LeadingAge LTSS Center @UMass Boston: 2017 Annual Report

CFAR | December 18, 2017

It’s been a busy research year for LeadingAge. We established the LeadingAge LTSS Center @UMass Boston, made progress on groundbreaking studies designed to test housing plus services models, and documented the impressive benefits associated with culture change in nursing homes. We invite you to review these and other accomplishments, and to learn more about our work.

LeadingAge LTSS Center @UMass Boston

During 2017, LeadingAge joined with the Gerontology Institute at the University of Massachusetts Boston to create a new research center called the LeadingAge LTSS Center @UMass Boston. The LTSS Center is the first of its kind in the country to combine the expertise of applied and academic researchers with the unique perspectives of providers and consumers of long-term services and supports (LTSS). Learn more about the LTSS Center by visiting LTSScenter.org and by viewing our new video.

Housing Plus Services

The LTSS Center expanded its housing plus services research this year by participating in a major, federally funded housing plus services demonstration program, and by launching an exploration of sustainable financing options for housing plus services models. The center:

  • Helped to implement a randomized control trial: The LTSS Center began working on the Implementation Team for the Supportive Services Demonstration for Elderly Households in HUD-Assisted Multifamily Housing. The demonstration, funded by the U.S. Department of Housing and Urban Development (HUD), is designed to test a service-enriched housing model for low-income older adults in 40 intervention sites.
  • Explored financing options: Work began in July on a 1-year project to explore financing mechanisms that can support the development and implementation of housing plus services models.
  • Evaluated promising models: The LTSS Center began preparing to evaluate a pilot project through which housing providers and health plans will deliver coordinated services and supports to residents of affordable senior housing communities in Massachusetts. Late in the year, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services published the findings from a 4-year evaluation of Vermont’s Support and Services at Home (SASH) program that the LTSS Center conducted with RTI International.
  • Raised awareness: Ongoing efforts to raise awareness of housing plus services models included the release of a case study exploring the work of Housing With Services LLC, sponsorship of a Housing Plus Services workshop presented by the National Academies of Sciences, Engineering and Medicine, and publication of a Generations article in which LTSS Center Co-Director Robyn Stone urged the then-new Administration to develop a policy agenda focused on integrating health care, social services, and wellness initiatives with housing to support aging in community.

Strengthening the Home Care Workforce

The workforce crisis loomed large in the LTSS Center’s 2017 work, and included efforts to document the workforce challenges facing LTSS providers, and to offer recommendations for how policy makers could address those challenges. The center:

  • Studied workforce challenges: The LTSS Center identified top workforce-related challenges facing LeadingAge members, and examined the benefits and challenges of relying on migrant/immigrant workers to deliver LTSS to the world’s growing older population.
  • Recommended workforce solutions: A 10-month project to study current and future trends in home-based care and its impact on the future workforce yielded recommendations for new research that were presented to ASPE. In addition, Robyn Stone offered 6 recommendations for addressing the workforce crisis in a July article for Public Policy & Aging Report.
  • Analyzed the impact of health reform: LTSS Center Co-Director Marc Cohen’s research was featured in CAPPING MEDICAID: How Per Capita Caps Would Affect Long-Term Services & Supports and Home Care Jobs, which was released in June by LeadingAge and the Center for Consumer Engagement in Health Innovation at Community Catalyst.
  • Recognized a nurse leader: A committee of LeadingAge members worked with the LTSS Center to award the 2017 Joan Anne McHugh Award to Bahaa Barsoum, director of nursing at A.G. Rhodes Health and Rehab in Atlanta.

Nursing Home Quality

The LTSS Center made tremendous progress this year in its ongoing efforts to study strategies that help to improve quality in LTSS care settings. The center:

  • Completed 2 groundbreaking studies: Working in collaboration with Kansas State University and Francis E. Parker Home, the LTSS Center found that person-centered care, when adopted comprehensively, increases the satisfaction of residents with their quality of life and quality of care, and is associated with numerous clinically significant improvements in their health. To date, study findings have been published in The Gerontologist and the Journal of the American Medical Directors Association.
  • Examined disparities in nursing homes: LTSS Center Fellow Jennifer Gaudet Hefele, an assistant professor of gerontology at UMass Boston, joined 6 co-authors in publishing the results of the first study to examine differences in quality by race and ethnicity within nursing homes.

Paying For LTSS

The important topic of LTSS financing was added to the LTSS Center’s research agenda this year. The center:

  • Studied the economic profile of older adults: The LTSS Center’s Boston office began a study for the National Council on Aging that will analyze the economic and demographic profiles of middle-income older adults who may not have enough money live out retirement without a significant drop in their standard of living.
  • Lent our LTSS expertise: Marc Cohen was named co-chair of a study panel to help states design state-based LTSS social insurance programs. The study panel was organized by the National Academy of Social Insurance.

Intergenerational Issues

Intergenerational relationships are fast becoming an important part of the LTSS Center’s research agenda. During 2017, the center:

  • Explored intergenerational programming: The LTSS Center worked with Generations United to complete a 12-month study that identified the characteristics of intergenerational programs in senior housing communities, and the benefits those programs provide to all ages, including housing community staff. A final report will be released in January 2018.
  • Studied intergenerational relationships: The LTSS Center’s Boston office began to study how relationships between parents older than 95 with children older than 65 may affect well-being and care outcomes.

Other Accomplishments

Additional activities helped the LTSS Center make significant contributions to the fields of aging and applied research over the past year. Specifically, center team members:

  • Accepted honors for their achievements: Robyn Stone, who received the Maxwell A. Pollack Award for Productive Aging from the Gerontological Society of America in 2016 presented the Pollack Award Lecture at the IAGG World Congress of Gerontology and Geriatrics in San Francisco in July. In September, Stone was named an “Influencer in Aging” by Next Avenue, which later asked her to write an essay explaining what she would change about aging in America.
  • Advanced the applied research field: Robyn Stone continued her participation in the Bureau of Sages, a groundbreaking, Chicago-based initiative designed to actively engage older adults in guiding research and clinical work in the field of aging. The LTSS Center is now beginning a 2-year project to spread the Bureau of Sages concept across the country.
  • Promoted global models for aging-in-place: The LTSS Center worked with HUD, Ginnie Mae and the government of Japan to explore strategies that could help older adults remain in their homes and communities for longer. As part of the project, Robyn Stone participated in 2 forums on U.S.-Japan Housing and Finance: a February forum in Washington, DC, and a December forum in Tokyo.
  • Promoted health equity: Early in 2017, the center was awarded a 6-year grant from the Robert Wood Johnson Foundation (RWJF) to help establish an annual Award for Health Equity at LeadingAge. The 2017 award, which honors individuals working to achieve health equity within their communities, went to Sarah Schoeder and Kate West at Eaton Senior Communities.