Proposal Presented for the Master Plan for Aging (#84)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Proposes a formal collaboration among OMH, DOH, the Homecare Association of NYS, OMH Housing Providers and Alliance for Rights and Recovery, and other peer advocacy groups to address challenges for accessing needed services in OMH housing.
Justification
As older adults with mental illness age in OMH housing programs, it is apparent that the home care workforce is unequipped to effectively provide services to this population. Knowledge about eligibility and disconnection from family and informal caregivers creates challenges for those living in these housing programs. Cross-agency collaborations will allow a comprehensive understanding of the existing challenges and opportunities in these settings and address the needs of older adults with mental illness.
Full Proposal
OMH operates almost 50,000 units of housing in NYS, most of these permanent housing, and a significant proportion are older adults. For individuals residing in permanent OMH housing, all will eventually be older adults. As residents of OMH housing programs age, same as many older New Yorkers, they may require access to home care services. However, accessing services is challenged by not only the broad systemic factors limiting access to Home Care services, but also to population specific factors, and a lack of proximity to services, including but not limited to:
- Home Care workforce is not well trained in working with older adults with mental illness
- Stigma around adults with mental illness limiting workers interest in working with these individuals
- Lack of understanding of eligibility for such services for individuals in OMH housing
- Facilities that are physically isolated from surrounding communities.
- Disconnection from families, reducing access to family and other informal caregivers, increases reliance on paid caregivers
Benefits to the larger system of care for older adults to improving access to Home Care services for older adults with serious mental illness are similar to those of older adults in general: facilitating individuals remaining in their chosen residential setting as long as possible and reducing burden on other institutional settings (Assisted Living, Nursing Homes, etc.) where they will have to relocate without access to quality home care services.
This proposal suggests a formal collaboration with OMH, DOH, the Homecare Association of NYS, OMH Housing Providers and Advocacy groups (e.g., ACL and SHNNY) and other relevant stakeholders for a robust exploration of the challenges and opportunities to make systemic change to better address the needs of older adults with mental illness in New York.
This proposal is focused on primary prevention.
MPA Council Commentary
This proposal is categorized as near-term. Possible first steps for implementation could include engagement with the OMH’s housing and provider training (through the existing Geriatric Mental Health and Substance use Disorder Planning Council) and consultation with peers and peer bridgers well versed in the lived experience of trying to maintain community tenure while aging. If successful, the existing Council may propose opportunities for systemic change to ensure the needs of older adults in OMH housing are met. Proposed metrics for evaluating implementation may include improved understanding of OMH services among the workforce, improved service provision, and continued opportunities for systemic change.