Formerly IGSW News | VOLUME 23 | WINTER—SPRING 2016 | CADER@bu.edu

From the Director


Better results at lower cost?

CADER–Massachusetts General Hospital
Partnership Will Evaluate Acute Community Care


By Scott Miyake Geron

Five years after passage of the Affordable Care Act, studies show substantial gains in coverage, quality, and cost control. That's all good. But we who work in aging and disability know that longstanding and new challenges—from population pressures to rising costs of pharmaceuticals—mean we must redouble our efforts if we are to sustain and increase these gains. Here at CADER we are pleased to be joining in partnership with Massachusetts General Hospital to conduct a new study funded by PCORI, the Patient-Centered Outcomes Research Institute. PCORI is at the center of the Affordable Care Act's initiative to improve care and lower costs through research on effectiveness of treatments and care-delivery systems.

Specially trained and equipped paramedics respond to urgent-care calls to evaluate and treat patients within their homes or residential facilities. That's the innovative program to be examined in the study. By avoiding unnecessary costly emergency department visits and, potentially, hospital admissions, the program aims to reduce risks to patients and improve urgent care outcomes. Read more...

Boston University photo of Scott Miyake Geron




Issues and Views


Implications for consumers and the aging network

Managing Integrated Acute and Long-Term Services


By Robert Applebaum

These days we are seeing a strong push to integrate acute and long-term services. The push has come from the federal government, through the Centers for Medicare and Medicaid Services, and from the states themselves, to address concerns about the quality and cost of the health and long-term care system.

Risk-based, managed-care models are the choice of most states that are exploring strategies to integrate care for individuals eligible for Medicare and Medicaid. Rather than relying on fee-for-service reimbursement, these models rely on capitated payment (a set amount per person). This arrangement increases the incentive to integrate care, but it also is a big change for most community-based service agencies. For them, the new environment presents challenges and some opportunities.... Read more


Photo of Robert Applebaum courtesy Scripps Gerontology Center


Aging and disability agencies!

Develop the Business Skills to Help Managed-Care
Organizations Provide Participant-Directed Services


Aging and disability agencies, which have years of experience in participant-directed long-term supports and services, are in a unique position to help managed-care organizations introduce and sustain participant direction, which is increasingly demanded by recipients of supports and services and often required by Medicare, Medicaid, and other payers. In this course you'll learn how your agency can engage in business relationships with MCOs to provide consultation, training, and management for participant-directed services. Obtain more information about Building the Aging and Disability Network's Business Capacity: Participant Direction in Managed Long-Term Services and Supports, or sign up now to receive a 10 percent discount (enter code ENEWS2016).


In my opinion:

Older Adults Can Be Part of the Solution
To Challenges from Climate Change


In light of the landmark World Climate Change Conference of 2015 and the resulting Paris Agreement forged two months ago, as well as the Supreme Court's recent action staying the President's clean power plan, The LearningEdge asked Kathy Sykes, senior advisor for aging and sustainability at the U.S. Environmental Protection Agency, to bring us up to date about the connection between population aging and the environment.—Ed.

By Kathy Sykes

To ComeRecent events like the World Climate Change Conference have captured our attention, but they are only the latest chapter in a long story. Forty-five years ago, on April 22, 1970, teach-ins took place across the country to highlight concerns about the environment.

At the time, the impact of climate change was not understood. But we know now that our Earth and our well-being were—and continue to be—threatened by it. The prestigious journal The Lancet has stated that climate change is the biggest global health threat of the 21st century. Among those most at risk are older adults.... Read more about why, about how population aging itself poses environmental problems, and about the many ways that older adults are already working on mitigation of and adaptation to climate change.


Photo of Kathy Sykes courtesy U.S. EPA




Notable News and Resources


To strengthen ADA mandate

Senate Bill Would Guarantee Long-Term
Supports and Services in Home and Community


Legislation that would guarantee people with disabilities the option of receiving long-term supports and services (LTSS)—assistance with activities of daily living or health-related tasks—in a home- or community-based setting was recently introduced by Senator Charles Schumer (D-N.Y.) and is now pending in the U.S. Senate Committee on Health, Labor, and Pensions.... Read more about The Disability Integration Act of 2015.



CDC tips on 'people first' language

Talking with and About People with Disabilities


"The blind," no. "People with visual impairment," yes. To foster respectful, appropriate communication with and about people with disabilities, the Centers for Disease Control and Prevention has created a fact sheet that recommends and provides examples of "people first" language in place of language that is considered stereotypical and dehumanizing.... Read more


Find the right supports and services

A Guide to the Aging and Disability Networks


From paratransit and legal assistance to home-delivered meals and care management, the resources and services available to older adults and people with disabilities come from a complex array of organizations and programs. Here is a CADER course that guides practitioners through this maze. Course participants will develop awareness and skills to help them match the needs of older individuals and people with disabilities with appropriate information and referrals, crucial in any number of settings. Sign up now and receive a 10 percent discount! (enter code ENEWS2016) or obtain more info.