Purchase of service contracts and the functioning of private agencies.

During the past 15 years, social services have experienced a number of significant changes in clientele, provisions, delivery, and financing of services. The escalation of these changes became most dramatic with the passage of Title XX as an amendment to the Social Security Act, effective October 1, 1975. Title XX represents the groundwork of the emerging social service structure in the United States. The authors discuss the multiple issues in the expansion of Title XX and present findings from an exploratory study as to the implications.