ACL Issue Briefings
Each issue briefing discusses a particular issue affecting older adults or people with disabilities. Many include information about evidence-based programs that could address the challenge and provide examples of how ACL's networks can work together to address the issue.
Alzheimers and Dementia: Dementia-capable States and Communities: the Basics. Discusses how states and communities can become dementia-capable, that is, able to help people with dementia and their caregivers. To show how this can be done, there are examples of innovative programs.
Alzheimers and Dementia: Responding to the Wandering and Exit-seeking Behaviors of People with Dementia. Describes how to address the wandering and exit-seeking behavior of people with dementia who live in the community. Person-centered care is the key to responding to wandering. Knowing people and their needs and history helps caregivers anticipate ways to meet needs and prevent injury.
Assistive Technology (May 3, 2022): Highlights a model and innovative partnership at both the federal and state levels to improve the lives of older adults and people with disabilities. Specifically, this effort successfully purchased and distributed technology devices to older adults and people with disabilities served by local agencies and reduced social isolation and loneliness within this group. Key findings include: 1) A majority of the participants reported feeling less lonely and socially isolated after receiving a technology bundle through the Illinois CARE Connections (ICC) program; and (2) Participants in the ICC program reported that the technology bundles allowed them to maintain and increase communication and social interaction with their families to combat social isolation and loneliness during the pandemic.
Assistive Technology (August 27, 2019): Assistive technology (AT) includes software, devices, equipment and products that improve the functioning of individuals of all ages with disabilities. Assistive technology can affect a person’s well-being by improving their ability to walk, eat, bathe, communicate, see, speak and live independently. Technologies also can help address social isolation and improve quality of life by assisting people with communication, mobility, and other daily activities. This issue brief discusses: 1) the important role of assistive technology in helping people of all ages with disabilities live full and independent lives in their communities; and 2) certain sources of public funding for the technology, including Medicare, Medicaid, and programs that the Administration for Community Living (ACL) manages. While other public programs, such as those for Veterans, may fund assistive technology, those programs are beyond the scope of this issue brief.
Community Living for American Indian, Alaskan Native, and Native Hawaiian Elders. The Administration for Community Living’s (ACL) mission includes assisting American Indian, Alaskan Native, and Native Hawaiian Elders to live with dignity and self-determination, while participating fully in their communities. This issue briefing provides helpful information to the Aging Network, which includes many organizations serving American Indian, Alaskan Native, and Native Hawaiian Elders; and shares some of the innovative programs that promote health and support community living for Elders.
Disability and Pregnancy (January 28, 2021). This brief summarizes findings about reproductive education, experiences, and outcomes among women with long-term disability from research funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). This brief considers the accessibility of motherhood for women with disabilities and related outcomes within the social model of disability over the life course. This model views the experience of disability as created by an interaction between person and environment in which attitudinal, community, physical, policy, programmatic, social, and transportation barriers limit the full participation of people with disabilities. The social model contrasts with models that frame the body of a person with a disability as something to "fix." Identifying and removing barriers can improve health outcomes, including maternal health outcomes for women with disabilities. (Citations corrected on August 26, 2021)
Educating Adults about Chronic Disease Self-Management. Describes the evidence underlying the successful, nationwide implementation of chronic disease self-management education programs. Provides options for states and localities to consider related to financially sustaining these programs. These evidence-based programs use peer leaders to educate adults with chronic diseases about how to self-manage their conditions and live healthier lives. The programs can lead to improvements in healthy behaviors and less use of hospital and emergency department services.
Ensuring equitable access to COVID-19 vaccines: Strategies for Helping Older Adults and People with Disabilities Access COVID-19 Vaccines (April 13, 2021) provides creative approaches to outreach and education, vaccine appointment facilitation, ensuring website and vaccination site accessibility, and reaching people who cannot be vaccinated outside of their homes. Also included are examples of how the aging and disability network have collaborated with state agencies at virtually every stage of the vaccination process to ensure access for people with disabilities and older adults. This companion piece is a summary of ACL’s programs, with examples of activities and partnerships that can support vaccine access.
Global Roadmap for Healthy Longevity (National Academy of Medicine): This report describes a path forward so the world can reap the benefits of older people while avoiding predicted challenges of population aging. Through evidence-based recommendations, the report describes how challenges can be translated into opportunities to promote healthy longevity across the life course and around the globe. To ensure that all people of all ages can achieve healthy longevity equity is at the center of the report.
Grandfamilies Issue Briefing (July 11, 2019): The number of grandparents and other older relatives who are caring for children is significant and growing, in part due to the opioid crisis. Although these caregivers can benefit from their experiences, providing full-time care to children can decrease caregivers' abilities to address their own health and well-being. In addition, these caregivers also may need assistance in meeting the children’s needs. ACL produced this issue brief to describe grandparent caregivers and the grandchildren they are raising, the special challenges they face, and the resources that could be available to them. The issue brief also highlights examples of programs that assist kinship care families and other efforts under way at the federal level that policymakers intend to better address the needs of this population.
Group Homes: Joint Report: Ensuring Beneficiary Health and Safety in Group Homes Through State Implementation of Comprehensive Compliance Oversight (January 17, 2018): Model Practices to help states strengthen systems as part of efforts to ensure that group homes are safe and healthy places for people with disabilities, as part of a spectrum of integrated options.
Health Data on People with Intellectual and Developmental Disabilities (IDD) (September 30, 2019): In an effort to better understand the health status and prevalence of people with I/DD in the U.S., a workgroup comprising key agencies within the U.S. Department of Health and Human Services (HHS) and other experts in the field of I/DD convened during the first half of 2018 to review the current landscape and future directions related to surveillance for people with I/DD. That workgroup produced the following reports.
- Easy Read Summary: Learning More about Health of People with Intellectual and Developmental Disabilities (PDF)
- Working Through the Data Conundrum: Identifying People with Intellectual and Developmental Disabilities in National Population Surveys: Describes the need for, availability of, and recommendations for changes in surveillance data about people with I/DD, particularly adults. Priority criteria for identifying people with I/DD relate to measurements of learning, independent living, and age of onset. Additional identifying criteria relate to measurements of communication, self-direction, and expected duration.
- Enriching our Knowledge: State and Local Data to Inform Health Surveillance of the Population with Intellectual and Developmental Disabilities (PDF): Describes state level administrative datasets and systems, data collection efforts and surveys that hold promise for describing the population with I/DD. Many data systems do not capture the whole population of people with I/DD; rather, they identify only that portion who receive specific services. In other population level datasets, people with I/DD cannot be identified within the data. The report reviews promising approaches that identify people with I/DD in state level data, and that allow state level data to be examined within and across state data systems, including examples of data linkages.
Medicaid Buy-in Q&A (July 22, 2019): Work is about more than a paycheck. It can offer a sense of purpose, community, and belonging. Unfortunately, people with disabilities often face barriers to employment and some even choose to suppress their income to gain or maintain access to critical community services. Medicaid Buy-In is an optional Medicaid eligibility group which allows workers with disabilities with income above traditional limits to access essential Medicaid community-based services. ACL, the Centers for Medicare & Medicaid Services, and the Department of Labor’s Office of Disability Employment Policy developed this "question and answer" document to help grantees, stakeholders, and self-advocates better understand the "Medicaid buy-in" program.
Prepare for the Sunsetting of 3G: Mobile carriers are shutting down their 3G networks this year to make room for more advanced network services including 5G. Learn about the impact on older adults and people with disabilities and find resources to help navigate the transition.
Preparing for Medicaid Changes When the COVID-19 Public Health Emergency Expires (April 4, 2022) When the federal declaration of a public health emergency (PHE) due to the COVID-19 pandemic expires, many of the flexibilities initiated during the PHE will need to be rolled back. This return to pre-pandemic operations will have far-reaching impacts for older adults and people with disabilities. This fact sheet is available as a PDF or Word document.
Principles for Person-directed Services and Supports during Serious Illness. At ACL we believe that every person has the right to make choices and to control their own decisions. This right is independent of age or disability or stage of illness. To help ensure that people who have serious illnesses are able to control their care and services, ACL will be using these principles to inform policy discussions and enhance its existing programs and services related to serious illness among adults and individuals with disabilities. To develop these principles, ACL engaged in several activities: development of educational materials and resources, review of relevant literature, discussions with aging and disability stakeholders, and stakeholder review of draft principles.
Promoting Community Living for Older Adults Who Need Long-term Services and Supports. ACL describes how states could provide home and community-based services to adults with disabilities and help them remain in their homes and communities. The special circumstances of older adults with dementia, who are at high risk of nursing home use, are also described.
Opioid Crisis: The Opioid Public Health Emergency and Older Adults (December 2017): Opioid misuse and addiction have become a large, nation-wide issue. Opioid use disorder can affect people of all ages; racial, ethnic, sexual and gender minorities; income classes; and geographic areas. Older adults are among the groups affected by this problem because they often use prescription opioids to cope with painful chronic conditions, such as arthritis, or procedures, such as surgery.
Public Charge Rule Presentation: In September 2022, the Department of Homeland Security (DHS) finalized a rule defining the criteria it uses when determining whether a person can be denied a visa and/or legal residency because they are likely to become a “public charge.” This presentation discusses the implications of the rule for the disability community.
Research Supporting Competitive, Integrated Employment (June 29, 2022): Competitive, integrated employment (CIE) – working in the community, alongside people with and without disabilities, at competitive wages – offers a direct pathway to greater independence and self-sufficiency for people with disabilities. In this brief, ACL's National Institute on Disability Independent Living and Rehabilitation Research (NIDILRR) examines the research supporting CIE.
Opioid Crisis: Opioids and TBI Grantees Briefing (May 1, 2019): In a previous brief, ACL's NIDILRR described that people with traumatic brain injuries (TBIs) have significantly greater risk for opioid misuse and overdose. People with TBIs often experience chronic headaches and musculoskeletal injuries for which physicians prescribe opioids. Not only is having a TBI a risk factor for opioid misuse, but opioid misuse can be a risk factor for an acquired brain injury resulting from a lack of oxygen to the brain. Because of the increased risks for someone with a TBI who may require opioids coupled with other pain management interventions, ACL’s TBI State Partnership Program has established a three-pronged approach to improve outcomes for people with TBIs. The brief also highlights promising practices from states.
Opioid Crisis: Summary of ACL Stakeholder Discussion: Opioid Public Health Emergency (March 7, 2018): The meeting is a product of a collaboration among ACL’s Center for Policy and Evaluation, the Administration on Aging, and the National Institute for Independent Living and Rehabilitation Research (NIDILRR), along with other colleagues across ACL.
Opportunities to Improve Nutrition for Older Adults and Reduce Risk of Poor Health Outcomes. There are examples for states and others to consider when seeking to improve adults’ health and well-being through malnutrition interventions for community-living older adults, and those experiencing hospitalization.
Oral Health and Its Impact on Adults who are Older or Have Disabilities. Describes how a person’s overall health is related to their oral health and a number of options states have for expanding access to oral health.
Wheelchair-Accessible Medical Diagnostic Equipment: Cutting Edge Technology, Cost-Effective for Health Care Providers, and Consumer-Friendly (July 26, 2019): On the 29th anniversary of the Americans with Disabilities Act, ACL is releasing an issue brief explaining why it is good business for providers to invest in accessible medical diagnostic equipment (MDE). This fact sheet describes what accessible medical diagnostic equipment is, how it can help address health care disparities, and how it can help promote compliance with providers' disability rights obligations. It highlights the many benefits of incorporating accessible MDE for providers including the reduction of occupational injuries, increased workforce retention, and enhanced patient experience. Finally, this document highlights the availability of tax credits and technical assistance resources to facilitate the adoption of accessible MDE.
These articles and links are offered to help you learn more about the fields of aging and disability, and the issues facing older adults and people with disabilities, from a variety of perspectives. ACL is not responsible for content or websites produced by other organizations and does not necessarily endorse these materials or their authors.
White House Report - Emerging Technology to Support an Aging Population
Published in March of 2019, Emerging Technology to Support an Aging Population identifies innovations that have the potential to improve quality of life for all Americans, particularly those who live with physical or cognitive burdens due to aging or disability. The report also identifies the R&D needed to bring these innovations to fruition.
White House Conference on Aging
The White House Conference on Aging (WHCOA) was last held on July 13, 2015. It marked the 50th anniversary of Medicare, Medicaid, and the Older Americans Act, as well as the 80th anniversary of Social Security. The 2015 WHCOA provided an opportunity to recognize the importance of these key programs as well as to look ahead to the issues that will help shape the landscape for older Americans for the next decade.
In 2015, WHCOA produced a series of Policy Briefs on four topics: healthy aging, long-term services and supports, elder justice, and retirement security. After the Conference, the White House produced a Final Report.
“Reframing Aging” Project
A coalition of aging-focused organizations is funding research into how Americans understand the needs and contributions of older adults. Reports and background on this project are available from the FrameWorks Institute:Aging, Agency, and Attribution of Responsibility: Shifting Public Discourse about Older Adults (2015)
Gauging Aging: Mapping the Gaps Between Expert and Public Understandings of Aging in America (2015) (PDF)
Reframing Aging: Seeing What You're Up Against and Finding a Way Forward (2015) (webinar)
United Nations Division for Social Policy Development & Aging. This is the official website of the UN agency charged with policy development for the rights of older persons and population aging.
World Health Organization (WHO) Department of Aging & Life Course. This is the official website for the WHO division charged with policy development for the health of older persons. To ensure adults live not only longer but also healthier lives, WHO produced a comprehensive Global Strategy and Action Plan on Aging and Health (2016-2020), and a related resolution was adopted in May 2016 by the World Health Assembly.
National Aging Resources:
National Council on the Aging This association of organizations and professionals is dedicated to promoting the dignity, self-determination, well-being, and contributions of older persons.
National Consumer Voice for Quality Long-Term Care This is the leading national voice representing consumers in issues related to long-term care, helping to ensure that consumers are empowered to advocate for themselves. Consumer Voice maintains the Long-Term Care Ombudsman Resource Center, funded by ACL. The section for “new ombudsmen” is a rich resource for learning about the history, law, funding streams, key organizations, and best practices.
Global Aging Resources:
Global AgeWatch Index. This online portal, produced by HelpAge International, offers information on the demographics of aging and social, political, and economic markers. It ranks countries by how well their older populations are faring.
AgeSource Worldwide. This database provides access to statistical data that compare the situations of older adults across countries or regions around a variety of issues.
ACL and AoA play a vital role in information exchange on aging issues with other countries, and in collaborating with international organizations to enhance aging programs and policies worldwide. The U.S. government promotes the human rights of older persons by calling attention to the needs of older people and recommending approaches for governments and international organizations to respond to those needs. ACL also highlights the tremendous resources that older individuals provide to our communities and society: older adults offer a wealth of knowledge and experience, and contribute to the vitality of our local, state, and national communities and economies.
In 2002, the United Nations (UN) adopted the Madrid International Plan of Action on Aging (MIPAA), to respond to the opportunities and challenges of population aging in the 21st Century and to promote the development of a society “for all ages." As a Member State of the UN, the U.S. regularly participates in the UN-led Open-ended Working Group on Aging which reviews MIPAA implementation and periodically reports to the UN on progress. See the First Review and Appraisal of MIPAA (2007), Second Review and Appraisal (2011), and Third Review and Appraisal (2016).
ACL has played a significant role in raising international attention to elder abuse, neglect, and exploitation, and the lifetime disparities experienced by older women that can impact their welfare in later life. In collaboration with international organizations and the U.S. Department of State, efforts include:Leave No-One Behind: Aging, Gender, and the SDGs: Policy brief highlighting the role of older persons in achieving the new UN Sustainable Development Goals (SDGs), reflecting on the challenges and opportunities presented by growing aging populations worldwide Violence Against Older Women: ACL collaborated with a number of globally recognized organizations to produce this brief as part of the Violence Against Women and Girls Resource Guide U.S Strategy to Prevent and Respond to Gender-Based Violence Globally U.S. Department of State Strategy for Women’s Economic Empowerment Accordion content 1.
Violence Against Elders
The National Sexual Violence Resource Center offers a fact sheet on Sexual Violence in Later Life.
The Pennsylvania Coalition Against Rape created this manual to train law enforcement officers on working with sexually abused elders.
Department of Justice, Civil Rights Division, Disability Rights Section This webpage provides information on how DOJ works to achieve equal opportunity for people with disabilities by implementing the Americans with Disabilities Act (ADA). At the bottom of their home page, you will find a number of resources about the ADA.
Community Living and Olmstead This webpage describes the HHS Office for Civil Rights’ efforts to promote enforcement of the ADA and the U.S. Supreme Court’s decision in Olmstead v. L.C.
Office of Disability Employment Policy at the Department of Labor Newletter This office promotes policies and coordinates with employers and all levels of government to increase workplace success for people with disabilities. Their news letter includes articles on a variety of issues related to disability and employment.
Also, be sure to visit the "In the News" page of our Newsroom for the latest news stories on aging and disability issues.