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University of South Florida · College of Behavioral & Community Sciences · Aging Studies · FPECA

Florida Policy Exchange Center on Aging

Policy Areas

Assisted Living

Assisted Living (AL) communities provide non-medical, community-based residences for certain frail elders who do not require the intensive and skilled nursing care provided by nursing homes. There has been rapid growth of ALs as an important housing and long-term care option for older Americans during the past few decades.  ALs provide an estimated one million elders shelter (room), food (board), 24-hour access to nursing care, medication administration and help with performing personal care or assistance with activities of daily living. While most residents in AL communities pay for services privately, about 131,000 residents throughout the country receive assistance under the Medicaid program. Researchers affiliated with FPECA conduct assisted living studies related to the quality of care, transitions and trajectories of care, and types of care that can affect quality and transitions of care (e.g., Medicaid palliative and hospice care, mental health care, dementia care).  Other topics of study include social relationships, stigma, autonomy, and staffing patterns.

Nursing Homes

Nursing Homes (NH), also referred to as Skilled Nursing Facilities (SNF), provide for people who need long-term care or rehabilitation after surgery or are recovering from a more severe medical condition like a stroke. These communities provide all of the personal care and services of an assisted living facility with the addition of 24-hour nursing care. According to the current U.S. Census, approximately 4.2% of the population 65 and over currently reside in NHs. Due to the high cost usually associated with these facilities, most residents utilize Medicare or Medicaid to get reimbursed for NH stays. Nursing Homes are regulated at both the state and the federal level, receive licensure and regulation from the Department of Public Health for the state, and are certified by both Medicaid and Medicare. In addition, there are licensing standards for the administrators and the clinical staff. Researchers affiliated with FPECA conduct nursing home studies related to quality of care, transitions and trajectories of care (e.g., Medicaid palliative and hospice care, mental health care, dementia care). Other topics of study include social relationships, stigma, autonomy, and staffing patterns.

End of Life Issues

End of Life issues at FPECA are a core topic area of study and policy advocacy.  The National Hospice and Palliative Care Organization report that seven out of ten Americans die from chronic disease.  With an increasing number of older Americans living with advanced illness and needing care at the end of life, the quality of care they are receiving in both long term care and the community is of critical importance. How palliative and hospice care affects the quality and the cost of this care are focused areas of study.  Studies and policy advocacy work related to End of Life decision-making is another core area for FPECA faculty.  Issues surrounding end of life decision-making are recognized as public health issues, particularly with the recent “death panels” discussion in 2009 and 2010 preceding the pas-sage of the Patient Protection and Affordable Care Act.  In 2010, FPECA was a co-sponsor of the Florida Physician’s Order for Life Sustaining Treatment (POLST) Task Force which began work to phase in implementation of the POLST statewide.  A number of FPECA faculty are affiliated with this task force (Drs. Becker, Dobbs, Hyer, Reynolds, and Black).  A number of faculty are also members of the Hospice, Palliative and End of Life Care Research Center at USF.

Mental Health

Issues of Mental Health disparity that exist within the state of Florida are an important area of focus for FPECA. According to the Florida Coalition of Optimal Mental Health and Aging, in Florida, it is estimated that 785,000 (22%) age 65 and over have an emotional or mental health condition that requires attention. Unfortunately, few older adults receive treatment for these conditions. Studies that focus on the reduction of these disparities and performing interviews with frail elders about services that may keep them in their communities are part of FPECA’s mission.

Professional Resources

FPECA strives to provide Florida’s professionals with information and resources that allow for the highest quality of care, research, education, and policy development.