Improving the Lives of LGBT Older Adults

Although largely invisible until recently, LGBT older adults make up a significant (and growing) part of both the overall LGBT population and the larger 65+ population. While confronted with the same challenges that face all people as they age, LGBT elders also face an array of unique barriers and inequalities that can stand in the way of a healthy and rewarding later life. This report examines these additional challenges and how they make it harder for LGBT elders to achieve three key elements of successful aging: financial security, good health and health care, and social support and community engagement. The report also offers detailed recommendations for improving the lives, and life chances, of LGBT older Americans

Women, Health and Aging: Building a Statewide Movement

Provides an overview of current policy and program environments that affect the state's most vulnerable elder population, and considers some effective strategies to address the growing needs of older persons in California

Case Management Program For Frail Elders Manual, August 2008

The purpose of this manual is to guide operation of the Case Management Program for Frail Elders. After Background, Program Administration, Definitions, Consumer Eligibility, and Program Standards, the order follows the flow of a consumer entering the pro-gram from referral through ongoing case activities. The manual is written assuming the reader is the Case Manager. The effective date will appear in the bottom left hand corner of each page. This manual will be updated as needed via Iowa Aging Program Instructions (IAPI). This manual is used in conjunction with the Department of Human Services’ manuals which provide more detail about policies and procedures within the Medicaid elderly waiver program

On the Edge: Facing a Challenging and Uncertain Future

Introduces the Boston Elder Economic Security Standard as a tool to assess the real economic circumstances, needs, and resources of the low- and middle-income elderly in Boston, depending on their health, housing, marital status and other factors

Caring for Our Kupuna: Building an Aging in Place Movement in Hawaii

Government funding for elder care in the United States is becoming increasingly strained as the number of seniors and the cost of healthcare rise. Medicare paid $560 billion for hospital visits, prescription drugs, and other services in 2010 and expects to pay out just over$1 trillion by 2022. Medicaid, which covers long-term care for individuals with low income and assets, is the source of payment for 70% of nursing home stays across the country and paid $48.2 billion for senior residential care in 2007.As the costs of Medicare and Medicaid soar, practitioners in Hawaii and around the country have experimented with preventive and supportive aging-in-place services that reduce the cost of service while improving the lives of seniors. Rather than rushing an elder to the emergency room after a dangerous fall in the bathroom, providers have begun installing hand and safety rails in the home to prevent falls. Other providers are offering preventive health and nutrition classes that help seniors maintain their health and delay the need for long-term residential care. By focusing on preventive services rather than treating only advanced health needs, aging-in-place service providers are helping seniors maintain independence at home, avoid nursing home admission, reduce hospitalization, and minimize social isolation. Studies show that those who choose to age at home have better health outcomes while incurring significantly lower health costs than those who age in nursing homes. In addition to saving financial resources, aging in place is popular among seniors: a full 90% of American seniors share the desire to remain in their homes as they age.The value of aging in place is particularly relevant in Hawaii, which has the highest life expectancy of any state and the second highest cost of living in the country. By 2030, Hawaii expects to have an older population of 475,000 individuals, representing 29.7% of the population and a 310% increase during the 55-year period from 1980-2035. As the number of seniors aging in Hawaii rapidly increases, the state faces limited capacity in its residential care homes. With only 4,200 beds in nursing homes and 7,000 spaces in residential facilities in 2010, Hawaii's current facilities would be able to serve only 30% of the 38,000 older adults projected to need long-term care in 2035.6Increasing the portion of seniors aging in place could increase the happiness of Hawaii's seniors ("kupuna") and save significant resources for society. However, a continuum of wrap-around services must be available to seniors if they are to age in place effectively. Aging-in-place services must be available to transport elders, support needs in the home (safety, cleaning, cooking, etc.), connect elders with a community, provide respite for caregivers, and monitor and address health/nursing needs. Without this comprehensive support, elders living alone are not empowered to age with dignity and are more likely to become ill or incur injuries

AGEnda for Action: Building a Movement for Elder Women's Advocacy

Based on community listening sessions and interviews, outlines the priority issues for elder women in California and the insights of policy makers and advocates. Offers recommendations and an action agenda for funders, policy makers, and community groups

A Competitive Bidding Approach to Medicare Reform

Medicare reform is a critical issue for the public agenda. The most promising option for addressing Medicare reform is competitive bidding -- using health plans' bids to determine the government's contribution to a basic set of benefits in every market area. This paper begins with a review of the history of competitive bidding in Medicare. It then moves to a definition of terms, which is crucial in any discussion of competitive pricing because the often-heated public debate around these issues frequently distorts positions and confuses issues by conflating different terms and making some arguments appear other than they are. Following this terminological exercise, the report includes a series of sections discussing competitive bidding in Medicare, with special focus on the challenges to introducing it