Volume 6, Number 1, January 2012

We dedicate this issue of the Public Policy & Aging E-newsletter in the memory of our colleague Robert H. Binstock, in celebration of his many accomplishments and contributions to aging and public policy. For legislative histories, for dispassionate assessments of voting and electoral trends, and for an insider's grasp of policymaking, Bob was gerontologists' senior go-to expert. Blessed with an incredible memory, attention to detail, and a sense of "the big picture," Binstock shared his love of ideas generously. Amidst it all, he treasured the opportunity to play tennis ferociously and the piano masterfully. Until the very end, he was an integral member of the MacArthur Foundation Research Network on an Aging Society. For his sense of the past and his vision for future, not to mention his love of every moment, Bob will be sorely missed. We send our condolences to Martha, his daughter, and the countless friends who miss his presence.

--Andy Achenbaum

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A. Money Follows the Person: A 2011 Survey of Transitions, Services and Costs: With the passage of health reform, the Money Follows the Person (MFP) demonstration grant program was extended through 2016 giving states further options to transition Medicaid beneficiaries living in institutions back to the community. The Kaiser Commission on Medicaid and the Uninsured examined the 43 states and the District of Columbia that have received federal grant money under the program and produced a research brief on the findings.

B. Aging in Place: A State Survey of Livability Policies and Practices: As the older population grows, the degree to which it can participate in community life will be determined, in part, by how communities are designed. This AARP report examines state policies that are needed to help older adults age in place. These policies include integrating land use, housing and transportation; efficiently delivering services in the home; providing more transportation choices, particularly for older adults who no longer drive; and improving affordable, accessible housing to prevent social isolation.

C. Long-Term Services and Supports: Opportunities in the Affordable Care Act: States face multiple challenges as they consider whether to pursue opportunities in the Affordable Care Act (ACA) that would increase the community-based long-term services and supports (LTSS) available to Medicaid beneficiaries. To help states better understand these program requirements, this Center for Health Care Strategies, Inc. technical assistance brief describes the different LTSS program options available with particular emphasis on their budget impacts, requirements for participant eligibility, care coordination, and data reporting.

Perhaps no keyword is as difficult for legislators and policy analysts to define as "family." The Cleavers and other TV households portrayed in the 1950s and early 1960s do not begin to convey the variations in arrangements that currently exist due to changing demographics (such as multigenerational arrangements or grandparents raising grandchildren), shifts in the workplace and financial resources due to upheavals in the political economy, and unprecedented range of choices that individuals make about partners, unions, child-bearing and child-rearing. As Jack Rowe rightly notes in "Successful Societal Adaptation to the Aging of America" [see I-A], we should widen our focus beyond likely fiscal challenges besetting Social Security and Medicare to consider broadly how intergenerational relations and family members' evolving roles, among other neglected issues, will affect rights, roles, and responsibilities in U.S. society as its core institutions adapt. The five items in this section focus on different issues. Together, however, they attest to the complexity of factors at play.

-Andy Achenbaum

A. The Health and Well-Being of Grandparents Caring for Grandchildren: The number of U.S. grandparents raising or helping to raise their grandchildren have grown steadily in recent decades. This Population Reference Bureau newsletter provides an overview of the demographic characteristics of older grandparent caregivers and examines recent findings on their health and well-being.

B. GrandFacts: Data, Interpretation, and Implications for Caregivers: Focusing on grandfamilies headed by grandparents in which no parents of the grandchildren are present, this Generations United report highlights data on this sub-group of grandparent caregivers and the specific challenges they face. Findings include that one-third of the children are in families with incomes below the poverty level and that 42 percent of the children are teenagers.

C. Family Matters: Multigenerational Families in a Volatile Economy: This Generations United report considers the rising number of multigenerational families and elevates a different framework that considers and supports growing interdependence of generations in America. It includes the results of a new public opinion survey on the current state of intergenerational interdependence and makes recommendations for public policy strategies that value and engage all generations.

D. Caregiving Costs: Declining Health in the Alzheimer’s Caregiver as Dementia Increases in the Care Recipient: Many studies have shown that the health of family caregivers can be adversely affected, especially as their caregiving continues and becomes more intense. This National Alliance for Caregiving study looks at Alzheimer’s caregivers to see if their health use was different from non-caregivers and, if so, how much more that care was estimated to cost.

E. The Challenges of Family Caregiving: What Experts Say Needs to Be Done: A number of prominent authors have recently chronicled their experiences with family caregiving and called for a reexamination of caregiving policies. This AARP brief summarizes ten themes derived from ten authors who are reaching out to family caregivers and to those who need to better understand their needs and challenges, especially health care professionals and public policy makers.

A. Caring in America: A Comprehensive Analysis of the Nation’s Fastest-Growing Jobs: Home Health and Personal Care Aides: PHI has published the first in-depth analysis of the largest and fastest-growing workforce in the nation?the 2.5 million home care and personal assistance aides who provide long-term services and supports to elders and people living with disabilities in home and community-based settings. Between 2008 and 2018, the home care workforce is expected to grow at rates four to five times faster than jobs in the overall economy.

B. 50+ and Worried about Today and Tomorrow: Older Americans Express Concerns about the State of the Economy and Their Current and Future Financial Well-being: More than two years after the official end of the recession, Americans aged 50 and older remain deeply concerned about their current and future financial well-being. This AARP brief explores these concerns and the implications for policy makers.

C. Health and Aging Policy Fellows Application Now Available: The Health and Aging Policy Fellows Program is a unique opportunity for professionals in health and aging to receive the experience and skills necessary to make a positive contribution to the development and implementation of health policies that affect older Americans. The nine-to-12-month Program offers fellows the opportunity to participate in a residential track or a non-residential track. The residential track allows fellows to participate in the policymaking process on either the Federal or state level as legislative assistants in Congress, professional staff members in executive agencies or policy organizations. The non-residential track allows fellows to work on a policy project and brief placement(s) throughout the year at relevant sites. The deadline to apply is May 15, 2012.

A. Generations of Talent Study: A new Sloan Center on Aging & Work at Boston College study examines work experiences of employees across 11 countries. The study focuses on whether employees’ perceptions of their work experiences vary depending on the country where they work and if employees’ perceptions of their work experiences vary depending on their age- related factors such as chronological age, career stage, and life stage.

B. Australia’s Welfare 2011 In Brief: Using charts and graphs, this Australian Institute of Health and Wellness brief provides a demographic profile of Australia's aging population. Between 1970 and 2010 the number of people aged 65 or over almost tripled, while the number of children aged under 15 rose by only 17%. The brief also studies the aging of the Indigenous population in relation to the rest of the population. Click here to view Australia’s demographics compared to other developing nations.

C. Cooperation on Ageing Policies in the UNECE Region: This United Nations Economic Commission for Europe (UNECE) policy brief calls for strong regional and sub-regional cooperation between UNECE member states in various aging-related policy fields. By examining the labor market, pension systems, long-term care and health policies, migrant care workers, and adult learning and volunteering across regions, UNECE outlines potential recommendations in these areas.

Newsletter Editors: Dani Kaiserman and Greg O'Neill, National Academy on an Aging Society; Andy Achenbaum, University of Houston.

The Public Policy and Aging E-Newsletter is supported in part by a grant from the AARP Office of Academic Affairs. The views expressed are those of the authors and not necessarily those of The Gerontological Society of America, the National Academy on an Aging Society, or the AARP Office of Academic Affairs.

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