Policies and Services for the Elderly

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1 Plicies and Services fr the Elderly Fall 2010 COURSE NUMBER: SW MEETING DATES/TIME: Fridays 2-5pm (September 10, 2010 December 10, 2010) ROOM: B684 SSWB INSTRUCTOR: Lydia Li, PhD (3839 SSWB; phne: ) OFFICE HOUR: Wednesday 10-nn r by appintment 1. COURSE DESCRIPTION This curse will examine scial plicies, prblems, and trends in scial prgrams and services fr lder peple. It will fcus majr attentin n the strengths and limitatins f existing plicies and prgrams related t health, mental health, incme maintenance, incme deficiency, dependent care, husing, emplyment and unemplyment, and institutinal and residential care. This curse will prvide a framewrk fr an analysis f the services prvided t lder peple. This analysis will include the adequacy with which needs are met in varius subgrups f the elderly ppulatin and acrss cre diversity dimensins (including ability, age, class, clr, culture, ethnicity, family structure, gender (including gender identity and gender expressin), marital status, natinal rigin, race, religin r spirituality, sex, and sexual rientatin). It will als include prpsals fr change in plicies, prgrams and services. Prgrams will be cmpared in terms f access t benefits and services prvided t lder peple. 2. COURSE CONTENT This curse will familiarize students with scial plicies and prgrams fr meeting the rapidly grwing needs f the lder ppulatin in ur sciety. Plicies, prgrams, and services fr the elderly ppulatin will be examined frm histrical, bservatinal, and analytical perspectives. This curse will increase the student s awareness f prgrams and services prvided thrugh the Older Americans Act, the Scial Security Act, and as a cnsequence f public and cmmunity initiatives. Students will be expsed t cntent areas that will enable them t understand aging prgrams dealing with scial services, health care, husing, and ther elements f cmmunity and institutinal lng-term care systems. 3. COURSE OBJECTIVES Upn cmpletin f the curse, students will be able t: 1. Describe the evlutin and rganizatin f plicies and services fr lder peple in the 1

2 cntext f the prblems that give rise t the need fr such plicies and services. 2. Critique the strengths and weaknesses f the U.S. scial service delivery system fr lder peple. 3. Identify the prblems facing the develpment f services fr lder peple and suggest appraches t address these challenges. 4. Identify criteria fr assessing the success f prgrams fr lder peple. 5. Critically evaluate alternative plicies and services fr lder peple with a special emphasis n similarities and differences related t human diversity and dynamics f ppressin and privilege. 6. Discuss typical ethical cncerns related t plicies and services fr elderly peple. 7. Use a plitical ecnmy framewrk t critically evaluate plicies and services prvided t lder peple in terms f such issues as privilege, ppressin, diversity and scial justice. 4. COURSE DESIGN This curse takes a learner-center apprach with the belief that learning experiences have the greatest impact when they are relevant t the persnal wrld f the learner. This belief is implemented thrugh several ways. First, fr many class sessins, hmewrk that asks students t link real peple with plicy, prgrams and services has been assigned. Students experience f ding the hmewrk will be the basis f class discussin n the tpic f the day. S please cme t class t prepare sharing yur experience. Secnd, we will have five debates thrughut the curse. As a class, yu select aging plicy issues f yur interest t debate. Each student selects wn teammates and the team wrks tgether t develp debate strategies. All class members have the pprtunities t be judges and give final decisin. Third, yu select tpics/issues f yur cncerns fr the tw written assignments fact checking and plicy brief. If yu s desire, yu can write an Op-Ed essay r a letter t the Editr abut yur investigatin. Bnus pints will be given t thse wh chse t d s. Required readings assigned fr each sessin include tw types. One aims t prvide backgrund infrmatin abut specific aging plicy, prgrams and services. Anther is mre analytical which aims t prvide yu with alternative perspectives and new ideas t think abut a tpic r an issue. Sme readings may take time t digest while thers are easy read. We will integrate the readings in class discussin. I invite yu t give feedback abut the readings (via CTls) and suggest gd reading materials n the tpic (which will benefit the next chrt f students). In sum, this curse invlves yur active participatin in and ut f the classrm. Fr mst class sessins, the instructr will give brief lectures laying ut key issues related t the tpic. Guest speakers will be invited t deliver lectures n their expertise. Class discussin will be a main activity in the classrm. S be ready t talk, listen and challenge each ther including the instructr. 2

3 5. RELATIONSHIP OF THE COURSE TO CURRICULAR THEMES Multiculturalism and Diversity will be addressed thrugh analysis f differences in needs amng subgrups f the elderly ppulatin within the U.S. sciety and the differential applicatin and impact f plicies and services. Scial Justice and Scial Change will be addressed by cnsidering issues such as the distributin f scial security and ther benefits, varying standards fr assessing the need fr interventin (e.g., prtective services and guardianship), and differing utcmes fr behavir cnsidered harmful t self r thers. Prmtin, Preventin, Treatment, and Rehabilitatin will be addressed by cnsidering the spectrum f plicies and services ranging frm prmtin and preventin (e.g., pre-retirement prgrams and in-hme services) t treatment and rehabilitatin (e.g., incme supprt fr thse with inadequate resurces and nursing hmes). Behaviral and Scial Science Research will be addressed by the inclusin f theretical framewrks fr understanding scial rles, scial stratificatin, and scietal functining amng lder peple. The findings f research studies and evidence based interventin relevant t the design and evaluatin f plicies and services fr lder adults will als be included. 6. RELATIONSHIP OF THE COURSE TO SOCIAL WORK ETHICS AND VALUES This curse will address scial wrk values and ethics in terms f the extent t which plicies and services adequately meet the needs f lder peple. Special emphasis will be given t ethics and values cncerning plicies and services that prvide lder peple with autnmy. Intensive Fcus n Privilege, Oppressin, Diversity and Scial Justice (PODS) This curse integrates PODS cntent and skills with a special emphasis n the identificatin f theries, practice and/r plicies that prmte scial justice, illuminate injustices and are cnsistent with scientific and prfessinal knwledge. Thrugh the use f a variety f instructinal methds, this curse will supprt students develp a visin f scial justice, learn t recgnize and reduce mechanisms that supprt ppressin and injustice, wrk tward scial justice prcesses, apply intersectinality and intercultural framewrks and strengthen critical cnsciusness, self knwledge and self awareness t facilitate PODS learning. Intensive fcus cntent fr this curse includes scial justice, ppressin, and pwer relatinships that have implicatins fr scial plicies and services fr elderly peple. The plitical ecnmy f aging paradigm, a scial plicy paradigm by Dr. Carl Estes and clleagues, is used t critically analyze plicies and services prvided t lder peple. The plitical ecnmy f aging paradigm addresses the interlcking systems f ppressin f race, class, gender, and aging, thereby creating an excellent mdel fr understanding ppressin, privilege, and prpsals fr change. These cncepts will als be addressed thrugh a series f class discussins abut cmmn situatins in aging plicy practice where PODS issues are prminent in the develpment and applicatin f public plicy. 3

4 7. COURSE REQUIREMENTS A. Academic Cnduct and Integrity Please see the Student Cde f Academic and Prfessinal Cnduct in the Student Guide t the Master's in Scial Wrk Degree Prgram ( fr a discussin f student respnsibilities fr academic cnduct and integrity. In particular, please pay attentin t issues related t plagiarism. Students wh are fund respnsible fr academic miscnduct are subject t disciplinary actin up t and including dismissal frm the Schl f Scial Wrk, revcatin f degree, r any ther sanctin deemed apprpriate t address the vilatin. B. Attendance, Participatin and Gd Citizenship Students are expected t attend, arrive n time and stay thrughut all class sessins; participate actively in all class activities; and take initiatin t create and prmte a gd learning envirnment (physically, psychlgically and scially). If yu have gd reasns t miss a class, please ntify yur instructr at yur earliest cnvenience. Missing mre than tw class sessins may result in pints deducted frm final grade. In cnsideratin f yur classmates, please turn ff cell phnes, pagers, and all ther ptentially distracting devices during class. If yu are n call, please set yur pager t vibrate. Likewise, use f laptp cmputers shuld be kept t the minimum s that we can all fcus n what s happening in the classrm. Gd attendance and citizenship will bst up yur final grade particularly when it is at the margin f tw pssible grades. Accmmdatins fr Students with Disabilities If yu need accmmdatin fr a disability r ther special need, please let the instructr knw as early as pssible s that we can wrk ut the necessary arrangements. Als nte that Office f Student Services at the SSW ffers supprt t students with disabilities, as well as students with ther issues such as emtinal, health, family, and financial prblems. Religius Observances Please ntify me if religius bservances cnflict with class r due dates fr assignments s that we can make apprpriate arrangements. C. Assignments (please submit t the instructr a hard cpy f all written assignments except hmewrk which shuld be put in yur drpbx in Ctls.) (1) Plicy Brief (37% f final grade) Due: December 10 The date is January 2011 and yu have just started t wrk as a plicy analyst (fr a legislative r administrative decisin maker in city, state, r federal gvernment, r an advcacy grup fr lder persns, r a think tank). Yur first assignment is t draft a plicy brief abut a scial prblem relevant t lder adults. Please select a prblem f yur cncern, and write a paper (abut wrds) that includes (a) definitin f the 4

5 prblem, (b) majr factrs that led t this prblem and its cnsequences fr individuals, grups, and the sciety, (c) critical evaluatin f relevant plicies intended t address the prblem, (d) the plitics invlved (e.g., in framing the prblem), and (e) plicy ptins and yur recmmendatins with justificatin. There shuld be a balance f cverage in terms f understanding the issue and prpsing alternatives. The eightfld path framewrk may be a useful guide fr yur analysis. A prpsal (1-2 pages) f the plicy brief shuld be submitted t the instructr n Nvember 12. The prpsal shuld include a statement f the prblem and a brief backgrund abut the impact f the prblem and limitatins f existing plicy, prgrams and services. (2) Fact r Fictin? (25%) Due: Nvember 5 The 2010 Cngressinal electin is cming (Nvember 2). Plitical candidates, reprters, and ther media persnnel will be busy making speeches and cmments. Rather than simply accepting the presented facts, yu knw it is imprtant t d fact checking. Yu chse a surce (e.g., speech and debate f plitical candidates, televisin news shw, radi talk shw, newspaper article r clumn, internet blg) and specific facts (related t plicy, prgrams r services that affect lder adults r their caregivers) t check. An essay (abut 1000 wrds) reprting yur findings shuld include (a) the cntext that leads t yur investigatin, (b) the specific fact that yu check, (c) yur findings, (d) implicatins f the fact and fictin (e.g., hw the fact and fictin may differ in the understanding f the prblem r implicatins fr plicy.) Please give the instructr a ne-page prpsal by Octber 22. Bnus pints: Fr bth plicy brief and fact checking assignments, yu can chse t send an Op-Ed essay r a Letter t the Editr f a newspaper. If the essay r letter is published prir t the end f the semester, yu ll receive up t three extra pints. (3) Debate (20%) Each f yu will be in a debate team and there will be five in-class debates thrughut the semester. Fr details abut the tpics and rules, please see a separate handut. (4) Hmewrk (18%) A ttal f six hmewrk are assigned and their respective due date is nted n the curse schedule. It is imprtant that yu cmplete the hmewrk accrding t schedule because class discussin will be based n yur experience f ding the hmewrk. Each hmewrk culd earn yu three pints. The award f pints will be based n (a) yur sharing f experience and insight in the classrm and (b) yur written materials submitted t the instructr. Yur written hmewrk shuld be in yur drpbx in Ctls befre the crrespndent sessin. Late submissin is nt accepted in general except under special circumstances. 5

6 Writing Expectatins Written assignments shuld clearly cmmunicate the student s knwledge and thught, and be easily understd. A cncise writing style that directly makes pints and reflects a cmprehensive understanding f the subject matter is preferred. Students are required t use apprpriate referencing n the plicy brief and fact checking assignments. APA style is preferred but yu can use ther styles. The grading criteria fr these tw written assignments include: (1) cmpleteness, thrughness and timely submissin, (2) rganizatin and clarity, (3) dcumentatin and referencing, and (4) critical thinking, riginality and creativity. D. Grading Grades will be determined by adding the scres frm all assignments which then is cnverted int a letter grade using the fllwing scale: A+ = 10l%+; A = 100% - 96%; A-= 95% - 91% B+ = 90% - 86%; B = 85% - 83%; B-= 82% - 80% C+ = 79% - 76%; C = 75% - 73%; C--= 72% - 70% < 69 N Credit 8. REQUIRED TEXT AND ARTICLES Gelfand, D. (2006). The Aging Netwrk: Prgrams and Services (6th. Editin). NY: Springer. Required articles are available n ur curse website in CTls. Other readings, in additin t thse listed in this syllabus, may be assigned. They will be annunced and psted n CTls prir t the crrespnding class sessin. 6

7 9. COURSE CALENDAR AND READING ASSIGNMENTS This schedule is preliminary; any changes will be annunced in class and n CTls. Week 1 September 10: Intrductin Overview f syllabus Challenges t aging plicy The eightfld path Hudsn, R. (2010). Cntemprary challenges t aging plicy. In The New Plitics f Old Age Plicy (Chapter 1, pp. 1-17). Baltimre, MD: Jhn Hpkins University Press. Bardach, E. (2009). The eightfld path. In A Practical Guide fr Plicy Analysis (Part 1, pp. 1-64). CQ Press, Washingtn, D.C. (UM library ebk: Click PART I: The eightfld path) Week 2 September 17: Analytical Framewrk, Older American Act and Aging Netwrks The plitical ecnmy f aging framewrk Rle and challenges f the aging netwrks Estes, C. (2001). Plitical ecnmy f aging: A theretical framewrk. In Scial Plicy and Aging (Chapter 1, pp. 1-19). Thusand Oaks, CA: Sage. Gelfand, D. (2006). Legislative bases fr prgrams and services. In The Aging Netwrk: Prgrams and Services (Chapter 2, pp. 9-22). NY: Springer. O Shaughnessy (2008). The aging services netwrk: Brad mandate and respnsibilities. Public Plicy and Aging Reprt, Vlume 18 (3). Hudsn, R. (2010). The Older American Act and the aging services netwrk. In The New Plitics f Old Age Plicy (Chapter 14, pp ). Baltimre, MD: Jhn Hpkins University Press. *T read mre abut the Older American Act, g t the website f Administratin n Aging: Hmewrk 1 due: Summarize the eightfld path framewrk, and cmment n its utility (1-2 pages). Week 3 September 24: Incme Supprt Incme security in ld age 7

8 Inequality amng lder persns Gelfand, D. (2006). Age, emplyment, and incme maintenance. In The Aging Netwrk: Prgrams and Services (Chapter 3, pp ). NY: Springer. Wallace, S. & Villa, V. (2009). Healthy, wealthy and wise? Challenges t incme security fr elders f clr. In Rgne L. et al. (2009). Scial Insurance and Scial Justice: Scial Security, Medicare and the Campaign against Entitlements (Chapter 9). NY: Springer. Institute fr Wmen s Plicy Research (2007). The Ecnmic Security f Older Wmen and Men in the US. Grant J.M. et al. (2010). Financial and family security. In Outing Age 2010: Public Plicy Issues Affecting Lesbian, Gay, Bisexual and Transgender Elders (pp ). Natinal Gay and Lesbian Task Frce. Hmewrk 2 due: Calculate yur parents retirement incme. Use ne f the fllwing calculatrs t determine yur parents retirement incme. What factrs cntribute t the calculatin? Hw d the benefits differ between yur mther and father? Please submit a ne-page reprt f yur findings. a. Center fr Ecnmic Plicy Research b. AARP Retirement Calculatr c. Scial Security Administratin d. Urban Institute: Incme and Benefits Plicy Center e. Center fr Budget and Plicy Pririties Week 4 Octber 1: Future f Scial Security Fixing scial security Privatizatin Ball, R. (2009). The nine guiding principles f scial security. In Rgne et al. (Eds.). Scial Insurance and Scial Justice: Scial Security, Medicare, and the Campaign against Entitlements (pp. 9-14). NY: Springer. 8

9 Scial Security and Medicare Bards f Trustees (2010). Status f the Scial Security and Medicare prgram (summary). Available frm Brwn, J., Hassett, k., & Smetters, K. (2005). Tp ten myths f Scial Security refrm. (CRR WP ). Chester Hill, MA: Center fr Retirement Research at Bstn Cllege. 3c4de9t51d9eb41 Svihula J. & Estes, C. (2009). Scial Security privatizatin: The institutinalizatin f an idelgical mvement. In Rgne et al. (Eds.). Scial Insurance and Scial Justice: Scial Security, Medicare, and the Campaign against Entitlements (pp ). NY: Springer. Hmewrk 3 due: Scial Security Game (American Academy f Actuaries) American public s cnfidence in Scial Security is tanking. Actuaries say that unless it s fixed, it wn t be able t pay full benefits after Many slutins have been prpsed. The Academy f Actuaries has designed a game which asks yu t fix scial security. Pl. g t t play the game, and write a ne-page ( wrds) essay t reflect yur experience including justificatins fr yur vtes. Week 5 Octber 8: Medicare Medicare and changes intrduced by the health care refrm Equity, justice, and sustainability Neuman, T. (n.d.). Health refrm and Medicare (a vide tutrial). Kaiser Family Fundatin (2010). Medicare: A primer. Available frm: Mrgan, K. (2010). Medicare: Deservingness encunters cst cntainment. In Hudsn, R. (ed.). The New Plitics f Old Age Plicy (Chapter 12, pp ). Baltimre, MD: Jhn Hpkins University Press. Olsn, L. (2003). Because that s where the mney is. In The Nt-s-Glden Years. Lanham, MD: Rwman & Littlefield. Hmewrk 4 due: One f yur elderly relatives (r elderly clients) asks yu fr assistance in determining if she is eligible fr Medicare, and if s, (1) hw he/she ges abut applying fr it, (2) which health and drug plan he/she shuld use, (3) whether he/she shuld purchase Medigap. This website shuld be helpful Write a ne-page ( wrds) summary f yur advice. 9

10 Week 6 Octber 15: Medicaid Medicaid and lng-term care Health ratining Rudwitz, R. (2010). Health refrm: hw will Medicaid change (a vide tutrial) Kaiser Family Fundatin (2010). Medicaid: A primer. Available frm: AARP Public Plicy Institute (2008). Myths abut the Medicaid Prgram and the Peple It Helps. Andre, C. & Velasquez, M. (n.d.). Aged-Based Health Care Ratining. Week 7 Octber 22: Lng-Term Care Plicy and Challenges Cst f lng-term care Paying fr LTC The CLASS Act Lng-term care wrkfrce Kathryn G. Allen (2005). Lng-Term Care financing: Grwing demand and cst f services are straining federal and state budgets. Testimny befre the Subcmmittee n Health, Cmmittee n Energy and Cmmerce, Huse f Representatives Weiner, J. (2010). What des health refrm mean fr lng-term care. Public Plicy and Aging Reprt, 20(2), Stne R. & Harahan, M. (2010). Imprving the lng-term care wrkfrce serving lder peple. Health Affairs, 29(1), Hmewrk 5 due: Lng-term care planning fr yurself (r smene yu knw well). Mst peple d nt plan fr lng-term care. Why? Prbably many reasns including a tendency t avid thinking abut being dependent n thers fr daily life activities. Please use the fllwing tl t find ut yur lng-term care prfile and write a ne-page essay (300 wrds) t reprt yur experience. =default&brwser=ie%7c8%7cwinxp&language=english&defaultstatus=0&pagelist=hme 10

11 Week 8 Octber 29: LTC Hme and Cmmunity-Based Services Traditinal and innvative HCBS Rebalancing LTC system Supprting infrmal caregivers Gelfand, D. (2006). In-hme services. In The Aging Netwrk: Prgrams and Services (Chapter 13, pp ). NY: Springer. Gelfand, D. (2006). Adult day care. In The Aging Netwrk: Prgrams and Services (Chapter 14, pp ). NY: Springer. Engquist, G. Jhnsn, C., & Jhnsn, W. (2010). Medicaid-Funded Lng-Term Supprts and Services: Snapshts f Innvatin. Center fr Health Care Strategies Grabwski, D., Cadigan, R., Miller, E. et al. (2010). Supprting Hme and Cmmunity-Based Care: Views f lng-term care specialists. Medical Care Research and Review. Supplement t 67(4) 82S 101S. Week 9 Nvember 5: LTC Residential Services Institutinal care prblems and innvatins Racial disparity Gelfand, D. (2006). Lng-term care residences. In The Aging Netwrk: Prgrams and Services (Chapter 15, pp ). NY: Springer. Olsn, L. (2003). Nursing hmes: A system run amk. In The Nt-s-Glden Years: Caregiving, the Frail Elderly, and the Lng-term Care Establishment (Chapter 7, pp ). Lanham, MD: Rwman & Littlefield. Kren, M. (2010). Imprving quality in lng-term care. Medical Care Research and Review, 67, Smith, D., Feng, Z. et al. (2008). Racial disparities in access t LTC: The illusive pursuit f equity. J. f Health Plitics, Plicy and Law, 33(5), Week 10 Nvember 12: Emplyment, Life-lng Learning and Senir Center Gelfand, D. (2006). Emplyment, vlunteer, and educatinal prgrams. In The Aging Netwrk: Prgrams and Services (Chapter 6, pp ). NY: Springer. Turner, J. Et al. (2008). Lifelng learning fr an aging ppulatin: Lessns frm Scandinavia. 11

12 AARP Internatinal. Gelfand, D. (2006). Multipurpse senir centers. In The Aging Netwrk: Prgrams and Services (Chapter 11, pp ). NY: Springer. Week 11 Nv. 19: N Class (Prf. Li ut f twn) Week 12 Nv. 26: N Class (Thanksgiving Break) Week 13 Dec 3: Husing & Transprtatin Husing and transprtatin needs Strategies t meet the needs Hmewrk 6 due (ptin A): Identify an elderly persn (an elderly relative, neighbr r client) with a husing need (e.g., physical r financial difficulties t maintain his/her huse). Please help her find ut what ptins he/she has and what services she can utilize. Recmmend t her ne r tw ptins fr serius cnsideratin. What factrs d yu cnsider when making the recmmendatin? Write a ne-page essay ( wrds) t reprt yur effrt. OR Hmewrk 6 due (ptin B): Identify an elderly persn (an elderly relative, neighbr r client) with a transprtatin need (e.g., dn t want t drive anymre after a minr accident). Please help her find ut what ptins he/she has, what services are available, and hw t g abut t use the services. Write a ne-page essay ( wrds) t reprt yur effrt and assess the extent t which existing prgrams and services meet his/her transprtatin need. Gelfand, D. (2006). Husing cnditins f the elderly. In The Aging Netwrk: Prgrams and Services (Chapter 12, pp ). NY: Springer. AARP Public Plicy Institute (2010). Strategies t meet the husing needs f lder adults. Gelfand, D. (2006). Transprtatin. In The Aging Netwrk: Prgrams and Services (Chapter 7, pp ). NY: Springer. Kffman, D., Raphel, D. Weiner, R. (2004). Impact f Federal Prgrams n Transprtatin fr Older Adults. AARP Public Plicy Institute. 12

13 Week 14 December 10: Mental Health and Nutritin Mental health plicy, prgrams and regulatin Nutritin issues and prgrams Senir centers rle and future Karlin, BE, Duffy, M. (2004). Geriatric Mental Health Plicy: Impact n Service Delivery and Directins fr Effecting Change. Prfessinal Psychlgy: Research and Practice 35(5): Lee et al. (2010). Fd insecurity, fd and nutritin prgrams, and aging: Experiences frm Gergia. J. f Nutritin fr the Elderly, 29, Gelfand, D. (2006). Nutritin prgram. In The Aging Netwrk: Prgrams and Services (Chapter 10, pp ). NY: Springer. 13

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