Continuing Implications of the COVID-19 Pandemic for Older Adults.

The rapid onset of the COVID-19 pandemic presented a multi-faceted challenge to older adults, carers, and care institutions globally. A wide range of policies aimed at protecting older adults from serious illness and death from COVID-19 - including prioritizing vaccination for older adults, mandating vaccination among health care workers, and stringent isolation measures - achieved some success in mitigating these outcomes. However, older adults continue to bear the burden of risk for these most severe outcomes.

Housing and Community Partner Views on the Benefits of Housing With Services: The Right Care, Right Place, Right Time Program.

Background And Objectives: Older adult-focused housing with services programs seek to improve access to supportive services, particularly among individuals residing in subsidized housing. The Right Care, Right Place, Right Time (R3) program comprises 2 on-site wellness teams responsible for 400 participants across 7 housing sites in Greater Boston. These embedded teams work directly with residents to address health-related needs and access to services.

The Mediating Role of Proxy Respondents on the Relationship Between Cognitive Function and Self-Rated Health.

Background And Objectives: Proxy respondents are an important tool in survey research, especially among people with cognitive impairment. However, proxy respondents may be unable to accurately answer subjective survey instruments for cognitively impaired persons. This study investigates the mediating effect of proxy status on the relationship between cognitive impairment and subjectively rated health.

Medicaid Home and Community-Based Services in the Wake of the COVID-19 Pandemic.

The need to bolster Medicaid home and community-based services (HCBS) became more evident during the COVID-19 pandemic. This recognition stemmed from the challenges of keeping people safe in nursing homes and the acute workforce shortages in the HCBS sector. This article examines two major federal developments and state responses in HCBS options as a result of the pandemic.

Type of Home Care-Informal Versus At Least Some Formal-Matters for Recipients' Perceived Control.

Background And Objectives: Perceived control is an important psychological resource for middle-aged and older adults. Aging in place may help foster feelings of control, yet many community-dwelling older adults must rely on others-whether family, friends, or professionals-for physical assistance. This study investigated how receiving home care from different sources was associated with two facets of perceived control (mastery and perceived constraints) among adults with varying levels of physical disability.

Promoting Sustainability in Housing with Services: Insights From the Right Care, Right Place, Right Time Program.

Despite the widely-acknowledged potential of housing with services for improving the lives of low-income older adults, ensuring their financial sustainability has been challenging. This study aimed to address this issue, drawing on 31 key informant interviews and three focus groups with payers, housing providers, and community partners involved in the Boston-area Right Care, Right Place, Right Time Program, which enrolled about 400 older adults. Transcripts were qualitatively analyzed using thematic coding.

Focusing on the Positive: Home Health Aides' Desire for Autonomy and Control.

Home Health Aides (HHAs) are one of the fastest growing workforces in the country, yet the industry struggles to recruit and retain workers. This study explored HHAs' experiences with the level of control, autonomy, and decision-making authority in their work. Six focus groups with 37 HHAs were conducted in Massachusetts.

The effect of the right care, right place, right time (R3) initiative on Medicare health service use among older affordable housing residents.

Objective: To determine the effect of an affordable housing-based supportive services intervention, which partnered with health and community service providers, on Medicare health service use among residents.

Data Sources: Analyses used aggregated fee-for-service Medicare claims data from 2017 to 2020 for beneficiaries living in 34 buildings in eastern Massachusetts.

Study Design: Using a quasi-experimental design, a "difference-in-differences" framework was employed to isolate changes in outcomes, focusing on changes in pre- and post-intervention health service use across two stages of the intervention.

A Comparative Analysis of State Implementation of the Community First Choice Program.

The Patient Protection and Affordable Care Act included Community First Choice (CFC), a new optional Medicaid home and community-based services (HCBS) state plan benefit which states could adopt. Through the CFC program, states can provide expanded home and community-based attendant services and supports to older adults and persons with disabilities. A benefit of CFC is that states receive a higher federal match rate than other HCBS programs.

The Effects of Religiosity on Depression Trajectories After Widowhood.

This longitudinal study analyzed data from the 2006-2016 waves of the nationally representative Health and Retirement Study (HRS). Trajectories of depression among older adults ≥ 50 years ( = 1254) were examined over time to explore patterns of depression among those entering widowhood and the potential impact of religiosity on depressive symptoms during various stages of widowhood. Ordinary least squares (OLS) regression analysis was used to examine the association between widowhood and depression and the role of religiosity as a moderator of this association.

Enhancing Federal Revenue under the American Rescue Plan Act: An Opportunity to Bolster State Medicaid Home and Community-Based Services Programs.

The American Rescue Plan Act (ARPA) includes a one-year 10 percentage point increase in the Federal Medical Assistance Percentage for Medicaid-funded home and community-based services (HCBS). The goal is to strengthen state efforts to help older adults and people with disabilities live safely in their homes and communities rather than in institutional settings during the COVID-19 pandemic. This essay provides a detailed description and analysis of this provision, including issues state governments need to consider when expending the additional federal revenue provided.

Shining a Spotlight: The Ramifications of the COVID-19 Pandemic for Older Adults.

The COVID-19 pandemic has disrupted life globally through virus-related mortality and morbidity and the social and economic impacts of actions taken to stop the virus' spread. It became evident early in the pandemic that COVID-19 and the strategies adopted to mitigate its effects would have a disproportionate impact on older adults. This special issue of the reports original empirical research and perspectives on the ramifications of the COVID-19 pandemic for this population.

A comparative analysis of state adoption of the Community First Choice program.

Over the last several decades, policymakers have focused on rebalancing Medicaid-funded long-term services and supports toward home and community-based services (HCBS). The Patient Protection and Affordable Care Act (ACA) included several opportunities for states to further promote HCBS options. One optional opportunity for states to expand Medicaid HCBS was the 1915(k) Community First Choice (CFC) program.

A Comparative Case Study Analysis of Barriers and Facilitators to Implementing the Affordable Care Act's Balancing Incentive Program.

The Affordable Care Act included the opportunity for states to increase spending on Medicaid home and community-based services (HCBS) for older adults and persons with disabilities through the Balancing Incentive Program (BIP). This study utilized comparative case studies to identify the factors that facilitated or impeded states' implementation of BIP. Findings indicate factors that facilitated the implementation of BIP were communication with the federal government and its contractor, merging BIP with existing HCBS programs, and enhanced federal revenue.

Diagnoses of Chronic Health Conditions and Change in Subjective Age: The Moderating Role of Chronological Age.

Background And Objectives: Health is a predictor of subjective age, and although inconclusive, the strength of this association is not uniform across different age groups. This study investigates if new diagnoses of chronic health conditions are associated with a change in subjective age and if chronological age moderates this relationship.

Research Design And Methods: Using data from the Health and Retirement Study, residualized change regression analysis was performed for a sample of 5,158 respondents older than 50 years to examine their subjective age in 2014 relative to that reported in 2010.

The impact of health-related supports in senior housing on ambulance transfers and visits to emergency departments: The Right Care, Right Place, Right Time Project.

Objective: To test the impact of placing a wellness team (nurse and social worker) in senior housing on ambulance transfers and visits to emergency departments over 18 months.

Data Sources/study Setting: Intervention sites included seven Boston-area buildings, with five buildings at comparable settings acting as controls. Data derive from building-level ambulance data from emergency responders; building-level Medicare claims data on emergency department utilization; and individual-level baseline assessment data from participants in the intervention (n = 353) and control (n = 208) sites.

Federal Incentives to Reform Long-Term Care Under the Affordable Care Act: State Adoption of the Balancing Incentive Program, 2011-2014.

Objectives: The Balancing Incentive Program (BIP) was an optional program for states within the Patient Protection and Affordable Care Act to promote Medicaid-funded home and community-based services (HCBS) for older adults and persons with disabilities. Twenty-one states opted to participate in BIP, including several states steadfastly opposed to the health insurance provisions of the Affordable Care Act. This study focused on identifying what factors were associated with states' participation in this program.

Maximizing Home Health Aide Retention: The Impact of Control and Support on the Job.

Background And Objectives: This study examined relationships between the level of control and support and home health aides (HHAs) job satisfaction and intent to leave the job.

Research Design And Methods: Data derive from a survey of 512 HHAs in Massachusetts. Logistic regression using generalized estimating equations was employed for the analysis.

Pursuing Medicaid Block Grants with the Healthy Adult Opportunity Initiative: Dressing Up Old Ideas in New Clothes.

The Trump administration's Healthy Adult Opportunity waiver follows a long history of Republican attempts to retrench the Medicaid program through block grants and to markedly reduce federal spending while providing states with substantially greater flexibility over program structure. Previous block grant proposals were promulgated during the presidential administrations of Ronald Reagan and George W. Bush and majorities in Congress led by House Speaker Newt Gingrich and House Budget Committee Chair and then Speaker Paul Ryan.

Addressing the Consequences of School Closure Due to COVID-19 on Children's Physical and Mental Well-Being.

Prolonged school closures are one of the most disruptive forces in the COVID-19 era. School closures have upended life for children and families, and educators have been forced to determine how to provide distance learning. Schools are also an essential source of nonacademic supports in the way of health and mental health services, food assistance, obesity prevention, and intervention in cases of homelessness and maltreatment.

Thrust Into the Spotlight: COVID-19 Focuses Media Attention on Nursing Homes.

Objective: This study sheds light on the agenda-setting role of the media during the COVID-19 crisis by examining trends in nursing home (NH) coverage in 4 leading national newspapers-The New York Times, Washington Post, USA Today, and Los Angeles Times.

Method: Keyword searches of the Nexis Uni database identified 2,039 NH-related articles published from September 2018 to June 2020. Trends in the frequency of NH coverage and its tone (negative) and prominence (average words, daily article count, opinion piece) were examined.

Stepping into the Breach of Federal Inaction: Reforming the Financing of Long-Term Services and Supports in the Post-CLASS Era.

The growing need for long-term services and supports (LTSS) poses significant challenges to both individuals and government. This article documents the continuing failure to tackle this problem at the national level-a failure that was most recently seen in the fallout from the Affordable Care Act (ACA), which included the single piece of national legislation ever enacted to comprehensively address LTSS costs: the Community Living Assistance Services and Supports (CLASS) Act. The CLASS Act was passed as part of the ACA (Title 8) but was repealed in 2013.

Protecting and Improving the Lives of Older Adults in the COVID-19 Era.

The COVID-19 pandemic has impacted the lives of people throughout the world, either directly, due to exposure to the virus, or indirectly, due to measures taken to mitigate the virus' effects. Older adults have been particularly hard hit, dying in disproportionately higher numbers, especially in long-term care facilities. Local, regional, and national government actions taken to mitigate the spread of COVID-19 have thus served, in part, to shield older adults from the virus, though not without adverse side effects, including increased social isolation, enhanced economic risk, revealed ageism, delayed medical treatment, and challenges getting basic needs met.

Assessing the Relationship between Retail Store Tobacco Advertising and Local Tobacco Control Policies: A Massachusetts Case Study.

Objective: This study documents the extent of tobacco ads in retail stores and evaluates its association with the comprehensiveness of local tobacco control policies in the state of Massachusetts, US.

Methods: Using a two-stage cluster sampling method, we sampled 419 retail stores across 42 municipalities to assess the presence and count of nine mutually exclusive tobacco ad categories. Tobacco ads by store type and municipality were analyzed using summary statistics and contingency tables.

The Origins and Evolution of the Journal of Aging and Social Policy.

In this essay the current and previous editors discuss the history of the . In reviewing the past thirty years of publishing the Journal, one can see three phases: Phase 1 took pace during the first decade (1989-1997), Phase 2 covered the next decade and a half or so (1998-2015), and Phase 3 reflects the past five years, a period of continuing growth and success (2016-Present). Despite its inevitable challenges, the overcame each and has arrived.