AGING POLICY & PUBLIC HEALTH NEWS

from Health Benefits ABCs

February 1^st, 2020

Below please find our latest roundup of press releases, funding opportunities, state and local news, and new publications.

HEALTH BENEFITS ABCs NEWS & VIEWS

Dear Readers,

Happy New Year. This is the first edition of our newsletter for 2020. It goes without saying that this year promises to be extraordinary. As we go to press it looks likely the U.S. Senate will acquit President Trump in his impeachment trial. We are on the cusp of the first voting of the 2020 elections with the Iowa Caucuses in what no doubt will be a long and deeply contentious and divisive presidential election year. Congress closed out 2019 by completing action on FY 20 funding providing welcome appropriations increases for the Older Americans Act and other programs affecting older Americans including some new funding for Section 202 housing. We include below a brief summary of the FY 20 funding outcomes. The President’s FY 21 budget is due to be issued on February 10 and soon after the Appropriations Committees will begin their work on FY 21 funding. It looks likely the Older Americans Act will be reauthorized early this year. Prospects for reauthorizing the Elder Justice Act look promising. We look forward to keeping you updated on national policy developments affecting older adults, as well informing you about the work we do for the terrific organizations who trust us to work on their behalf. We will also update you on our work on behalf of American Indian and Alaska Natives through our not-for-profit organization, the International Association for Indigenous Aging or IA². Please do not hesitate to share with us any thoughts you have about what we share with you or anything else on your mind.

Bill Benson, Dave Baldridge, Kendra Kuehn, Jolie Crowder, Alayna Waldrum, Clara Pomper

LCAO establishes workgroup on Housing & LTSS

Efforts led by HBABCs’ Alayna Waldrum and Kendra Kuehn on behalf of the American Association of Service Coordinators (AASC) have resulted in the formation of a new workgroup on Housing and Long-Term Services & Supports under the Leadership Council of Aging Organizations (LCAO). AASC together with HBABCs proposed the new workgroup in order to create a forum for greater attention on housing-related issues of importance to older adults, such as affordable housing and service coordination. AASC partnered with B’nai B’rith to host the first meeting on the new workgroup on January 23^rd 2020 at the offices of B’nai B’rith. B’nai B’rith, a major provider of senior housing and employer of service coordinators, works closely with AASC on advocacy in support of federal housing policy for older adults. As a result of the workgroup’s efforts, the February 5th LCAO meeting in Washington, D.C. will feature Jennifer Molinsky, Senior Research Associate at Harvard University’s Joint Center for Housing Studies (JCHS), who will speak about the JCHS report, Housing America’s Older Adults 2019. B’nai B’rith, a major provider of senior housing and employer of service coordinators, works closely with AASC on advocacy in support of federal housing policy for older adults. AASC, B’nai B’rith and HBABCs welcome any input about housing and LTSS issues that could be considered by the new workgroup. The Harvard JCHS report can be accessed at: https://www.jchs.harvard.edu/housing-americas-older-adults-2019

Benson Facilitates CDC Meeting on Cancer Prevention

HBABCs’ Bill Benson served as the facilitator for a CDC and National Association of Chronic Disease Directors (NACDD) strategic planning meeting on future directions of CDC’s Cancer Prevention Across the Lifespan (CPAL) workgroup, held in Atlanta January 30, 2020. CDC’s CPAL is a cross-cutting group within CDC’s Division of Cancer Prevention and Control established to address cancer risk and protective factors at each phase of life. CDC has engaged NACDD to provide support for CPAL activities. Over the past 7 years the CPAL has focused on prenatal and early childhood; adolescence; early adulthood (ages 19-44 years); midlife (ages 45-64 years); and older adulthood (65 years and older). A June 2019 supplement to The Gerontologist (journal of the Gerontological Society of America), “Opportunities for Cancer Prevention During Older Adulthood,” featured CPAL’s work related to older adults. Current focus areas for the CPAL include caregiver stress as a cancer risk factor and environmental health. Benson was part of NACDD’s team supporting CPAL’s work on early adulthood and older adults, as well as involved with CPAL’s current work. For more information about the CPAL go to: https://www.cdc.gov/cancer/dcpc/prevention/lifetime.htm.

Farewell to Jim Sykes

All of us at HBABCs and IA² are saddened by the death of James (Jim) T. Sykes. Jim passed away December 24, 2019 at age 84. Jim was well-known in the aging world for his many contributions to aging policy over more than five decades at both the national level and in the State of Wisconsin. Just a few highlights from his many accomplishments: one of 12 individuals appointed by President Kennedy to help form the Peace Corps; election to the Dane County (WI) Board of Supervisors; appointment by President Carter to the Federal Council on Aging; Chairman of the Board of the National Council on Aging. He spent many years with the University of Wisconsin and remained associated with the University serving in 2019 as Professor Emeritus and Senior Advisor for Aging Policy. The American Society on Aging recognized Jim with their Hall of Fame Award. Bill Benson was one of those who nominated Jim for the award. Jim was also known for his work on aging policy in a number of other countries. At age 75 Jim received a Fulbright Scholarship to conduct research in Pakistan. Jim co-led with Larry Branch a number of aging study trips to Cuba. Benson joined Jim for one of those trips to Cuba in 2003. Bill notes he introduced Jim to his friend Diane Patterson, a gerontologist in Orange County, California, at an ASA conference. Jim and Di were married in 2017. Jim’s daughter Kathy recently retired from federal service after a long career. She worked with Bill at the U.S. Senate Special Committee on Aging in the late 1980s.

NAPSA Makes Recommendations to Elder Justice Coordinating Council

On December 3, 2019, the federal Elder Justice Coordinating Council met to discuss agency efforts and hear from experts including Pam Teaster from the Virginia Tech Center for Gerontology, Bob Blancato of the Elder Justice Coalition, and Lori Smetanka of the National Consumer Voice for Quality Long-Term Care. National Adult Protective Services Association national policy advisor and Health Benefits ABCs Principal Bill Benson and policy analyst Kendra Kuehn contributed Adult Protective Services updates and needs to the testimony of Elder Justice Coalition chair Bob Blancato. Blancato highlighted the continuing challenges in the field and the need for resource commitment at the national level to elder justice and APS. The Elder Justice Coordinating Council was established by the Elder Justice Act and is chaired by the Secretary of the Department of Health and Human Services. It consists of 14 agencies tasked with increasing cooperation and coordination across federal, state, local, and private entities. In reports to Congress the Council details the activities of the Council and its member agencies, and makes recommendations for legislation, model laws, and other actions.

The Elder Justice Coordinating Council requested public comments at the end of last year to guide its future direction. Benson and Kuehn developed comments for NAPSA with extensive feedback from leadership and members. NAPSA highlighted the need for increased funding directly to APS programs as authorized in the Elder Justice Act. More coordination is also needed from federal agencies such as the Social Security Administration. Greater distribution and outreach of federal materials and resources were also recommended. More information on the Elder Justice Coordinating Council can be found at https://acl.gov/programs/elder-justice/elder-justice-coordinating-council-ejcc.

IA² Finds Healthcare Providers in Indian Country Want to Address Elder Abuse, Need Support

Funded by the Department of Justice’s National Resource Center for Reaching Victims, the International Association for Indigenous Aging conducted a needs assessment on screening and management of elder abuse by clinical providers in Indian Country. Let by IA2² Research Manager Jolie Crowder, PhD, a survey and interviews were conducted across a wide variety of health and service providers to inform the assessment. Clinicians brought up obstacles including a lack appropriate screening instruments and limited resources for intervention. Despite the challenges, 89% of providers surveyed felt providers should play a role in screening for and addressing elder abuse. The team has presented this information and Crowder’s groundbreaking dissertation work in webinars for the National Center on Elder Abuse and Title VI Senior Services programs, recordings are forthcoming (https://olderindians.acl.gov/title-vi-webinars). The executive summary and full report is available http://iasquared.org/wordpress2/what-we-do/current-projects/elder-abuse-project/. Further information on Dr. Crowder’s work is available at http://iasquared.org/wordpress2/2019/05/07/ia2-research-manager-adds-phd-to-her-title/.

Congress Passes Funding for Remainder of Fiscal Year 2020

Following nearly three months of continuing resolutions, appropriations have been passed and signed for the remainder of federal fiscal year 2020. Funding for the Administration for Community Living’s Adult Protective Services efforts remained flat at $12 million. These efforts include competitive grants to states, the National Adult Maltreatment Reporting System, and the technical assistance resource center. The Social Services Block Grant, a critical source of funding for many Adult Protective Services and many other social services programs, remained at $1.7 billion. Several Older Americans Act programs received increases, including a $1 million increase to the Long-Term Care Ombudsman program for a total of nearly $23 million. Title VI or Services for Native Americans increased slightly by $500,000, significantly less than the need. On the affordable housing front, the Department of Housing and Urban Developments’ Section 202: Housing for the Elderly program received a significant increase to $793 million, an increase of $115 million. $100 million is included in this funding for service coordinators who are essential to helping elder residents remain independent. Health Benefits ABCs applauds these limited increases but notes much more is needed to address these issues. More information on current appropriations and the process is available at https://crsreports.congress.gov/AppropriationsStatusTable.

PUBLIC POLICY

From: LA Times

Column: Trump makes his most aggressive move yet to gut Medicaid

January 30, 2020

Rebuffed by the courts in its previous efforts to gut Medicaid, the Trump administration teed up a new, far-reaching attack on the program that could affect the health of millions of low-income Americans. Officially unveiled Thursday under the Orwellian label “Healthy Adult Opportunity,”the new rules would encourage states to cut benefits and narrow eligibility for residents who qualify under the Affordable Care Act’s Medicaid expansion provision.

HEALTH/MENTAL HEALTH/PUBLIC HEALTH

From: Psychology Today

Why Do the Elderly Commit Suicide?

January 28, 2020

Statistics from the National Council on Aging state that those 85 years and older have the highest suicide rate of any age group. It is over four times higher than the nation’s overall rate of suicide^[1]. As with most age groups, the majority of elders who kill themselves are male. As high as those figures are, the American Association for Marriage and Family Therapy (AAMFT) suggests that the rates for elder suicide are under-reported by 40 percent or more due to what they refer to as “silent suicides.”

MEDICARE/MEDICAID

From: Forbes

The Medicare Part D Drug Plan Donut Hole Is Closed. What Does That Mean?

January 21, 2020

Just about every Medicare beneficiary has heard about the donut hole in a Medicare Part D drug plan. Many will admit they don’t understand it but they all know it means drugs will cost more. Now, they’ve heard that the donut hole closed on January 1, 2020. They are ecstatic because they believe their drugs will be free. And, once again, it’s likely they don’t understand what’s happening.

From: AP News

Tricky trade-offs for states in Trump’s new Medicaid Offer

January 30, 2020

The Trump administration Thursday offered states more control over Medicaid spending for some of their poorest residents, but first governors must accept a limit on how much the feds kick in.

That’s a potentially tricky deal for states facing rising costs in the federal-state health program for low-income people. Republican governors in Oklahoma and Arkansas welcomed the offer, but it’s unclear how many states will take it up.

HEALTH CARE REFORM

From: Oxford Academic

Creating an Age-Friendly Public Health System

January 1, 2020

An age-friendly public health system is one that recognizes aging as a core public health issue and leverages its skills and capacities to improve the health and well-being of older adults. The impacts of the Florida pilot project to be described in the proposed article will be scalable in local and state health departments across the country. The value of this project is its flexibility in design and application, with multilevel policy and programmatic impacts through multisector collaboration.

From: The Hill

When a health policy causes harm

January 21, 2020

Policies, whether they are federal, local, state, administrative, or at an individual institution’s level, sometimes fail to address the deeper issues that created the problem or ignore the issues that may arise as a result. Social problems and social determinants of health affecting everyone, from youth to elders, can’t be addressed with a simple checkbox system or a straightforward policy.

From: NPR

Several ‘Best’ U.S. Hospitals Penalized Over Too-High Rates of Infection, Injury

January 31, 2020

The Centers for Medicare & Medicaid Services on Wednesday identified 786 hospitals that will receive lower payments for a year under the Hospital-Acquired Condition Reduction Program, a creation of the Affordable Care Act. The penalties are designed to encourage better care without taking the extreme step of tossing a hospital out of the Medicare and Medicaid programs, which would drive most hospitals out of business.

BUDGET NEWS

From: Congressional Budget Office

The Budget and Economic Outlook: 2020 to 2030

January 2020

In this report, the Congressional Budget Office provides detailed projections of the federal budget and the U.S. economy under current law for this year and the decade that follows as well as projections for the following two decades. The cumulative deficit currently projected for the next 10 years is slightly larger than what CBO projected last August because deficit increases resulting from new legislation and other changes are greater than the deficit-reducing effects of revisions to CBO’s economic forecast. Beyond 2030, projected deficits have increased substantially. As a result, debt held by the public as a percentage of gross domestic product (GDP) in 2049 is now projected to be 30 percentage points higher than it was in CBO’s previous long-term projections

From: City Limits

City and State Budgets Pose Challenges for Aging New Yorkers

January 28, 2020

Advocates have long been ringing the alarm about how the aging crisis would eventually hit New York economically, and potentially at higher cost if lawmakers don’t support long-term care and other senior services. When it was learned that a third of the state’s $6.1 budget gap was attributable to Medicaid, many were left wondering how the Cuomo administration would rein in spending.

FRAUD NEWS

From: AARP

Social Security Imposter Fraud Now Tops List of Biggest Scams

January 29, 2020

Two key messages from Wednesday’s hearing: Anybody can become a victim — and making people aware of the scam through outreach and education is key to stopping the crooks. One victim, Machel Andersen, 56, of North Odgen, Utah, told senators she lost $154,646 to a Social Security scammer in December.

From: Special Committee on Aging

Senate Aging Committee Shines Spotlight on Social Security Scam – the #1 Reported Scam to Fraud Hotline

January 29, 2020

At a Senate Aging Committee hearing led by U.S. Senators Susan Collins (R-ME) and Bob Casey (D-PA) on the Social Security scam today, Mrs. Andersen explained how the purported SSA official handed her over to a fake DEA investigator who exploited her fear and distress over this information. He instructed her to wire all of her available assets—amounting to more than $150,000—to an offshore account that would supposedly be protected while action was taken against the drug cartel. She was warned that if she did not cooperate, she would be assumed to be conspiring with the drug cartel and arrested. Over the course of several days, the scammer continued to manipulate Mrs. Andersen with a variety of threats and official-looking documents.

ASSOCIATION & ORGANIZATION NEWS

From: American Addiction Centers

Addiction Treatment Options for the Elderly

January 28, 2020

The U.S. Census Bureau reports that, in 2012, there were 43.1 million adults over the age of 65, and this number is estimated to double by 2050, up to 83.7 million. Many of these senior citizens are members of the baby boomer generation – those born between 1946 and 1964 – who grew up in a culture of free love and drug experimentation. This generation may be taking illicit drug and alcohol abuse, as well as struggles with addiction, with them into their advancing age.

From: American Society on Aging

A Bridge Not So Far: A New Action Network Connects

January 9, 2020

When John Auerbach, president and CEO of Trust for America’s Health (TFAH), Anne De Biasi, TFAH’s director of policy development, and Megan Wolfe, TFAH’s policy development manager, began researching how to engage county health departments in planning for their communities’ burgeoning older adult population, they found that many public health department staffs had no knowledge of organizations that were already assisting older adults with supportive services. Having worked in public health for 30 years, this lack of knowledge didn’t exactly surprise Auerbach, but it might be news to professionals working in the aging services sector. This disconnect between county health departments and community-based aging services will soon become a thing of the past when TFAH succeeds in fostering The John A. Hartford Foundation’s Age-Friendly Health Systems and Age-Friendly Public Health initiatives, or what Wolfe calls “one big social movement.”

RESEARCH AND ANALYSIS

From: Taylor & Francis Online

Qualitative study of loneliness in a senior housing community: the importance of wisdom and other coping strategies

Older adults are at a high risk for loneliness, which impacts their health, well-being, and longevity. While related to social isolation, loneliness is a distinct, internally experienced, distressing feeling. The present qualitative study sought to identify characteristics of loneliness in older adults living independently within a senior housing community, which is typically designed to reduce social isolation.

From: Population Reference Bureau

Aging and Health in China: What Can We Learn From the World’s Largest Population of Older People?

January 31, 2020

No other country in the world is experiencing population aging on the same scale as China. The United Nations projects that there will be 366 million older Chinese adults by 2050, which is substantially larger than the current total U.S. population (331 million).[1 ]By that time, China’s share of adults ages 65 and older will have risen from just 12% to a projected 26%. While life expectancy in China is increasing, older adults may spend more of their advanced years in poor health and with disabilities. Families have been the primary source of care for older adults, but the country’s rapid economic development and urbanization have separated millions of older adults from their children, contributing to an increasing demand for community-based health care.

HOUSING POLICY AND NEWS

From: Joint Center for Housing Studies of Harvard University

Accessibility Features For Older Households in Subsidized Housing

January 14, 2020

As the overall population ages, the number of very low-income older adult households that qualify for HUD housing assistance is rising rapidly. Older adults tend to stay in subsidized housing longer than younger families. As a result, older adults make up a growing share of HUD-subsidized renter households. In the last ten years alone, the share of older adults in HUD-subsidized housing has risen five percentage points, and older adult households now make up over a third of all subsidized renters. In this paper, we examine whether the subsidized housing stock is suitable for aging in place. We ask: What physical challenges do older subsidized renters face? What difficulties do they experience with their housing environment? And, are subsidized units more equipped with accessibility features than units without rent assistance?

From: American Bar Association

Is a Housing Affordability Crisis on the Horizon for Seniors?

January 15, 2020

At a time when the shortage of affordable housing in communities around the United States regularly makes the headlines, another less visible housing crisis is also intensifying. The number of elderly people with “worst case housing needs” – defined as renters with very low incomes who do not receive government housing assistance and pay more than one-half of their income for rent, live in severely inadequate conditions, or both – is increasing rapidly. Nearly 10 million households with an occupant over age 65 spend more than 30 percent of their incomes on housing; roughly 5 million of those households spend more than 50 percent.

From: Urban Institute

Our Aging Public Housing Puts Older Americans At Risk

January 30, 2020

Over the past several years, devastating fires in public housing developments across the country have made headlines for displacing and injuring residents and destroying units. As evidenced by this and other reports, much of the nation’s public housing stock is in poor condition, creating health hazards that put older adults at serious risk. Broken boilers, mold and mildew, rodent infestations, and fires—to name a few—have damaging effects on residents of all ages, including vulnerable seniors.

From: Senior Voice Alaska

Pioneer Home residents file lawsuit over rate increases

February 1, 2020

On Nov. 4, 2019, a lawsuit was filed against Alaska Pioneer Homes Director Clinton Lasley, Commissioner of the Department of Health and Social Services (DHSS) Adam Crum, Alaska State Governor Michael J. Dunleavy and the State of Alaska on behalf of Alaska Pioneer Home residents Eileen Casey of Ketchikan, Marion and Howard Rider of Juneau and all Pioneer Home residents. The lawsuit is in response to the state’s recent decision to implement an extreme rate increase, a move that is considered a financial necessity by Lasley and other state officials.

FUNDING OPPORTUNITIES

From: Grants.gov

Disaster Assistance for State Units on Aging (SUAs) and Tribal Organizations in Major Disasters Declared by the President

Due September 7, 2020

State Units on Aging in states for which some or all of the state has been declared a federal Major Disaster area by the President of the United States under the Stafford Act. Federally recognized tribal organizations who are receiving a grant under Title VI of the Older Americans Act (as amended) within the areas declared a federal Major Disaster area by the President of the United States under the Stafford Act Foreign entities are not eligible to compete for, or receive, awards made under this announcement.

From: Grants.gov

Environmental Influences on Aging: Effects of Extreme Weather and Disaster Events on Aging Populations (R01 Clinical Trial Optional)

Due: March 8, 2021

The purpose of this funding opportunity announcement is to advance our understanding of the impact of extreme weather and disaster events in aging human populations. Together with the companion FOA (PAR- 19-XXX ) that focuses on underlying mechanisms of aging utilizing animal models, these two FOAs will help to explicate the behavioral, biological, and socioecological processes that occur during extreme weather or disaster events and that affect aging processes. Through the integration of the population studies and the companion mechanistic studies FOA, the ultimate goal is to improve the health and well-being of older adults via increased knowledge about extreme weather and disaster preparedness, response, and recovery.

NEW PUBLICATIONS & RESOURCES

From: American Medical Association

Avoid “elder-speak” with your aging patients

January 17, 2020

Within the next two decades, one-in-five Americans will be older than 65. Physicians face unique challenges in treating elderly patients, who often suffer from multiple chronic diseases, lower health literacy rates and difficulty paying for their care on a fixed income.  In an “AMA Moving Medicine” podcast episode about improving health outcomes for vulnerable patient populations, Paul H. Wick, MD, former chair of the AMA Senior Physicians Section, discusses health issues and disparities unique to elderly populations.

Read the transcript of the presentation at https://www.ama-assn.org/delivering-care/population-care/avoid-elder-speak-your-senior-patients

GENERAL INTEREST

From: Oxford Academic

Creating an Age-Friendly Public Health System

January 1, 2020

The public health system in America—at all levels—has relatively few specialized initiatives that prioritize the health and well-being of older adults. And when public health does address the needs of older adults, it is often as an afterthought. In consultation with leaders in public health, health care, and aging, an innovative Framework for an Age-Friendly Public Health System(Framework) was developed outlining roles that public health could fulfill, in collaboration with aging services, to address the challenges and opportunities of an aging society.

From: Is Global

Green Spaces: A Resource for Mental Health

January 8, 2020

Exposure to nature may be indispensable for human wellbeing. Humans are suggested to have an intrinsic urge to connect with nature and other forms of life. Contact with nature may help reduce feelings of stress, restore the ability to concentrate and pay attention, and improve the emotional state. Indeed, experimental studies have observed that study participants had an improved mood, more self-esteem, and a lower level of stress when they were exposed to natural environments. Regarding longitudinal exposure, epidemiological studies observed that an increased long-term exposure to green spaces is associated with improved mental health.

From: Stanford Medicine

‘Ageotypes’ provide window into how individuals age, Stanford study reports

January 13, 2020

The researchers determined that people generally age along certain biological pathways in the body: metabolic, immune, hepatic (liver) and nephrotic (kidney). People who are metabolic agers, for example, might be at a higher risk for diabetes or show signs of elevated hemoglobin A1c, a measure of blood-sugar levels, as they grow older. People with an immune ageotype, on the other hand, might generate higher levels of inflammatory markers or be more prone to immune-related diseases as they age. But the ageotypes are not mutually exclusive, and a metabolic ager could also be an immune ager, for example.

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