Академический Документы
Профессиональный Документы
Культура Документы
Aging in America
Climbing the Ladder Toward Recovery: The North Carolina Mobile Medication Program Winner
o O u r S ponsors!
Thank You T
Premier Sponsorships
Distinguished Sponsorships
Individual Sponsorships
Winner 8
R3: Right Care,
Right Place, Right Time:
Effectively Integrating
Senior Care and Housing
Kim Brooks
Chief Operating Officer, Senior Living
Hebrew SeniorLife
Competition Judges
Advisory Committee
Special Recognition
Officers
Stephen Fantone C. Bruce Johnstone Jim Stergios
Chairman Vice-Chair Executive Director
Lucile Hicks James Joslin Mary Z. Connaughton
Vice-Chair Treasurer Clerk & Assistant Treasurer
Members
Nancy Anthony Alfred Houston Amir Nashat
David Boit Keith Hylton Diane Schmalensee
Frederic Clifford Gary Kearney Kristin Servison
Andrew Davis John Kingston Chairman Emeritus
Ellen Roy Herzfelder Nicole Manseau William B. Tyler
Charles C. Hewitt, III Preston McSwain
Foreword
G
ood policy goes slow on ideology mographics, our burgeoning aging population
and accelerates big impact. If that presents challengesbut also ample economic
Competition is a case study in how to use In defining the playing field for 2017, Pioneer
the wisdom of crowds to advance good posed two questions:
policy. Now in its 27th year, the trajecto- How do we establish the care and support sys-
ry of the Competition has provided highly tems that our older populations need?
practical solutions to real-life challeng- How do we unlock the enormous social capital
es. Often the problems we were trying to of our healthier aging population?
solve were deeply human; certainly that Given those parameters, the specific goals
is the case of previous years when we fo- of this years Competition are clear: We want
cused on issues like social services for aging to be a meaningful and productive time of
the indigent, effective care for those with lifeand that includes engaging older Amer-
icans in the workplace. We want to highlight
mental health issues, or ways to lower re-
new, successful ideas in housing, transporta-
cidivism rates or reintegrate people with
tion, custodial care and assistance options that
criminal backgrounds. make an independent and fulfilling life for
aging Americans possible. We want to enhance
training for medical and geriatric professionals
In 2017, Pioneer set a fundamentally different and identify policies to better coordinate care
task for the Competition. Our focus this year for older Americans. We want to leverage new
is to improve the quality of life for the aging. technologies to improve the lives of seniors.
Whereas the themes of the Competition in And, if you have thoughts on how to ensure the
previous years affected limited populations, future viability of retirement systems, we want
there is no other with aging. There is no pol- those ideas, too!
icy solution to or escape from this universal
In defining our objectives, Pioneer sought the
and inevitable part of the human experience.
counsel of an outstanding line-up of local,
The aging problem is truly a new phenome- state and national experts. They include: John
non; and it is, in fact, the positive outcome of N. Morris, Director of Social and Health Policy
a society that is working. We have more people Research and Alfred A. & Gilda Slifka Chair in
who are living longer because we, like many Social Gerontological Research at the Institute
other developed societies worldwide, have for Aging Research; Elissa Sherman, Presi-
achieved new levels of prosperity. With pros- dent of LeadingAge Massachusetts; Kevin Ca-
perity comes greater attention to health and hill, Research Economist at Boston Colleges
to the demand for improved medical processes Sloan Center on Aging & Work; Mark Mather,
and techniques to extend lifeand to main- Associate Vice President of U.S.Programs at
tain a high quality of life. From 1930 to 2010, the Population Reference Bureau; and Bron-
life expectancy in the United States rose from wyn Keefe, Research Assistant Professor at the
60 to 79 years. Most often, the additional years Boston University School of Social Work. These
have come hand in hand with the ability to are a few of the experts and policymakers who
lead a more fulfilling lifestyle. Given the Com- helped Pioneer refine and disseminate the
monwealths and the countrys changing de- 2017 Competitions problem statement.
The Institutes gratitude goes to the dozens Our 2017 first-place winner is an initiative with
of state legislators, executive branch officials, demonstrated success in supportive housing
and media outlets whose advice and outreach for older adults. The Right Care, Right Place,
expanded the number and quality of entries Right Time: Effectively Integrating Senior Care
received. and Housing initiative from Hebrew Senior-
Life makes use of wellness teams designed for
We also thank the highly respected panel of
specific housing sites, marrying housing with
external judges who evaluated the 2017 BGC
health care in a way that reduces the transfer
submissions: Charles Baker, Sr., Professor
of seniors from homes to hospitals and emer-
Emeritus at Northeastern Universitys College
gency rooms. As existing programs in Brook-
of Business Administration; Nick Dougherty,
line and Vermont have illustrated, this model
Program Director at PULSE@MassChallenge;
for senior housing generates significant sav-
Gary P. Kearney, M.D., F.A.C.S., Pioneer In-
ings in reduced medical costs while ensuring
stitute Board Director; Robin Lipson, Chief of
seniors are able to live independently.
Staff and Chief Strategy Officer at the Execu-
tive Office of Elder Affairs, Commonwealth of This work is the product of an exceptional team.
Massachusetts; James F. Seagle, Jr., President My sincere thanks go to Shawni Littlehale, who
at Rogerson Communities; and Joanna Weiss, leads this Pioneer program and has built the
freelance journalist and former Boston Globe Competition into a national reference point for
columnist. innovative public policy. Id also like to thank
Matthew Blackbourn, who has demonstrated
The 2017 Competition recognized proposals in
keen research, management, and social media
a number of areas, including ways to augment
skills, and has helped grow the Competitions
state efforts to improve the early detection of
reach and quality. Shawni and Matt were ably
Alzheimers disease, and two local instances of
assisted by talented staff members (Mary Con-
public agencies employing innovative models
naughton and Greg Sullivan), fellows (Michael
to give elders cheaper and more reliable trans-
Weiner and Alexander Carlin), and interns, in-
portation and keep them engaged in the work-
cluding Benjamin Margolin and Mariella Ruti-
force.
gliano. All have my gratitude.
We received a number of standout submissions
My final thank you is the most important, and
focusing on housing solutions for older adults.
it is to you. Without your support, this conver-
One awardee calls for a unique collaboration
sation about aging policy would be stuck in its
among existing senior service groups to create
various silos, and there would be little hope of
a replicable housing model specifically for se-
developing a forward-looking set of solutions.
niors with lifelong developmental disabilities.
The Institute and the Commonwealth of Mas-
Another winning idea came from graduate stu-
sachusetts are greatly in your debt.
dents that have created a digital platform to
connect millions of renters to older adults with Sincerely,
spare bedrooms, in an effort to address both
affordable housing concerns and the social iso-
lation and declining income among adults 55
and older. Other awardees focused on ensuring
internal quality in assisted living communities James Stergios, Executive Director
and programming to protect poor seniors from
homelessness and establish a stable channel to
permanent housing.
Problem Statement
T
he needs of seniors in supportive hous- term services available through the Com-
ing span a range of physical, behavior- monwealth. There is significant potential for
al, and social issues. Many seniors are improved outcomes and savings if care from
designated as frail or at risk based on housing staff, payers, and community based
U.S. Department of Housing and Urban Devel- providers is better coordinated.
opment (HUD) definitions, and their physical
health issues decrease mobility, impede gross
and fine motor skills, and affect vision, mak- Proposed Solution
ing it difficult for seniors to shop, clean, bathe, Hebrew SeniorLife (HSL) has provided health
and cook, activities needed to maintain their care and housing for seniors, research into
independence. These seniors are at increased aging, and education for future geriatric pro-
risk of falling, a primary cause of emergency viders since 1903. HSL provides direct care for
transports to hospitals, and because of the 3,000 seniors every day.
social isolation often associated with their
HSLs Right Care, Right Place, Right Time: Effec-
decreased mobility, they are also at increased
tively Integrating Senior Care and Housing (R3)
risk of depression.
initiative provides coordinated, person-cen-
In addition, isolation can tered services to vulnera-
cause seniors to fall behind ble seniors with the aim of
on routine health care ap- Many seniors living in enabling them to live inde-
pointments, which then lead supportive housing meet pendently in the commu-
to the need for acute care the income guidelines for nity for as long as possible,
services. Lack of medication receiving the right care in
housing, but do not meet
adherence, in particular, is a the right place at the right
the income guidelines for
significant factor in seniors time. The long-term vision
no longer being able to live
MassHealth coverage. is to create a replicable,
independently. The lack of coordination scalable, and sustainable
between housing and model of housing with sup-
Further complicating the sit-
uation is that many seniors in
healthcare is a missed portive services.
Specifically, the wellness teams activities in- unnecessary calls and transports, and facil-
clude: itate communication/information flow.
Using technology (such as reverse 911) to The primary aim of R3 is to reduce the inci-
conduct wellness checks and assist with dence of unnecessary transfers of seniors from
medication adherence. their homes to hospitals, emergency rooms,
Coordinating with primary care providers, and long-term care facilities, as well as to re-
mental health providers and hospitals. duce associated costs. Our focus throughout
will be on improving seniors quality of life and
Partnering with emergency responders to ability to live independently.
analyze call data to identify trends, reduce
tential savings in the form of slower growth in comes measures, communication strategies
costs of approximately $1,053,600 annually. and tools, resident assessments, satisfaction
surveys, and other related resources from the
If we calculate potential savings based on
R3 experience will be made available to other
our projected reductions in avoidable trans-
senior housing sites and interested stakehold-
fers, the potential medical expense savings
ers to develop an optimal approach in inno-
are consistent with the SASH savings. Using
vative healthcare delivery in affordable senior
baseline emergency response information
housing, replicable not only in Massachusetts,
for one of HSLs locations with 560 residents
butwith more than two million low-income
over a one year period, estimated medical
older adults currently living in affordable se-
expense savings would
nior housing across the country 4nationwide,
be $600,000 annually.
...related resources as well.
Additionally, avoiding
from the R3 expe-
just three placements to If successful, we expect the program will serve
rience will be made long-term care, assum- as a model for enhanced linkages between
available to other ing an average length of health care and housing across the U.S.
senior housing sites stay of two years and a
and interested stake- daily rate of $225 for the
long-term care facility, Endnotes
holders to develop
1. U.S. Department of Health and Human Services, Of-
would equate to savings
an optimal approach fice of Disability, Aging and Long-term Care Policy.
to the Commonwealth Support and Services at Home Evaluation: First Annual Re-
in innovative
of $490,000 annually. port, (https://aspe.hhs.gov/report/support-and-ser-
healthcare delivery vices-home-sash-evaluation-first-annual-report,
and counseling can be started early in the Under our proposed AD screening program,
course of AD to slow its progression and enable the state would have to spend approximately
caregivers to cope better with the burdens of $2,530 for each AD diagnosis. Drug treatment
the disease would delay later entry into expen- alone would likely delay nursing home insti-
sive nursing homes. We propose states create tutionalization by more than a year. In Wis-
incentives for early detection by reimbursing consin, the state Medicaid program pays on
primary care physicians and county health de- average 31 percent of the more than $46,000
partments for the costs of administering the annual reimbursement to nursing homes, or
animal naming and Cognistat tests. about $14,000. Even if this amount were re-
We estimate the costs of administering these alized years after diagnosis, its present value
tests to be $2.30 and $17.20, respectively. To would still be significantly higher than the cost
reimbursement rates at 150% of actual cost, or We analyzed the present value of net social
$3.50 and $26, respectively. and fiscal benefits from early detection and
treatment of AD.6 We took into account sev-
eral uncertainties: the mortality risks of the
Projected Outcomes AD patient and his or her spouse; the risk of
In the short-run, the AD screening program institutionalization at various stages of dis-
would add to state health-care costs. Based on ease progression; the effect of drug treatment
the experience of the Wisconsin Alzheimers on the rate of disease progression; the effect
Institutes use of the animal naming test and of caregiver intervention on the risk of insti-
Cognistat, followed by diagnosis, and taking tutionalization; the probability that patients
would be diagnosed and treated at a later stage spent $1.85 billion on long term care while
of the disease when symptoms become more Massachusetts spent $4.63 billion, reflecting
apparent; and the relevant shadow prices a larger population and higher nursing home
needed to monetize all effects. costs.
ing drug treatment with caregiver intervention 5. Louise Robinson, Alan Gemski, Clare Abley, John
would increase net social benefits to $93,000, Bond, John Keady, Sarah Campbell, Kritika Samsi,
and Jill Manthorpe, "The Transition to Dementia
state savings to $15,000, and federal savings to
Individual and Family Experiences of Receiving a Di-
$29,000. Drug treatment alone provides fiscal agnosis: A Review." International Psychogeriatrics 23:7
benefits to Wisconsin in excess of the expect- (2011), 10261043.
ed costs per diagnosed case of $2,530. It should 6. David L. Weimer and Mark A. Sager, Early Identi-
also be noted that, because screening offers fication and Treatment of Alzheimers Disease: So-
cial and Fiscal Outcomes, Alzheimers & Dementia 5:3
potential savings to the federal government,
(2009), 215226.
one would expect states to be able to get Med-
icaid waivers to help pay for the program.
Contact The Authors
16 Better
Better Government
Government Competition
Competition 2017
2017
Jewish Community Housing For The Elderly And Jewish Family & Childrens Service Runner Up
Address
132 Chestnut Hill
Avenue
Neighborhood
Brighton
Land Sq. Feet
13,847 sq ft
Building Size
56,172 sq ft
Residential Units
Compounding the challenges experienced by have 3,000 square 61
older adults with ID/DD is the fact that there feet of ground floor
has been little collaboration between providers commercial space
serving older adults and those serving indi- for tenants and
viduals with ID/DD. If older adults with ID/DD neighbors, and a connecter bridge that will
are to have access to housing and services that provide seamless indoor passage between the
support positive aging in community, provid- new building and JCHEs existing 700-unit
ers serving each of these populations will need Brighton Campus. All residents will benefit
to combine their resources and expertise to de- from full access to JCHEs on-site services,
velop creative solutions. amenities, and programs, including a fitness
center, computer center, art studio, library,
performances, classes, and clubs.
Proposed Solution
From JF&CS, the residents with ID/DD will re-
Jewish Family & Childrens Service (JF&CS) and
ceive intensive individual 24/7 live-in support,
Jewish Community Housing for the Elderly (JCHE)
plus case management and personal care from
are embarking on a collaboration designed to
JF&CSs highly trained team.
better serve individuals with disabilities who
are aging. Working together, they are creat-
ing a replicable housing model that will enable Positive or Projected
individuals with lifelong developmental dis-
Outcomes
abilities to age in communities where they are
respected, supported, and positively engaged. By allowing residents with ID/DD to engage in
their community, we expect this model to pre-
The home of this collaborative project will be at vent or decrease social isolation. Plus, aging
JCHEs all-new, all-affordable 57,400 square caregivers will hopefully experience signifi-
foot supportive senior housing building at 132 cant relief knowing that their loved ones are
Chestnut Hill Avenue in Brighton (scheduled housed, cared for, and socially and intellectu-
to open fall 2018). The 61-unit, fully-accessi- ally engaged.
ble building will showcase a five-unit suite (5
bedrooms with private bathrooms and com- A broad body of research shows that support-
mon living and kitchen area, plus space for ive housing effectively helps people with dis-
overnight staff) designed specifically for older abilities maintain stable housing. People liv-
adults with ID/DD. The new structure will also ing in supportive housing less frequently use
costly systems like emergency health services. identify future implementation opportunities
Supportive housing can also aid people with at other JCHE buildings; 2) promote adoption
disabilities in receiving better health care of the collaborative model by creating and dis-
especially preventative care which ultimately seminating a best practices handbook; and 3)
reduces Medicare/Medicaid expenditures. provide technical assistance to other organiza-
tions looking to replicate our model. Ultimate-
ly, it is the shared goal of JCHE and JF&CS to
Future Goals develop permanent, inclusive, and supportive
JCHE and JF&CS anticipate that this pioneering housing where individuals aging with disabil-
model to house older adults with ID/DD with- ities can do so successfully and live out the re-
in a supportive senior housing framework will mainder of their lives.
be replicated in Massachusetts and beyond by
those who are interested in better meeting the
needs of this growing population. By integrat-
Contact The Authors
ing aging individuals with ID/DD into a senior
housing facility that includes robust support
services designed to meet the needs of older
adults, while also providing targeted supports
that will allow them to thrive in this setting,
JF&CS and JCHE hope to serve as a model for
similar projects. The model could be adapted
Amy Rimma
for housing facilities that are being developed Schectman Zelfand
in the future, or with slight modifications to
existing facilities. 30 Wallingford Road
Brighton, MA 02135-4753
JCHE and JF&CSs goals for the future are to: 1) p: 617-912-8400
Mobilizing
Five Keys Charter
the Talent
School
of
to Reduce
Older Adults
Recidivism
to Support Critical
Government
Authors Name Services
Company Name
Doug Dickson
Board Chair
Encore Boston Network
engaging older adults who have the neces- munities in which they serve. At least 75
sary skills and experience, and developing percent of older volunteers will recommit
ways to connect them to DCF staff. to work beyond the initial year because
2. Insuring a quality work experience by de- their needs are being met and they under-
signing opportunities that can be done by stand the critical nature of their contribu-
teams of volunteers; by recognizing vol- tion to DCFs mission.
unteer contributions in ways that include a 4. Creation of a guide, to be shared with other
social component; and by designing activ- DCF offices and government agencies, of
ities that extend relationships beyond the best practices based on lessons gleaned
workplace. from the pilot.
3. Testing transportation options for volun-
teers that include stipends to cover costs, Future Goals
carpools, or directly provided group trans-
1. Based on the success Encore Boston Net-
portation. Virtual opportunities that elimi-
work achieves in filling volunteer positions
nate the need for transportation altogether
in 4 Boston offices, they will look to expand
will also be explored.
the program to the other 25 DCF offices in
the state.
Projected Outcomes 2. Leverage the DCF prototype to encourage
The lessons learned in the DCF pilot will be other government agencies and municipal-
migrated to other agencies at the state and ities to adopt similar approaches.
municipal levels. In that sense, Encore Boston
Networks primary measure of success will be
Endnotes
whether every older adult who wants to remain
Colin Deppe, et al., Age, affective experience, and tele-
actively engaged will have an opportunity to do vision use, American Journal of Preventive Medicine,
so. More specifically, Encore Boston Networks 2010
22 Better
Better Government
Government Competition
Competition 2017
2017
Return to Community Initiative Runner Up
RTCI helps
private pay
MDS (Minimum Data Set) admission assess- Once assistance has nursing home
ment. Certain criteria are pulled from the MDS been agreed to, an
residents
to determine if the resident meets the target interview is con-
return to the
profile. Residents appear on the list if they: ducted with the res-
community
Have resided in a nursing facility for at least ident and primary
early in
45 days, caregiver to deter-
mine the residents their stays.
Have a goal of returning to a community needs, both physi-
setting, and
cally and mentally.
Have a 70% or higher probability rate of The CLS may rec-
being successful in the community, based ommend the resi-
on their health and functional characteris- dent apply for state assistance through Med-
tics as recorded upon admission. icaid or a home and community-based services
Community Living Specialists conduct visits (HCBS) waiver. Veterans are referred to the
to residents on the target list to provide un- County Veteran Service Officer to determine
biased information regarding the residents benefit eligibility. If the resident faces barriers
options for residing in the community and to to discharge, referral to the Ombudsman for
make them aware that they have the right to Long-term Care may be necessary.
live in the least restrictive environment. The Community Living Support Plans, which sug-
CLS explains the free service that is available gest the services that will be provided when
for being discharged back to the community. If residents leave a facility, are developed based
the resident agrees to the assistance, release of on the physical, social and emotional needs of
information is obtained that gives the CLS ac- the individual. Because not all individuals will
cess to the medical chart, ability to speak with be able to live in a home setting, options such
nursing facility staff and other health care pro- as adult foster care, group homes and assisted
viders, and to collect private information for living are explored.
data analysis and evaluation.
Ensure prescribed medications are filled, Minnesota has consulted with other states. As
Conduct medication reconciliation, other states think about replicating the model,
Ensure an appointment with a primary care they will need to consider: 1) strategic engage-
ment with the provider community to ensure
physician is scheduled, and
it will buy into the model; 2) a single point of
Make additional caregiver and consumer
entry for initial referrals combined with local-
referrals, if needed.
ly accessible staff that can meet with residents
Ongoing follow-up occurs 30, 60 and 90 days in almost real time. Having referrals come into
after discharge, with further follow-up offered a single web portal or toll free line allows for
for five years. quality monitoring to ensure intake is correct
and appropriately handled.
Outcomes
Since its inception in 2010, the RTCI has as- Endnotes
1. Keehan, S. P., Poisal, J. A., Cuckler, G. A., Sisko, A. M.,
sisted in the transition of 4,500 residents, 95%
Smith, S. D., Madison, A. J., . . . Lizonitz, J. M. (2016).
of whom received formally provided services National Health Expenditure Projections, 2015-
upon discharge from a facility. 85% received 25: Economy, Prices, And Aging Expected To Shape
care from a nurse or home health aide. Small- Spending And Enrollment. Health Aff (Millwood),
35(8), 1522-1531. doi:10.1377/hlthaff.2016.0459
er percentages had alarms or other technol-
ogy (55%), in-home or home delivered meals 2. Arling, G., Kane, R. L., Cooke, V., & Lewis, T. (2010).
Targeting residents for transitions from nursing
(34%), other in-home services (33%), or trans- home to community. Health Serv Res, 45(3), 691-711.
portation (21%). doi:10.1111/j.1475-6773.2010.01105.x
the MBTA pays up to the next $13, with cus- least equal or better service for no additional
tomers responsible for any additional costs. cost. Pilot enrollment was initially limited to
Customers can book directly via smartphone the first 400 individuals to enroll so as to en-
or via Lyfts call-in service. sure that the solution could be
Uber and Lyft provide access to tested at a smaller scale until it
wheelchair accessible vehicles Customers save began to generate savings and
(WAVs). money as well: a improvements both for custom-
part of the pilot is paid out of the traditional RIDE tial success, the pilot has since
been opened to all customers
the budget for the traditional costs customers
of The RIDE, with over 1,000
RIDE vendors. Since costs are $5.25, but pilot costs
enrolled to date. Collective-
only billed on consumption and average only $4.52 ly, these customers have taken
the partnership can be stopped
a trip. more than 20,000 trips.
at any time, the potential finan-
cial downside is limited. Costs per trip have averaged $9
vs. the traditional RIDE per-trip cost of $59.
Customers save money as well: a same-day
Outcomes trip on the traditional RIDE costs customers
Prior to launch, the MBTA decided that, at a $5.25, but pilot costs average only $4.52 a trip.
minimum, the pilot would have to provide at
Customers have expressed satisfaction. The
pilots Net Promoter Score (a measure of cus-
tomer satisfaction) is 79%. For comparison, the
transit industry average is 12% and the MBTAs
fixed route average over the last 12 months was
11%. Customer satisfaction was linked to the
following improvements:
appointment ran long, the pilot has been a because it is so time consuming and exhaust-
savior. ing due to my medical issues. For all intents
Lower wait and travel times. Customers and purposes, I have pretty much been house-
bound due to the constraints of The RIDE. The
save 34 minutes on average on their trips.
To date, more than 11,000 hours have been great thing about the [pilot] program is if I feel
saved by pilot customers. well enough to go out to a store on the spur of
the moment, I can go within minutes. I do not
Increased Trips. Because of the per-trip
have to plan ahead.
savings the pilot has achieved, the MBTA
can allow customers to take more trips and
still save money. Pilot user trips are up by Future Goals
over 25% compared to their baseline histo-
The MBTA has set an ambitious goal of deliv-
ry, but the MBTA still saves money.
ering 10% of the RIDEs estimated 1.9 million
Accessible Options. Both Uber and Lyft FY18 trips via Uber or Lyft. In addition, it will
provide options for those who may lack work to maintain accessibility for riders by
familiarity with technology or access to integrating Uber/Lyft bookings into the MB-
smartphones. For seniors and others who TAs call center, avoiding the need for smart-
do not have bank accounts, both companies phones, and increasing WAV supply as demand
allow payment via prepaid debit card and increases.
other non-credit solutions. For custom-
ers with mobility devices and wheelchairs,
Contact The Author
both companies have accessible vehicle op-
tions.
I cannot begin to describe, one customer Ben Schutzman
10 Park Plaza
says, how thrilled I am with this service. It
3rd Floor
has given me back something I lost a couple Boston, MA 02116
of years ago and thought I would never have
again a sense of independence. I have been
using The RIDE for a couple of years but have e: ben.schutzman@gmail.com
p: 617-222-3200
only been going out for medical appointments
28 Better
Better Government
Government Competition
Competition 2017
2017
Boston Medical Center Elders Living at Home Program Special Recognition
nesterly
Rachel Goor Noelle Marcus
Graduate of MITs Masters Graduate of MITs Masters
in City Planning Program in City Planning Program
We wondered if it might be
possible to employ the sharing
economy to better use existing
resources and increase the
amount of affordable housing.
30 Better
Better Government
Government Competition
Competition 2017
2017
nesterly Special Recognition
dwellers at some point lived in a boarding nesterly plans to launch a pilot in Cambridge
house, a form of intergenerational co-housing. this summer, and expand to the Boston mar-
Today, there are a handful of small non-profits ket by fall, to serve the large local student and
making senior-youth housing matches in their aging populations in both of those cities. Our
local communities. However, to our knowl- goal is eventually to serve populations around
edge, no one has tried to leverage technology, the world.
and the sharing economy it has helped to cre-
While our product will start with students and
ate, to scale a homesharing model.
older households in the Boston area, we be-
The demand for such a program could not be lieve nesterly can positively affect the broader
more timely: community by increasing overall housing sup-
1 in 3 U.S. households will be headed by ply and thereby relieving pressure on the local
someone aged 65 or older by 2035. (Source: housing market.
Projection from the Joint Center for Hous- The shortage of affordable housing, the pres-
ing Studies). sure on the local housing market from growing
70% of adults over the age of 45 prefer to stay student populations, and a rapidly aging senior
in their homes and communities. (Source: population are all critical challenges that nest-
Survey conducted by AARP in 2014). erly will help communities face.
e: nmarcus@mit.edu
32 Better
Better Government
Government Competition
Competition 2017
2017
Wisconsin Coalition for Collaborative Excellence in Assisted Living Special Recognition
Staff 4.41
Rights 4.43
Environment 4.51
Activities 4.26 member ALCs. Preliminary data show the early
Meals and Dining 4.15 adopters have better regulatory compliance
and fewer reports of complaints from residents
Health 4.46
and their respective family members. The data
Overall 4.44
also show a marked improvement in the early
Total 4.38 adopters quality measurements and resident
satisfaction over the duration of their Coalition
Comparing calendar year (CY) 2013 to CY 2016, membership.
the average number of falls with injury per ALC
has declined from 1.58 falls with injury/ALC to
Contact The Author
1.35 falls with injury/ALC. Re-hospitalizations
per ALC show a similar decline, from 1.57 to
1.34 re-hospitalization/ALC. Staff retention Kevin Coughlin
(68%) and staff immunization rates (67%) were 1 W. Wilson
high compared to national averages for ALCs. Room 550
Madison, WI 53703
One study analyzed the regulatory compliance
data of ALCs that have been members of the
e: Kevin.Coughlin@dhs.wisconsin.gov
Coalition for three years compared to non-
p: 608-266-6989
P
ioneer Institutes Better Government Competition, founded in 1991, is an
annual citizens idea contest that seeks out and rewards the most innovative
public policy proposals. The Competition grand prize winner receives $10,000; four
runners-up receive $1,000 each, and other proposals receive special recognition.
Recent winners have included proposals on pension reform, virtual schooling, job
training, housing, and many other pressing topics.
History
2013 Revving Up the Great American 1997 Bringing Competition to State and
Job Engine Local Government
2012 Restoring Federalism 1996 Public Safety and Fight Against Crime
25th Annual
BETTER GOVERNMENT COMPETITION 2016
Individuals Living
with Mental Illness
Pioneer Institute for Public Policy Research is an independent, non-profit organization that specializes in the support,
distribution, and promotion of research on market-oriented approaches to Massachusetts public policy issues. As
a tax-exempt 501(c)(3) organization, Pioneer Institute relies solely on donations from individuals, foundations, and
corporations, and does not solicit or accept government funding. All contributions are tax-deductible.