Another long day -- this time working on "implementation strategies" for the top 50 resolutions. Delegates weren't told what the all-important ten top resolutions are, although they were known late last night and apparently leaked to the press this afternoon.
The press get more info than the delegeates. Great.
There was some passionate debate, a fracas on the Social Security implementation forum, a ruckus at dinner. (Don't you just love the print journalism vocabulary?) Delagates worked hard, delt with difficult questions, and reached consensus on many implementation issues. Will any of it matter?
I personally attended three implementation sessions: resolution 25 regarding emergency response, resolution 42 on promoting innovative models of non-institutional long-term care, and number 46 on promoting innovative emperical and practice-based research.
There was a very strong consensus among the issue 25 group (probably 30-40 people) that we want someone in charge at the federal, state, and local level for emergency response. And this is not FEMA, at least not as it is currently structured and run. Further, that we need to educate individuals and care-givers about disaster preparedness. We need emergency response planning and community points-of-contact for all elderly, disabled, or otherwise vulnerable people. And finally, the idea of a GIS (geographic information system) combined with GPS (global position system) for tracking the location of first responders in relation to the addresses of the elederly and vulnerable was well received. Oh, and there must be funding at the federal and state level to make these things possible, including subsidies for disaster preparedness for individuals and caregivers who cannot afford to purchase the basics.
The strong consensus on 42 (perhaps as many as 50 delegates) was that people don't want to be institutionalized, and that the beaurocratic barriers and funding priorities of the state and federal government that push people into institutionalized care must be broken down. Home care is demonstrably more cost-effective, but in many states you can't get any kind of assistance unless you go into a nursing home. Telemedicine and telemonitoring technology that could help caregivers be more effective also got support from the room. However, the big issue is the broken model of assistance that essentially requires institutionalization, and the lack of funded alternatives.
The discussion of 46 (probably 30 delegates) proved to be the most intense of the ones I personally participated in. The contentious issue surrounded a proposal that I put forward -- that we need to escalate aging and Alzheimers research to the very highest level of goverment by creating a DARPA (Defense Advanced Research Projects Agency) like agency to fund innovative research and commercialization in this area. We probably spent 30 minutes discussing this resolution -- the disagreement was on the emphasis on Alzheimers. The members of my working group believe (and I think with good justification) that this disease should be our top research priority. Others in the audience diagreed. Other resolutions included sustainable funding for promoting evidence-based aging research, a ten-year commitment for NIH to focus on aging research, and the strong need to promote evidence-based best practices in all types of caregiving. (The DARPA-like agency resolution was put to a "vote" with the Alzheimers language left in.)
In all of these sessions I made it a point to propose language that would address the needs, concerns, and participation of minorities (ethnic, linguistic, and LGBT). None of that language made it into the adopted implementation strategies.
I didn't see the Social Security fracas, as I did not attend that session. At dinner there was a rumpus in which a delegate got into a shouting match with the CEO of Alvamed. Unfortunately, I had bailed to go get sushi with a friend and wasn't there to witness this either.
The bottom line is that good work is geting done by delegates, but frustration is running high. We have been dissed by the Prez (he and Laura won't show), our concerns over process have been ignored, and God knows what will happen to the implementation resolutions now that they have been handed off.
77 million baby-boomers will hit retirement age in the next decade, and this wasn't important enough for the president to show up to the White House Conference on Aging. This is perhaps the biggest demographic revolution in history. Not a priority for the adminstration.
I'm going to bed, and if I oversleep the opening session so be it. I've done what I can to affect this process. I'll report back here what I know. And we will see what the next ten years hold -- who knows, maybe ten years from now I'll go to the next WHCoA. Maybe in ten years we'll even have an administration that cares.
