Volume 5 Number 3, May 2011 (Topic: LGBT Older Adults)

Public Policy & Aging E-Newsletter

Volume 5, Number 3, May 2011

This bimonthly e-newsletter highlights key developments and viewpoints in the field of aging policy from a wide variety of sources, including articles and reports circulating in the media, academy, think tanks, private sector, government and nonprofit organizations.

The goal of this email publication is to reach teachers, students, and citizens interested in aging-related issues, especially those who may not have sufficient access to policy information disseminated both in Washington and around the country.

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I. WHAT’S HAPPENING IN WASHINGTON?

A. Older Americans Act: More Should Be Done to Measure the Extent of Unmet Need for Services: In advance of Older Americans Act (OAA) program reauthorization scheduled for 2011, the Government Accountability Office (GAO) analyzed: (1) what is known about the need for home- and community-based services like those funded by OAA and the potential unmet need for these services; (2) how have agencies used their funds, including Recovery Act funds, to meet program objectives, and (3) how have government and local agencies measured need and unmet need. This report shares the findings and recommendations based on the GAO's study.

B. Raising the Age of Medicare Eligibility: A Fresh Look Following Implementation of Health Reform: Several major deficit-reduction and entitlement reform proposals include raising Medicare's age of eligibility from 65 to 67 as a way of improving Medicare's solvency. This Kaiser Family Foundation report estimates the expected effects of such a change on the federal budget, as well as on affected seniors' out-of-pocket costs, employers, Medicaid, and others in light of the major changes in coverage enacted under the 2010 health reform law.

C. Redesigning Long Life: This annual report describes how the Stanford Center on Longevity combines scientific and technological discoveries with entrepreneurial action to address the challenges of aging societies. This year's report outlines progress made and projects created to improve mind, mobility, and financial security for older adults.

II. WHAT’S HAPPENING AROUND THE COUNTRY?

A. How National Health Care Reform Will Affect a Variety of States: This RAND research brief looks at how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in five states. In all of the states studied - California, Connecticut, Illinois, Montana, and Texas - the proportion of uninsured residents is projected to decline significantly under health reform. Government costs are projected to rise in four of the states studied, which is primarily a function of increased spending on Medicaid.

B. State-by-State Data: What if Ryan's Medicaid Block Grant Had Taken Effect in 2000?: This Center for Budget and Policy Priorities report reviews the House Budget Committee Chairman Paul Ryan's proposal to convert Medicaid to a block grant. The overview considers the impact on Medicaid as if Ryan's plan was enacted in the year 2000, and finds a significant cut to most states.

C. Can State and Local Pensions Muddle Through?: Although retirement plans were moving toward prefunding their promised benefits, two financial crises in 10 years have thrown them off course. Between 2008 and 2009, the ratio of assets to liabilities dropped from 84 percent to 79 percent. But, according to this Boston College Center for Retirement Research issue brief, this decline is only the beginning of the bad news that will emerge as the losses are spread over the next several years.

III. THIS ISSUE'S MAJOR POLICY STORY: LGBT Older adults

As the nation begins its observance of Older Americans Month, the editors of this Public Policy & Aging E-newsletter invite readers to learn about recent policy advances for older lesbian, gay, bi-sexual, and transgendered (LGBT) individuals. Among these include a proposal from SAGE and the Leadership Council of Aging Organizations that LGBT older adults receive greater recognition and a larger share of resources when the Older Americans Act is reauthorized. Their policy needs are palpable, if not often discussed by gerontologists. Amidst likely cutbacks in social services because of the current Federal budget crisis, growing numbers of this diverse subset of our senior population are going to find it difficult to gain access to care-giving and other basic forms of medical and economic assistance. LGBT elders typically have far less family support available than their heterosexual peers. Many under state law or corporate guidelines are ineligible for partners' health-care benefits. Available research indicates that poverty rates, sense of isolation, employment discrimination, and stigmatization among older lesbian, gay, bi-sexual, and transgendered older adults exceed averages for aged Americans as a whole.

Special thanks goes to my colleague, Dani Kaiserman, for bringing to our attention these five policy briefs concerning one of the most invisible segments of an invisible, but rapidly aging minority.

--Andy Achenbaum

A. LGBT Older Adults and Reauthorization of the Older Americans Act: A Policy Brief: In 2011, the Older Americans Act comes up for reauthorization, which will create an unprecedented opportunity to ensure that these sizable resources support LGBT older adults and their loved ones. This SAGE policy brief shares insights from LGBT older adults and presents SAGE's official recommendations.

B. The Health of Aging Lesbian, Gay and Bisexual Adults in California: This UCLA Center for Health and Policy Research policy brief presents unique population-level data on aging LGB adults. Findings show that this population has higher rates of several serious chronic physical and mental health conditions when compared to similar heterosexual adults. The report calls on general health care and aging services to develop programs targeted to the specific needs of aging LGB adults and for LGB-specific programs to increase attention to the chronic conditions that are common among all older adults.

C. LGBT Older Adults in Long-Term Care Facilities: Several organizations, including the National Senior Citizens Law Center and the National Gay and Lesbian Task Force, collaborated to release a collection of stories about the experiences of LGBT individuals and caretakers in long-term care settings. The survey from which the stories were taken revealed major barriers in staff and resident harassment, discrimination against partners, and fear of being out and vulnerable. To read the full report, click here.

D. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding: In order to help assess the state of the science in understanding the health needs of LGBT populations, the Institute of Medicine (IOM) produced a report to evaluate current knowledge of the health status of LGBT populations, to identify research gaps and opportunities, and to outline a research agenda to help NIH focus its research in this area. The IOM finds that to advance understanding of the health needs of all LGBT individuals, researchers need more data about the demographics of these populations across different life stages. Click here for a summary.

E. U.S. Department of Health and Human Services Recommended Actions to Improve the Health and Well-Being of Lesbian, Gay, Bisexual, and Transgender Communities: This U.S. Department of Health and Human Services' (HHS) summary of actions lists the efforts made by HHS to improve the lives of LGBT people, and recommendations for future action. Actions taken include updates to equal employment opportunity policy and non-discrimination policy, and the establishment of an internal LGBT Coordinating Committee. Especially pertinent to older adults and end-of-life care, HHS will look towards improving hospital visitation and advanced directive procedures.

IV. WORTH NOTING

A. Distilled Demographics: Population Projections: This Population Reference Bureau video series highlights key demographic concepts such as fertility, mortality, and migration. These short videos explain the assumptions behind demography projections----factors such as the current birth rate, contraceptive use, education levels, policy and funding, and more.

B. Enhancing Use of Clinical Preventive Services Among Older Adults: Closing the Gap: This report calls attention to the use of potentially lifesaving preventive services by adults aged 65 years and older. The report demonstrates, through analysis of state and national data sources, that these services are underused among the older population and that new opportunities in the Affordable Care Act can help increase use of these services.

C. CLASS Hearings Highlight Need for Improvements to LTC Financing: The Health Subcommittee of the House Energy & Commerce Committee held a hearing on the CLASS program, the voluntary long-term care insurance program that was included in the Affordable Care Act. Three Republican representatives co-sponsored a bill on the same day of the hearing to repeal the CLASS Act. View the written testimonies from hearing presenters, including Kathy Greenlee, Assistant Secretary of the Administration on Aging, and Larry Minnix, the CEO of LeadingAge and Chair of Advance CLASS.

V. WHAT'S HAPPENING ABROAD?

A. Tsunami Warning: Caring for Japan's Elderly: Among their entire population, Japan's elderly were hardest hit by the March 2011 earthquake, as noted immediately in media coverage from both Japan and abroad. This National Bureau of Asian Research (NBR) research brief describes how older adults are vulnerable to natural disasters. NBR calls on Japan to draw on a legacy of technology, entrepreneurship, and social innovation to meet the powerful demographic forces of Japan's aging population.

B. Global Aging and the Future of Emerging Markets: The CSIS Global Aging Initiative's latest report looks at the potential impact of shifting demographics on economic growth and social and political stability in emerging markets. The report concludes that demographic trends will continue to drive the rise of emerging markets over the next few decades. But, it also identifies a series of risks to growth and stability that may become acute by the 2020s, including the "premature aging" of China, demographic implosion in Russia, and a new resurgence of youth populations in much of the Muslim world.

C. Population Aging: Is Latin America Ready?: The past half-century has seen enormous changes in the demographic makeup of Latin America. This World Bank report contains seven chapters that each set to answer a question about aspects of population aging. Topics covered include how age influences the demand for heath care in Latin America, poverty and the life cycle in Latin America, and the economics of happiness and health policy.

VI. PERSPECTIVES ON POLICY: ROB HUDSON, EDITOR, PP&AR

This latest Public Policy & Aging Report (Volume 21, Number 1) explores the uneven experiences of older workers during the first decade of the 21st century due to macro-level economic circumstances and well-known population characteristics. The articles discuss macro-level economic circumstances and well-known population characteristics of older adults that disentangle the employment experiences of today's older workers. Bob Harootyan and Tony Sarmiento provide a historical context, addressing aggregate trends in labor force participation (LFP), the roles of gender and education in determining those rates, employer attitudes toward older workers, and public policy shortcomings in improving employment prospects. Neeta Fogg and Paul Harrington investigate the odd juxtaposition of relatively high demand for older workers during this decade against high rates of unemployment among them. Next, Andrew Sum, Ishwar Khatiwada, and Mykhaylo Trubskyy turn attention to the especially problematic experiences of low-income older workers. Unemployment among these workers rose sharply during the decade, notably among women, minorities, high school drop-outs, the unmarried, and very old workers. Carl Van Horn, Nicole Corre, and Maria Heidkamp buttress these findings through survey data gathered at the Heldrich Center at Rutgers, examining the fate of the long-term unemployed. Sara Rix's article focuses on the aging baby boomer cohort, reviewing the likelihood of their remaining in the labor force at older ages and why that may be the case. Finally, Judith Gonyea and I review the legislative and administrative history of the Senior Community Service Employment program (SCSEP) that emerged as part of the Great Society and now constitutes Title V of the Older Americans Act.

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Newsletter Editors: Dani Kaiserman, Sarah F. Wilson, 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.