Interview

Improving the Health of Older Adults

Kari Benson, MPA Executive Director of Minnesota Board on Aging

The mission of the Minnesota Board on Aging (MBA) is reported as ensuring that all Minnesotans can age well and live well. Would you please explain what this means?

For MBA, this means assisting older adults as they need help around the house, or they need help with personal care. We are here to connect Minnesotans to services that help them live where and how they want to live—and to help them stay independent, healthy and keep living their lives. And the concept of “all Minnesotans” really means assisting all Minnesotans from every corner of the state and from every community as we’re getting older.

Most people are not aware of how large the MBA is. Would you please give us a brief overview of the different divisions and initiatives?

MBA is made up of 25 members appointed by the governor to represent all areas of the state, and we really serve in three key roles—administrator, advocate and advisor. So for example, MBA administers over $50 million each year for caregiving services for older adults, their families and friends. The board has two direct service programs, one is the Senior LinkAge Line, a free, statewide service that focuses on helping older persons remain in their homes and communities, providing accurate information on Medicare, caregiver support and any other issues facing older adults. The other is the Office of Ombudsman for Long-Term Care which works to enhance the quality of life and services for people receiving long-term services and supports.

Some of your work follows federal initiatives and some is unique to Minnesota. What can you tell us about how funding and direction works around this?

One of the most important characteristics about the work that we do is that we’re part of a national aging services network. MBA administers federal funding from the Centers for Medicare and Medicaid Services, the Administration for Community Living and state-funded aging programs. Federal funding we receive is the same in every state, so there are some commonalities, and there are services and resources that we all need as we age, so we really benefit from being part of that national network. While we are connected that way, there’s flexibility for each state to use the dollars and implement the funding in ways that are most beneficial to each state and its unique needs.

What can you share with us about your legislative work and priorities?

One MBA priority heading into the next session is to ask the legislature to convene a task force on aging. We’re seeking to have an exploration process to determine the best structure at the state to raise visibility that our population is aging. And we want to prepare so we have the capacity and authority to plan for that structuring—to work across state government. Essentially, we’re seeking authorization from the legislature to address that more needs to be done as a state. And MBA really wants the legislature—and all of our other partners in the state—to really take a look at that. That way, MBA and our partners are not advocating for bits and pieces here and there, and we’re not competing with each other. We’re moving toward a much more collaborative process, which is exciting and we’re making such good progress on that effort! Ultimately, we hope that this “AGEnda Collaborative” will help us be clearer for the legislature and possibly have more of an impact addressing the needs of what older Minnesotans need now and in the future. 

What can you share with us about the MBA public policy work?

So much of MBA’s policy work is tied to the state legislature, but the Board does also advocate for policy changes needed at the federal level as needed for national issues important to older adults, for example, elder rights issues. We’ve benefited greatly from our Congressional delegation support in pushing forward elder support at the federal level. 

We need to actively combat ageism.

Health care work force shortage issues are beyond the crisis point. What are some ways MBA is dealing with this?

MBA agrees it is a crisis and we’re concerned about both the health care workforce and the long-term care workforce shortage—including those who provide personal care assistance and those who provide long-term services and supports to older adults. MBA is active in two key ways: we deliver services to support family, friends and loved ones who are caregiving—those who are not getting paid for their services. And if you’re the primary caregiver, you often need a break or help and finding that help is a key role for MBA. The second priority for MBA in this area is to advocate for better pay for long-term services and support workers--especially those serving older adults. We are concerned about a lack of workers across the board in health care, and we’re troubled by the lack of training for those serving older adults in geriatrics, particularly those older adults with dementia. And with an ever-growing older adult population, there are more older Minnesotans struggling with dementia and we need to do more with our capacity as a state to serve those older adults.

What can you tell us about the Age-Friendly Minnesota Council?

The council was first established by Governor Tim Walz in 2019-2020 by executive order. In the most recent legislative session, lawmakers authorized funding for the Council for the next two years. So it’s in place now and it is made up of representatives from multiple state agencies, as well as community partners, and the goal is to develop a master plan on aging for the state and develop a work plan that makes Minnesota an age-friendly state. The World Health Organization and the American Association for Retired People have partnered to set up a framework that we are using as a guide that helps MBA determine what else we need.

What are the seven area agencies on aging and how does MBA interact with them?

MBA is designated by the federal government to administer funds for the Older Americans Act, so we’re the state unit on aging for Minnesota. Part of our responsibility is designating the Area Agencies on Aging regions for the state. We designate the entities and allocate funds to them for delivery of services to older adults and family caregivers. Area agencies in Duluth, Sartell, Warren, Cass Lake, Mankato, Rochester and Arden Hills play a key role in administering the Senior LinkAge line—and six of the seven agencies have call centers that make up the LinkAge Line, and MBA manages that infrastructure. The big thing for physicians to know is that our partners are very willing and ready to help them assist older clients navigate care transitions. So, for example, if an older adult is in the hospital and is going to be discharged, Senior LinkAge can help with that process and follow-up. For more on that, I would direct readers to Minnesotahelp.info.

What are some of the initiatives you have undertaken to assure equity in your services?

MBA has a Diversity, Equity, Inclusion and Access Strategic Directive in place and that’s been used to guide efforts in addressing and advancing equity for all older adults. One of the biggest ways MBA implements this is to contract with providers in cultural and ethnic communities and tribal nations to provide culturally appropriate service for elders, so communities get the services that make the most sense for them and their families. That has been a big priority of ours and we’ve made significant progress in that area. Of course there’s still much to be done, and we are going to continue to work toward giving often underserved people and communities the resources and support they need. Also, we’re trying to make our services accessible to individuals, so we’ve got Senior LinkAge materials available in various languages. We’re working to put native-language-speaking staff in place across multiple communities, especially in the Twin Cities metro area, so they can conduct outreach in their communities and help people navigate through sometimes complicated processes, particularly Medicare.

How can your work help physicians deliver better outcomes to their senior patients?

To expand a bit on what I mentioned earlier, the Senior LinkAge Line provides many opportunities for partnerships or closer working relationships with physicians to help older adults find services they need. So when a physician sees that an older patient needs help with care, they can encourage that patient to take advantage of the service. MBA thinks it could be helpful for physicians to write prescriptions for older adults directing them to take advantage of MBA’s range of classes promoting health, exercise, chronic disease management, fall prevention and mental health wellness. And I recommend that, because people are often reluctant to take the classes, prescribing the classes may make people more inclined to participate. Ultimately, our goal is to partner with physicians in encouraging older adults to maintain or improve their health; a healthy lifestyle is still possible when you’re older, and it can have such an impact on quality of life.

What would you like physicians to know about how they can contribute to your work?

MBA is encouraging physicians to support older clients to stay active, support their health and really maintain their independence. MBA wants to dispel stereotypes about getting older and remind physicians and patients that there are things we can do as we get older to stay active and live the lives we want to live. Often it’s too easy to perpetuate stereotypes when you have such a short window to see people in your office, but we need to remember that life isn’t over when you turn 70, 80 or even 90.

What are some of the continuing challenges facing MBA amid COVID?—

MBA’s main concern is that while we’re doing what we need to do to be safe—there’s been—at times—an alarming degree of social isolation. That’s not unique to older adults, but when you have mobility limitations and it’s harder to get around, it’s easy to get isolated. We’ve seen a skyrocketing trend of isolation in older adults, which impacts their health. It’s something we’re asking physicians to discuss with their older patients and ask them whether they feel lonely, are they connected, who are they connected to, are they seeing people—even if it’s virtually? A lot of us are experiencing that isolation. And for older adults who are fearful about COVID, it’s important to remember there are guidelines to help us whether it be from the Health Department or Centers for Disease Control. Older adults need to know the measures they can take—things they can do in a safe way, get out of the house and live their lives.

What are some of the challenges MBA is focused on in the future?

MBA’s biggest concern is that as a state, we could be doing more than trying to meet the challenge of a growing older population. We can look at this demographic shift as an opportunity, not necessarily a negative thing. Really, the underlying issue is ageism. Statewide, nationally and internationally we could do more to acknowledge ageism exists and it is limiting to us as individuals as we get older. We must promote the fact that older adults can be active in our communities, and for each of us, our health plays a big part in that contribution. We need to actively combat ageism and not feed into the existing stereotypes that we have about older people.

Kari Benson, MPA, is the director of the Minnesota Department of Human Services Aging and Adult Services Division (DHS). In that role she also serves as the Executive Director of the Minnesota Board on Aging (MBA). She provides statewide aging services leadership and oversees planning for and providing sustainable service and support options to help older Minnesotans live well at home. Kari manages Minnesota’s state and federally funded home and community-based services programs and critical services such as the Senior LinkAge Line^®, Adult Protection and the Long-Term Care Ombudsman.