Policy and Program Planning for Older Adults and People with Disabilities (eBook)

Contents

Preface

Acknowledgments

Introduction

Share Policy and Program Planning for Older Adults and People With Disabilities: Practice Realities and Visions, Second Edition

PART I: Understanding Policy and Program Development

1. Background and Demographic Profile of People Growing Older and/or People With Disabilities

LEARNING OBJECTIVES

PREPARING FOR THE “BOOM”

THE CHANGING DEMOGRAPHIC STRUCTURE AND AGING POPULATION

CHANGES IN OUR POPULATION PROFILE

Living Arrangements

Education Level

Economic Well-Being

Changes in Rural Population

Trends in Morbidity and Mortality

THE CHANGING DEMOGRAPHIC STRUCTURE OF THE OLDER ADULT POPULATION WITH DISABILITIES AND IMPAIRMENTS

CHANGES WITHIN THE SOCIAL, POLITICAL, AND CULTURAL EXPECTATIONS OF COMMUNITIES

CHALLENGES FOR AGING AND DISABILITY POLICIES AND PROGRAMS

REALITIES AND VISIONS

DISCUSSION QUESTIONS

REFERENCES

2. Social, Political, Economic, and Demographic Factors and Historical Landmarks Impacting Aging and Disability Public Policy

LEARNING OBJECTIVES

THE ROLE OF HISTORICAL LANDMARKS IN SHAPING SOCIAL TRENDS AND PUBLIC POLICIES

THE RELATIONSHIP BETWEEN HISTORICAL LANDMARKS AND AGING AND DISABILITY-RELATED POLICIES

TRENDS IN POLICY, SOCIAL, AND POLITICAL INFLUENCES AND LANDMARKS IN THE UNITED STATES

The Roaring ‘20s: 1920–1929

The Dirty ‘30s: 1930–1939

The War-Torn ‘40s: 1940–1949

The Golden Age: 1950–1959

The Age of Technology Explosion: 1960–1969

The Decade of Presidential Resignation: 1970–1979

The Era of Economic Entrenchment: 1980–1989

The Era of Globalization: 1990–1999

The Dawning of a New Century: 2000–2009

The Age of Individualism (2010 and Beyond)

SUMMARY

DISCUSSION QUESTIONS

REFERENCES

3. Philosophical Paradigms and Policy Frameworks Impacting Aging and Disability Policy

LEARNING OBJECTIVES

PHILOSOPHICAL PARADIGMS AND THE RELATIONSHIP TO AGING POLICY AND POLICY ANALYSIS

WHAT IS POLICY ANALYSIS?

PHILOSOPHICAL PARADIGMS

Blaming the Victim

Elitism

Social Welfare as a Right

Econometric Perspectives

Cause Versus Function

Cronyism

Feminism

Public Policy Advocates’ Understanding of the Paradigms

IMPLEMENTATION STRATEGIES

Window of Opportunity

Implementation

Incrementalism

Rationalism

Street-Level Bureaucrats

Public Policy Advocates’ Understanding of the Implementation Strategies

A MODEL FOR SOCIAL WELFARE POLICY ANALYSIS

Social Problem/Social Issue

Goal

Policy or Legislation

Implementation of Policy or Legislation

THE USE OF NEEDS ASSESSMENTS FOR POLICY DEVELOPMENT AND COMMUNITY PLANNING

SUMMARY

DISCUSSION QUESTIONS

REFERENCES

4. Evidence-Based Policy Development: Tools for Public Policy Development and Analysis

LEARNING OBJECTIVES

WHAT IS AN EVIDENCE BASE?

WHAT IS EVIDENCE-BASED PROGRAM AND POLICY DEVELOPMENT?

WHY AN EVIDENCE BASE?

SOCIAL WORK AND PROGRAM PLANNING FOR OLDER ADULTS AND PEOPLE WITH DISABILITIES: AN AUTHORITY-BASED OR EVIDENCE-BASED PROFESSION?

APPROACHES TO EVIDENCE-BASED POLICY DEVELOPMENT

SOURCES OF EVIDENCE

Congressional Universe

Congress.gov Database

Government Printing Office

Government Accountability Office

Secondary Data Sources Useful in an Evidence-Based Approach

BENCHMARKS USED IN THE HEALTHCARE ARENA FOR PROGRAM PLANNING AND POLICY DEVELOPMENT

EVIDENCE AND ITS ROLE IN POLICY DEVELOPMENT AND COMMUNITY PLANNING

What Is a Needs Assessment?

SUMMARY

ADDITIONAL RESOURCES

Websites

DISCUSSION QUESTIONS

REFERENCES

PART II: The Legislative Basis for Programs and Services Affecting Older Adults and/or People With Disabilities

5. The Social Security Act

LEARNING OBJECTIVES

BACKDROP TO OUR CURRENT SOCIAL SECURITY PROGRAM

Social Security in Europe

The Genesis of Social Security in the United States

Contents of the Original Social Security Act

THE CURRENT SOCIAL SECURITY ACT

Some Guidelines for Social Security Programs

Basic Information When One Is Receiving Social Security Disability Benefits

About Benefits

Other Benefits One May Be Eligible for

What Must Be Reported to SSA?

SOCIAL SECURITY DISABILITY INSURANCE FOR CHILDREN

When a Child Reaches Age 18

If an 18-Year-Old Child Is Still in School

If a Child Is Disabled

If One Has a Stepchild and Gets Divorced

Reviewing One’s Medical Condition

Helping One Return to Work

Protection of One’s Personal Information

SOME REFORMS WORTH NOTING

PROPOSALS FOR REVISION AND WHY

Implications of a Privatized System

DILEMMAS FOR THE FUTURE

A Culture of Impoverished Older Adults

Older Women and Poverty

An Empty Pot at the End of the Rainbow

SUMMARY

DISCUSSION QUESTIONS

ADDITIONAL RESOURCES

Websites

YouTube Resources Related to Social Security

REFERENCES

6. Medicare

LEARNING OBJECTIVES

INTRODUCTION

HISTORICAL PERSPECTIVE

HOW DOES MEDICARE WORK?

Hospital Insurance (Part A)

Medical Insurance (Part B)

Costs of Medicare Part A Coverage

Part B Coverage Costs

Part B Costs for Those Qualifying for Original Medicare

Medicare Part C

Part C Coverage Costs

Medicare Part D

HOW DOES MEDICARE AFFECT ACCESS TO HEALTHCARE, COST CONTAINMENT, AND QUALITY?

WHAT IS MEDICAID AND HOW DOES IT DIFFER FROM MEDICARE?

Eligibility

Medicaid Waiver Opportunities

THE EFFECTS OF REIMBURSEMENT ON HEALTHCARE QUALITY, ACCESS, AND COSTS

CHALLENGES FOR THE FUTURE

An Empty Pot at the End of the Rainbow?

Rationing of Healthcare Services—To Be or Not to Be?

SUMMARY

CASE STUDY DISCUSSION

DISCUSSION QUESTIONS

ADDITIONAL RESOURCES

Websites

YouTube Resources Related to Medicare

Podcast

REFERENCES

7. The Older Americans Act

LEARNING OBJECTIVES

BACKGROUND AND OVERVIEW

THE OLDER AMERICANS ACT OF 1965

Title I: Definitions

Title II: Administration on Aging

Title III: Grants for Community Planning, Services, and Training

Title IV: Research and Development Projects

Title V: Training Projects

Title VI: General

AMENDMENTS TO THE OLDER AMERICANS ACT: 1967–2000

The National Family Caregiver Support Program

LEGISLATIVE AMENDMENTS OF 2016

Title I

Title II

Title III

Title IV

Title V

Titles VI and VII

The 2010 Reauthorization

LEGISLATIVE AMENDMENTS of 2016 (PL 114–144)

Aging and Disability Resource Centers

Area Plans

Disease Prevention and Health Promotion Services

Elder Abuse

Funding Formula

Holocaust Survivors

Home- and Community-Based Services

Long-Term Care Ombudsman Program

National Family Caregiver Support Program

Nutrition Services

Legal Assistance

Title IV Demonstration Projects

PHILOSOPHICAL PARADIGMS IMPACTING LEGISLATIVE AMENDMENTS

SUMMARY

USEFUL WEBSITES

Websites

YouTube Videos

Podcast

DISCUSSION QUESTIONS

REFERENCES

8. The Americans With Disabilities Act

LEARNING OBJECTIVES

THE INTERSECTION BETWEEN DISABILITY AND AGING

HISTORY OF THE DISABILITY MOVEMENT

THE JOURNEY TOWARD THE AMERICANS WITH DISABILITIES ACT

THE AMERICANS WITH DISABILITIES ACT OF 1990

Title I: Employment

Title II: Public Services

Title III: Public Accommodations and Services Offered Through Private Entities

Title IV: Telecommunications

Title V: Miscellaneous Provisions

IMPLICATIONS OF THE AMERICANS WITH DISABILITIES ACT ON THE AGING AND OLDER ADULT POPULATIONS

Title I: Employment

Title II: Public Services

Title III: Public Accommodations and Services Offered Through Private Entities

Title IV: Telecommunications

THE AMERICANS WITH DISABILITIES ACT AMENDMENTS OF 2008

Title I

Title II

Title III

Title IV

Title V

AGING AND DISABILITY RESOURCE CENTERS

SUMMARY

USEFUL WEBSITES

ADDITIONAL RESOURCES

YouTube Videos

Podcasts

DISCUSSION QUESTIONS

REFERENCES

9. Mental Health: The Community Mental Health Act

LEARNING OBJECTIVES

WHAT IS MENTAL HEALTH?

Definition of Mental Health

Paradigms of Mental Health

HISTORY OF LEGISLATIVE EFFORTS AFFECTING OLDER ADULTS AND OTHERS WITH MENTAL DISORDERS

The 2000 National Family Caregivers’ Support Program

The New Freedom Commission on Mental Health

INFLUENCES TO CONSIDER IN THE DEVELOPMENT OF MENTAL HEALTH LEGISLATION

Patterns of Service Utilization

Health Beliefs and the Role of Culture

A CURRENT MENTAL HEALTH PROFILE OF OLDER ADULTS AND PEOPLE WITH DISABILITIES IN THE UNITED STATES

A CLOSER VIEW OF THE MEANING OF MENTAL HEALTH

MH, Older Adults, and Physicians

MH, Older Adults, and Social Services

THE EPIDEMIOLOGY OF MH ISSUES OF OLDER ADULTS

Depression in Older Adults

Late-Onset Depression

Alzheimer’s Disease

Anxiety Disorders

Schizophrenia in Late Life

MH and Older Adults

MH in Rural Communities Versus Urban Communities

SOCIAL WORK, MENTAL HEALTH, AGING, AND SERVICE UTILIZATION

PROGRAMS AVAILABLE TO MEET THE MENTAL HEALTHCARE NEEDS OF OLDER ADULTS AND PEOPLE WITH DISABILITIES

Medicare

Medicaid

Area Agencies on Aging

SERVICE DELIVERY SETTINGS FOR MENTAL HEALTHCARE FOR OLDER ADULTS

ISSUES FACING OLDER ADULTS, PEOPLE WITH DISABILITIES, AND MENTAL HEALTHCARE NEEDS

Financing Mental Healthcare for Older Adults

Community-Based Care

Models for Gero-Psychiatry

Prevention Services

Screening and Detection

Medications

People With Chronic Mental Health Needs Who Are Aging

Oppressed Groups and Visible Minorities

MODEL PROGRAMS AND BEST PRACTICE APPROACHES TO MENTAL HEALTH SERVICE DELIVERY

The Center for Older Adult Recovery at Hanley Center

The Gatekeeper Program

MENTAL HEALTHCARE CHALLENGES FOR THE FUTURE

SUMMARY

ADDITIONAL RESOURCES

Websites

YouTube Videos

Podcast

DISCUSSION QUESTIONS

REFERENCES

10. The Patient Protection and Affordable Care Act

LEARNING OBJECTIVES

THE AFFORDABLE CARE ACT BECOMES LAW

COMPONENTS OF THE ACA

Title I: Quality, Affordable Healthcare for All Americans

Title II: Role of Public Programs

Title III: Improving the Quality and Efficiency of Healthcare

Title IV: Prevention of Chronic Disease and Improving Public Health

Title V: Healthcare Workforce

Title VI: Transparency and Program Integrity

Title VII: Improving Access to Innovative Medical Therapies

Title VIII: Class Act

Title IX: Revenue Provisions

Title X: Strengthening Quality, Affordable Healthcare for All Americans

SUMMARY

DISCUSSION QUESTIONS

ADDITIONAL RESOURCES

YouTube Videos

Websites

Podcasts

REFERENCES

11. Caregivers/The Caregiver Support Act

LEARNING OBJECTIVES

CAREGIVERS AND THE CAREGIVER SUPPORT ACT

RAISE FAMILY CAREGIVERS ACT—PUBLIC LAW 115–119

Importance of Family Caregivers

A CURRENT PROFILE OF RELATIVE CAREGIVERS RAISING CHILDREN IN THE UNITED STATES

REASONS FOR THE INCREASE IN RELATIVE CAREGIVING

ISSUES FACING GRANDPARENTS RAISING GRANDCHILDREN

Poverty

Social/Role Issues

Socialization

Healthcare

Policy and Legislation

PROGRAMS AVAILABLE TO MEET THE NEEDS OF RELATIVE CAREGIVERS AND GRANDPARENTS RAISING GRANDCHILDREN

Medicare

Medicaid

Area Agencies on Aging

Child Welfare

MODEL PROGRAMS AND PROACTIVE APPROACHES TO ADDRESSING THE NEEDS OF GRANDPARENTS SERVING AS CAREGIVERS FOR GRANDCHILDREN

CHALLENGES FOR RELATIVE CAREGIVERS AND GRANDPARENTS RAISING GRANDCHILDREN IN THE FUTURE

SUMMARY

ADDITIONAL RESOURCES

Websites

YouTube Videos

Podcasts

DISCUSSION QUESTIONS

REFERENCES

12. The Elder Justice Act

LEARNING OBJECTIVES

THE ELDER JUSTICE ACT

LEGISLATIVE PROVISIONS ADDRESSED WITHIN THE ELDER JUSTICE ACT

A CURRENT PROFILE OF ELDER ABUSE FACING OLDER ADULTS IN THE UNITED STATES

WHO REPORTS ELDER ABUSE?

PROGRAMS AND SERVICES AVAILABLE TO ADDRESS ISSUES OF ELDER ABUSE

Medicare

State-Based Services Offered Through Departments on Aging

The Centers for Disease Control and Prevention

Area Agencies on Aging

TYPES OF ELDER ABUSE AND NEGLECT

MODEL PROGRAMS AND BEST-PRACTICE APPROACHES TO ADDRESSING THE LEGAL NEEDS OF OLDER ADULTS

Breaking the Silence—Media Campaign (Illinois Department on Aging)

The B*SAFE Program

CHALLENGES FOR ELDER ABUSE AND NEGLECT PROGRAMS IN THE FUTURE

CHALLENGES FOR LEGAL ISSUES IN AGING FOR THE FUTURE

LEGAL ISSUES AND OLDER ADULTS

POWER OF ATTORNEY

Types of Powers of Attorney

Legal Authority Granted via a Power of Attorney

Selecting an Agent for a Power of Attorney

Monitoring and Oversight

HEALTHCARE POWER OF ATTORNEY

Living Wills and Advance Directives

PROGRAMS AND SERVICES AVAILABLE TO ADDRESS LEGAL ISSUES FOR OLDER ADULTS

Medicare

State-Based Departments on Aging

The Older Americans Act and Area Agencies on Aging

MODEL PROGRAMS AND BEST PRACTICES TO ADDRESS THE LEGAL NEEDS OF OLDER ADULTS

American Association of Retired Persons

American Society on Aging

CHALLENGES FOR LEGAL ISSUES IN THE AGING ARENA FOR THE FUTURE

SUMMARY

ADDITIONAL RESOURCES

Websites

YouTube Videos

DISCUSSION QUESTIONS

REFERENCES

13. Housing and Long-Term Care

LEARNING OBJECTIVES

A HISTORICAL OVERVIEW OF HOUSING POLICY AND OPTIONS FOR PEOPLE GROWING OLDER AND PEOPLE WITH DISABILITIES

A CURRENT PROFILE OF LONG-TERM CARE AND COMMUNITY-BASED CARE NEEDS

AN OVERVIEW OF THE PROGRAMS TO MEET HOUSING NEEDS OF OLDER ADULTS

Senior Apartments

Categories of Senior Apartments

STRATEGIES FOR REMAINING IN ONE’S HOME

Home Equity Conversion

Sale Leaseback

MAINTENANCE PROGRAMS

Home Maintenance and Repair

Illinois Home Weatherization Assistance Program

ISSUES FACING LONG-TERM AND COMMUNITY-BASED CARE FOR OLDER ADULTS

Long-Term Care Facilities

Assisted Living Facilities

Community-Based Care

Consumer-Directed Home Help and Care Options

People With Disabilities Requiring Community-Based Care

OPPRESSED GROUPS AND VISIBLE MINORITIES

SUMMARY

DISCUSSION QUESTIONS

ADDITIONAL RESOURCES

Websites

YouTube Videos

Podcast

REFERENCES

14. Substance Use and Misuse

LEARNING OBJECTIVES

LEGISLATIVE HIGHLIGHTS RELATED TO SUBSTANCE ABUSE/MISUSE

WHAT IS THE SCOPE OF SUBSTANCE MISUSE?

The State of Opioid Use

Alcohol and Substance Abuse Disorders

Substance Use/Abuse and People with Disabilities

SOCIAL WORK, MENTAL HEALTH, AGING, AND SERVICE UTILIZATION

PROGRAMS AVAILABLE TO MEET THE SUBSTANCE ABUSE CARE NEEDS OF OLDER ADULTS

Medicare

Medicaid

Area Agencies on Aging

SERVICE DELIVERY SETTINGS FOR SUBSTANCE USE/MISUSE CARE FOR OLDER ADULTS AND PEOPLE WITH DISABILITIES

ISSUES FACING OLDER ADULTS AND PEOPLE WITH DISABILITIES WITH SUBSTANCE ABUSE/MISUSE CARE NEEDS

Financing Mental Healthcare for Older Adults

Community-Based Care

Models for Gero-Psychiatry

Prevention Services

Screening and Detection

Medications

MODEL PROGRAMS AND BEST-PRACTICE APPROACHES TO SUBSTANCE USE/MISUSE SERVICE DELIVERY

The Center for Older Adult Recovery at Hanley Center

SUBSTANCE USE/MISUSE CARE CHALLENGES FOR THE FUTURE

SUMMARY

DISCUSSION QUESTIONS

ADDITIONAL RESOURCES

Websites

YouTube Videos

Podcast

REFERENCES

PART III: Tools for Policy and Program Development

15. Health Behavior Models and Health Promotion Frameworks

LEARNING OBJECTIVES

WHAT ARE HEALTH PROMOTION FRAMEWORKS?

HEALTH PROMOTION FRAMEWORKS AND HEALTH POLICY

The Health Belief Model

The Theory of Reasoned Action

Transtheoretical Model and Stages of Change Theory

IMPLICATIONS OF THE HEALTH PROMOTION MODELS AND PROGRAM DEVELOPMENT FOR AGING AND DISABILITY-RELATED PROGRAMS AND SERVICES

SUMMARY

ADDITIONAL RESOURCES

Websites

YouTube Videos

DISCUSSION QUESTIONS

REFERENCES

16. Media, Social Media, and Advocacy Strategies for Change

LEARNING OBJECTIVES

ADVOCACY AND ITS ROLE IN PROGRAM AND POLICY DEVELOPMENT

THE USE OF MEDIA ADVOCACY

What Is Media Advocacy?

When Using Media for Advocacy

FORMS OF MEDIA ADVOCACY

Newspaper Articles

News Releases

Letters to the Editor

Radio Spots or Television Interviews

Media Events or Press Briefings

Fact Sheets

Media Artifacts

Social Media

WHAT STRATEGIES ARE BEST TO USE?

Consider the Audience

Consider the Message

Consider Time

Consider Financial Resources

Consider Human Resources

USING MEDIA ADVOCACY FOR POLICY DEVELOPMENT AND PROGRAM PLANNING

SUMMARY

ADDITIONAL RESOURCES

Websites

YouTube Videos

Podcast

DISCUSSION QUESTIONS

REFERENCES

17. Coalitions and Coalition Building for Advocacy and Policy Development

LEARNING OBJECTIVES

WHY ADVOCACY?

STRATEGIES FOR ADVOCACY: COALITION BUILDING

What Are Coalitions?

What Are Some Reasons for Developing Coalitions?

PARTNERS FOR COALITION ENTITIES

Academia

Public Health Expertise

Human Service Providers

Consumer Organizations

Faith-Based Communities

Law and Safety Enforcement

Media/Education

Volunteer Associations

Sports and Recreation Entities

HOW DO WE BUILD COALITIONS?

COMMUNICATION SKILLS FOR EFFECTIVE COMMUNITY NEGOTIATIONS

Sources of Conflict

Roles of Coalition Members

Understanding the Roles Participants Will Take On

What Influences These Roles Within Coalitions?

MODEL COALITIONS AND THEIR OUTCOMES

The National Coalition on Mental Health and Aging

The Ontario Healthy Communities Coalition

Quad Counties Mental Health and Aging Coalition

The National Federation of the Blind

The Coalition of Health and Disability Advocates

The Coalition of Citizens With Disabilities

The Pioneer Network Coalition

SUMMARY

ADDITIONAL RESOURCES

Websites

Videos

DISCUSSION QUESTIONS

REFERENCES

18. Needs Assessment Tools

LEARNING OBJECTIVES

INTRODUCTION

WHO IS RESPONSIBLE FOR CARRYING OUT NEEDS ASSESSMENTS?

WHY WOULD INDIVIDUALS, GROUPS, OR ORGANIZATIONS BE INTERESTED IN CONDUCTING A NEEDS ASSESSMENT?

CORE CONCEPTS OR BUILDING BLOCKS THAT SERVE AS A FOUNDATION FOR NEEDS ASSESSMENTS

Need

Target Groups

Systems

Outcomes

Plan of Action

Evidence Base

STRATEGIES FOR DEVELOPING A NEEDS ASSESSMENT

Social Indicators

Key Informants

Community Forum

Field Study and Survey Data

Rates Under Treatment or Agency Service Data

Focus Groups

Environmental Scans

A MODEL FOR NEEDS ASSESSMENT

SUMMARY

ADDITIONAL RESOURCES

Websites

YouTube Videos

Podcast

DISCUSSION QUESTIONS

REFERENCES

19. From Tools to Vision

LEARNING OBJECTIVES

USING TOOLS AND STRATEGIES TO REACH YOUR VISION

FROM TOOLS TO POLICY DEVELOPMENT

FROM TOOLS TO PROGRAM DEVELOPMENT

SUMMARY

DISCUSSION QUESTIONS

REFERENCES

PART IV: Realities and Visions for the Future

20. Challenges for Policy and Program Planning for the Future: Realities and Visions for the Future

LEARNING OBJECTIVES

INTRODUCTION

THE TOP 10 LIST OF CHALLENGES FOR THE FUTURE IN THE AREAS OF DISABILITY AND AGING

1. Designing Paradigms to Meet the Demographic and Social Needs of Our Graying and Disabled Populations Through Evidence-Based Approaches

2. Social Security

3. Medicare

4. Understanding Health Behavior and Planning With This Understanding in Mind

5. Using the Media, Advocacy, and Coalitions for Social Change

6. Home- and Community-Based Care

7. Mental Health Programs, Services, and Issues

8. Health Programs, Services, and Issues

9. Long-Term Care

10. Diversity and Special Populations

SUMMARY

REFERENCE

Appendix A: Regional Support Centers

Appendix B: Healthy People 2020 Objectives for Older Adults

Appendix C: Healthy People 2020 Objectives for Disability and Health

Appendix D: Overview of Relevant Legislation That Impacts Older Adults and People With Disabilities

Appendix E: Aging and Disability Resource Centers

Appendix F: Overview of ICD-10 and ICF: Application to People With Disabilities and Older Adults

Patricia Welch Saleeby

Index