7/24/2015. Presentation Overview. Administration for Community Living. Administration for Community Living

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1 Aging in New England: Implications for Nursing 21 st Annual Gerontological Nursing Conference August 21, 2015 Presentation Overview Administration for Community Living Aging in America-A National Perspective White House Conference on Aging, 4 Initiatives Best-Practice Models in the Region and New England Recognizing Opportunities in Elder Justice & Special Populations Multi-disciplinary Team models in NY & NH Compassionate Care/Geriatric Release of Aging Prisoners Prevention, Assessment and Intervention Strategies: Implications for serving for the Seniors of Tomorrow 2 Administration for Community Living ACL and AOA For older adults and persons with developmental disabilities Reflects: 1) Administration on Aging 2) Administration on Intellectual and Developmental Disabilities, and 3) The Office on Disability 3 Administration for Community Living Another Re-Organization! For older adults and persons with all disabilities: 1) Administration on Aging, 2) Center for Integrated Programs 3) Administration on Disabilities 4) National Institute on Disability, Independent Living, and Rehabilitation Research 5) Center for Policy & Evaluation 6) Center for Budget & Management 7) Office of Regional Operations 8) Office of External Affairs 4 5 Hot Topics: Reasons to Celebrate! 50 th Anniversary of the Older Americans Act 50 th Anniversary of Medicare & Medicaid 80 th Anniversary of Social Security 6 1

2 Why Is This Important? The United States is getting older and more diverse. 10,000 adults in the US turn 65 every day! This change has implications for policy, services, and daily life. We can t do Advocacy alone. It is a key element in the foundation of our work. Advocacy requires Coordination, Collaboration, Partnership and good Data. National Perspective Healthy Aging Is Our Goal but how did we get here? 1920 s - Elderly viewed as poor, frail, needy* 1930 s 1970 s, Compassionate Ageism It s the Governments role to help aging people.* 1980 s - The Year of the Greedy Geezer* 2006 Caregiver Support, Person Centered Plans 2009 AARP Magazine with Mick Jagger on Cover 2013 Betty White on Super Bowl Commercial 2014 Depiction of Older Americans via Halloween Costume 8 * Aging Nation,, Schultz & Binstock National Perspective on Aging? Today s Seniors Want Livable Communities???? 9 10 Adding Value: Community Based Organizations -Stanford model of chronic disease self-management -Diabetes self-management -Nutrition counseling -Meal provision -Education about Medicare preventive benefits White House Conference on Aging (WHCoA) Boston Tampa Cleveland assistance/system navigation -Evidence-based care transitions -Care coordination -Medical transportation -Evidence-based medication reconciliation programs -Evidence-based fall prevention programs/home risk assessments -Caregiver support -Environmental modifications assistance/system navigation -Nursing facility transitions (Money Follows the Person) -Person-centered planning -Assessment/pre-admission review -Environmental modifications -Caregiver support -LTSS innovations 11 assistance/system navigation -Evidence-based care transitions -Person-centered planning -Chronic disease selfmanagement -Benefits outreach and enrollment -Employment related supports -Community/beneficiary/ caregiver engagement Seattle White House Conference on Aging was held July 15, Phoenix 2

3 Retirement Security WHCoA Four Focus Areas Identified for Discussion 1) Financial Security in Retirement 2) Healthy Aging 3) Long Term Services and Supports 4) Elder Justice 13 Historically, financial security in retirement has depended on three factors: Social Security, a pension from a company plan, and savings and investments. Retirement security also means having enough resources to pay for housing, medical bills, food, utilities, taxes and leisure. The following is the priority list of recommendations from New Yorker s on Retirement Security: -Protect Social Security, do not privatize -Increase the Social Security Cost of Living Adjustment (COLA) -Raise or eliminate the tax cap to make it solvent into the future -Increase financial literacy across all ages -Raise the amount of Social Security benefits -Increase funding for and expansion of Title V employment programs -Expand access to affordable housing -Require Medicare to cover home care and other long term care expenses -Make changes in tax policy to end tax on Social Security benefits, increase taxes on the wealthy and make changes to 401K and other retirement accounts. 14 Healthy Aging Long Term Services & Supports The following is the priority list from New Yorker s on Healthy Aging: The following is the priority list of recommendations from New Yorker s on Long Increase health education aimed at older adults by making them more aware of Term Services and Supports: programs & importance of adopting a healthy life style. Target younger people: Improve quality of care and life for residents of skilled nursing and assisted living preparing them for a longer life and understanding the aging process. facilities with better oversight, expanding and increasing funding for the Increase funding for nutrition programs, including home delivered and Ombudsman program, increasing staffing levels and ensuring that there is congregate meals and access to fresh food through farmers markets. sufficient space in quality facilities. Continue encouraging exercise among older adults by providing tax credits for More funding for HCBS, and a Medicare funding component. participation in exercise programs, increasing affordable exercise facilities and Expand and improve access to senior transportation, increase support for public developing programs specifically designed for older adults in gyms/health clubs. transportation serving seniors and initiate increased funding for paratransit. Continue expansion and support of livable communities initiatives in both Create new initiatives to develop a better educated and trained direct care existing and planned developments in urban, suburban and rural areas. workforce by (1) increasing pay for direct care workers and (2) creating career Increase coverage under Medicare, and Parts A, B and D where appropriate, of ladders through programs and certifications offered by various organizations like health screenings, testing/preventive services like the shingles vaccination. community colleges. Increase funding research and development of evidence based programs. Provide more education, training and support for family caregivers recognizing Develop a single payer health plan for the nation, aka Medicare for all. the vital role that they play in providing care for millions of older persons and Increase funding to support existing volunteer opportunities through established those with disabilities who would otherwise be in higher cost settings. programs such as RSVP and Senior Corps and develop new initiatives to Increase funding and access to both medical and social adult day programs. encourage new retirees to volunteer. 15 Better funding for Alzheimer s disease research and care strategies. 16 Elder Justice Best Practice Models in Aging Services The following is the priority list of recommendations from New Yorker s on Elder Justice: Elder Abuse prevention and reporting training should be required for anyone who works directly with older people. Institute a Federal requirement for uniform mandatory reporting of all cases of elder abuse along with the creation and maintenance of a national elder abuse registry. Increase enforcement of existing elder abuse laws. Replicate statewide the enhanced multi-disciplinary teams (EMDT s) that would investigate and follow through to the resolution of difficult and complex abuse cases. Fund a TV, radio and print media campaign to educate and inform both the general public, and older people in particular, about the types and prevalence of elder abuse, what to look for & what steps to take to prevent future abuse. Increase funding, training and number of personnel working in APS. Provide more support for the victims of elder abuse through the creation of a comprehensive network of support services with older adult shelters. Provide more training on financial abuse to bank officials, managers and tellers while holding all such institutions more accountable for their errors in oversight. Increase the funding and expand the scope of the Ombudsman 17 Program. Setting a Standard: New York City Livable Community Project Age-Friendly New York is a Public/Private Partnership NYC Mayors Office, Lead Supports NORCS, Innovative Senior Centers, Falls Prevention, Safe Streets for Seniors. Well Organized, Well Supported by Stakeholders Willing to Share Experience Utilizing Data: Tufts Health Plan Foundation, Boston MA Community Profiles Provide A Data Snapshot of a Community. Long-Range Planning Can Be Done with Efficiency and Effectiveness. Utilizes Precious Dollars in Targeted Areas. Serves as a resource for State/Federal Partners. 18 3

4 Tools to help you build age-friendly communities. Best Practice Models in Aging Services Social/Clinical Models for Special Populations How many? Living alone? Race/ethnicity? Build on cultural strengths, tailor svc Dual eligibles? What is the age distribution? Healthy aging is associated with education. Social Models Specialty Senior Centers LGBTQ Senior Centers/vision impaired Adult Night (vs. Day) Centers Housing for Grandparents Raising Grandchildren Chronic Disease Self Mgmt for Older Americans and Aging Prisoners. Clinical Models Adult Elder Abuse Care Centers End of Life Centers that are free to guests and encourage family attendance. Federally Qualified Health Care Centers Prison Hospice Care 22 Recognizing Opportunities for Elder Justice/Human Rights as a Nurse/Caregiver 23 End of Life Care Death and Dying Compassionate Care with Diversified Populations Elder Domestic Violence Aging Prison Population Transgender Healthcare and Support That Includes Sensitivity Training as Well As A Person Centered Focus. Multi-Disciplinary Teams (NY & NH) Alzheimer s Disease/Memory Issues 24 4

5 Strategies for Long Term Services and Supports in New England Major Shift: CMS Data FY13 First year that HCBS were a majority of LTCSS. Increased from 49% in FY13 to 51% in FY13. Trends New Models for Housing, Beacon Hill Model, Monadnock at Home (Village to Village) Home Share Programs(VT /MA/NH) Care Coordination, CDSMP & Fall Reduction Strategies, Continued Person Centered Care through ADRC s Family Support Education/Caregiver Support Adult Medical Day/Adult Night Programs Recognizing the importance of social interaction and encouraging specialty senior centers. Recognizing Partnerships: Tri-State Roundtable on Aging Conference Report The Next Generation.. Aging Strategies in the Future 27 Value of ALL Partnerships Education/Information Healthy Aging is for the Lifespan Encourage Fiscal Stewardship through the Lifespan Healthy Aging/Dignity in Death Use of Data Best Practices Advocacy Choice Education Dedication Celebrate the Positive Aging Process LISTEN TO THE VOICE OF THE PEOPLE 28 Contact Information Thank you for allowing me to be a join you for the 21 st Annual Gerontological Nursing Conference Kathleen Otte - Bi-Regional Administrator US Administration for Community Living, NY, NY Kathleen.Otte@acl.hhs.gov 29 5