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Purpose – Medicaid funding for long-term services and supports (LTSS) is a key avenue for community access for people with disabilities and others. Between 1997 and 2009, the boundaries of community access were redrawn and redefined with the introduction of a series of 13 bills to change how Medicaid requires states to fund LTSS. Although they did not successfully pass into law, their presence is felt in the language of the Community First Choice (CFC) Option, part of the Patient Protection and Affordable Care Act (PPACA) of 2010. This chapter documents and analyzes the changes in the concept of community access as reflected across these bills and the CFC.

Methodology – The text of these 13 bills and the CFC were compared with attention to structure, order, and meaning. Documents were hand coded and electronically searched. Codes were entered into atlas.ti for comparison and analysis.

Findings – Four significant changes in the conceptualization of community access emerged: (1) who deserves access to community, (2) what community access entails, (3) why people deserve access to community, and (4) how community access should be organized. With the exception of the reasons why people deserve access to community, the expanded concept of community access illustrated across these bills is reflected in the text of CFC.

Originality/value of the chapter – This chapter contributes to the limited literature that documents and analyzes the historical development of community access across policy documents. In addition, it highlights the relevance of incremental analysis to understanding social change through the legislative process.

The purpose of this paper is to analyze the effects of network-based individual social capital on the access of rural households to services.

In the context of development economics, an innovative data collection approach is used to determine network-based social capital. The approach originates from the field of sociology and entails a personal network survey. The authors define four social capital variables according to tie strength and social distance between the respondent and his/her network member.

Social network ties are not homogeneous. The econometric results suggest that social capital with weaker ties in combination with socially distant ties can potentially improve households’ access to rural services.

The empirical survey focusses on a single province in Northern Vietnam. Thus, the main limitation of the micro-study is its regional focus. A more representative sample of the whole country would be desirable to backup the policy recommendation.

The results indicate that access to services in rural Vietnam it still too personalized and subjective. Thus, a thorough review of the access procedures and making them more objective would be better choice. This would also root out a potential alley for corruption and nepotism.

The management of autonomous, heterogeneous network resources and services provides new challenges which libraries are now addressing. This paper outlines an approach based on the construction of broker services which mediate access to resources. It outlines a framework – the MODELS Information Architecture – for thinking about the components of broker services and their logical arrangement. It describes several development projects and services which show how brokers are developing. It uses examples drawn from the serials environment to describe some of the issues. Technologists understand that they must build more stable and unobtrusive media. They must establish more coherent contexts into which the technology may disappear.

While governments have invested in broadband infrastructure to ensure universal access, researchers argue that infrastructure alone does not guarantee internet use. The purpose of this paper is to investigate the effectiveness of one such government initiative on households’ internet adoption and use.

The authors used data from 2002 to 2014, including two choice experiment surveys and broadband access and subscription data.

The results of Survey 1 show that urban households valued existing e-services more than rural households, indicating the importance of government investment in broadband access. The results of Survey 2 show that when a publicly funded new broadband network equalized access costs, rural households valued overall e-services more than urban households, highlighting the dual role of access to e-services and their perceived benefits. Importantly, these results suggest that rural households resist social change, which lowers their valuation of certain new publicly funded e-services.

These findings extend the digital divide literature by providing empirical support for the applicability of the global village vs urban leadership framework in households’ valuations of e-services.

While the government has worked diligently to enhance access, it also needs to focus on the types of content and services and better communication with communities.

Recent research has focused on inequities in skills and usage, not internet access. Furthermore, the authors examined the inequality in benefits of access to meaningful e-services and better communication with beneficiaries.

Undergraduates are highly susceptible to the development of mental health difficulties. Afro-Caribbean students are particularly vulnerable to the pressures of university yet are less likely than other ethnic groups to receive early intervention. This paper aims to understand the barriers and facilitators that Afro-Caribbean undergraduates perceive towards accessing mental health services in the UK.

Critical Incident Technique was used as the qualitative method because it explores the critical factors that contribute to or detract from a specific experience. Seventeen Afro-Caribbean undergraduates participated in five focus groups. This involved engaging in a novel psychosocial activity that incorporated vignettes to encourage the identification of barriers and facilitators to service access. The data were analysed thematically to generate categories of critical incidents and wish-list items.

Analysis revealed rich data from a sub-group rarely researched within UK literature. Fifteen barriers, eleven facilitators and five wish-list items were identified. The importance of mental health literacy, social networks, cultural sensitivity and concerns surrounding services underpinned many categories.

Findings provide a new perspective on barriers reported in previous literature. Novel facilitators were highlighted where, although psychological and sociocultural factors were deemed valuable, structural changes were most desired. Recommended changes illustrate innovative interventions that could make services accessible for young adult Afro-Caribbean populations. Future research should explore the barriers and facilitators identified by Afro-Caribbean undergraduates across various universities who have successfully accessed and engaged with services. This could provide a holistic perspective on viable facilitators enabling access despite the presence of barriers.

The current approach to universal service involving the provision of specific services (such as fixed voice, public payphones, ability to make emergency calls, etc.) needs re‐thinking in a convergent, NGN environment. This paper seeks to be part of that re‐thinking.

Questions addressed include: Should we move to a focus on universal access to communications infrastructure, allowing consumers to dictate preferred services? Since access to the full range of NGN services, including VoIP, requires broadband connection, should the scope of USOs be “upgraded” to include broadband?

A shift towards universal network access seems sensible provided that a number of conditions exist. One is that traditional services defined under universal service obligations (USOs), remain available. In particular, a shift to VoIP raises questions about whether present features of universal service (quality, ability to make emergency calls, etc) can be sustained. Another condition is widespread access to broadband. Another condition is that consumers are empowered to exercise the increased choice of services that will be available in an NGN environment. Such consumer empowerment requires that market power, information asymmetry, barriers to “switching”, as well as “systematic bias” in consumer decisions be effectively addressed.

Stimulates the policy reconsideration that is needed in regard to universal service in an NGN environment.

This paper aims to provide a comprehensive understanding of factors that contribute to refugees’ exclusion from health-care services. More specifically, using institutional theory, this paper identifies regulative pillar-, normative pillar- and cultural/cognitive pillar-related challenges that result in refugees having limited or no access to health-care services.

The paper draws on both secondary research and empirical insights from two qualitative fieldwork studies totaling 37 semi-structured meso-level interviews, observations and focus groups in three Turkish cities (Izmir, Ankara and Edirne), as well as a total of 42 micro-level, semi-structured interviews with refugees and migrants in one large city (Izmir) in Turkey.

This study reveals that systematically stratified legal statuses result in different levels of access to public health-care services for migrants, asylum seekers or refugees based on their fragmented protection statuses. The findings suggest access to health-care is differentiated not only between local citizens and refugees but also among the refugees and migrants based on their legal status as shaped by their country of origin.

While the role of macro challenges such as laws and government regulations in shaping policies about refugees have been examined in other fields, the impact of such factors on refugee services and well-being has been largely ignored in service literature in general, as well as transformative service research literature in particular. This study is one of the first attempts by explicitly including macro-level factors to contribute to the discussion on the refugees’ access to public health-care services in a host country by relying on the institutional theory by providing a holistic understanding of cognitive, normative and regulative factors in understanding service exclusion problem.

The purpose of this paper is to examine barriers to accessing mental health services, from the perspective of young people of refugee background who have been service users, and to suggest strategies to improve access to mental health services.

A qualitative study was conducted with 16 young people (aged 18-25), who had been refugees and who had attended mental health professionals in Australia. Interview transcripts were analysed thematically to examine participants’ perspectives on what hinders initial access to mental health services.

Stigma about mental health problems was particularly prominent. Many believed a high level of disturbance was the threshold for entering services, and for some there was no knowledge of such services’ existence. Options for assistance other than mental health services were often preferred, according to young people’s explanatory models. Apprehension was expressed that sessions would be uncomfortable, distressing or ineffective. The desire to be self-reliant functioned as a further barrier. Finally, structural obstacles and social exclusion deterred some young refugees from accessing services.

Implications include the need for service providers to be equipped to provide culturally sensitive, responsive services that ideally offer both practical and psychological assistance. Potential referrers, including health professionals and community leaders, could facilitate increased access if trained to recognise and address barriers. Finally, findings indicate potential content for awareness-raising initiatives for young refugees about mental health problems and services.

This paper is original in its sample, method, topic and findings; being drawn from the first known qualitative research exploring views of young mental health service users who have been refugees about barriers to accessing mental health services.

The Bradley Library Information Support System (BLISS) is a comprehensive local area network designed to provide library users with an array of electronic information access and management services to support Bradley University's curriculum, research, and scholarly activities. The LAN is designed in a client/server architecture, with function‐specific Unix servers operating over an Ethernet network, to support a range of services both within the library and campuswide. BLISS workstations are available to both patrons and staff and located throughout the library; some BLISS resources are network‐accessible to the general campus community. A menu interface lists the resources available and establishes a transparent connection between the user and the selected resource. BLISS is a joint project of the library and computing services, providing a platform for the development of cohesive electronic information services and for the training, documentation, and mediation serices necessary to effectively use them.