First published in 1999. When human populations and their needs change, organizations responsible for their care inevitably react. With the rapidly and significantly increased demand for chronic care at mid-twentieth century, solutions deemed satisfactory in the past were entirely inadequate. Thus, community leaders and politicians began promoting several approaches to long-term care services in the two decades between 1945 and 1965, but without an adequate source of financing to establish an effective system. In contrast to acute care services and despite the need, chronic care remained unavailable and of poor quality. This study consists of six chapters: an introduction and conclusion, along with four case studies that examine in detail the development of a long-term care system in Philadelphia between 1945 and 1965.