Federal Policy Update

Health Care Reform and Care Coordination

As reported in previous editions of Aging Care Forward, the National Care Coordination Coalition (N3C) advocated throughout the health care reform process for the inclusion of provisions for care coordination. In the beginning of January, N3C wrote to legislators involved in the merger of the House-passed (H.R. 3962) and Senate-passed (H.R. 3590) health care reform bills making the case for preserving existing care coordination provisions in the final bill. All of the care coordination provisions in H.R. 3590 remained intact when it became law on March 23, 2010, including provisions to:

• Learn more about models and financing mechanisms for coordinated care through demonstration and pilot projects;
• Create an Innovation Center within the Centers for Medicare & Medicaid Services (CMS);
• Establish a Community-Based Care Transitions Program; and
• Establish community-based interdisciplinary teams to support primary care practices.

The new law's provisions for new options and financial support for states to provide long-term services and supports also enhance opportunities for high-quality, well-coordinated and integrated care. As implementation of the new law begins, N3C will work to bring stakeholders together to share ideas and act as a resource to policy makers.

Obama To Nominate Dr. Donald M. Berwick to be the New Administrator of Centers for Medicare and Medicaid Services

At the end of March, the White House confirmed that President Obama will soon nominate Dr. Donald M. Berwick to become the administrator of the Centers for Medicare and Medicaid Services (CMS). Currently, Berwick is a professor at Harvard, and president and CEO of the Institute for HealthCare Improvement, which leads several projects related to patient-centered care and care coordination. If confirmed, Berwick will lead the agency's efforts to implement health care reform. To learn more about him, see this bio: http://www.hsph.harvard.edu/faculty/donald-berwick/.

Importance of Family Caregivers Emphasized in Obama Administration Budget Proposal

President Obama released his proposal for the FY 2011 federal budget on February 1. The budget reflects the three-year freeze on non-security, discretionary funding which President Obama announced in his State of the Union address. Programs for health and older adults were largely spared from cuts.

The budget includes a $1 billion increase for the National Institutes of Health, including a $33 million increase for the National Institute on Aging; a $1 million increase for the National Long-Term Care Ombudsman Program; a $500,000 increase for Elder Abuse Prevention; a $15 million increase for CMS enforcement of nursing home regulations; a $930 million increase for the Social Security Administration to address processing backlogs; an $8 million increase for senior nutrition programs; a $25.5 billion six-month extension of increased federal Medicaid matching grants to states; and $1.7 billion to address fraud in the Medicare and Medicaid programs.

Of particular interest is the proposal's inclusion of a large increase ($102.5 million) for services and supports for family caregivers. The new funding is aimed at counseling, training and respite care for caregivers; services such as transportation for older adults and people with disabilities; and respite care for family members of individuals with special needs. For a copy of the full proposal, and for a breakdown by department, go to: http://www.whitehouse.gov/omb/budget/Overview/.

Weighing In on Reauthorization of the Older Americans Act

Since 1965, the Older Americans Act (OAA) has formed the framework for the development of a nationwide service system for older adults. In 2011, Congress will consider reauthorization and amendments to the Act which will take effect in FY 2012. Currently, the Administration on Aging (AoA) is soliciting input from stakeholders concerning the reauthorization. Opportunities for sharing input include attending an OAA Reauthorization Input Events, and submitting comments either by mail or via the AoA website. For more information, visit the AoA site at http://www.aoa.gov and click on the OAA Reauthorization icon located at the top in the right column.

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More News from the Social Work Leadership Institute

Hartford Partnership Program for Aging Education (HPPAE)

New England Expansion
In December SWLI expanded its HHPAE model at 17 social work schools across New England. The region has presented some unique issues, including “brain drain” from rural New Hampshire where services for older residents are already stretched thin; and states like Vermont with a relative small population (600,000), which ends up having a big impact on securing federal dollars for aging care support.

How Are We Doing?
We recently completed a substantive evaluation of the first HPPAE grantee cycle including a student survey, and the findings are positive -- and eye-opening. We expect to release the findings publicly later this spring. Stay tuned!

Viewpoint: Hartford Partnership Program for Aging Education
A Q&A with Dr. Tondy Baumgartner, MSW, LCSW, and Assistant Professor at the School of Social Work at the University of Montana

Q: What have been the biggest developments to come about as a result of the HPPAE grant?

A: Since receiving the HPPAE grant, the School of Social Work has become much more involved in interdisciplinary work in the local and state community. Specifically, we now participate in two interdisciplinary programs. The first takes a multifaceted approach to rural health care in Montana. Students from the School of Social Work now partner with students from the Schools of Pharmacy and Physical Therapy to visit residents living in local retirement communities and nursing homes. There, students assess residents for potential emotional and physical ailments that would benefit from access to existing statewide social services. After identifying areas of need, students help residents connect with appropriate service providers.

Additionally, social work students now partner with service providers in the local community to offer pre-medical, pre-pharmacy and pre-physical therapy students a sense of what their potential professions can offer personally and professionally. Each week, social work students and community service providers present aspiring graduate students with information about social services. In particular, presenters highlight the differences between rural and urban social work practice.

Q: How many of the students who participated in the HPPAE program have gone on to a career in aging care?

A: Nearly all of the HPPAE students are now working in aging care.

Q: How will you keep up the momentum generated by the HPPAE grant, now that funding has ended?

A: We are continuing to offer rotation-based field work for social work students. Additionally, we have now developed a gerontology seminar and are offering academic support and financial assistance so that students can present their research findings and experiences at a statewide gerontology conference.

Viewpoint: Leadership Academy in Aging
A Q&A with Dr. Laura Bronstein, Department Chair at Binghamton University Department of Social Work and 2009 graduate of the Academy:

Q: What's the greatest challenge confronting deans and directors of social work today?

A: In the current economic climate, resources are lacking, and deans and directors are being called upon to do more and more. As a result, attention is often diverted away from long-term program development and towards day-to-day program management. The Leadership Academy offers a chance for deans and directors to place development and innovation front and center.

Q: As part of the Academy, you were required to develop a gerontological project at your school. What was yours?

A: My project was developing the Institute for Intergenerational Studies at Binghamton University, which houses the Southern Tier Center on Aging. The Center is an interdisciplinary program that brings together researchers, physicians and community service providers. It fosters applied research, inter-professional education, and the development of multidisciplinary conferences, the first of which, Enhancing Quality of Life in Later Years, is planned for October 1-3, 2010.

Intergenerational studies is an area I've always been interested in, but the Academy created a space for me to really develop a program that spanned academic departments and professions. Getting feedback from other deans and directors was invaluable, and the Institute of Intergenerational Studies as we know it is a product of the Academy.

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