Category Archives: Health Policy

Prize Winners in ‘Better Caregiving, Better Lives’
Story Contest Answer the Challenge

Rosemary Rawlins, whose story "Gratitude for End of Life Lessons" tied for second prize in the contest, sits in "the Bistro" with her mother.

Rosemary Rawlins, whose story “Gratitude for End of Life Lessons” tied for second prize in the contest, sits in “the Bistro” with her mother.

“Every time my Mother has a stroke, she wakes up a completely different person. This is okay because, as my Dad once observed, we’ve liked every person she’s been.”

“In the past few months, my sister has stopped talking. She’ll want to say something, realize she can’t, throw up her arms and roar.”

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Aging and Disability Services Need—and Deserve—Support

The Administration for Community Living, aging, disabilityThroughout my career in aging, I have worked for and with community-based agencies. I know how essential these agencies are in helping older people remain well and in their homes by providing and coordinating needed supportive services.

These critical services for older people who have difficulty with daily tasks or younger people with disabilities include home delivered meals, shopping, cooking, bathing, bill paying and/or emotional support, as well as support for their caregivers. In-home assessments determine exactly what is needed for each individual and their family.

The agencies providing these services have always operated on slim budgets funded by federal block grants and philanthropy. Due to funding limits, there are months-long waiting lists for older people who are desperately trying to remain as independent as possible for as long as possible in their own homes.

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Hartford Change AGEnts Action Awardees: A Super Team Bound to Bowl You Over

While most people will be watching the Super Bowl Sunday, Rachael Watman is rooting for another team: the latest Hartford Change AGEnts Action Awards winners.

While most people will be watching the Super Bowl Sunday, Rachael Watman is rooting for another team: the latest Hartford Change AGEnts Action Awards winners.

I am not going to win many fans here: I don’t watch the Super Bowl nor do I really like football.

My husband just confirmed my suspicion that the Seattle team and somebody from New England are playing Sunday; he then schooled me on the details regarding “Deflategate.”

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Care Transitions Evaluation Is Premature and Confusing

As Orson Welles might have said: "We will evaluate no program before its time."

As Orson Welles might have said: “We will evaluate no program before its time.”

One of the first things you learn in “foundation school” is how easy it is to kill even great programs by evaluating them before they are ready.

Nothing innovative starts working on day one as well as it will with practice, adjustment, and refinement. Even more deadly is an evaluation with low-cost methods that doesn’t really provide the information you want and need. One of the painful lessons I’ve learned is to always buy the highest quality and therefore most expensive evaluation you can afford, because it’s cheaper in the long run.

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Opening the Window of Opportunity to Needed Health Policy Change

Health_Affairs_Jan2015_300pPolicy change is hard. Just think about the 2010 Affordable Care Act, its tortuous path toward enactment, and the ongoing debates five years later that swirl around the law and its implementation.

There are many theories for how policy change happens, but one of my favorites is Kingdon’s policy streams model. To simplify a bit, it proposes that a window of opportunity opens when three separate streams come together: a problem gets defined and recognized as such, viable solutions are available, and there is political will to match them up.

Except for the political will part (thank you, partisan gridlock), at first glance this might seem easy. But think about how often your problem is not seen as a problem by others. For years, we faced this challenge when it came to making the case that older adults don’t get the care they should because they have special needs that require specialized, geriatrics-expert knowledge. Because of this challenge and the constantly shifting political landscape, it’s important to have policy solutions at the ready for the time when the problem and politics streams come together.

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Tools You Can Use: The Quality Care Through a Quality Workforce Toolkit

megaphone_illustration_300pWe were introduced to Sally and her daughter Edna last year in a video from our grantee Community Catalyst. I learned recently that Sally has since passed away, but I am so grateful that her and her daughter’s story lives on.

It embodies the promise of the Voices for Better Health initiative, which advocates for quality care for low-income older adults and younger disabled people dually enrolled in both Medicare and Medicaid, as Sally was.

And fortunately, as states rapidly move to integrate Medicare and Medicaid financing and care for the “duals” population, advocates from Voices for Better Health and anyone concerned about people like Sally have a new resource.

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Grappling with the Tough Questions of How We Live—and Die

SeniorsRoses_400pI think it would be safe to say that most of us have trouble facing our own mortality. The idea that tomorrow isn’t promised fails to get many of us to actually live that way (I know I’m guilty).

Longer term and more connected to the John A. Hartford Foundation’s  work, we don’t like to think of ourselves as “old”—let alone dying—and we don’t plan well for futures that will likely include the need for long-term care or services later in life.

Our health care system and policies reflect this short sightedness, as well. That’s why it’s been refreshing to see some provocative writing about these issues over the past few weeks that might help us all think and do more to live our final years in old age the way we would want.

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Dying in America: There Must Be a Better Way

DyingInAmericaCover400pLast week, the Institute of Medicine released a new report titled Dying in America.

The committee that worked on the report included some long-time grantees and friends of the John A. Hartford Foundation,  such as June Simmons  of the Partners in Care Foundation, Jean Kutner, a Beeson Scholar  and faculty member at the University of Colorado, Diane Meier, leader of the Center to Advance Palliative Care, Patricia Bomba  of Rochester, NY’s Excellus Blue Cross/Blue Shield, and Joan Teno of the Center of Excellence in Geriatric Medicine at Brown University.

As always, we are proud to be associated with leaders who give their time to explore such urgent issues.

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Of Knights, Knaves, and Pawns: Physician Disillusionment and the Need to Realign Our Health Priorities

Doctored_Book_Cover_300pEver since I began working as a program officer at the John A. Hartford Foundation, I’ve tried to do my best to put myself in the shoes of the health professionals with whom we’ve worked and whose education and training historically has been one of our main concerns.

I’ve often found memoirs and other lightly fictionalized accounts to be the best way to get into the culture and daily experience of these health professionals. I’ve read Samuel Shem’s The House of God, countless memoirs of nurses and physicians, and even a very affecting memoir of a nurse’s aide in a nursing home.

One of the tricks of such reading is that we experience what our imagination and the author’s words together conjure in a special state of willing suspension of disbelief. Psychological research suggests that this process of imagination and purposeful lowering of critical skepticism is, in fact, what makes fiction so persuasive and engenders the feeling that novelists understand a truth about human character that other ways of knowing can’t match.

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Welcome to the New Cohort of Health and Aging Policy Fellows

Health-and-Aging-Policy_300While many of our legacy grant programs continue to support the development of leaders in the field of aging and health research and education (see this week’s earlier Health AGEnda post about our latest Hartford/VA social work research scholars), new and growing investments under the John A. Hartford Foundation’s current strategic plan are also nurturing leaders in aging and health practice and policy change.

As part of our Leadership in Action funding portfolio, we recently approved a $1.6 million grant to co-fund the Health and Aging Policy Fellows program, in partnership with The Atlantic Philanthropies. The program, which offers fellows the experience and skills necessary to make a positive contribution to the development and implementation of health policies that affect older Americans, has just announced its 2014-15 class and we welcome them to the Hartford family and our community of Change AGEnts.

With representatives from many of our legacy strategy programs, including the Archbold Pre-Doctoral Nursing Scholars, the Social Work Doctoral Fellows and the Jahnigen Scholars in surgical and related medical specialties, we are assured that many of our academic program alumni are right there with us in the shift to our current portfolio of strategies focused on taking geriatrics expertise and evidence and making real and lasting improvements in health care delivery for our aging population.

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