Elaine Theresa Jurkowski, PhD, MSW, is a professor at Southern Illinois University Carbondale’s School of Social Work, where she teaches courses in health and aging policy, research, and program evaluation and social work practice. Dr. Jurkowski also holds joint appointments with the Department of Public Health and Recreation Professions and SIU’s School of Medicine’s Family Practice Residency Program.

• ContentsPrefaceAcknowledgmentsIntroductionShare Policy and Program Planning for Older Adults and People With Disabilities: Practice Realities and Visions, Second EditionPART I: Understanding Policy and Program Development1. Background and Demographic Profile of People Growing Older and/or People With DisabilitiesLEARNING OBJECTIVESPREPARING FOR THE “BOOM”THE CHANGING DEMOGRAPHIC STRUCTURE AND AGING POPULATIONCHANGES IN OUR POPULATION PROFILELiving ArrangementsEducation LevelEconomic Well-BeingChanges in Rural PopulationTrends in Morbidity and MortalityTHE CHANGING DEMOGRAPHIC STRUCTURE OF THE OLDER ADULT POPULATION WITH DISABILITIES AND IMPAIRMENTSCHANGES WITHIN THE SOCIAL, POLITICAL, AND CULTURAL EXPECTATIONS OF COMMUNITIESCHALLENGES FOR AGING AND DISABILITY POLICIES AND PROGRAMSREALITIES AND VISIONSDISCUSSION QUESTIONSREFERENCES2. Social, Political, Economic, and Demographic Factors and Historical Landmarks Impacting Aging and Disability Public PolicyLEARNING OBJECTIVESTHE ROLE OF HISTORICAL LANDMARKS IN SHAPING SOCIAL TRENDS AND PUBLIC POLICIESTHE RELATIONSHIP BETWEEN HISTORICAL LANDMARKS AND AGING AND DISABILITY-RELATED POLICIESTRENDS IN POLICY, SOCIAL, AND POLITICAL INFLUENCES AND LANDMARKS IN THE UNITED STATESThe Roaring ‘20s: 1920–1929The Dirty ‘30s: 1930–1939The War-Torn ‘40s: 1940–1949The Golden Age: 1950–1959The Age of Technology Explosion: 1960–1969The Decade of Presidential Resignation: 1970–1979The Era of Economic Entrenchment: 1980–1989The Era of Globalization: 1990–1999The Dawning of a New Century: 2000–2009The Age of Individualism (2010 and Beyond)SUMMARYDISCUSSION QUESTIONSREFERENCES3. Philosophical Paradigms and Policy Frameworks Impacting Aging and Disability PolicyLEARNING OBJECTIVESPHILOSOPHICAL PARADIGMS AND THE RELATIONSHIP TO AGING POLICY AND POLICY ANALYSISWHAT IS POLICY ANALYSIS?PHILOSOPHICAL PARADIGMSBlaming the VictimElitismSocial Welfare as a RightEconometric PerspectivesCause Versus FunctionCronyismFeminismPublic Policy Advocates’ Understanding of the ParadigmsIMPLEMENTATION STRATEGIESWindow of OpportunityImplementationIncrementalismRationalismStreet-Level BureaucratsPublic Policy Advocates’ Understanding of the Implementation StrategiesA MODEL FOR SOCIAL WELFARE POLICY ANALYSISSocial Problem/Social IssueGoalPolicy or LegislationImplementation of Policy or LegislationTHE USE OF NEEDS ASSESSMENTS FOR POLICY DEVELOPMENT AND COMMUNITY PLANNINGSUMMARYDISCUSSION QUESTIONSREFERENCES4. Evidence-Based Policy Development: Tools for Public Policy Development and AnalysisLEARNING OBJECTIVESWHAT IS AN EVIDENCE BASE?WHAT IS EVIDENCE-BASED PROGRAM AND POLICY DEVELOPMENT?WHY AN EVIDENCE BASE?SOCIAL WORK AND PROGRAM PLANNING FOR OLDER ADULTS AND PEOPLE WITH DISABILITIES: AN AUTHORITY-BASED OR EVIDENCE-BASED PROFESSION?APPROACHES TO EVIDENCE-BASED POLICY DEVELOPMENTSOURCES OF EVIDENCECongressional UniverseCongress.gov DatabaseGovernment Printing OfficeGovernment Accountability OfficeSecondary Data Sources Useful in an Evidence-Based ApproachBENCHMARKS USED IN THE HEALTHCARE ARENA FOR PROGRAM PLANNING AND POLICY DEVELOPMENTEVIDENCE AND ITS ROLE IN POLICY DEVELOPMENT AND COMMUNITY PLANNINGWhat Is a Needs Assessment?SUMMARYADDITIONAL RESOURCESWebsitesDISCUSSION QUESTIONSREFERENCESPART II: The Legislative Basis for Programs and Services Affecting Older Adults and/or People With Disabilities5. The Social Security ActLEARNING OBJECTIVESBACKDROP TO OUR CURRENT SOCIAL SECURITY PROGRAMSocial Security in EuropeThe Genesis of Social Security in the United StatesContents of the Original Social Security ActTHE CURRENT SOCIAL SECURITY ACTSome Guidelines for Social Security ProgramsBasic Information When One Is Receiving Social Security Disability BenefitsAbout BenefitsOther Benefits One May Be Eligible forWhat Must Be Reported to SSA?SOCIAL SECURITY DISABILITY INSURANCE FOR CHILDRENWhen a Child Reaches Age 18If an 18-Year-Old Child Is Still in SchoolIf a Child Is DisabledIf One Has a Stepchild and Gets DivorcedReviewing One’s Medical ConditionHelping One Return to WorkProtection of One’s Personal InformationSOME REFORMS WORTH NOTINGPROPOSALS FOR REVISION AND WHYImplications of a Privatized SystemDILEMMAS FOR THE FUTUREA Culture of Impoverished Older AdultsOlder Women and PovertyAn Empty Pot at the End of the RainbowSUMMARYDISCUSSION QUESTIONSADDITIONAL RESOURCESWebsitesYouTube Resources Related to Social SecurityREFERENCES6. MedicareLEARNING OBJECTIVESINTRODUCTIONHISTORICAL PERSPECTIVEHOW DOES MEDICARE WORK?Hospital Insurance (Part A)Medical Insurance (Part B)Costs of Medicare Part A CoveragePart B Coverage CostsPart B Costs for Those Qualifying for Original MedicareMedicare Part CPart C Coverage CostsMedicare Part DHOW DOES MEDICARE AFFECT ACCESS TO HEALTHCARE, COST CONTAINMENT, AND QUALITY?WHAT IS MEDICAID AND HOW DOES IT DIFFER FROM MEDICARE?EligibilityMedicaid Waiver OpportunitiesTHE EFFECTS OF REIMBURSEMENT ON HEALTHCARE QUALITY, ACCESS, AND COSTSCHALLENGES FOR THE FUTUREAn Empty Pot at the End of the Rainbow?Rationing of Healthcare Services—To Be or Not to Be?SUMMARYCASE STUDY DISCUSSIONDISCUSSION QUESTIONSADDITIONAL RESOURCESWebsitesYouTube Resources Related to MedicarePodcastREFERENCES7. The Older Americans ActLEARNING OBJECTIVESBACKGROUND AND OVERVIEWTHE OLDER AMERICANS ACT OF 1965Title I: DefinitionsTitle II: Administration on AgingTitle III: Grants for Community Planning, Services, and TrainingTitle IV: Research and Development ProjectsTitle V: Training ProjectsTitle VI: GeneralAMENDMENTS TO THE OLDER AMERICANS ACT: 1967–2000The National Family Caregiver Support ProgramLEGISLATIVE AMENDMENTS OF 2016Title ITitle IITitle IIITitle IVTitle VTitles VI and VIIThe 2010 ReauthorizationLEGISLATIVE AMENDMENTS of 2016 (PL 114–144)Aging and Disability Resource CentersArea PlansDisease Prevention and Health Promotion ServicesElder AbuseFunding FormulaHolocaust SurvivorsHome- and Community-Based ServicesLong-Term Care Ombudsman ProgramNational Family Caregiver Support ProgramNutrition ServicesLegal AssistanceTitle IV Demonstration ProjectsPHILOSOPHICAL PARADIGMS IMPACTING LEGISLATIVE AMENDMENTSSUMMARYUSEFUL WEBSITESWebsitesYouTube VideosPodcastDISCUSSION QUESTIONSREFERENCES8. The Americans With Disabilities ActLEARNING OBJECTIVESTHE INTERSECTION BETWEEN DISABILITY AND AGINGHISTORY OF THE DISABILITY MOVEMENTTHE JOURNEY TOWARD THE AMERICANS WITH DISABILITIES ACTTHE AMERICANS WITH DISABILITIES ACT OF 1990Title I: EmploymentTitle II: Public ServicesTitle III: Public Accommodations and Services Offered Through Private EntitiesTitle IV: TelecommunicationsTitle V: Miscellaneous ProvisionsIMPLICATIONS OF THE AMERICANS WITH DISABILITIES ACT ON THE AGING AND OLDER ADULT POPULATIONSTitle I: EmploymentTitle II: Public ServicesTitle III: Public Accommodations and Services Offered Through Private EntitiesTitle IV: TelecommunicationsTHE AMERICANS WITH DISABILITIES ACT AMENDMENTS OF 2008Title ITitle IITitle IIITitle IVTitle VAGING AND DISABILITY RESOURCE CENTERSSUMMARYUSEFUL WEBSITESADDITIONAL RESOURCESYouTube VideosPodcastsDISCUSSION QUESTIONSREFERENCES9. Mental Health: The Community Mental Health ActLEARNING OBJECTIVESWHAT IS MENTAL HEALTH?Definition of Mental HealthParadigms of Mental HealthHISTORY OF LEGISLATIVE EFFORTS AFFECTING OLDER ADULTS AND OTHERS WITH MENTAL DISORDERSThe 2000 National Family Caregivers’ Support ProgramThe New Freedom Commission on Mental HealthINFLUENCES TO CONSIDER IN THE DEVELOPMENT OF MENTAL HEALTH LEGISLATIONPatterns of Service UtilizationHealth Beliefs and the Role of CultureA CURRENT MENTAL HEALTH PROFILE OF OLDER ADULTS AND PEOPLE WITH DISABILITIES IN THE UNITED STATESA CLOSER VIEW OF THE MEANING OF MENTAL HEALTHMH, Older Adults, and PhysiciansMH, Older Adults, and Social ServicesTHE EPIDEMIOLOGY OF MH ISSUES OF OLDER ADULTSDepression in Older AdultsLate-Onset DepressionAlzheimer’s DiseaseAnxiety DisordersSchizophrenia in Late LifeMH and Older AdultsMH in Rural Communities Versus Urban CommunitiesSOCIAL WORK, MENTAL HEALTH, AGING, AND SERVICE UTILIZATIONPROGRAMS AVAILABLE TO MEET THE MENTAL HEALTHCARE NEEDS OF OLDER ADULTS AND PEOPLE WITH DISABILITIESMedicareMedicaidArea Agencies on AgingSERVICE DELIVERY SETTINGS FOR MENTAL HEALTHCARE FOR OLDER ADULTSISSUES FACING OLDER ADULTS, PEOPLE WITH DISABILITIES, AND MENTAL HEALTHCARE NEEDSFinancing Mental Healthcare for Older AdultsCommunity-Based CareModels for Gero-PsychiatryPrevention ServicesScreening and DetectionMedicationsPeople With Chronic Mental Health Needs Who Are AgingOppressed Groups and Visible MinoritiesMODEL PROGRAMS AND BEST PRACTICE APPROACHES TO MENTAL HEALTH SERVICE DELIVERYThe Center for Older Adult Recovery at Hanley CenterThe Gatekeeper ProgramMENTAL HEALTHCARE CHALLENGES FOR THE FUTURESUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosPodcastDISCUSSION QUESTIONSREFERENCES10. The Patient Protection and Affordable Care ActLEARNING OBJECTIVESTHE AFFORDABLE CARE ACT BECOMES LAWCOMPONENTS OF THE ACATitle I: Quality, Affordable Healthcare for All AmericansTitle II: Role of Public ProgramsTitle III: Improving the Quality and Efficiency of HealthcareTitle IV: Prevention of Chronic Disease and Improving Public HealthTitle V: Healthcare WorkforceTitle VI: Transparency and Program IntegrityTitle VII: Improving Access to Innovative Medical TherapiesTitle VIII: Class ActTitle IX: Revenue ProvisionsTitle X: Strengthening Quality, Affordable Healthcare for All AmericansSUMMARYDISCUSSION QUESTIONSADDITIONAL RESOURCESYouTube VideosWebsitesPodcastsREFERENCES11. Caregivers/The Caregiver Support ActLEARNING OBJECTIVESCAREGIVERS AND THE CAREGIVER SUPPORT ACTRAISE FAMILY CAREGIVERS ACT—PUBLIC LAW 115–119Importance of Family CaregiversA CURRENT PROFILE OF RELATIVE CAREGIVERS RAISING CHILDREN IN THE UNITED STATESREASONS FOR THE INCREASE IN RELATIVE CAREGIVINGISSUES FACING GRANDPARENTS RAISING GRANDCHILDRENPovertySocial/Role IssuesSocializationHealthcarePolicy and LegislationPROGRAMS AVAILABLE TO MEET THE NEEDS OF RELATIVE CAREGIVERS AND GRANDPARENTS RAISING GRANDCHILDRENMedicareMedicaidArea Agencies on AgingChild WelfareMODEL PROGRAMS AND PROACTIVE APPROACHES TO ADDRESSING THE NEEDS OF GRANDPARENTS SERVING AS CAREGIVERS FOR GRANDCHILDRENCHALLENGES FOR RELATIVE CAREGIVERS AND GRANDPARENTS RAISING GRANDCHILDREN IN THE FUTURESUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosPodcastsDISCUSSION QUESTIONSREFERENCES12. The Elder Justice ActLEARNING OBJECTIVESTHE ELDER JUSTICE ACTLEGISLATIVE PROVISIONS ADDRESSED WITHIN THE ELDER JUSTICE ACTA CURRENT PROFILE OF ELDER ABUSE FACING OLDER ADULTS IN THE UNITED STATESWHO REPORTS ELDER ABUSE?PROGRAMS AND SERVICES AVAILABLE TO ADDRESS ISSUES OF ELDER ABUSEMedicareState-Based Services Offered Through Departments on AgingThe Centers for Disease Control and PreventionArea Agencies on AgingTYPES OF ELDER ABUSE AND NEGLECTMODEL PROGRAMS AND BEST-PRACTICE APPROACHES TO ADDRESSING THE LEGAL NEEDS OF OLDER ADULTSBreaking the Silence—Media Campaign (Illinois Department on Aging)The B*SAFE ProgramCHALLENGES FOR ELDER ABUSE AND NEGLECT PROGRAMS IN THE FUTURECHALLENGES FOR LEGAL ISSUES IN AGING FOR THE FUTURELEGAL ISSUES AND OLDER ADULTSPOWER OF ATTORNEYTypes of Powers of AttorneyLegal Authority Granted via a Power of AttorneySelecting an Agent for a Power of AttorneyMonitoring and OversightHEALTHCARE POWER OF ATTORNEYLiving Wills and Advance DirectivesPROGRAMS AND SERVICES AVAILABLE TO ADDRESS LEGAL ISSUES FOR OLDER ADULTSMedicareState-Based Departments on AgingThe Older Americans Act and Area Agencies on AgingMODEL PROGRAMS AND BEST PRACTICES TO ADDRESS THE LEGAL NEEDS OF OLDER ADULTSAmerican Association of Retired PersonsAmerican Society on AgingCHALLENGES FOR LEGAL ISSUES IN THE AGING ARENA FOR THE FUTURESUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosDISCUSSION QUESTIONSREFERENCES13. Housing and Long-Term CareLEARNING OBJECTIVESA HISTORICAL OVERVIEW OF HOUSING POLICY AND OPTIONS FOR PEOPLE GROWING OLDER AND PEOPLE WITH DISABILITIESA CURRENT PROFILE OF LONG-TERM CARE AND COMMUNITY-BASED CARE NEEDSAN OVERVIEW OF THE PROGRAMS TO MEET HOUSING NEEDS OF OLDER ADULTSSenior ApartmentsCategories of Senior ApartmentsSTRATEGIES FOR REMAINING IN ONE’S HOMEHome Equity ConversionSale LeasebackMAINTENANCE PROGRAMSHome Maintenance and RepairIllinois Home Weatherization Assistance ProgramISSUES FACING LONG-TERM AND COMMUNITY-BASED CARE FOR OLDER ADULTSLong-Term Care FacilitiesAssisted Living FacilitiesCommunity-Based CareConsumer-Directed Home Help and Care OptionsPeople With Disabilities Requiring Community-Based CareOPPRESSED GROUPS AND VISIBLE MINORITIESSUMMARYDISCUSSION QUESTIONSADDITIONAL RESOURCESWebsitesYouTube VideosPodcastREFERENCES14. Substance Use and MisuseLEARNING OBJECTIVESLEGISLATIVE HIGHLIGHTS RELATED TO SUBSTANCE ABUSE/MISUSEWHAT IS THE SCOPE OF SUBSTANCE MISUSE?The State of Opioid UseAlcohol and Substance Abuse DisordersSubstance Use/Abuse and People with DisabilitiesSOCIAL WORK, MENTAL HEALTH, AGING, AND SERVICE UTILIZATIONPROGRAMS AVAILABLE TO MEET THE SUBSTANCE ABUSE CARE NEEDS OF OLDER ADULTSMedicareMedicaidArea Agencies on AgingSERVICE DELIVERY SETTINGS FOR SUBSTANCE USE/MISUSE CARE FOR OLDER ADULTS AND PEOPLE WITH DISABILITIESISSUES FACING OLDER ADULTS AND PEOPLE WITH DISABILITIES WITH SUBSTANCE ABUSE/MISUSE CARE NEEDSFinancing Mental Healthcare for Older AdultsCommunity-Based CareModels for Gero-PsychiatryPrevention ServicesScreening and DetectionMedicationsMODEL PROGRAMS AND BEST-PRACTICE APPROACHES TO SUBSTANCE USE/MISUSE SERVICE DELIVERYThe Center for Older Adult Recovery at Hanley CenterSUBSTANCE USE/MISUSE CARE CHALLENGES FOR THE FUTURESUMMARYDISCUSSION QUESTIONSADDITIONAL RESOURCESWebsitesYouTube VideosPodcastREFERENCESPART III: Tools for Policy and Program Development15. Health Behavior Models and Health Promotion FrameworksLEARNING OBJECTIVESWHAT ARE HEALTH PROMOTION FRAMEWORKS?HEALTH PROMOTION FRAMEWORKS AND HEALTH POLICYThe Health Belief ModelThe Theory of Reasoned ActionTranstheoretical Model and Stages of Change TheoryIMPLICATIONS OF THE HEALTH PROMOTION MODELS AND PROGRAM DEVELOPMENT FOR AGING AND DISABILITY-RELATED PROGRAMS AND SERVICESSUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosDISCUSSION QUESTIONSREFERENCES16. Media, Social Media, and Advocacy Strategies for ChangeLEARNING OBJECTIVESADVOCACY AND ITS ROLE IN PROGRAM AND POLICY DEVELOPMENTTHE USE OF MEDIA ADVOCACYWhat Is Media Advocacy?When Using Media for AdvocacyFORMS OF MEDIA ADVOCACYNewspaper ArticlesNews ReleasesLetters to the EditorRadio Spots or Television InterviewsMedia Events or Press BriefingsFact SheetsMedia ArtifactsSocial MediaWHAT STRATEGIES ARE BEST TO USE?Consider the AudienceConsider the MessageConsider TimeConsider Financial ResourcesConsider Human ResourcesUSING MEDIA ADVOCACY FOR POLICY DEVELOPMENT AND PROGRAM PLANNINGSUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosPodcastDISCUSSION QUESTIONSREFERENCES17. Coalitions and Coalition Building for Advocacy and Policy DevelopmentLEARNING OBJECTIVESWHY ADVOCACY?STRATEGIES FOR ADVOCACY: COALITION BUILDINGWhat Are Coalitions?What Are Some Reasons for Developing Coalitions?PARTNERS FOR COALITION ENTITIESAcademiaPublic Health ExpertiseHuman Service ProvidersConsumer OrganizationsFaith-Based CommunitiesLaw and Safety EnforcementMedia/EducationVolunteer AssociationsSports and Recreation EntitiesHOW DO WE BUILD COALITIONS?COMMUNICATION SKILLS FOR EFFECTIVE COMMUNITY NEGOTIATIONSSources of ConflictRoles of Coalition MembersUnderstanding the Roles Participants Will Take OnWhat Influences These Roles Within Coalitions?MODEL COALITIONS AND THEIR OUTCOMESThe National Coalition on Mental Health and AgingThe Ontario Healthy Communities CoalitionQuad Counties Mental Health and Aging CoalitionThe National Federation of the BlindThe Coalition of Health and Disability AdvocatesThe Coalition of Citizens With DisabilitiesThe Pioneer Network CoalitionSUMMARYADDITIONAL RESOURCESWebsitesVideosDISCUSSION QUESTIONSREFERENCES18. Needs Assessment ToolsLEARNING OBJECTIVESINTRODUCTIONWHO IS RESPONSIBLE FOR CARRYING OUT NEEDS ASSESSMENTS?WHY WOULD INDIVIDUALS, GROUPS, OR ORGANIZATIONS BE INTERESTED IN CONDUCTING A NEEDS ASSESSMENT?CORE CONCEPTS OR BUILDING BLOCKS THAT SERVE AS A FOUNDATION FOR NEEDS ASSESSMENTSNeedTarget GroupsSystemsOutcomesPlan of ActionEvidence BaseSTRATEGIES FOR DEVELOPING A NEEDS ASSESSMENTSocial IndicatorsKey InformantsCommunity ForumField Study and Survey DataRates Under Treatment or Agency Service DataFocus GroupsEnvironmental ScansA MODEL FOR NEEDS ASSESSMENTSUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosPodcastDISCUSSION QUESTIONSREFERENCES19. From Tools to VisionLEARNING OBJECTIVESUSING TOOLS AND STRATEGIES TO REACH YOUR VISIONFROM TOOLS TO POLICY DEVELOPMENTFROM TOOLS TO PROGRAM DEVELOPMENTSUMMARYDISCUSSION QUESTIONSREFERENCESPART IV: Realities and Visions for the Future20. Challenges for Policy and Program Planning for the Future: Realities and Visions for the FutureLEARNING OBJECTIVESINTRODUCTIONTHE TOP 10 LIST OF CHALLENGES FOR THE FUTURE IN THE AREAS OF DISABILITY AND AGING1. Designing Paradigms to Meet the Demographic and Social Needs of Our Graying and Disabled Populations Through Evidence-Based Approaches2. Social Security3. Medicare4. Understanding Health Behavior and Planning With This Understanding in Mind5. Using the Media, Advocacy, and Coalitions for Social Change6. Home- and Community-Based Care7. Mental Health Programs, Services, and Issues8. Health Programs, Services, and Issues9. Long-Term Care10. Diversity and Special PopulationsSUMMARYREFERENCEAppendix A: Regional Support CentersAppendix B: Healthy People 2020 Objectives for Older AdultsAppendix C: Healthy People 2020 Objectives for Disability and HealthAppendix D: Overview of Relevant Legislation That Impacts Older Adults and People With DisabilitiesAppendix E: Aging and Disability Resource CentersAppendix F: Overview of ICD-10 and ICF: Application to People With Disabilities and Older AdultsPatricia Welch SaleebyIndex

Elaine Theresa Jurkowski, PhD, MSW, is a professor at Southern Illinois University Carbondale’s School of Social Work, where she teaches courses in health and aging policy, research, and program evaluation and social work practice. Dr. Jurkowski also holds joint appointments with the Department of Public Health and Recreation Professions and SIU’s School of Medicine’s Family Practice Residency Program.

• ContentsPrefaceAcknowledgmentsIntroductionShare Policy and Program Planning for Older Adults and People With Disabilities: Practice Realities and Visions, Second EditionPART I: Understanding Policy and Program Development1. Background and Demographic Profile of People Growing Older and/or People With DisabilitiesLEARNING OBJECTIVESPREPARING FOR THE “BOOM”THE CHANGING DEMOGRAPHIC STRUCTURE AND AGING POPULATIONCHANGES IN OUR POPULATION PROFILELiving ArrangementsEducation LevelEconomic Well-BeingChanges in Rural PopulationTrends in Morbidity and MortalityTHE CHANGING DEMOGRAPHIC STRUCTURE OF THE OLDER ADULT POPULATION WITH DISABILITIES AND IMPAIRMENTSCHANGES WITHIN THE SOCIAL, POLITICAL, AND CULTURAL EXPECTATIONS OF COMMUNITIESCHALLENGES FOR AGING AND DISABILITY POLICIES AND PROGRAMSREALITIES AND VISIONSDISCUSSION QUESTIONSREFERENCES2. Social, Political, Economic, and Demographic Factors and Historical Landmarks Impacting Aging and Disability Public PolicyLEARNING OBJECTIVESTHE ROLE OF HISTORICAL LANDMARKS IN SHAPING SOCIAL TRENDS AND PUBLIC POLICIESTHE RELATIONSHIP BETWEEN HISTORICAL LANDMARKS AND AGING AND DISABILITY-RELATED POLICIESTRENDS IN POLICY, SOCIAL, AND POLITICAL INFLUENCES AND LANDMARKS IN THE UNITED STATESThe Roaring ‘20s: 1920–1929The Dirty ‘30s: 1930–1939The War-Torn ‘40s: 1940–1949The Golden Age: 1950–1959The Age of Technology Explosion: 1960–1969The Decade of Presidential Resignation: 1970–1979The Era of Economic Entrenchment: 1980–1989The Era of Globalization: 1990–1999The Dawning of a New Century: 2000–2009The Age of Individualism (2010 and Beyond)SUMMARYDISCUSSION QUESTIONSREFERENCES3. Philosophical Paradigms and Policy Frameworks Impacting Aging and Disability PolicyLEARNING OBJECTIVESPHILOSOPHICAL PARADIGMS AND THE RELATIONSHIP TO AGING POLICY AND POLICY ANALYSISWHAT IS POLICY ANALYSIS?PHILOSOPHICAL PARADIGMSBlaming the VictimElitismSocial Welfare as a RightEconometric PerspectivesCause Versus FunctionCronyismFeminismPublic Policy Advocates’ Understanding of the ParadigmsIMPLEMENTATION STRATEGIESWindow of OpportunityImplementationIncrementalismRationalismStreet-Level BureaucratsPublic Policy Advocates’ Understanding of the Implementation StrategiesA MODEL FOR SOCIAL WELFARE POLICY ANALYSISSocial Problem/Social IssueGoalPolicy or LegislationImplementation of Policy or LegislationTHE USE OF NEEDS ASSESSMENTS FOR POLICY DEVELOPMENT AND COMMUNITY PLANNINGSUMMARYDISCUSSION QUESTIONSREFERENCES4. Evidence-Based Policy Development: Tools for Public Policy Development and AnalysisLEARNING OBJECTIVESWHAT IS AN EVIDENCE BASE?WHAT IS EVIDENCE-BASED PROGRAM AND POLICY DEVELOPMENT?WHY AN EVIDENCE BASE?SOCIAL WORK AND PROGRAM PLANNING FOR OLDER ADULTS AND PEOPLE WITH DISABILITIES: AN AUTHORITY-BASED OR EVIDENCE-BASED PROFESSION?APPROACHES TO EVIDENCE-BASED POLICY DEVELOPMENTSOURCES OF EVIDENCECongressional UniverseCongress.gov DatabaseGovernment Printing OfficeGovernment Accountability OfficeSecondary Data Sources Useful in an Evidence-Based ApproachBENCHMARKS USED IN THE HEALTHCARE ARENA FOR PROGRAM PLANNING AND POLICY DEVELOPMENTEVIDENCE AND ITS ROLE IN POLICY DEVELOPMENT AND COMMUNITY PLANNINGWhat Is a Needs Assessment?SUMMARYADDITIONAL RESOURCESWebsitesDISCUSSION QUESTIONSREFERENCESPART II: The Legislative Basis for Programs and Services Affecting Older Adults and/or People With Disabilities5. The Social Security ActLEARNING OBJECTIVESBACKDROP TO OUR CURRENT SOCIAL SECURITY PROGRAMSocial Security in EuropeThe Genesis of Social Security in the United StatesContents of the Original Social Security ActTHE CURRENT SOCIAL SECURITY ACTSome Guidelines for Social Security ProgramsBasic Information When One Is Receiving Social Security Disability BenefitsAbout BenefitsOther Benefits One May Be Eligible forWhat Must Be Reported to SSA?SOCIAL SECURITY DISABILITY INSURANCE FOR CHILDRENWhen a Child Reaches Age 18If an 18-Year-Old Child Is Still in SchoolIf a Child Is DisabledIf One Has a Stepchild and Gets DivorcedReviewing One’s Medical ConditionHelping One Return to WorkProtection of One’s Personal InformationSOME REFORMS WORTH NOTINGPROPOSALS FOR REVISION AND WHYImplications of a Privatized SystemDILEMMAS FOR THE FUTUREA Culture of Impoverished Older AdultsOlder Women and PovertyAn Empty Pot at the End of the RainbowSUMMARYDISCUSSION QUESTIONSADDITIONAL RESOURCESWebsitesYouTube Resources Related to Social SecurityREFERENCES6. MedicareLEARNING OBJECTIVESINTRODUCTIONHISTORICAL PERSPECTIVEHOW DOES MEDICARE WORK?Hospital Insurance (Part A)Medical Insurance (Part B)Costs of Medicare Part A CoveragePart B Coverage CostsPart B Costs for Those Qualifying for Original MedicareMedicare Part CPart C Coverage CostsMedicare Part DHOW DOES MEDICARE AFFECT ACCESS TO HEALTHCARE, COST CONTAINMENT, AND QUALITY?WHAT IS MEDICAID AND HOW DOES IT DIFFER FROM MEDICARE?EligibilityMedicaid Waiver OpportunitiesTHE EFFECTS OF REIMBURSEMENT ON HEALTHCARE QUALITY, ACCESS, AND COSTSCHALLENGES FOR THE FUTUREAn Empty Pot at the End of the Rainbow?Rationing of Healthcare Services—To Be or Not to Be?SUMMARYCASE STUDY DISCUSSIONDISCUSSION QUESTIONSADDITIONAL RESOURCESWebsitesYouTube Resources Related to MedicarePodcastREFERENCES7. The Older Americans ActLEARNING OBJECTIVESBACKGROUND AND OVERVIEWTHE OLDER AMERICANS ACT OF 1965Title I: DefinitionsTitle II: Administration on AgingTitle III: Grants for Community Planning, Services, and TrainingTitle IV: Research and Development ProjectsTitle V: Training ProjectsTitle VI: GeneralAMENDMENTS TO THE OLDER AMERICANS ACT: 1967–2000The National Family Caregiver Support ProgramLEGISLATIVE AMENDMENTS OF 2016Title ITitle IITitle IIITitle IVTitle VTitles VI and VIIThe 2010 ReauthorizationLEGISLATIVE AMENDMENTS of 2016 (PL 114–144)Aging and Disability Resource CentersArea PlansDisease Prevention and Health Promotion ServicesElder AbuseFunding FormulaHolocaust SurvivorsHome- and Community-Based ServicesLong-Term Care Ombudsman ProgramNational Family Caregiver Support ProgramNutrition ServicesLegal AssistanceTitle IV Demonstration ProjectsPHILOSOPHICAL PARADIGMS IMPACTING LEGISLATIVE AMENDMENTSSUMMARYUSEFUL WEBSITESWebsitesYouTube VideosPodcastDISCUSSION QUESTIONSREFERENCES8. The Americans With Disabilities ActLEARNING OBJECTIVESTHE INTERSECTION BETWEEN DISABILITY AND AGINGHISTORY OF THE DISABILITY MOVEMENTTHE JOURNEY TOWARD THE AMERICANS WITH DISABILITIES ACTTHE AMERICANS WITH DISABILITIES ACT OF 1990Title I: EmploymentTitle II: Public ServicesTitle III: Public Accommodations and Services Offered Through Private EntitiesTitle IV: TelecommunicationsTitle V: Miscellaneous ProvisionsIMPLICATIONS OF THE AMERICANS WITH DISABILITIES ACT ON THE AGING AND OLDER ADULT POPULATIONSTitle I: EmploymentTitle II: Public ServicesTitle III: Public Accommodations and Services Offered Through Private EntitiesTitle IV: TelecommunicationsTHE AMERICANS WITH DISABILITIES ACT AMENDMENTS OF 2008Title ITitle IITitle IIITitle IVTitle VAGING AND DISABILITY RESOURCE CENTERSSUMMARYUSEFUL WEBSITESADDITIONAL RESOURCESYouTube VideosPodcastsDISCUSSION QUESTIONSREFERENCES9. Mental Health: The Community Mental Health ActLEARNING OBJECTIVESWHAT IS MENTAL HEALTH?Definition of Mental HealthParadigms of Mental HealthHISTORY OF LEGISLATIVE EFFORTS AFFECTING OLDER ADULTS AND OTHERS WITH MENTAL DISORDERSThe 2000 National Family Caregivers’ Support ProgramThe New Freedom Commission on Mental HealthINFLUENCES TO CONSIDER IN THE DEVELOPMENT OF MENTAL HEALTH LEGISLATIONPatterns of Service UtilizationHealth Beliefs and the Role of CultureA CURRENT MENTAL HEALTH PROFILE OF OLDER ADULTS AND PEOPLE WITH DISABILITIES IN THE UNITED STATESA CLOSER VIEW OF THE MEANING OF MENTAL HEALTHMH, Older Adults, and PhysiciansMH, Older Adults, and Social ServicesTHE EPIDEMIOLOGY OF MH ISSUES OF OLDER ADULTSDepression in Older AdultsLate-Onset DepressionAlzheimer’s DiseaseAnxiety DisordersSchizophrenia in Late LifeMH and Older AdultsMH in Rural Communities Versus Urban CommunitiesSOCIAL WORK, MENTAL HEALTH, AGING, AND SERVICE UTILIZATIONPROGRAMS AVAILABLE TO MEET THE MENTAL HEALTHCARE NEEDS OF OLDER ADULTS AND PEOPLE WITH DISABILITIESMedicareMedicaidArea Agencies on AgingSERVICE DELIVERY SETTINGS FOR MENTAL HEALTHCARE FOR OLDER ADULTSISSUES FACING OLDER ADULTS, PEOPLE WITH DISABILITIES, AND MENTAL HEALTHCARE NEEDSFinancing Mental Healthcare for Older AdultsCommunity-Based CareModels for Gero-PsychiatryPrevention ServicesScreening and DetectionMedicationsPeople With Chronic Mental Health Needs Who Are AgingOppressed Groups and Visible MinoritiesMODEL PROGRAMS AND BEST PRACTICE APPROACHES TO MENTAL HEALTH SERVICE DELIVERYThe Center for Older Adult Recovery at Hanley CenterThe Gatekeeper ProgramMENTAL HEALTHCARE CHALLENGES FOR THE FUTURESUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosPodcastDISCUSSION QUESTIONSREFERENCES10. The Patient Protection and Affordable Care ActLEARNING OBJECTIVESTHE AFFORDABLE CARE ACT BECOMES LAWCOMPONENTS OF THE ACATitle I: Quality, Affordable Healthcare for All AmericansTitle II: Role of Public ProgramsTitle III: Improving the Quality and Efficiency of HealthcareTitle IV: Prevention of Chronic Disease and Improving Public HealthTitle V: Healthcare WorkforceTitle VI: Transparency and Program IntegrityTitle VII: Improving Access to Innovative Medical TherapiesTitle VIII: Class ActTitle IX: Revenue ProvisionsTitle X: Strengthening Quality, Affordable Healthcare for All AmericansSUMMARYDISCUSSION QUESTIONSADDITIONAL RESOURCESYouTube VideosWebsitesPodcastsREFERENCES11. Caregivers/The Caregiver Support ActLEARNING OBJECTIVESCAREGIVERS AND THE CAREGIVER SUPPORT ACTRAISE FAMILY CAREGIVERS ACT—PUBLIC LAW 115–119Importance of Family CaregiversA CURRENT PROFILE OF RELATIVE CAREGIVERS RAISING CHILDREN IN THE UNITED STATESREASONS FOR THE INCREASE IN RELATIVE CAREGIVINGISSUES FACING GRANDPARENTS RAISING GRANDCHILDRENPovertySocial/Role IssuesSocializationHealthcarePolicy and LegislationPROGRAMS AVAILABLE TO MEET THE NEEDS OF RELATIVE CAREGIVERS AND GRANDPARENTS RAISING GRANDCHILDRENMedicareMedicaidArea Agencies on AgingChild WelfareMODEL PROGRAMS AND PROACTIVE APPROACHES TO ADDRESSING THE NEEDS OF GRANDPARENTS SERVING AS CAREGIVERS FOR GRANDCHILDRENCHALLENGES FOR RELATIVE CAREGIVERS AND GRANDPARENTS RAISING GRANDCHILDREN IN THE FUTURESUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosPodcastsDISCUSSION QUESTIONSREFERENCES12. The Elder Justice ActLEARNING OBJECTIVESTHE ELDER JUSTICE ACTLEGISLATIVE PROVISIONS ADDRESSED WITHIN THE ELDER JUSTICE ACTA CURRENT PROFILE OF ELDER ABUSE FACING OLDER ADULTS IN THE UNITED STATESWHO REPORTS ELDER ABUSE?PROGRAMS AND SERVICES AVAILABLE TO ADDRESS ISSUES OF ELDER ABUSEMedicareState-Based Services Offered Through Departments on AgingThe Centers for Disease Control and PreventionArea Agencies on AgingTYPES OF ELDER ABUSE AND NEGLECTMODEL PROGRAMS AND BEST-PRACTICE APPROACHES TO ADDRESSING THE LEGAL NEEDS OF OLDER ADULTSBreaking the Silence—Media Campaign (Illinois Department on Aging)The B*SAFE ProgramCHALLENGES FOR ELDER ABUSE AND NEGLECT PROGRAMS IN THE FUTURECHALLENGES FOR LEGAL ISSUES IN AGING FOR THE FUTURELEGAL ISSUES AND OLDER ADULTSPOWER OF ATTORNEYTypes of Powers of AttorneyLegal Authority Granted via a Power of AttorneySelecting an Agent for a Power of AttorneyMonitoring and OversightHEALTHCARE POWER OF ATTORNEYLiving Wills and Advance DirectivesPROGRAMS AND SERVICES AVAILABLE TO ADDRESS LEGAL ISSUES FOR OLDER ADULTSMedicareState-Based Departments on AgingThe Older Americans Act and Area Agencies on AgingMODEL PROGRAMS AND BEST PRACTICES TO ADDRESS THE LEGAL NEEDS OF OLDER ADULTSAmerican Association of Retired PersonsAmerican Society on AgingCHALLENGES FOR LEGAL ISSUES IN THE AGING ARENA FOR THE FUTURESUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosDISCUSSION QUESTIONSREFERENCES13. Housing and Long-Term CareLEARNING OBJECTIVESA HISTORICAL OVERVIEW OF HOUSING POLICY AND OPTIONS FOR PEOPLE GROWING OLDER AND PEOPLE WITH DISABILITIESA CURRENT PROFILE OF LONG-TERM CARE AND COMMUNITY-BASED CARE NEEDSAN OVERVIEW OF THE PROGRAMS TO MEET HOUSING NEEDS OF OLDER ADULTSSenior ApartmentsCategories of Senior ApartmentsSTRATEGIES FOR REMAINING IN ONE’S HOMEHome Equity ConversionSale LeasebackMAINTENANCE PROGRAMSHome Maintenance and RepairIllinois Home Weatherization Assistance ProgramISSUES FACING LONG-TERM AND COMMUNITY-BASED CARE FOR OLDER ADULTSLong-Term Care FacilitiesAssisted Living FacilitiesCommunity-Based CareConsumer-Directed Home Help and Care OptionsPeople With Disabilities Requiring Community-Based CareOPPRESSED GROUPS AND VISIBLE MINORITIESSUMMARYDISCUSSION QUESTIONSADDITIONAL RESOURCESWebsitesYouTube VideosPodcastREFERENCES14. Substance Use and MisuseLEARNING OBJECTIVESLEGISLATIVE HIGHLIGHTS RELATED TO SUBSTANCE ABUSE/MISUSEWHAT IS THE SCOPE OF SUBSTANCE MISUSE?The State of Opioid UseAlcohol and Substance Abuse DisordersSubstance Use/Abuse and People with DisabilitiesSOCIAL WORK, MENTAL HEALTH, AGING, AND SERVICE UTILIZATIONPROGRAMS AVAILABLE TO MEET THE SUBSTANCE ABUSE CARE NEEDS OF OLDER ADULTSMedicareMedicaidArea Agencies on AgingSERVICE DELIVERY SETTINGS FOR SUBSTANCE USE/MISUSE CARE FOR OLDER ADULTS AND PEOPLE WITH DISABILITIESISSUES FACING OLDER ADULTS AND PEOPLE WITH DISABILITIES WITH SUBSTANCE ABUSE/MISUSE CARE NEEDSFinancing Mental Healthcare for Older AdultsCommunity-Based CareModels for Gero-PsychiatryPrevention ServicesScreening and DetectionMedicationsMODEL PROGRAMS AND BEST-PRACTICE APPROACHES TO SUBSTANCE USE/MISUSE SERVICE DELIVERYThe Center for Older Adult Recovery at Hanley CenterSUBSTANCE USE/MISUSE CARE CHALLENGES FOR THE FUTURESUMMARYDISCUSSION QUESTIONSADDITIONAL RESOURCESWebsitesYouTube VideosPodcastREFERENCESPART III: Tools for Policy and Program Development15. Health Behavior Models and Health Promotion FrameworksLEARNING OBJECTIVESWHAT ARE HEALTH PROMOTION FRAMEWORKS?HEALTH PROMOTION FRAMEWORKS AND HEALTH POLICYThe Health Belief ModelThe Theory of Reasoned ActionTranstheoretical Model and Stages of Change TheoryIMPLICATIONS OF THE HEALTH PROMOTION MODELS AND PROGRAM DEVELOPMENT FOR AGING AND DISABILITY-RELATED PROGRAMS AND SERVICESSUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosDISCUSSION QUESTIONSREFERENCES16. Media, Social Media, and Advocacy Strategies for ChangeLEARNING OBJECTIVESADVOCACY AND ITS ROLE IN PROGRAM AND POLICY DEVELOPMENTTHE USE OF MEDIA ADVOCACYWhat Is Media Advocacy?When Using Media for AdvocacyFORMS OF MEDIA ADVOCACYNewspaper ArticlesNews ReleasesLetters to the EditorRadio Spots or Television InterviewsMedia Events or Press BriefingsFact SheetsMedia ArtifactsSocial MediaWHAT STRATEGIES ARE BEST TO USE?Consider the AudienceConsider the MessageConsider TimeConsider Financial ResourcesConsider Human ResourcesUSING MEDIA ADVOCACY FOR POLICY DEVELOPMENT AND PROGRAM PLANNINGSUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosPodcastDISCUSSION QUESTIONSREFERENCES17. Coalitions and Coalition Building for Advocacy and Policy DevelopmentLEARNING OBJECTIVESWHY ADVOCACY?STRATEGIES FOR ADVOCACY: COALITION BUILDINGWhat Are Coalitions?What Are Some Reasons for Developing Coalitions?PARTNERS FOR COALITION ENTITIESAcademiaPublic Health ExpertiseHuman Service ProvidersConsumer OrganizationsFaith-Based CommunitiesLaw and Safety EnforcementMedia/EducationVolunteer AssociationsSports and Recreation EntitiesHOW DO WE BUILD COALITIONS?COMMUNICATION SKILLS FOR EFFECTIVE COMMUNITY NEGOTIATIONSSources of ConflictRoles of Coalition MembersUnderstanding the Roles Participants Will Take OnWhat Influences These Roles Within Coalitions?MODEL COALITIONS AND THEIR OUTCOMESThe National Coalition on Mental Health and AgingThe Ontario Healthy Communities CoalitionQuad Counties Mental Health and Aging CoalitionThe National Federation of the BlindThe Coalition of Health and Disability AdvocatesThe Coalition of Citizens With DisabilitiesThe Pioneer Network CoalitionSUMMARYADDITIONAL RESOURCESWebsitesVideosDISCUSSION QUESTIONSREFERENCES18. Needs Assessment ToolsLEARNING OBJECTIVESINTRODUCTIONWHO IS RESPONSIBLE FOR CARRYING OUT NEEDS ASSESSMENTS?WHY WOULD INDIVIDUALS, GROUPS, OR ORGANIZATIONS BE INTERESTED IN CONDUCTING A NEEDS ASSESSMENT?CORE CONCEPTS OR BUILDING BLOCKS THAT SERVE AS A FOUNDATION FOR NEEDS ASSESSMENTSNeedTarget GroupsSystemsOutcomesPlan of ActionEvidence BaseSTRATEGIES FOR DEVELOPING A NEEDS ASSESSMENTSocial IndicatorsKey InformantsCommunity ForumField Study and Survey DataRates Under Treatment or Agency Service DataFocus GroupsEnvironmental ScansA MODEL FOR NEEDS ASSESSMENTSUMMARYADDITIONAL RESOURCESWebsitesYouTube VideosPodcastDISCUSSION QUESTIONSREFERENCES19. From Tools to VisionLEARNING OBJECTIVESUSING TOOLS AND STRATEGIES TO REACH YOUR VISIONFROM TOOLS TO POLICY DEVELOPMENTFROM TOOLS TO PROGRAM DEVELOPMENTSUMMARYDISCUSSION QUESTIONSREFERENCESPART IV: Realities and Visions for the Future20. Challenges for Policy and Program Planning for the Future: Realities and Visions for the FutureLEARNING OBJECTIVESINTRODUCTIONTHE TOP 10 LIST OF CHALLENGES FOR THE FUTURE IN THE AREAS OF DISABILITY AND AGING1. Designing Paradigms to Meet the Demographic and Social Needs of Our Graying and Disabled Populations Through Evidence-Based Approaches2. Social Security3. Medicare4. Understanding Health Behavior and Planning With This Understanding in Mind5. Using the Media, Advocacy, and Coalitions for Social Change6. Home- and Community-Based Care7. Mental Health Programs, Services, and Issues8. Health Programs, Services, and Issues9. Long-Term Care10. Diversity and Special PopulationsSUMMARYREFERENCEAppendix A: Regional Support CentersAppendix B: Healthy People 2020 Objectives for Older AdultsAppendix C: Healthy People 2020 Objectives for Disability and HealthAppendix D: Overview of Relevant Legislation That Impacts Older Adults and People With DisabilitiesAppendix E: Aging and Disability Resource CentersAppendix F: Overview of ICD-10 and ICF: Application to People With Disabilities and Older AdultsPatricia Welch SaleebyIndex