The value of a gerontology certificate: a survey of Frank J Manning alumni, 1980-2001.

The Frank J. Manning Certificate Program in Gerontology at the University of Massachusetts Boston was established in 1979 as part of an Administration on Aging (AoA) grant to develop and expand services to the elderly citizens of the Commonwealth of Massachusetts. The program was designed to implement concepts associated with productive aging theory and traditionally has targeted learners age 60 and older. Alumni representing classes from 1980 to 2001 were surveyed by phone to learn if the original program objectives still have relevance today and to document how alumni have utilized knowledge and skills attained in the program. Almost 80% (364) of surviving alumni completed interviews. Specifically, alumni were asked about their volunteer experiences, employment, and advocacy efforts within the aging network of programs and services, as well as the impact of their training on their own aging. About 3/4 of the alumni had volunteered with elders since completing the program, while 1/4 worked in the aging network. Additional outcomes support the notion of life-long learning with many alumni continuing their education beyond the certificate program. In addition, many alumni reported utilizing knowledge and skills in caregiving for family members and friends. This study will help document the value of certificate-level training in Gerontology for its students and for the communities they serve.

Home health and home care in Massachusetts after the Balanced Budget Act of 1997: implications of cost containment pressures for service authorizations.

This paper explores the response of the Massachusetts state-funded home care program for the elderly when its clients encountered barriers to the receipt of home health services because of HMO enrollment and the implementation of the Balanced Budget Act of 1997. Clients of three regional case management agencies serving the Massachusetts state home care program whose home care services were interrupted because of hospitalization between January 1 and April 30, 1999 and whose services were resumed after they returned home were studied. Detailed data are reported that show how the long-term personal assistance services provided through the state program were often complemented by temporary home health services after elders returned home. The multivariate analysis revealed that the authorization of state-funded personal care services was keyed to the status of home health aide services. After hospitalization, the presence of a home health aide reduced the likelihood of authorization of personal care. At final assessment, the situation was reversed, that is, the withdrawal of a home health aide increased the likelihood of authorization of personal care. The findings suggest that more restrictive Medicare reimbursement policies for home health services led to greater state expenditures for personal care services. In other words, less generous Medicare financing shifted a greater portion of the burden of financing home care to the state of Massachusetts. These findings raise important policy questions about the balance of responsibility between the federal government and states to provide financing of home care services for the elderly.