Operation,

 

46

   

Target Population,

 

53

   

Human Resources,

 

53

   

Funding,

 

58

   

Functions of the Long-Term Care Ombudsman Program,

 

62

   

Resident-Level Advocacy,

 

62

   

Systems-Level Advocacy,

 

72

   

Summary,

 

76

3

 

STATE COMPLIANCE IN CARRYING OUT THE LONG-TERM CARE OMBUDSMAN PROGRAMS

 

79

   

Introduction,

 

79

   

Compliance with Mandated Federal Provisions,

 

79

   

Extent of Compliance,

 

80

   

Direct Individual Advocacy Services,

 

80

   

Systemic Advocacy,

 

86

   

Factors that Enhance or Impede Compliance with the Program’s Federal Mandates,

 

88

   

Leadership Within the Organizational Framework,

 

88

   

Elements of Infrastructure,

 

93

   

Institutional Care Context,

 

96

   

Summary,

 

98

4

 

CONFLICTS OF INTEREST

 

101

   

Introduction,

 

101

   

Legislative and Conceptual Aspects of Conflict of Interest,

 

102

   

Older Americans Act Provisions on Conflict of Interest,

 

102

   

Definitions and Conceptual Variations,

 

104

   

Types of Conflict of Interest for the Ombudsman Programs,

 

108

   

Amelioration of Individual Conflict of Interest,

 

119

   

Conclusions and Recommendations,

 

121

   

Summary,

 

126

5

 

EFFECTIVENESS OF THE STATE LONG-TERM CARE OMBUDSMAN PROGRAMS

 

129

   

Introduction,

 

129

   

Evaluation Context,

 

130

   

Evaluation Strategy: Formative and Summative Evaluations,

 

130

   

Effectiveness Questions,

 

131

   

Data and Information Sources,

 

132

   

Quality as a Central Issue in Effectiveness,

 

133

   

Political and Environmental Factors Relevant to Effectiveness,

 

134

   

Models of Implementation and Measures of Effectiveness,

 

135



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