ABSTRACT
Auspices for long-term, community-based services at mid-twentieth century reflected place and population-specific needs, because needs of the long-term sick varied by location, and funding was local and small-scale. In the late 1940s, Health and Welfare Council's (HWC) Division on Aging assumed responsibility for long-term care planning and recommended development of community-based support programs such as home helps and meals-on-wheels. Innovations were frequently small, focused projects within neighborhood or aggregate-based community agencies; extending these to the wider community proved an overwhelming task due to lack of leadership, personnel, and funding. Admission and program maintenance decisions arose from a settlement perspective of individual need and community benefit, rather than from strict social welfare judgments which tended to control and distill community need into a moral framework. Decades of dispute between the organizations reflected the differences between a settlement approach to social need and community organization, contrasted with HWC's central authority to direct charitable funds emphasizing moral management of care recipients.
