Boston Partnership for
Older Adults

For information:
Emily Shea
617-348-6340
shea@bostonabcd.org

Chapter 1: How did this Partnership get started? How are they structured?  What have they been doing?

I. WHY did the Partnership happen here?

• Significant growth in the population of the “oldest old” taxed medical and social services in Boston, while budget cuts slashed available supports. 14% of the total city population is over 60, and 11% of that population is over 85 years of age.
• Poverty among older adults was growing faster than in any other age group, with nearly 20% of older adults living in poverty and over 60% of the older adult population living on less than $30,000 a year in this city with the highest cost of living in the country.
• The Boston Commission on Affairs of the Elderly convened the original Partnership, calling together six existing coalitions focused on neighborhoods, multi-cultural communities, faith-based groups, public health, Lesbian Gay Bi-sexual Transgender issues, and information/access issues. Providers, foundations, city departments and universities became part of the Partnership over time.
• Eventually, the Partnership moved from its home in the city commission to a new host at a local non-profit agency, which allowed the Partnership to seek grants for which it was not eligible when housed in a municipal organization. This also preserved the “neutral table” where partners could discuss issues and potential solutions freely with less concern about alienating a municipal funding source.
• In this city of significant “turf issues” between diverse populations, government agencies, politicians, providers and funders, the Partnership wanted to respond to gaps in care (especially for underserved populations) and to include these populations in planning and decision making. They envisioned a “coalition of coalitions” between many disparate groups.

II. GETTING STARTED: What Partnership Findings, Goals and Structure emerged?

The Partnership reviewed 50+ information sources, ranging from telephone surveys, focus groups, visioning meetings, reports and a “door-to–door” needs assessment to create its “study of studies” and initial strategic plan.

Findings from the data collection process: a) Despite a variety of information sources about older adults, it was difficult to get a comprehensive picture of the issues facing Boston’s older adults across the city; and even more difficult to muster a coordinated response. b) The large population of elders “at risk” due to low income, frailty, advanced age, or membership in a marginalized group experienced many challenges: difficulty accessing health care, exposure to abuse and exploitation, shortages of providers attuned to geriatric issues, and urban isolation.

Initial Goals of the Partnership:

1. To identify, quantify and understand the needs of Boston’s vulnerable elders by creating a single database of currently available demographic data of Boston’s elders…..mapping service systems, analyzing gaps and barriers
2. To build a “coalition of coalitions” model to promote investment in the Partnership and readiness to support change.
3. To create a shared vision of what it means to be an elder-friendly city for the most vulnerable elders and to establish a manageable group of issue areas for focus.
4. To broaden the definition of stakeholder to include the public through a public education campaign…that motivates citizen action and support for change.

During the implementation phase, the Partnership structure evolved into a 35 member board (functioning as core leadership) with 12 workgroups focused on core goals and priorities. Recognition that it was difficult to focus on 12 issues at once caused several workgroups to be tabled due to lack of significant progress and resources (these workgroups were focused on Centralized Access to Information, Marketing & Public Education, Workforce Development and Housing & Homelessness).

III. WHAT - Implementing initiatives to address issues. What did they do?

This Partnership identified 12 priorities in the two broad categories of “Supporting the System/Building Capacity”; and “Impacting Change in Key Areas”.

Priority 1: Centralized Data: The Partnership created seven groundbreaking reports such as “100,000 Voices on Growing Older in Boston: Understanding the Experiences and Needs of Boston’s Older Adults.” The distribution of over 2,000 copies of this report resulted in significant media coverage locally and nationally, through newspapers, the Associated Press, radio and TV. Follow-up reports (“What Does it Take to Keep an Elder at Home?” “Boston’s Vision for Aging with Dignity,” “Views of Aging in Boston: Mapping Demographics and Supportive Services,” “There’s No Place Like Home: Part 1 and Part 2,” and a report on the “Mental and Cognitive Health of Older Adults”) helped make the public more aware of the issues of older adults and moved partners towards a “big picture” perspective.

Priority 2: Health Care: To address the shortage of physicians with a geriatric specialty, one workgroup created a function-focused Geriatric Assessment tool that any physician could use to assess the health and well being of older adults. Insurance coding on the form facilitated medical costs re-imbursement, which was an incentive to promote adoption of the assessment tool. A companion patient survey in multiple languages helps older adults raise additional health concerns. After testing in a small pilot, the tools are now available on the web at www.bostonolderadults.org.

Priority 3: Developing Business Partnerships: This Partnership developed an elder-friendly business district in the Mission Hill neighborhood of Boston (a first for Boston and the nation). They presented this expansion of the elder friendly individual business concept at the national “Main Streets” conference of the National Historic Preservation Trust in the summer of 2006. Many infrastructure improvements in the whole business district of the neighborhood resulted in repaired sidewalks, better timed cross walks, improved sidewalk lighting, and better snow removal. Local businesses received training about recognizing at-risk older customers and making their stores “elder accessible;” they now also distribute the city’s information & resource phone number.

Priority 4: Accessible Transportation: The Partnership created the intergenerational “Got Respect” training program to promote the safety of and respect for older adults who use public transit. A workgroup created the curriculum and video by partnering with the police department school unit, older adults and teens. Staff changes at the Police Department impeded adoption, but one police woman is pushing for a pilot in the neighborhood she serves.

Priority 5: Mental and Cognitive Health: The Mental Health and Aging report shaped a State ”request-for–proposals” to improve mental health services for older adults. The Massachusetts Association of Older Adults, the Boston University Institute for Geriatric Social Work, and the Partnership collaborated on training about geriatric mental health issues..

Priority 6: Social Services and Cultural Competence: The published report on “Focus Groups of Culturally Diverse Elders” helped identify the expectations held by eight diverse populations of elders about direct care workers and discussed how to remove barriers to service use. Training was also offered about the special needs of elders who are Lesbian, Gay, Bisexual, or Transgender.

Priority 7: Social Services and Elder Abuse: To address a growing elder abuse problem, the Partnership held a “Mandated Reporter” conference (which sold out), re-convened an Elder Protection roundtable, and established training at the Police Academy, all resulting in an 800% increase in reports of elder abuse cases from all sources.

Priority 8: Enhanced and Targeted Advocacy: The Partnership gave testimony to the new Governor, Deval Patrick, on its “10 Point Plan for Aging with Dignity”; and testified before the legislature on the “Elder Choice” bill to leverage more funding to community based services. They also created an Advocacy Protocol for decision making about issues, positions, spokespeople and advocacy that was utilized by other Partnerships.

Priority 9: Coordinated and Targeted Funding: A conference on “Philanthropy and Aging: Funding the Future” was convened for 25 foundation representatives; with sessions focused on coordinating and targeting funding to aging population needs. Data from a follow-up CEO survey were inconclusive due to a low response rate.