ABSTRACT
This chapter points out changes that have taken place, then suggests potential changes, and makes predictions about which elements in the system can be expected to remain stable. A recent merger of the City and County Health Departments had, in itself, added impetus to these changes in the delivery of health care. There appeared to have been three general changes taking place between the data collection and this final report. First, the particular changes made in the various agencies during the time period could be seen as falling into a pattern of reform, not so much the content of services as the method of their delivery. A second apparent change was a move both toward and away from local control of local services. A third change that marked the interim period was the recognition by a number of agencies that the client himself should have some voice in the manner in which he was being served.
