The first section of this paper presents background information on the elderly population, the supply of nursing homes and other providers, and Medicaid expenditures. The next section briefly describes the principal agencies involved with long-term care in the District. The next five sections of the paper analyze issues related to policy development and implementation, home- and community-based services, nursing homes, and other topics, including the D.C. Office on Aging and Adult Protective Services in the Department of Human Services. The paper concludes by examining the District of Columbia's challenges for the future in organizing, financing, and assuring quality of care in long-term care for the elderly.
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