VOLUME 19 | MAY–JUNE 2012 | IGSW at Boston University

From the Director


Dismantling 'service silos'

DHHS Combines Aging and Disability Agencies


By Scott Miyake Geron

Scott GeronOn April 16th, DHHS Secretary Kathleen Sebelius announced the creation of a new agency, the "Administration for Community Living," which will bring together the Administration on Aging, the Office on Disability, and the Administration on Developmental Disabilities into a single entity. This consolidation is expected to benefit two constituencies—adults age 65 and older, and people of any age with developmental or other disabilities—both of whom face similar challenges living in the community and have similar needs for healthcare and social supports and services. But until now, the two groups have approached care and service in different ways, reflecting the traditional "service silo" structure of our system. The challenge will be to continue to meld the two separate sets of policies and philosophies that have evolved.... Read more


Photo of Scott Miyake Geron courtesy Boston University


Update your skills with this IGSW course

Core Issues in Aging and Disability


Creation of the new Administration for Community Living in the Department of Health and Human Services is only the latest among many changes taking place to integrate long-term services for older adults with those for people with disabilities. As service providers increasingly work with individuals from both populations, IGSW's comprehensive course will bring you up to date. The course guides you to new resources and clarifies federal laws and regulations that affect disability and aging.

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Issues and Views


Affordable Care Act in limbo

What's at Stake for Home- and Community-Based Care?


By Edgar E. Rivas

Whether the Supreme Court's current deliberations on the fate of the Patient Protection and Affordable Care Act (ACA) represent "the case of the century" or merely a decision on the most important healthcare legislation since Medicare and Medicaid, it's clear that millions of Americans have a lot riding on the outcome. Not the least of these are the growing numbers of older adults and people with disabilities whose health and well-being depend on home- and community-based care. The ACA has already provided new opportunities for much-needed enhancement of these services, with more due over the next months and years as the law's various provisions are scheduled to take effect. Where do these programs stand now? Read more

Photo courtesy Edgar Rivas



Nationwide problem, local solution

Community-Based Program Screens Older Adults
for Binge Drinking, Other Substance-Use Problems


By Mary Johnson

Binge drinking is a dangerous and costly public health problem, with people age 65 and older the most frequent binge drinkers, according to a new CDC report, Binge Drinking: Nationwide Problem, Local Solutions. However, a program at Boston Medical Center shows how a local institution, with strong support from the state, can indeed provide a simple, low-cost solution that is effective in reducing this and other substance-use problems in a range of community settings. Lee Ellenberg (at right), clinical director of the program, tells how and why it works—especially for older adults. Read more

Photo courtesy Lee Ellenberg




News to Note


It's not what you think

Why Are Older Drivers in More Fatal Crashes?


Most people would not be surprised to learn that older drivers are in fatal car crashes more often than their younger counterparts. But the commonly accepted reason—that elders are worse drivers—is incorrect, according to a commentary published in the April 3 edition of CMAJ, the journal of the Canadian Medical Association. Instead, the overrepresentation of older adults in fatal crashes is mainly due to their "frailty"—"the age-related increase in the probability of dying as a result of a crash," writes Ezra Hauer, professor emeritus, Department of Civil Engineering, University of Toronto.... Read more



From Affordable Care Act provisions

Report Predicts Amount of Insurance Company
Rebates for Consumers This Year, Based on 2010


It's too soon to know the exact amount of rebates that insurance companies will have to pay to consumers in August as the result of a set of Affordable Care Act protections that went into effect in 2011, but a new Commonwealth Fund Report shows that had these provisions been activated in 2010, healthcare consumers across the nation would have received nearly $2 billion in rebates for that year. The report, Estimating the Impact of the Medical Loss Ratio: A State-by-State Analysis, offers a prediction of what consumers will see this year, when insurers are required to issue rebates to 2011 policy holders.... Read more