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Listening Session: WH Conference on Aging

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Grantmakers In Aging/Grantmakers In Health Joint Listening Session for the White House Conference on Aging

This Listening Session for the White House Conference on Aging took place at the GIA Annual Meeting, on October 24, 2014, in San Francisco, CA.

The 75-minute morning session gathered more than 60 representatives from Grantmakers In Aging (GIA) and Grantmakers in Health (GIH), with a broad range of funding interests.  Moderated by GIH Program Director Colin Pekruhn, it featured Kathy Greenlee, Administrator, Administration for Community Living, who represented the White House Conference on Aging (WHCOA), and included framing remarks from Anne Montgomery of the Altarum Institute and John Feather, CEO, of Grantmakers In Aging (GIA).

Listening to, and sharing views, with Administrator Kathy Greenlee

Administrator Greenlee provided an overview of the 2015 WHCOA, which is tentatively scheduled for next summer, though a specific date is still in discussion.  She stressed the administration’s support for the event, lauded Nora Super, the WHCOA Executive Director, reminded participants of the WHCOA web site (whitehouseconferenceonaging.gov), and reviewed the history of White House Conferences in the past.

Importantly, she noted that this WHCOA would differ significantly from previous conferences, as it would not include specially invited delegates who would travel to DC, but would rely on technology to get significant input from, and create regional and local engagement with, a broad range of key stakeholders and older adults. Hundreds of comments have already come in through the WHCOA Web site. The group asked whether GIA and GIH members could host focus groups and other local listening or input sessions, and Greenlee suggested that the WHCOA would be describing its outreach/input plans in the Winter/Spring timeframe. Further, this WHCOA will not involve voting on resolutions, as in the past.

Nevertheless, Greenlee confirmed, the 2015 WHCOA will continue the tradition of creating an important moment to highlight issues of aging and frame policy priorities that the country will advance in the decade ahead.

Finally, Greenlee briefly described the four domains around which the WHCOA would be organized. These included retirement security, healthy aging, long term services and supports, and elder justice. The group spent approximately 15 minutes on each topic, identifying key issues to address.  Below, emerging from this set of rich discussions, we describe the key themes and ideas that participants exhorted WHCOA leaders to consider.

Healthy aging

  • Concentrate on the vulnerable and marginalized—those who need the most support to age well.  Duals, immigrants, LGBT elders, people with HIV/AIDS, grandparents taking care of grandchildren, the homebound, old old—these are the groups that need the most attention.
  • Consider the workforce that can make healthy aging (and long-term services and supports) possible. This came up a number of times, from educating primary care providers about geriatrics, to providing support to CNAs and direct care workers, enhancing the role of community health workers, and ensuring that geriatric social workers are available to meet the complex needs of older adults. Business leaders should also be engaged to create workplaces that facilitate healthy aging.
  • Be aware of an Institute of Medicine report on family caregiving, which will come out around the same time as the WHCOA, and the role these caregivers (an unpaid workforce) play in promoting healthy aging.
  • Provide older adults with information about what their options are on health care to reflect the fact that different individuals have different treatment preferences. Some, for example, may wish to choose less intensive courses of intervention and should be informed and enabled to do so.
  • Focus on outcomes and the programs and services that produce better health at lower cost for key populations.

Long Term Services and Supports (LTSS)

  • Build the capacity of the LTSS system, including community-based organizations and agencies.  The success of LTSS will have a lot to do with the quality and sustainability of health-related services.
  • Integrating social and medical services is critical.  How do we create comprehensive coordinated services, organized through a single care plan, that reflect choices older adults and their families make?
  • Workforce again came up in a number of guises, some pointing to opportunities to expand diversity, including by training rural, middle aged individuals to provide care, stressing the importance of cultural competence, and paying close attention to marginalized populations, including refugees and older adults with HIV, in order to better serve a more varied and multi-cultural, multi-ethnic older population. One commenter cited the need for foundations to improve the cultural competence of their own staffs.
  • Expand palliative care access in communities, beyond the growth of these hospital- based services.
  • Improve care coordination for patients with Alzheimer’s, building on work funded by SCAN in California and other places.

Elder Justice

  • Build on GIA’s Frameworks Institute project to create effective messages on this issue to engage and inspire stakeholders and the broader public.
  • Continue to develop expertise and data on forensic evidence of abuse, multi-disciplinary teams of social services providers, APS, and law enforcement, and other hopeful models in order to understand what works and to scale the best projects.
  • Again, consider the workforce dimensions of this issue to include a whole range of people (e.g., first responders, law enforcement, postal workers, etc.) to build their awareness of this issue and their ability to take action, and also to increase the capacity of Adult Protective Services providers.
  • Take advantage of public-private partnerships to build on hopeful programs supported by the Archstone, SCAN, Unihealth, and other foundations and expand their use. 
  • Explore predictive analytics and other methods of creating preventative measures that allow professionals to intervene and help to avoid elder abuse in the first place.

Retirement and Income Security

  • Expand the availability of new tools and resources, like those from the National Council on Aging’s Economic CheckUp, the Women’s Institute for a Successful Retirement (WISER), and others, which could allow not only older people, but folks in their 40s, 50s, and 60s to get information they need to achieve economic security (and not just in retirement).
  • Build education about achieving economic security into care management protocols so this becomes part of the standard of care. This will require additional training for social workers and coordinators. It could also be extended to the direct care workforce, which is often financially unprepared for retirement.
  • Take a holistic view of economic security and understand that it intersects with the other topics, particularly health and LTSS.  How can we help families of varying backgrounds and socio-demographic profiles make sound choices for their economic well-being and their health as older adults? Families need to know what the best options are in both domains.

Cross-cutting comments, other issues

The session also provided 10 minutes for other comments on issues that had not yet been discussed.  These included:

  • Help society think across generations, restore the social compact between young and old, and reinforce the importance of social justice.  This is important to counter recent efforts to delegitimize with Medicare and Medicaid, as entitlements that are bankrupting the country, rather than an expression of this compact and what makes our nation strong.
  • How do we ensure that graduating gerontologists are finding gainful employment?
  • Focus on the built environment in discussions of all of these issues, its impact on elders and others, and engage planners, architects, transportation professionals, etc. to be part of our solutions.

Thinking about Success

As the comment period came to a close, there was a question for Administrator Greenlee, asking if she could describe what success looks like for the Sixth WHCOA. She replied that she would measure success based on adequate engagement with a broad and diverse group of stakeholders and “wide input” on the front end, so that the national conference will reflect a “nationwide” rather than a D.C. perspective.  And following the WHCOA, she would gauge success by a robust action agenda that can be implemented --“what we do with information to make something move.  At the end of the day, what moves?”