Advancing States Through the OAA Reauthorization

Abstract States are major policymakers and funders of community-based services for older Americans and ADvancing States played a significant role in supporting the OAA authorization this year. This presentation will provide the states' perspective regarding funding, services, research and demonstrations, and more.

This study aims at investigating to what extent inequalities in the use of formal, informal and privately paid care have changed over time.Data from the Longitudinal Aging Study Amsterdam (LASA) was used from three points in time (1995, 2005 and 2015) that capture distinct periods in the recent development of the Dutch long-term care system.In particular, the reforms of 2007 and 2015 might have impacted care uses.All participants (N = 1810) were living at home and between the age of 75 and 85 at measurement.The results indicate that, adjusted for health and partner status, formal, informal and privately paid care have decreased over time.Socioeconomic differences in informal care use have increased over time, but no change was found for privately paid or formal care use.These findings suggest that changes in the LTC system and long-term care resources in particular benefit lower socioeconomic groups.

POLICY SERIES: THE OLDER AMERICANS ACT REAUTHORIZATION: MAJOR SUCCESSES AND SHORTCOMINGS Chair: Brian Lindberg
This session provides an update on the2020 Older Americans Act (OAA) reauthorization process and passage of the new law "Supporting Older Americans Act of2020."Presenters will provide insights on both the content of the new law and the process that led to the bicameral, bipartisan legislation.Speakers will include representatives of the aging network and other stakeholders, who will discuss key changes to the OAA and how they may be implemented over the next five years.

FRAMING THE ISSUE Brian Lindberg, GSA, Washington, District of Columbia, United States
The GSA Public Policy Advisor will facilitate a discussion about the 2020 reauthorization of the Older Americans Act with key stakeholders from Washington, DC.Also, the presentation will include perspective on GSA's active role in policy development and the legislative process.

THE AGING NETWORK AND THE OLDER AMERICANS ACT REAUTHORIZATION Amy Gotwals, National Association of Area Agencies on Aging, Washington, District of Columbia, United States
This presentation will cover a range of OAA reauthorization proposals -successes and what was not possible this year.As a leader in the aging network, n4a played a major role in the legislative process, and the discussion will include top priorities for improving the ability of the network to serve older adults with community-based supports and services.

ADVANCING STATES THROUGH THE OAA REAUTHORIZATION Damon Terzaghi, ADvancing States, Arlington, Virginia, United States
States are major policymakers and funders of communitybased services for older Americans and ADvancing States played a significant role in supporting the OAA authorization this year.This presentation will provide the states' perspective regarding funding, services, research and demonstrations, and more.

NEW PIECES FOR THE OLDER AMERICANS ACT PUZZLE Andrew MacPherson, Healthsperien, Washington, District of Columbia, United States
With the passage of the new "Supporting Older Americans Act of 2020," Congress acknowledged and address several under appreciated issues -the growing social isolation and loneliness of older adults, and the significant role that the aging network does and can play in providing supportive services to older adults with advanced illness (also known as serious illness).This presentation will provide information on these and other pieces of the OAA puzzle.

THE ROAD TO IMPROVED ASSISTED LIVING QUALITY: STATE EFFORTS AND NEW METRICS
Chair: Tetyana Shippee Discussant: Lindsay Schwartz Assisted living (AL), a senior housing option that combines housing, support services, and health care, is recognized as one of the fastest-growing components of the long term care industry.AL is also a relatively expensive service, whether it's paid for privately or publicly.Also, an increasing proportion of AL residents have diagnoses of Alzheimer's and related dementias.However, little is known about AL quality, in part due to lack of measures.Quality of AL matters to residents, their families, and policy makers because AL is not only about the experience of receiving specific services, but about a place that many will call home.Concerns have been surfacing regarding the quality of AL, including poor staffing, inadequate teamwork, and poor management, which can negatively impact resident well-being and result in abuse and neglect in some cases.This symposium will feature four presentations that will review efforts from two states that have been actively developing measures to address AL quality: Oregon and Minnesota.We focus on new legislation in both states to address AL quality, the new metrics being adopted, and preliminary results.Individual presentations will describe 1) Oregon's new quality measures for AL ;2) Oregon's use of Resident VIEW project, including measures of person-centered care from the perspectives of residents; 3) Minnesota's development of AL report card, and 4) development and results from MN pilot surveys of resident quality of life and family satisfaction in all licensed ALs in the state.Policy implications for other states and researchers will be discussed.

. University of Minnesota -School of Public Health, Minneapolis, Minnesota, United States
Concerns around assisted living (AL) quality have prompted the 2019 passage of the MN legislature, which provided funding for the development of an Assisted Living Report Card.We present results from the first two phases of this project.The first phase involved a national literature review of quality measures and technical advisory panels to understand the types of domains and indicators for AL quality that are measured.Nine quality domains were identified.The second phase focused on state-wide stakeholder engagement to determine priority rankings for nine AL quality domains and indicators identified.Quality of life, staff quality and resident safety were the top three domains across all stakeholder groups.The state will implement surveys of AL resident quality of life and family satisfaction as mandated by the legislature, but findings indicate that other aspects of quality such as staff-related measures and resident safety, are also important to address.Oregon legislation requires assisted living (AL) communities to report selected quality measures to the state licensing agency.The Quality Measurement Program (QMP) includes five metrics that assess different areas of resident safety and wellbeing: falls, antipsychotic medication use, staff training, staff retention, and resident satisfaction.This paper describes findings based on our 2019 survey of AL communities and offers suggestions for stakeholders interested in public reporting and quality metrics.Assisted living providers reported 28% of AL residents and 38% of memory care (MC) residents fell at least once in the prior 90 days, with 39% and 45% reporting an injury, respectively.Antipsychotic medication use was 20% among AL and 44% among MC residents.These findings and the survey methods used to collect them, combined with stakeholder and state agency staff participation, informed the current QMP approach.We describe how to collect meaningful quality metrics within the AL context.

QUALITY IN ASSISTED LIVING: DOES IT LIE IN THE EYES OF THE BEHOLDER?
Diana White, Tunalilar Ozcan, Serena Hasworth, and Jaclyn Winfree, Portland State University, Portland, Oregon, United States Quality is defined in multiple ways and by different stakeholders (e.g., residents, regulators, informed observers).Using a two-stage stratified sampling strategy, we collected data from N=241 residents living in 31 assisted living and residential care communities (AL/RC) in Oregon.Residents rated their overall satisfaction and satisfaction with the AL/ RC as a place to live and to receive care.Each interviewer completed a facility profile summarizing their observations about the setting, including quality of staff-resident interactions and physical environment.Residents and interviewers were also asked whether they would recommend the community to others.Finally, we used deficiency citations given during regular inspections by the licensing agency to