June 2020, Volume XXXIV, Number 3
Serving older adults and caregivers
Metropolitan Area Agency on Aging
Please describe how the Metropolitan Area Agency on Aging (MAAA) was started.
MAAA began in 1973 as a program of the Metropolitan Council in response to the Older Americans Act (OAA). The federal government created the OAA to address the nutritional and social needs of older adults that began to emerge with extended longevity. We became an independent nonprofit in 1994.
Please tell us about the Older Americans Act and how it informs your policies.
The Act was created in 1965 by Congress, the same year as Medicare. The two programs provide funding streams and policies to deliver social services and health care across the nation. Along with Social Security, the OAA and Medicare are our nation’s compact with older citizens for health and security in old age. OAA services and programs are aimed at helping older adults live independently in their homes and communities. This orientation has helped to spur a strong network of provider organizations that make it possible to be safe and cared for at home rather than in an institutional setting—which matches peoples’ desires and is the most cost-effective way to live.
How has your mission changed over time?
Our mission has expanded. We help people optimize health and well-being as they age, focusing on low-income older adults and those who face social inequities. Our work complements clinical health care, addressing the 80-plus percent of health that happens outside the clinic. We provide home-delivered meals, transportation, care management, chore services, evidence-based health promotion programs, and caregiver support through a network of service providers. We also provide consultations on Medicare, housing, and financial support and act as consultants to other organizations, helping them seek funds and design services.
We connect patients with services and programs that will help them maintain and follow treatment protocols.
How has the Minnesota Elder Care and Vulnerable Adult Protection Act impacted your work?
We report suspected abuse and neglect as directed under the provisions of this Act when we learn of it through our interactions with older adults and others. This reporting occurs primarily in our service as the state of Minnesota’s partner in providing Senior LinkAge Line services. Our staff—most of whom are social workers and human services professionals—are ultimately concerned with the health and safety of the older adults we serve.
What can you tell us about how MAAA works with state agencies serving older Minnesotans?
The Minnesota Board on Aging gives our nonprofit organization the designation of “Area Agency on Aging.” We partner with them to administer OAA and state funding. They guide MAAA’s Area Agency on Aging work and hold us accountable for the public funds we manage. We also work with the Minnesota Department of Health (MDH) to bring evidence-based healthy aging programs to people across Minnesota.
Please tell us about the Live Well at Home program.
Live Well at Home is a funding program of the Minnesota Department of Human Services (DHS) to encourage expansion of services to support older adults living in the community and their family caregivers. We help organizations in the Twin Cities prepare their proposals to align with the objectives of DHS.
What does the Juniper program do and how can physicians become involved?
Juniper offers classes across the state to help older adults take an active role in maintaining good health—something we all desire. We collaborate with the other six AAAs in Minnesota, 130-plus health care and community organizations, and health plans to deliver classes that help people manage chronic conditions, get fit, and prevent falls. People who take the classes report eating healthier, increasing physical activity, working more effectively with their health care professionals, and feeling better. They also form ties to other older adults and learn about community services that can boost their well-being. The classes are beneficial for people with diabetes, high blood pressure, heart disease, COPD, arthritis, depression, fall risk, and other health conditions.
In response to the COVID-19 pandemic, we now offer Juniper classes using HIPAA-secure video conferencing. People are changing their routines, are at increased risk for isolation, and many are skipping their regular medical appointments for fear of contracting the coronavirus. Chronic conditions can easily get out of control in this situation. Participants have found that online classes work well. In some cases, attendance has been higher and more consistent than with our in-person classes. People love that classes such as a Tai Ji Quan: Moving for Better Balance or Living Well with Diabetes are now available online for everyone, anywhere in the state. One participant in the Living Well with Chronic Pain class told the instructor how grateful he was that he could attend virtually.
We know that people are more likely to participate in a Juniper class if their physician recommends it. Physicians can help by referring patients to classes through our portal at yourjuniper.org or by giving their patients our web address (https://metroaging.org) or toll-free phone number (855-215-2174). Most classes are free or low cost, and some health plans also cover the cost. A second way to get involved is to consider becoming an advisor to Juniper. We welcome input from physicians.
Physicians serving older patients may not be aware of how your work can help their patients stay healthy. Please share some ways of improving this communication.
We’d love to have physicians think about us as their partner in keeping people healthy. Through our networks, we connect patients with services and programs that will help them maintain and follow treatment protocols. We are happy to provide information tailored for physicians, including webinars, short in-person presentations, and written materials, both for provider and patient use.
What are some of the biggest challenges to your work related to COVID-19?
As an administrator of federal funds, including over $6 million in the Families First Coronavirus Response Act and CARES Act funds, we need to stay tuned to the most pressing needs of older adults and their family caregivers and be highly responsive. It’s our job to maximize the investment of these resources for the greatest impact. We are seeing increased need for home-delivered meals, caregiver support, and alleviating isolation. We project that we will double the OAA dollars we provide to community partners this year for home-delivered meals compared to last year, and we do not expect the demand to diminish any time soon. When Adult Day Centers were ordered closed by the Governor in late March, we saw a spike in demand for caregiver services as family caregivers were called upon to provide full-time care. Our partners have stepped up to meet the changing needs, often by designing and delivering new services such as telephone reassurance or by expanding existing services. We have seen powerful new partnerships form, such as one between Metro Meals on Wheels and Afro Deli. Together they provided over 12,000 halal home-delivered meals during April, an option that was previously not available.
What final thoughts you would like to share with our readers?
Research published by Health Affairs in April 2020 attests that when health care providers partner with AAAs, older adults have improved health outcomes and reduced per-capita health care spending. MAAA has the interest and capacity to engage in partnerships with physicians to address the health-related social needs of older adults. We’ve learned your language, meet requirements for data security as a HIPAA-covered entity, and can bring resources to the table that respect both data and what’s important to older adults. Connect with us to innovate together to improve the health of your patients and our communities.
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