Digital Commons Network^™

Pension Action Center, Michele Tolson, Pension Action Center, University Of Massachusetts Boston, Gerontology Institute, University Of Massachusetts Boston

Office of Community Partnerships Posters

The Pension Action Center (PAC) strives to improve retirees’ and workers’ standard of living in retirement through individual case advocacy; referrals to appropriate programs and professionals; and issue analysis and reform of public policy. The center, which is part of the Gerontology Institute at UMass Boston, focuses on the experience of participants in retirement plans throughout its work. The PAC is a one-of-a-kind organization in New England that touches the lives of thousands of people.

Planning For The Growing Older Population: Conducting Community Needs Assessments, Caitlin Coyle, Hayley Gravette, Jan Mutchler, Gerontology Institute, University Of Massachusetts Boston

Office of Community Partnerships Posters

Goals and Objectives: To describe the aging population of each community; To investigate the needs, interests and opinions of mature residents relating to their aging needs for age-related services in their respective communities; To provide recommendations to community partners and their stakeholders about how to create strong communities for older adults, based on needs assessment results; Generate reports and other documents to be used by the Department of Elder Services, other town offices, organizations that provide services, advocates, and community members.

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Rebalancing Long-Term Care Under The Affordable Care Act, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

Federal approval of Rhode Island’s Global Consumer Choice Compact Global Waiver in 2009 provided Rhode Island with greater flexibility to modify its Medicaid program. Because 96% of long-term care expenditures in Rhode Island were directed toward institutional settings, a primary goal was to facilitate the state’s efforts to shift the locus of long-term care to non-institutional settings. This study draws lessons from Rhode Island’s experience with the Global Waiver for the long-term care rebalancing provisions of the Patient Protection and Affordable Care Act of 2010. Data derive from 325 archival sources and 26 semi-structured interviews. Results suggest that prospectively documenting …

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Designing And Implementing State Health Reform, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

Provisions in the Medicaid statute permit states to apply for waivers from traditional program requirements. On January 16, 2009, the federal government approved Rhode Island's Global Consumer Choice Compact Waiver. In exchange for a cap on combined federal and state spending of $12.075 billion through 2013, Rhode Island received greater flexibility to adopt certain Medicaid program changes. This study analyzes the design and implementation of the Global Waiver to draw general lessons for health reform at the state-level, a key concern given ongoing state discretion to improve their health care systems under the Patient Protection and Affordable Care Act. Data …

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Block Granting Medicaid And Other Retrenchment, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

On January 16, 2009, the Federal government approved Rhode Island’s application for a Global Consumer Choice Compact Medicaid Waiver whereby the state became the first granted permission to operate its entire Medicaid program under the state plan and a single 1115 “research and demonstration” waiver. The Global Waiver has been implemented in the context of Republican proposals to turn Medicaid into a block grant which would give states substantially more flexibility administering the program in exchange for receiving an upfront allotment from the Federal government. Proponents have held up the Global Waiver as a successful example of what might be …

Aging In Hingham: A Community Affair, Jan Mutchler, Caitlin Coyle, Hayley Gravette

Gerontology Institute Publications

The purpose of this needs assessment is to investigate the needs, interests, and opinions of mature residents of Hingham, Massachusetts, relating to their aging experiences and needs for age-related services. This assessment was undertaken by the Gerontology Institute of the McCormack Graduate School at UMass Boston on behalf of the Town of Hingham Department of Elder Services (hereinafter referred to as the Department of Elder Services). The focus of this report is on Hingham residents aged 60+ (referred to here as “Seniors”) and residents aged 45-59 (referred to here as “Boomers”). Information about these two age groups was obtained both …

Clinical Trial Participation Among Ethnic/Racial Minority And Majority Patients With Advanced Cancer: What Factors Most Influence Enrollment?, Rachel Jimenez, Baohui Zhang, Steven Joffe, Matthew Nilsson, Lorna Rivera, Jan Mutchler, Christopher Lathan, M. Elizabeth Paulk, Holly G. Prigerson

Women’s and Gender Studies Faculty Publication Series

BACKGROUND: Studies using administrative data report that racial/ethnic minority patients enroll in clinical trials less frequently than white patients. We studied a cohort of terminally ill cancer patients to determine a) if racial/ethnic minority patients have lower rates of drug trial enrollment than white patients once socioeconomic characteristics are accounted for and b) what factors most influence drug trial enrollment among patients with advanced canceroverall.

METHODS: Coping with Cancer (CwC) is a National Cancer Institute/National Institute of Mental Health (NCI/NIMH)-funded multisite, prospective, longitudinal study of patients with advanced cancer. Baseline interviews assessed drug trial enrollment as well as socioeconomic characteristics. …

A New Approach To An Old Problem: Defining Nursing’S Role In Successful Transitions To Long-Term Residential Care, Kyleen Aldrich

Honors College Theses

A growing body of nursing research addresses the transitional period for older adults entering long-term residential care. However, gaps exist in our understanding of nursing’s role in the transition process. Our aim is to examine the available evidence and develop a model of nursing strategies and interventions to ease the transition to long-term care. This model describes interventions that nurses can incorporate into everyday practice.

A literature review was conducted to examine the transitional care needs and interventions for older adults with a goal of developing a model addressing transitions to long-term care.

Most nursing studies provided descriptive information about …

The National Elder Economic Security Standard Index, Gerontology Institute, University Of Massachusetts Boston

Gerontology Institute Publications

The Elder Economic Security Standard Index (Elder Index) is a new tool for use by policy makers, older adults, family caregivers, service providers, aging advocates, and the public at large. Developed by the Gerontology Institute at the University of Massachusetts Boston and Wider Opportunities for Women (WOW), the Elder Index is a measure of income that older adults require to maintain their independence in the community and meet their daily costs of living, including affordable and appropriate housing and health care. The development and use of the Elder Index promotes a measure of income that respects the autonomy goals of …

Town Of Cohasset Senior Center Study, Jan Mutchler, Hayley Gravette, Caitlin Coyle

Gerontology Institute Publications

The Town of Cohasset is considering the construction of a new Senior Center that will provide the opportunity for expanded programming within a dedicated building. In support of planning efforts by the Town of Cohasset, a study was conducted by the Gerontology Institute of the McCormack Graduate School at UMass Boston. The study addresses the need for, and probable utilization of, a new Senior Center, and includes consideration of the recreational, educational and health-related programs that are likely to be offered through the new Center. Results of the study presented in this report respond to three questions: First, what are …

Evaluation Of Lift Up Your Voice! Advocacy Training For Older Adults And Their Caregivers: Executive Summary, Alison Gottlieb, Nina M. Silverstein, Kelli Barton

Gerontology Institute Publications

The Lift Up Your Voice! (LUYV) training, a component of Community Catalyst’s effort to support the Campaign for Better Care (CBC), is designed to mobilize grassroots advocacy structures of vulnerable older adults by directly engaging and empowering older adults and their caregivers. The goal of the evaluation is to assess the effectiveness LUYV in recruiting potential advocates, educating them about the health care reform, empowering them via advocacy skills training, and engaging them in state-based CBC activities.

Letter Regarding Irs Form 8955-Ssa Participant Notice Requirement, Mia Midenjak, Ellen A. Bruce

Pension Action Center Publications

On April 27, 2012, the Pension Action Center wrote to the Internal Revenue Service to advocate for the pension rights of American workers and retirees. The Pension Action Center’s letter was prompted by a request from the American Society of Pension Professionals and Actuaries (ASPPA) that plans be relieved of their legal obligation to notify departing workers of their right to a pension.

Protect Your Pension: Important Documents You Should Keep, Mia Midenjak

Pension Action Center Publications

No matter what kind of pension or retirement plan your employer offers, you should keep certain documents indefinitely to ensure that your retirement benefit is paid correctly. Based on our experience with finding lost retirement income and assisting workers and retirees to get the benefits they have earned, we recommend that you save the following information.

Evaluating Economic Security For Massachusetts Seniors, Jan Mutchler, Ellen A. Bruce, Alison Gottlieb, Jiyoung Lyu, Yao‐Chi Shih, Gerontology Institute, University Of Massachusetts Boston

Office of Community Partnerships Posters

The Elder Economic Security Standard Index measures the income that Massachusetts’ seniors need to maintain independence and meet basic living expenses. The sizable gap between Social Security benefits and living expenses occurs throughout Massachusetts, but is more substantial for singles than for couples. Those who are older, single, female or a member of a racial or ethnic minority group are exposed to especially high risk of falling short of Index values. The Elder Index estimates the living costs for seniors in every locality in the country and serves as a valuable tool for community members, policy makers, and those working …

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …

The Massachusetts Elder Economic Security Index (2011), Gerontology Institute, University Of Massachusetts Boston

Gerontology Institute Publications

The Elder Economic Security Standard^TM Index measures the income that Massachusetts’ seniors need to maintain independence and meet their basic living expenses in the community. The Elder Index uses an income measure that reflects the actual expenses for basic needs of older adults, and includes cost estimates for housing, food, medical care, transportation, and household essentials. Elder Index values are calculated for each state, on a county-by-county basis, providing policy makers and individuals a benchmark for determining what income or governmental supports are needed in their communities.

Elder Economic Security Initiative™: The Elder Economic Security Standard™ Index For North Carolina, Gerontology Institute, University Of Massachusetts Boston, Wider Opportunities For Women

Gerontology Institute Publications

This report addresses income adequacy for North Carolina’s older adults using the national WOW-GI National Elder Economic Security Standard Index (Elder Index) methodology. The Elder Index benchmarks basic costs of living for elder households and illustrates how costs of living vary geographically and are based on the characteristics of elder households, including household size, home ownership or renter status and health status. The costs are based on market costs for basic needs of elder households and do not assume any public or private supports.

Elder Economic Security Initiative™: The Elder Economic Security Standard™ Index For South Dakota, Gerontology Institute, University Of Massachusetts Boston, Wider Opportunities For Women

Gerontology Institute Publications

This report addresses income adequacy for South Dakota’s older adults using the national WOW-GI National Elder Economic Security Standard Index (Elder Index) methodology. The Elder Index benchmarks basic costs of living for elder households and illustrates how costs of living vary geographically and are based on the characteristics of elder households, including household size, home ownership or renter status and health status. The costs are based on market costs for basic needs of elder households and do not assume any public or private supports.

Summary Of Mass State Pension Reform Law Chapter 176 Of The Acts Of 2011, Ellen A. Bruce

Pension Action Center Publications

Massachusetts passed significant changes to its public pension system meant to create cost savings for the state and to encourage employees to work longer. Most of the changes apply only to people hired after April 2, 2012. This summarizes the most important changes.

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

The Role Of Home Environments In Residential Adjustment Decision Making In Later Life, Kimberly Joy Stoeckel

Graduate Doctoral Dissertations

Using the nationally representative Health and Retirement Study, this research explored the multi-faceted influence of the accessibility of housing environments on the occurrence and characteristics of residential adjustments made by older adults aged 70 or older. A range of housing adjustment outcomes were examined, including home modifications and relocation into age-segregated senior housing. Analysis of the accessibility gains following relocation was also included in the empirical analyses.

The Ecological Theory of Aging (Lawton & Nahemow, 1973) provided the conceptual framework for the research. The longitudinal design of the HRS empirically advanced understanding of the key theoretical constructs by sensitizing the …

A Primer For Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. To ensure that providers behave appropriately, the federal and state governments have established an extensive set of regulations that nursing homes must comply with if they are to be reimbursed for patients insured by Medicaid. Consumers exert considerable influence here by focusing on regulations and enforcement of non-compliance.

States also seek to align providers’ interests with those of other interested parties through controls and incentives built into state reimbursement systems, including with respect to facility cost and quality, access to care, payment equity, service capacity, and budgetary …

Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota For State Policymakers, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. State governments design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control.

Often, participation in the process of developing Medicaid payment policy is limited to state agency officials and providers of care and, occasionally, union representatives and state legislative staff. Invited less frequently to reimbursement policy discussions are consumer representatives. Lack of consumer involvement in the development of state rate setting systems has the potential to result in the …

Senior Transportation Abstracts: A Focus On Options, Helen Kerschner, Nina M. Silverstein

Gerontology Institute Publications

This collection of abstracts represents a publication of importance for understanding the needs, challenges, solutions, and/or every day issues related to senior transportation services. While several of the abstracts include information about senior driver safety, the collection’s primary purpose is to present a holistic approach to transportation options for older adults. Such a collection is timely because, although the practice of providing transportation to older adults is not new, research and preparation of practical informational and technical materials related to older adult transportation service needs and service delivery are quite recent.

Coming Of Age In Marshfield: A Needs Assessment Of Aging Services, Jan Mutchler, Sandra Mccoskrie Blanchette

Gerontology Institute Publications

The purpose of this needs assessment is to investigate the needs, interests, and opinions of mature residents of Marshfield, Massachusetts, relating to their aging experiences and needs for age‐related services. On behalf of the Marshfield Council on Aging (COA), this assessment was conducted by the Collins Center for Public Management and the Gerontology Institute of the McCormack Graduate School at UMass Boston. The focus of this report is on Marshfield residents aged 60+ (referred to here as “Seniors”) and residents aged 45‐59 (referred to here as “Boomers”). Information about these two age groups was obtained both through the U.S. Census …

Massachusetts Senior Legal Assistance Project Needs Evaluation: Current Demand For Legal Services, Alison Gottlieb, Lauren A. Martin, Ellen A. Bruce

Gerontology Institute Publications

The Gerontology Institute at the University of Massachusetts Boston was contracted to conduct a statewide needs assessment for the MSLAP. As agreed upon by the MSLAP Advisory Board, the focus of this assessment was to analyze the demand for services Massachusetts legal service providers have experienced recently as a means to understanding the legal needs of Massachusetts elders (age 60 and older). A second needs assessment was conducted by the Massachusetts Executive Office of Elder Affairs. That needs assessment surveyed home care workers and other elder agency personnel to gauge their assessment of elders’ legal needs in Massachusetts. Read together, …

Protecting Your Retirement Savings From Potential Creditors, Pension Action Center, Gerontology Institute, University Of Massachusetts Boston

Pension Action Center Publications

State and federal laws provide strong protections to New England residents to shield their retirement savings from creditors. The particular protections available depend on whether you have filed for bankruptcy, how your retirement savings are kept, and where you live.

Chronic Disease Self-Management Programs: Relevance For Persons With Dementia, Nina M. Silverstein, Alison S. Gottlieb

Gerontology Institute Publications

The context for this study is the work of the Healthy Brain Initiative. The CDC has established a cooperative agreement with the Alzheimer’s Association to develop and implement a multifaceted approach to look at cognitive health as a public health issue. Late in 2010, the Association commissioned a review of the major chronic disease prevention programs from a systems approach to begin to understand the source of findings that Medicare beneficiaries with Alzheimer’s and related disorders are much higher cost than those simply with a single chronic disease and no AD. This led to the conclusion that Chronic Disease Self‐Management …

Fun With Numbers: Disclosing Risk To Individual Investors, Christian A. Weller

Gerontology Institute Publications

This paper discusses the need for better information on investment risks. The information should be relevant, concise, and accessible to individual investors. More and better information on factors that are likely to influence an investment’s performance and investors’ decisions should eventually lead to better investment decisions – more savings and higher retirement incomes. This paper presents a number of ways to disclose risk to individual investors. There are three numerical and three visual representations to risk. The discussion centers on the pros and cons of each risk representation. All risk descriptions show relevant information, are concise, and more or less …

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. Medicaid is a major source of funding for long term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional, …