2024-06-26 00:00:00 - Joint Committee on State Administration and Regulatory Oversight

2024-06-26 00:00:00 - Joint Committee on State Administration and Regulatory Oversight

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ROBIN LIPSON - EXECUTIVE OFFICE OF ELDER AFFAIRS - SB 2797 - Thank you, Mr. Chair. Thank you very much. Good morning, Mr. Chair and members of the committee. I am thrilled to be here on behalf of the Healey Driscoll administration. Thank you for the opportunity to testify in favor of legislation filed by Governor Healey to rename the executive office of elder affairs to the executive office of aging and independence. My name's Robin Lipson, and I'm the Acting Secretary of elder affairs, and I'm excited to share with you why we'd like to update our name. Elder Affairs was established more than 50 years ago. We were one of the first agencies in the country responsible for addressing the needs of older people. Our programs and services provide support to help adults age in the community of their choice which is most often in their home or other community based setting rather than in a long term care facility.

The population of adults aged 60 and older has grown rapidly over the past few years and we know the needs of this growing population are evolving. In 2022, we began a rigorous review and extensive234 community engagement to learn more about our consumer needs including how residents hear about or engage with services, what their perception of us is, and why they might not be accessing our services. Throughout the project, we spoke to older adults and caregivers across Massachusetts to gather input. We ensured we heard from a diverse group of voices, rural, urban, varied in race, gender, and ability, and across the economic spectrum. We also included input from our partners, including aging services access points, councils on aging, AARP, the Alzheimer's Association, and others.273 We learned older275 adults deeply value the ability to maintain their independence through their aging journey.

Consumers felt281 our agency name was vague and did not clearly explain what we do or how we could begin to support them.287 We also talked about terminology and learned consumers do not refer to themselves as293 elders, instead, they prefer neutral terms such as older adults or aging adults. The Executive Office of Aging and Independence is a name302 that provides a clear description of what our agency does and the community it serves, but it also reflects our older population's values. This name change proposal is just one piece of the puzzle. Behind the scenes, we've embedded the community feedback into our daily work, we have overhauled our program descriptions, the images we use, and have fundamentally changed the way we talk about aging.

Altogether, our goal is to modernize our agency to reduce negative stereotypes around aging and to normalize aging as a natural process. Updating our agency name symbolizes to older adults that we heard them, we listened to their needs and priorities and reacted. It informs our residents that the Healey Driscoll administration is here to support residents throughout their aging journey. Finally, the proposed legislation before you replaces outdated language across our relevant state statutes such as elder, elderly persons, and handicapped. It also incorporates gender neutral language. The Healey Driscoll administration is committed to inclusivity and by updating our name, we recognize that everyone deserves to be able to age on their own terms. Thank you again for the opportunity to testify today and for your time and attention.
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REP CABRAL - Now this simply changes the name of the secretariat, it does not change the the powers of the secretary?

LIPSON - That's correct. It merely changes the name that we use to do business. It does not change our mission, our or or any other mechanics or operations of the agency.

CABRAL - Organizational speaking, you're still under HHS?

LIPSON - We are part of the434 executive office of health and human services and, I don't know if you've heard from Secretary Walsh directly, but she has prioritized preparing for an aging442 as one of her strategic priorities. So, we are trying to uplift the work of the agency by using a name that more people can identify with and understand.

CABRAL - I like the word aging other than...

LIPSON - It is a real word and it's a neutral word. We're all doing it, right? Everyone's doing it.

CABRAL - All of us are heading there, right? We all aging, that's a nice nice term.
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SEN MIRANDA - I just want to say that names do matter. In my district, there are many cultural communities where aging in place or having your own independence really matters, and there are multiple generations of families living in the same homes. We have lots of senior buildings that and, all the way to the South End. And we have a lot of housing developments that have actually the largest concentration in the state where most of the folks living there are either, differently abled, disabled, or they're elders. So, the part about the independent, like, the Commonwealth being able to help people live independently is I think many seniors do not want to, you know, many of them come to me in my district and they wanna continue going to church and going to the civic meetings and playing bingo, and being able to to age peacefully and age in safe and healthy communities. So, I think this is a step in the right direction.

LIPSON - Well, thank you. You are saying exactly what consumer said when we spoke with them around the state, you just summarized that beautifully. We heard that569 over and over and over again. So thank you.
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REP MARSI - Thank you, Mr. Chairman. I like this idea, you know, what the Senator just said, I agree with that. But I also think that, like, the House did to modernize the terminology, how we refer to special needs people, which speaks to me and my family, I put that in this category, so I support this.
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ELIZABETH CONNELL - MASSACHUSETTS COUNCILS ON AGING - SB 2797 - Thank you, Chairman. I would like to thank all the additional legislators and guests who are attending today. I thank you for the opportunity to appear before this joint committee on state administration regulatory oversight today in support of S 2797, an act filed by Governor Healey to rename the executive office of elder affairs to the executive office of aging and independence. I'm Betsy663 Connell, I'm the executive director for the Massachusetts Association of Councils on Aging. We're the nonprofit membership association of the 350 Councils on Aging and in the Commonwealth, serving all of your districts who support the 1,700,000 older adults in Massachusetts leading healthy and purposeful lives. The Massachusetts Councils on Aging supports this act as it enacts appropriate language regarding the older adults of our Commonwealth and places important emphasis on independence.

Independence empowers older adults to lead fulfilling lives, maintain their identity, their sense of self worth, and empowers them to contribute to their communities in meaningful ways. Renaming this executive office also helps to reframe aging and reduces ageism involving stereotypes, prejudice and discrimination against older adults. Reframing aging challenges these negative perceptions and promotes more accurate and respectful view of older adults. Reframing aging is a continuous731 process that involves the societal norms, personal735 attitudes and institutional practices that work to create a more inclusive and supported environment for older adults to live fulfilling independent lives. The renaming of the Executive Office of Elder Affairs to the executive Office of Aging and Independence shifts the focus from decline to growth and from limitations to possibilities, ultimately benefiting all of our older adults and our entire Commonwealth. I appreciate your time again, and I respectfully urge the committee to support S 2797 to give this act a favorable report. Thank you very much.
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CABRAL - To begin with, I do support the change of793 the name by the way. So, I think it's a much better appropriate name. But many years ago, I know,804 I remember that, this executive office was an office that sat as part of the cabinet independent of Health and Human Services, and it was restructured to be technically, continue to be a secretariat, but under the office of Health and Human Services. Do you think or do you believe that the next step after changing the name should be a conversation about, is it appropriate for the Secretariat to continue as it is or should it be one that is independent of HHS because the aging community is growing by the day because of the baby boomers, right? Just like we did. I mean, we did with veteran affairs, I used to be a commissioner. We made it a secretariat and that secretariat is independent and sits as part of the Governor's cabinet. So, it's at the table, it's in the room, if you will. Your thoughts on that?
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CONNELL - You know, that topic of conversation has come up. Periodically, you know, in terms of whether or not this is something that927 needs to be considered. I think it's929 something that everyone in the aging network has talked about, the importance of elevating this. I think we'd be really happy to have further discussions about that. What that could bring to the table with the increase in the population of older adults now being almost 24% of the state's population. You know, is it appropriate now for the secretariat to be placed in the Governor's cabinet? So I think would be happy to talk with everybody about that.

CABRAL - Okay. So there is a ongoing conversation, I hope, in discussion on this, and this is certainly not in any way minimizing health and human services. I mean, it's an important Secretariat, obviously. But as this population grows, I think, it's not like being in the room where things happen, right? It's almost like reminds me of the play on Hamilton, right? Got to be in the room. So that's the idea. I know, this was changed, if my memory serves me well, I think this was changed1015 when, I believe, and1019 if I'm wrong, correct me, during the Romney administration. I was, by the way, at that time, the Chairman of the Committee on Human Services, Elderly Affairs, Veterans, Mental Health, and Substance Abuse. Today, that committee is four committees, but that change took place then, and I think it took place because of what I thought were sort of conflicts between HHS and the Secretary of elder affairs. Obviously, who won that fight was HHS. So, that's the reason for the question, that's the reason for the1067 idea that maybe it's time to have that conversation again.
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ELIZABETH DUGAN - UMASS BOSTON - SB 2797 - Good morning. My name is Elizabeth Dugan, I'm an associate professor of gerontology at the University of Massachusetts, Boston, and I served on former Governor Baker's counsel to address aging issues in Massachusetts. I'm here to testify in support of S 2797, an act to rename the executive office of elder affairs to the executive office of aging and independence, and it's really heartening to hear your reaction so far. Thank you committee members for your thoughtful remarks so far. My research team develops the healthy aging data reports.org website, thanks to the support of the Point 32 Health Foundation. On that site, you can find healthy aging reports for Massachusetts, New Hampshire, Rhode Island, Connecticut, Mississippi, and Wyoming, and we'll be adding Maine and updating the New England states in 2025.

This research reports more than 150 indicators for each city, town, and neighborhood, and, also maps the distribution of rates for each indicator. The indicators include population characteristics, community health outcomes, along with the social factors that can influence health. These tools aim to help smart policy makers, service providers, and1188 advocates to understand where health disparities exist and some of the levers that may be pulled to1194 mitigate them. This work1196 is practical and powerful. We learn from our state partners because every state is unique, with unique strengths and challenges and political context. What they all have in common, however, is a sense of urgency in adapting to the new reality of longevity in aging populations.

We are living in a new demographic age, when most of us can expect to live to old age, it's a remarkable transformation. While just 100 or so years ago, life expectancy was 47, and now it is pushing 80. What a tremendous gift we've been given, yet we face a structural lag where our social, cultural, and physical environments haven't quite caught up to this new1239 reality that is filled with both opportunities and challenges. I recognize that a Bill about changing the name of the state agency may not seem that exciting or important, rose is rose after all, but this is an important and overdue name change, and I thank the committee for your consideration of it and hope for your support of it. Because the name change will increase awareness of services and opportunities for all older residents in the Commonwealth, many states around the country are making similar branding changes to better serve their residents.

As Massachusetts has long been recognized the leader in aging policy and research, making the changes encompassed in this Bill will move us back to the forefront by discarding an ageist and outdated label and having one that is more in line with the critically important work of the agency today and in the decades to come. Thank you. Chair, in response to your question, I would fully support making this a cabinet level position and thinking creatively about how to capture the young, healthy, older people, and expand opportunities with this new population. So you have one full supporter on that idea.

CABRAL - Thank you. I thought I would. But, one of the big issues today is housing, right? And certainly, housing is a big issue for our aging population as1331 well. I do have every month office hours in my district, right? First Friday of the month unless it falls on a holiday weekend, then we move into the second Friday. A lot of the folks who come in and talk to me are older constituents, that had many issues. Some of them is housing. About six months ago, one of those older constituents in my district, she came and you don't need to make an appointment, first come, first serve to sign in. The issue was about, she is someone who worked all her life, lives by herself because her husband had passed away already, and she was facing possibly eviction because she was living on a three decker's, on one of the floors of the three decker's, paying $600 a month rent.

That landlord was a very nice landlord, but the landlord decided to sell that property, and the new owners notified her that as soon as the transaction took place of ownership, they expect that the rent was going to go up to $1400, and her social security check is $1400. So how do you deal and that you help someone in that situation? Someone who worked all our life, gave back to our community, raised a family, and today is in a situation that, possibly, this pretty glitch cannot afford $1400. So, there are many of those issues that I come across, in particular with the older members of my community or my district. So, that's a big issue. I know we've been talking about housing, it is a big issue, but it's also a big issue for older residents of the Commonwealth, and, I think it needs special attention. So, I think, that's just one example of what I believe the Secretary of aging and independence should really start focusing on.
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PAUL LANZIKOS - DIGNITY ALLIANCE MASSACHUSETTS - SB 2797 - Good morning, Chair Cabral and the members of the committee. My name is Paul Lanzikos, and I'm the coordinator of Dignity Alliance Massachusetts, a statewide voluntary advocacy group focused on the needs and concerns and interests of old adults, people with disabilities, their families, and caregivers. I'm also a former Secretary of Elder Affairs serving during the administration of Governor Michael Dukakis. We commend the administration for taking interest in the elder services portfolio, and we do hope that this is the start of an important dialogue about destroying the prominence and influence of the Secretary of Elder Affairs, perhaps soon to be known as the Secretary of Aging and Independence. We are agnostic as to the name change, some of our participants like to change, others prefer the status quo. But most importantly, and consistent with your question, Mr. Chairman, we'd like this joint committee and the legislators as the whole to focus on the role and functioning of the agency.

By current statute, and that's Chapter 19 (a), the Massachusetts secretary of elder affairs is vested with the strongest authority and responsibility of any state unit on aging in the country. In fact, no changes to the statute have to be made to have these the secretary a fully participating member of the Governor's cabinet. While we should take pride in the position and office having this level of potential influence to relevant government affairs, the current constraints and expectations of the position as it's located within the bureaucracy of state government do not match the statutory charge. There was a time when the executive office was viewed as one of the preeminent state agencies in the country focused on the needs and interests of older adults. While probably seen today is a very competent line agency, and1654 it is, and it has a very vital role. Its role1658 as a significant participant in public policy making at the cabinet level in a range of critical areas such as you've already indicated, Mr. Chairman, housing, transportation, economic development, workforce, and the like has diminished.

Lastly, there are various periodic reports required by the statute that elder affairs as well as other agencies have on the books, and they are not adhering to issuing reports in a timely fashion, which have significant and formative value to the legislature, your work as a committee, legislature as a whole, and the general public. We ask the joint committee to review adherence to statutory reporting requirements, and we enthusiastically, endorse your call for a much broader conversation about restoring this important agency which has responsibility, as you already heard, about a quarter of today's citizens, well over 40% of the voting citizenry in the Commonwealth. The issues affecting us, as older folks are not just relevant to people who are older. In fact, it talks about the well-being of all of us who have the good fortune of living in the Commonwealth and hope to do so for decades to come. So we would fully endorse the call for that broader conversation and would hope to be an active participant.
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CABRAL - Again, I believe, and I could be wrong, and maybe you will know this information better than I do. I believe, it was through the Michael Cox administration that this secretariat was elevated to a secretariat,1779 not just an agency and be independent from HHS. Am I right?

LANZIKOS - Well, actually its roots are in the administration of Governor sergeant, and in the entire 12 years during the Dukakis administration, the Secretary of elder affairs was a fully participating member of the cabinet. I attended, cabinet meetings on a regular basis. I'm sitting in1815 the cabinet room adjacent to the Governor's office, interacting with all the other cabinet secretaries, on a whole array of issues well beyond the service issues that were administered by executive office of elder affairs. We were recognized as important contributors to policy development. I interacted regularly with the Governor and Lieutenant Governor, and which is not to to say that what the executive office of elder fears assumed to be likely, aging independence, has very1852 important roles as an operating line agency, and we would hope that and expect that to continue. But this much broader role in all the current issues that are before the public and especially the legislature, I think, would benefit from that position being restored to functioning at the cabinet level. I say, again, no statutory changes have to occur, it's just a matter of policy. If you look at Chapter 19 (a) and especially Section 4, it details a whole litany of roles and responsibilities that the current executive office of elder affairs has, but not necessarily pursuing with vigor.

CABRAL - Thank you, Mr. Secretary, appreciate that clarification. I do remember also another wonderful agency that was created during Governor sergeant, it was the office for children. Also, it was created during the sergeant administration, and today that office no longer exist either. That was all broken up, actually during the Obama administration. I think it's time to bring the office for children or a new version of the office for children back. I would like to call it the children's cabinet, but we're working on that. Thank you very much for your testimony. I really appreciate it.
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BETSEY CRIMMINS - MASS HOME CARE - SB 2797 - Good morning, and thank you, Chair Cabral and members of the joint committee, for this opportunity to testify in support of S 2797, an act1974 to rename the executive office of elder affairs to the executive office of1978 aging and independence. My name is Betsy Crimmins, and I'm the executive director of Mass Home Care, which is the nonprofit membership association for the 27 ASAPs aging service access points, and AAA area agencies on aging, in Massachusetts. Our statewide network provides home and community based services to over 66,000 older adults per month. The coordinated system of home and community based services offered through the currently named Executive Office of Elder Affairs, in partnership with our network, provides essential caregiver resources and cost saving supports that enable individuals to successfully age in place in their homes and communities where they want to be.

We've worked very closely with EOEA for decades and are in full support of the new name as it was undertaken by EOEA in a very thoughtful and community centered process. Members of our network, other aging services entities, older adults, and their caregivers were invited to be part of this process and provided feedback and suggestions as EOEA moved forward to find a new name that more accurately reflects the need for services and supports through every stage of aging. How we talk about aging is crucially important to eliminating some of the stigma and other negative assumptions about growing older. A state agency with a name that includes the words aging and independence together signals to everyone that the Commonwealth of Massachusetts values the aging process that we all go through and is committed to ensuring that as people age and need support, the focus is on retaining independence and dignity. Thank you.
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CABRAL - You've been hearing my comments. I don't think, I hate to say it over again, but I think, wondering if you feel the same way in terms of having it at some point a broader conversation.

CRIMMINS - I absolutely support the broader conversation. I would caution that EOEA now is so integrated with Mass Health, which is also part of EOHHS, that to move forward as an independent entity, you'd want to make sure that all the processes and all of that integration, which have taken years, frankly, to develop remain intact. How you do that, I wouldn't pretend to understand right now, but I would just want to make sure that any move to an independent entity would take that into account. Many of the programs that EOEA administers right now are Mass health programs, and there's great value in having the two entities together as well.

CABRAL - Well, I hear what you're saying. Obviously, we would want a secretariat that has a strong voice. But I think it's also important for that person to be in the room along with the Secretary of Health and Human Services. Because there are many issues that come and are discussed during those cabinet meetings that I think having someone who represents our older residents, perspective.

CRIMMINS - I absolutely agree with that. I feel one of biggest problems is that older adult issues typically aren't at any table. So any chance to get at an important table, like sitting with the Governor in her cabinet absolutely is crucially important.

CABRAL - Yes, because health insurance is so big. Income I mean, it's half of state government, it's 50% of the state budget, and there's a whole lot for, let's say, one person. So, actually, I've nothing that is anything in an active way, but it's been discussing the past that probably HHS needs to be broken up as well. So, I'm not proposing that at this time or at least that's not where my thoughts are at this point. But I think, having the voice of aging residents in that room when conversations take place, be around mental health, be around housing, be around economic opportunities, whatever that might be, because that person is focused in that area, where the Secretary of Health and Human Services focus on everything, right? They try to cover everything. And by and large, you know, the present secretary is doing a wonderful job, obviously, and the previous secretary. I knew the previous secretary very well, she was a long time public servant, I should say. Especially during the pandemic, I think she did an awesome job. But having said that, thank you for your testimony and for your thoughts.
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EMILY SHEA - AGE STRONG COMMISSION - SB 2797 - Good morning, Chair Cabral, Vice Chair Tyler, members of the committee. My name is Emily Shea and I'm the Age Strong commissioner for the city of Boston. So my department is at the city is Boston's council on aging and also Boston's area agency on aging. So, you've heard from a couple of our trade associations up here today. So, we are very proud to be here today in support of the name change from the executive office of elder affairs to the executive office of aging and independence. I also want to thank Acting Secretary Lipson and her whole team for their partnership on so many important issues impacting older adults across the commonwealth and, in my purview, the city of Boston, and our residents. So, I think it's important to update language to make sure that what we call ourselves is accessible and resonates with the people that we serve.

In 2018, we went through this process in Boston, so similar to EOEA, we had a name, the Commission on Affairs of the Elderly, that our residents didn't see themselves in. They told us, we work primarily with folks over the age of 60, and they told us that they were not elderly, and didn't feel like that word represented them. So, similar to EOEA, we sought input on a name by asking the people that we work with, our older residents, and I know EOEA did the same thing here through focus groups, we actually helped them arrange a couple of them, and they also asked stakeholders to weigh in, and we did as well, so following the same process. In this process, I participated in a virtual forum and gave about two hours of virtual feedback to the name change. Similar to our process at Age Strong, I know that EOEA also looked at the work of the reframing aging project, because it's up to all of us through2459 our language to tackle what's2461 a very pervasive ageism.2463

With our name, Age Strong, we use the principles of reframing aging because every time we say the word age, which has negative connotations, we pair it with2474 a positive word, strong. The executive office of aging and independence does the same thing, reinforcing a positive view of aging in our Commonwealth. Massachusetts has always been a leader in aging, we were the first state to eliminate mandatory retirement ages, we were the first state to elevate the head of elder affairs to a secretariat level, and I'm here to support the name change, and also want to encourage the administration and the legislature to do everything possible to elevate aging in the Commonwealth. It is important that we make sure that the executive office of aging and independence has a strong voice and that we invest in our communities, in making them age and dementia friendly in all facets. Because if we're lucky, we're all aging, and we deserve the opportunity to live and age well
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REP TYLER - I just want to thank you so much for your commentary.
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CABRAL - I'm happy that the city of Boston is here to testify in support of2562 this change. I think it's important that the city's play in Boston, all the cities play a big role also reaching out and supporting older members of the community. In the past, sometimes, it becomes an afterthought and there should be an afterthought of the services that all the residents need. I know in some cases, in my area of the state, Council on Aging, for example, facilities have been moved around so many times that, the aging population sometimes have it away if they exist, if they're located the way how they're located.

Hopefully, right now there's some stability there in the area of the state, and that's precisely why I think it's important to have a strong voice at the state level that filtrates down to little communities that this is a primary in terms of the importance, not enough to talk. You know, because in my own city, in my own district, the older residents of my district, they have significant number, they are around 20 some odd percent of the population and they do face a lot of challenges. I think it's important to have a strong agency, a strong voice at the state level and also at the local level, for those citizens. So thank you very much.
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