Reinvesting in home and community-based services

How the Biden Administration’s $1.9 trillion relief bill will impact Medicaid in Massachusetts

The American Rescue Plan Act (ARPA) — a COVID-19 relief and recovery package — was signed into law by President Joseph Biden last month. Among the $1.9 trillion relief bill’s provisions is a temporary enhanced federal matching percentage (FMAP) for Medicaid home and community-based services. The FMAP is the proportion of every Medicaid dollar spent paid for by the Federal government. Massachusetts could receive as much as $409.2 million during the one-year period covered.

Prof. Miller discusses COVID-19 relief bill

“One of ARPA’s goals is to strengthen state efforts to help seniors and people with disabilities live in their homes and communities rather than in nursing homes or other institutional settings,” said Edward Alan Miller, PhD, a fellow at the Gerontology Institute at UMass Boston and professor in the university’s Department of Gerontology. “The imperative to do so has been underlined by the COVID-19 pandemic which increased demand for safe, high quality alternatives to institutional settings where morbidity and mortality threats from the virus are greatest.”

Organizations serving vulnerable populations — AARP Massachusetts, the Dignity Alliance of Massachusetts and Disability Advocates Advancing our Healthcare Rights — gathered stakeholders statewide recently to look at how this new funding could be directed in Massachusetts and, in particular, expanding and strengthening home and community-based services. Miller was among the speakers to address the group.

The Centers for Medicaid and Medicare Services (CMS) had already allowed states certain flexibilities in meeting the COVID-19 crisis through the option to adopt temporary changes to their Medicaid programs covering home and community-based services. Furthermore, prior legislation had increased the federal matching rate by 6.2 percentage points across Medicaid services for the duration of the Coronavirus emergency. ARPA increased the federal matching rate by an additional 10 percentage points for home and community-based services (HCBS), specifically. The federal government typically pays for half of Massachusetts Medicaid costs. Combined with the early increase, 66.2% of the Commonwealth’s HCBS costs would be paid for by the federal government under ARPA for one year.

“Key stakeholders see the value of the flexibility ARPA provides to address needs across a range of services and populations needing home and community-based support,” says Miller. “There is particular interest in improving the work conditions of direct care workers, including raising wages and benefits to increase their quality of life and improve recruitment and retention. These are issues that directly impact the quality of care delivered.”

In addition, care recipients and advocates view the ARAP legislation as an opportunity to fund the additional services and supports necessary to maintain older adults and younger people with physical disabilities, developmental disabilities, and severe mental illness at home and in the community, not just during the pandemic but beyond.

One key area the legislation does not detail is whether changes considered by states need to be shared, reviewed, or approved in advance by the federal government. The Massachusetts Office of Health and Human Services is waiting for guidance from CMS before finalizing or implementing plans to take advantage of the enhanced federal match. Although the funding period began April 1, 2021, the state would not lose money if plans were not implemented by that date.

 “Developing strategies and processes that best enable states to take advantage of ARPA’s enhanced federal matching funds would give them a leg up should substantial additional resources become available through the American Jobs Plan and other potentially forthcoming federal legislation,” said Miller. Critical to success is consultation with community stakeholders to outline plans on how to expend the additional revenues in the most effective way possible to the greatest benefit of care recipients, their families, and the front-line staff who care for them.”

How Massachusetts Can Become a Living Laboratory for Aging

Reposted from The Boston Globe 

Let’s measure what’s going on in cities and towns so we can identify how a community’s aging circumstances change over time.

Historically speaking, population aging is new and presents a growing, largely untapped resource. Aging is something we all have in common, and we can leverage that collective reality to create moon-landing levels of advancements. We need a mindset that sees the older population as a solution and opportunity, not a burden or cause for panic.
One of the keys to seizing this opportunity is to measure what’s going on in our cities and towns and identify how a given community’s aging circumstances change over time. This goes far beyond simple head counts of how many are over 65. It requires granular information on a community-by-community level to really be effective.
My research team at the Gerontology Institute in the McCormack Graduate School of Policy and Global Studies at the University of Massachusetts Boston has been creating such tools for nearly a decade, with support from the Tufts Health Plan Foundation. We started in Massachusetts, collecting detailed data, most recently in 2018, about older adults living in every one of the Commonwealth’s 351 cities and towns, and we then produced similar information for Rhode Island, New Hampshire, and Connecticut. All this information can be found in our Healthy Aging Data Reports, available at healthyagingdatareports.org.

Continue reading

Transforming the Future of Aging

Bei Wu works toward improving health status through research and policy

If the world of academic gerontology had a rock star, it would be Bei Wu, MS ‘97, PhD ’00.

Recognized for her extensive research and pursued by top tier universities, Wu has become an international leader in the field since graduating from the University of Massachusetts Boston’s Department of Gerontology. Add the years in policy work before earning her doctorate and Wu chuckles that, having spent more than half of her life in the field of gerontology, she herself is now experiencing the aging process.

“I’ve become my own study subject,” Wu says.

Today, Wu is the Director of Global Health and Aging Research at the Rory Meyers College of Nursing, and Director for Research at the Hartford Institute for Geriatric Nursing at New York University (NYU) and the inaugural co-director of NYU’s Aging Incubator, a university-wide aging initiative.

Given her considerable success in gerontology, it’s fitting she credits her grandmother — with whom she was extremely close — for nudging her into the field. Born in Shanghai, Wu’s parents left her and her brother in their grandparents’ care when the two were young. After college, Wu accepted a research position with the Shanghai Commission on Aging only after prompting by her grandmother.

“At the time, very few people thought aging would be a challenging issue in the future,” Wu says.

But writing policy briefs and launching studies on intergenerational support with the United Nations Population Fund convinced Wu to pursue graduate studies. With no options available in China, she chose UMass Boston.

“UMass Boston has had a significant impact on my career,” Wu says. “The gerontology program has a critical mass of excellent faculty.” Continue reading

Gerontology Institute teams with CANALA for Project to Improve Economic Opportunities for Older People of Color

Caitlin CoyleAARP Foundation has awarded a grant to the Gerontology Institute at the University of Massachusetts Boston for a two-year project to increase access to economic opportunities for older people of color in the greater Boston area.

The $288,000 grant will fund the project that builds on the institute’s age-friendly work across the state, particularly the Age Friendly Boston Initiative, and its expertise in economic security issues in later life.

“We’re very excited because this project addresses economic security, a crucial need facing older adults,” said Caitlin Coyle, a research fellow at the institute and lead researcher on the project.

“It begins to answer a question we have encountered in a number of age-friendly community initiatives,” she said. “The question is, from a practical perspective, how do we build the capacity for authentic equity and inclusion?”

The project will be a joint effort by the institute’s Center for Social and Demographic Research on Aging and CANALA, a research collaboration of UMass Boston’s Institute for Asian American Studies, the Institute for New England Native American Studies, The Mauricio Gaston Institute for Latino Community Development and Public Policy, and the William Monroe Trotter Institute for the Study of Black Culture. Continue reading

Journal Special Edition Dedicated to COVID-19 and Older Adults: Lessons From the Pandemic

Edward Alan Miller

Editor-in-chief Edward Alan Miller

The impact of the COVID-19 pandemic on older adults around the world has been nothing short of breathtaking. Like any sudden crisis, it begs a few common questions: What actually happened and how did we respond? What lessons should we take from that experience? And, most importantly, what do we do now?

In a special double-issue of the Journal of Aging and Social Policy, dedicated to the COVID-19 pandemic crisis, leading gerontology researchers tackle those questions from a wide range of perspectives. The issue, Older Adults and COVID-19: Implications for Aging Policy and Practice, offers 28 scholarly articles available online free of charge.

“The COVID-19 pandemic has devastated populations and economies globally but older adults have been particularly hard hit, due both to direct exposure to the virus itself and to the adverse consequences of efforts taken to mitigate its effects,” said Edward Alan Miller, a University of Massachusetts Boston gerontology professor and JASP’s editor-in-chief. Continue reading

COAs and COVID-19: Managing New Issues on Communications, Food Security and Volunteerism

Bread in Bridgwater

Among many volunteers, a retired Bridgwater State University professor baked bread for distribution through his local COA.

The Gerontology Institute’s Center for Social and Demographic Research on Aging is publishing a series of blog posts to follow the ongoing impact of the coronavirus pandemic on Councils on Aging across Massachusetts.  We encourage COA readers to tell us about their experiences or responses to blog posts by using the reply box at the bottom of each post.

It’s a good thing Zoom and lots of other communications technology exists these days. But the old-fashioned telephone is also playing important role in the plans councils on aging are following to keep in touch with their elder residents.

In Bridgewater, the Fire Department is assisting to help identify phone numbers from census data for over 5,000 residents who are age 60 or older. Those numbers are being used to make wellness calls, but also develop a huge database for town’s emergency response protocol.

In Billerica, volunteers are making about 150 calls each week to check in with elder residents and evaluate their needs.

“During calls to check on patrons, they are so grateful to be remembered,” said Billerica COA Director Jean Bushnell. “It was remarkable to discover that care and concerned flowed both ways, they were actually worried about our staff.” Continue reading

COAs and COVID-19: How Councils Are Adapting to Serve Their Communities

The Gerontology Institute’s Center for Social and Demographic Research on Aging is launching a series of blog posts to follow the ongoing impact of the coronavirus pandemic on Councils on Aging across Massachusetts. Posts reporting on conversations with COA directors about how they manage the evolving COVID-19 challenge will appear on the Gerontology Institute Blog. We encourage COA readers to tell us about their experiences or responses to blog posts by using the reply box at the bottom of each post. 

 How do you deal with a problem as overwhelming as the coronavirus pandemic? David Stevens prefers to think about that answer in phases.

Stevens, the executive director of the Massachusetts Councils on Aging (MCOA), has been leading an effort to provide support, coordinate resources and lead communication with his 350 member-COAs since the COVID-19 crisis gripped the state. Continue reading

Boston’s Senior Civic Academy Helps Older Adults Understand and Engage Local Government

The Boston Senior Civic Academy was created in 2018 by city officials, with the assistance of the Gerontology Institute’s Center for Social and Demographic Research on Aging. Its curriculum is designed to help older adults better understand how local government works and develop skills to advocate for issues important to them. Institute research fellow Caitlin Coyle has played a central role in the development of the academy. She recently spoke with the Gerontology Institute Blog about the program.

Q: How did Boston’s Senior Civic Academy come about?

Caitlin Coyle: The program was developed as a part of the Age Friendly Boston Initiative. As part of that initiative, we did a comprehensive needs assessment for the city of Boston several years ago. We found seniors felt that local policy makers and advocates did not necessarily take into consideration their experiences, needs and preferences. In response, this program was created as an opportunity for seniors to become more involved and to empower them as self-advocates at the policy level. It also created an opportunity for public education about how policy and decisions are made at the local, state and federal levels. Continue reading

Making Streets Safer: UMass Boston Research Team Studies Car Crashes Injuring Older Pedestrians

By Taryn Hojlo

Walking activities are normally good for older adults. One rare but dangerous exception: Car crashes that involve pedestrians.

This is a growing problem. The number of pedestrian fatalities increased by 37 percent across the United States between 2008 and 2017, according to the National Highway Traffic Safety Administration. Nearly half of pedestrian fatalities in 2017 were age 50 or older.

A research team from UMass Boston’s Gerontology Institute recently studied risks to older pedestrians in Massachusetts and to what extent they could be prevented. Their report included specific suggestions for improving older pedestrians safety. It was prepared in cooperation with MassDOT, Office of Transportation Planning, and the U.S. Department of Transportation, Federal Highway Administration. Continue reading

UMass Becomes First University System to Join the Age-Friendly University Global Network

BOSTON – In August 2019, the five-campus University of Massachusetts system endorsed the 10 principles of the Age-Friendly University, as defined by Age-Friendly University (AFU) Global Network at Dublin City University, joining an international effort intended to highlight the role of higher education in responding to the challenges and opportunities associated with an aging population.

UMass is the first university system to join the AFU Global Network, earning the designation for its campuses in Amherst, Dartmouth, Lowell and the UMass Medical School in Worcester. UMass Boston endorsed the principles and joined the network in 2017.

“I’m pleased that with the support of all five of our chancellors, UMass has received this designation as an Age-Friendly University,” said President Marty Meehan. “It reaffirms our long-held commitment to making a world-class public research university education accessible to all people in the Commonwealth, regardless of age.” Continue reading