislation.

The establishment of the JDC-Brookdale Institute in 1974 was a direct expression of the belief that research could contribute to the development of public policy and professional practice.

The primary objective of the Brookdale Institute is to influence social welfare practice and policies and encourage better links between researchers and policymakers. Special features of the Institute include:

— Cooperation between the voluntary sector and the government in the governance and funding of the Institute. The overall program and policy of the Institute is determined by a Board composed of representatives of the Government of Israel (the Ministry of Health, the Ministry of Finance, and the National Insurance Institute) and the American Jewish Joint Distribution Committee.

— Direct involvement of the ministries in defining critical research issues and making a commitment to examine them

— Interorganizational cooperation among the various national ministries

— A focus on applied research, with findings feeding directly into the decisionmaking process even prior to publication

— An emphasis on a focused multiyear program of applied research to accompany major national initiatives and policy debates

— A major focus on dissemination and implementation-related activities and a commitment of the research staff to these objectives

— The development of methodology, expertise and an organizational culture to use research funds in a highly effective way, in order to maximize their contribution. The basis of this contribution is the partnership that has been formed with Israel's policymakers and the ongoing and intensive dialogue with them around the research priorities, and effective ways of using the results.

— The challenge to continually strengthen and cultivate the capacity to do research in a way that really makes a difference in the lives of people, and to reaffirm the commitment of each member of the Institute as an individual and the Institute as a whole to that objective.

The operating principles of the Institute include:

1. A set of long-range programmatic goals expressed in a five-year plan focusing on issues of national concern. A long-term commitment to programmatic goals as expressed in a five-year plan is viewed as a precondition for achieving a significant impact on public policy and professional practice. The development of each five-year plan is preceded by a process of agenda-setting which involves researchers, policymakers and service professionals. Within the framework of the plan, there is an annual process of priority setting that involves a dialogue between researchers and policymakers, which is in part an outgrowth of the various contacts between the Institute and the field. These contacts include participation of Institute staff on a broad range of ongoing committees and special commissions in which critical issues are defined. The development of the agenda is heavily influenced by the findings of earlier research, which not infrequently get translated into requests for further research from the field.

2. Close collaboration with partners in the field. There is a major commitment on the part of the Institute to working closely with the potential consumers of the research findings to help apply them and to making a major investment of time and resources in the dissemination of the findings and their implications. This maximizes the potential impact of research findings and enables the Institute to have a broad impact for a relatively small investment.

3. The integration of planning, evaluation, dissemination and education. There is often a systematic progression in which initial research efforts generate clearly defined proposals for systematic change. Efforts are then made to demonstrate the proposals in the field. Through the evaluation of these demonstrations, opportunities are provided for obtaining more in-depth answers to key question and, finally, an active policy of national dissemination is evolved. Training and educational needs are taken into account at each phase of the process.

The Brookdale Institute also plays a major role as a conflict resolver, convener, and facilitator of the process of national policy development and consensus building. Beyond its ability to work with individual policymakers and organizations and ministries, the Institute has excelled in its ability to work on issues that cut across a number of ministries and to establish a common and coordinated framework for exploring issues of mutual concern, despite the fact that these issues are controversial and sensitive. These efforts have been focused on issues which involve complex interorganizational relations, are the subject of major controversy and conflict, and involve major structural changes in the way things are done, and thus require a complex process of change. This role has found expression in the assistance provided by the Institute to parliamentary committees and governmental commissions. The Institute played such a role in promoting the development of regulatory systems for long-term care institutions, in the development of comprehensive community care systems, and in assisting various municipalities in developing master plans for services for the elderly.

The progress which has been made in developing more effective national systems provides encouraging evidence that it is possible through a sustained and intensive effort and close cooperation between researchers and policymakers to bring about major improvements in the service system for the elderly. In addition, these developments have begun to serve as a stimulus in other areas of social policy.

Sponsors: The American Jewish Joint Distribution Committee (AJJDC)

The Government of Israel

Financing: The Brookdale Foundation of New York

The American Jewish Joint Distribution Committee (AJJDC)

The Government of Israel

Bibliography:

Dluhy, M.; Habib, J.; Pelaez, M.; and Rothman, M. 1988. Approaches to Linking Policy and Research in Aging: Israel and Florida. Report of a Conference. Southeast Florida Center on Aging, Miami, and JDC-Brookdale Institute, Jerusalem. (English)

Annual Report and Complete List of Publications Available Upon Request

For Further Information:

JDC-Brookdale Institute, POB 13087, Jerusalem 91130 Israel

Tel. 972-2-6557400; Fax 972-2-5635851.

*The AJJDC is an international voluntary organization with a major role in developing social services in Israel.