Ohio's options for elders initiative: cutting corners or the cutting edge?

This article presents results from the evaluation of Ohio's community-based long-term-care demonstration project. The initiative, named "Options for Elders," was an attempt to develop a more comprehensive and rational service delivery system for disabled older people. The demonstration involved a single point of entry to long-term-care services, a telephone screen, varying levels of care management, and funding for services. The needs of clients were initially assessed by telephone, and clients were assigned to levels of care management and services based on the concept of medical triage. By placing additional responsibility on a telephone screener, the Options approach attempted to reduce the amount of in-home care management provided. The model is a unique and controversial attempt to develop a more cost-effective system of care management.