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Policy Lessons from COVID "Nursing home residents need access to technology to speak to their loved ones."— Lieke van Heumen, PhD 2019-2020 Health and Aging Policy Fellow Responding to COVID-10 required the Aging Services Network to become even more creative in responding to the constraints the pandemic put on service delivery. They now feel much more prepared to deal with the challenges that a pandemic brings. Even if there are new lockdowns, they can use the experiences 2020 required to continue to serve seniors. In this week's episode, we are joined by Lieke van Heumen and Samantha Koehler. We'll learn about: Challenges for the Aging Services Network Nutrition and Social Isolation Policy Solutions Lieke's Next Steps in her Career after completing the Health and Aging Policy Fellowship Part One of 'Policy Lessons from COVID with Lieke van Heumen and Samantha Koehler' The Aging Services Network consists of the agencies, programs, and activities supported by the Older Americans Act that help older adults who live in the community be healthy and have the social engagement they need. Some states only have a state unit on aging; they don't have an Area Agency on Aging in each county. If you are unsure if your county has an Area Agency on Aging (AAA), use the Eldercare Locator website to connect with the nearest be available AAA in your area. In this week's episode, we discuss the challenges COVID posed for The Aging Services Network and how they responded. At the start of the pandemic, along with the rest of the country, seniors were asked to stay home to protect themselves and others from the virus. You can imagine how difficult it became for them to access nutritional resources, home and community-based services, and stay socially connected without being able to leave their homes. During the spring of 2020, Senator Bob Casey (D-PA) held a series of roundtables with 52 of the Area Agencies on Aging in Pennsylvania to hear directly from them about their concerns, as they tried to ensure the health and well-being of the seniors they serve. Senator Casey also spoke with the Pennsylvania Council on Aging, an organization of older adults across Pennsylvania designated to inform the Pennsylvania Department of Aging on issues that impact them. Several different challenges were revealed during these insightful conversations, including the lack of: (1) sufficient COVID testing; (2) Personal Protective Equipment (PPE); (3) sufficient staffing of the long-term care workforce; (4) technology for nursing home residents to stay in touch with their family members; and (4) concerns about Ombudsmen not being able to access seniors in congregate settings. These conversations with the AAA's also revealed the need for flexibility with program funding; flexibility that would allow distribution of funds based on the specific needs of each county. Some expressed concern about older adults' ability to enroll in Medicare because of the closure of some of the Social Security offices, and about delays in receiving care due to the stay at home orders. Many AAA's shared concerns about older adults' increased mental health needs due to increased loneliness, social isolation, and anxiety. And finally, they shared that many more older adults were requesting home-delivered meals than before the pandemic. "We saw a boom in older Americans requiring nutrition assistance." — Samantha Koehler, U.S. Senate Special Committee on Aging COVID has impacted access to nutrition for many older adults in this country. How has the aging services network responded? Prior to COVID, seniors have long relied on a patchwork of federally funded nutrition programs to meet their needs. And yet food security has long persisted, even with this patchwork of programs administered out of the Administration for Community Living and the U.S. Department of Agriculture. Due to the pandemic, even small changes in access to and availability of nutritious meals can put the health and well-being of older adults in jeopardy. Millions of seniors across the country are served each year by senior nutrition programs, particularly the home-delivered meal program. Many of us know this program as Meals on Wheels America. The home-delivered meal program and the congregate meal program are authorized by the Older Americans Act. Many seniors are also served by the Supplemental Nutrition Assistance Program (SNAP) and the Commodity Supplemental Food Program (senior food box program). These are all authorized programs under the Farm Bill and administered by the U.S. Department of Agriculture. In March, when COVID-19 hit, there was a boom in older Americans requiring nutrition assistance. As part of both the Families First Coronavirus Response Act and the CARES Act which were passed in March, Senator Casey championed over a billion dollars in funding for programs authorized under the Older Americans Act, including a significant increase in funding for home-delivered meals and congregate meal programs. The Area Agencies on Aging have used that funding to serve increasing numbers of seniors in need of nutritious foods. But most importantly, that legislation also included flexibility for Area Agencies on Aging to designate individuals who usually attended senior centers for congregate meals as eligible for home-delivered meals. Senator Casey has also been advocating for expansion of the Supplemental Nutrition Assistance Program or SNAP. When the pandemic started, we began hearing from older Pennsylvanians who are SNAP recipients that although they had SNAP benefits, they were not able to use them because they were afraid and unable to leave their homes to go to the grocery store. Many people relied on grocery delivery during the initial phases of the pandemic. Yet, for low-income seniors who utilize SNAP there were limited options to have their groceries delivered. Throughout the pandemic's summer months, there was an expansion of the SNAP online purchasing program that Senator Casey had been pushing for. This allowed some individuals to receive grocery deliveries using their SNAP card. But additional barriers remain. Senator Casey has continued to call on the U.S. Department of Agriculture to increase access to SNAP grocery delivery by including additional retailers and purchasing options. We have come a long way in the past seven months. However, we have a long way to go to make sure that seniors continue to have access to nutrition and that the Area Agencies on Aging and the SNAP program can continue to serve seniors as the pandemic unfortunately continues. Part Two of 'Policy Lessons from COVID with Lieke van Heumen and Samantha Koehler' Social isolation and loneliness are something that is experienced at very high rates in the older population and has worsened because of the pandemic. This has caused a lot of concern for the mental and physical health of older adults, and will probably have a long-term impact. Senator Casey co-sponsored the ACCESS Act with Senator Klobuchar (S. 3517), the purpose of this Act is to facilitate virtual visits for those who live in nursing homes. This fall, Senator Casey also published a report: 'Reimagining Aging in America: Blueprint to Create Health and Economic Security for Older Adults. This report explores how the pandemic has impacted seniors and offers policy solutions to address the inequities of aging in America. Preventing social isolation and loneliness is an important focus in the report. Some policy solutions that need to be enacted to alleviate social isolation and loneliness in seniors include giving Area Agencies on Aging and senior centers the tools and the funding that they need to implement virtual programming and support seniors to participate in small group activities. Another priority is expanding Internet access and increasing access to phones and tablets, which can partly be accomplished through passing the Act. "Millions of seniors across the country are served each year by senior nutrition programs, particularly the home-delivered meal program." — Samantha Koehler, U.S. Senate Special Committee on Aging Moving forward, what are some of the policy solutions that will be required to alleviate the problems older American's are facing? Access to nutritious foods and social isolation are issues during this pandemic, but those are just two of the many issues seniors are facing at this time. There are also issues related to seniors in terms of keeping economic security during this pandemic, issues related to job loss. We continue to hear from seniors in Pennsylvania and from our Aging Network in Pennsylvania that these issues persist. While they are certainly grateful for the funding and the flexibility they have received so far, this is just a step in the right direction, and we cannot go backward. We need to continue supporting the Aging Network because they are in need, and seniors are in need. What can the general public do to help? Or, how can individuals volunteer? At the beginning of the pandemic there were some concerns about having less volunteers available since many are older adults themselves. However the influx of volunteers has been overwhelming, particularly from younger individuals like college-age students who were home and physically unable to be on their college campuses. If you are a local business or individual, and you want to donate or volunteer, just giving a call to your local organization that serves seniors is the best thing that you could be doing. It is good to realize that there are ways of volunteering without leaving your home. Samantha highlights the importance of researchers knowing how to speak policy. She says, "I don't think that policy professionals always know how to speak about research. The more researchers that can translate their research into short, easy to consume pieces of information for policy professionals, the more likely we will consume that research. By having Lieke as a fellow, and the other fellows that we've had on the committee, just spreading the word of how to better communicate with policy with individuals in the policy sphere is so important." About Dr. Lieke van Heumen, PhD Dr. Lieke van Heumen is a Clinical Assistant Professor in the Department of Disability and Human Development at the University of Illinois at Chicago. Her research expertise is aging of adults with lifelong disabilities, specifically intellectual and developmental disabilities. She holds a PhD in Disability Studies from the University of Illinois at Chicago. She received both her undergraduate and master's degrees in psychology with a specialization in gerontology from the Radboud University in the Netherlands. Before moving to Chicago, she worked as a direct support professional and later as a psychologist in several Dutch group homes for older individuals with intellectual disabilities. She is a 2019-2020 American Political Science Association Congressional Fellow and 2019-2020 Health and Aging Policy Fellow. About Samantha Koehler, MSW, MPH Samantha Koehler is a Senior Policy Aide for Ranking Member Bob Casey of the U.S. Senate Special Committee of Aging. Her current work focuses on the intersection of aging and health policy, including the Older Americans Act, rural health, and Medicare access and affordability. Previously, Samantha served as a direct practice social worker. As a Care Manager for older adults, she focused on long-term care planning and access to health care and social services. Samantha has her MSW and MPH from the University of Michigan. About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I truly enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home and office visits) then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my PhD in Nursing and a post-Master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11) and then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 and led to me joining the faculty at George Washington University (GW) School of Nursing in 2018 as a (tenured) Associate Professor where I am also the Director of the GW Center for Aging, Health and Humanities. Find out more about her work at https://melissabphd.com/.