An alliance of health and consumer advocacy groups in the Granite State is working to create a coordinated system of long-term care for healthy aging.

New Hampshire has one of the fastest-growing aging populations in the U.S. - and a majority of people say they'd prefer to "age in place" rather than enter an assisted-living facility or nursing home.

Jennifer Delaney, associate state director of advocacy and outreach for AARP New Hampshire, said new legislation would expedite access to home- and community-based services and give more people a choice in their long-term care.

"Folks can get Medicaid services without waiting for the application to process," said Delaney. "That's one of the big things that sends folks directly to nursing homes, because a lot of the home-care agencies aren't able to absorb that cost."

Delaney says AARP is also working to strengthen the state's Service Link hotline, which connects older adults to a wide range of support services.

Legislation known as the "Systems of Care for Healthy Aging" bill would create a new long-term systems of care director position to ensure oversight and accountability.

Delaney said AARP has teamed up with groups like the New Hampshire Alliance for Healthy Aging and Alzheimer's Association on the bill.

It also advocates strengthening New Hampshire's Prescription Drug Affordability Board, which was created in 2021 to bring greater transparency to how drug prices are set.

When it comes to prescription pricing, Delaney said, sunlight is always the best disinfectant.

"So, it sheds light on how the manufacturers set prices," said Delaney, "so that will hopefully lower prices for drugs across the board in New Hampshire."

Delaney added that no one should have to choose between buying prescription drugs or putting food on the table, and she said she thinks the board can serve as a model for other states looking to reduce potential price-gouging for life-saving medications.

The board has already faced legislative challenges to dismantle or reduce its ability to do just that.

AARP Iowa has released a series of videos asking congressional candidates how they would support Iowans who are unpaid caregivers.

The group traveled Iowa this summer on its "Cruisin' for Caregivers tour" to not only educate people about the issue but to hear from caregivers about what is important to them. Caregivers from each district sat down with Congressional candidates to discuss the challenges they face and potential solutions. AARP Iowa said unpaid family caregivers in the state provide what amounts to about $5 billion worth of services every year.

Paige Yontz, state advocacy manager for AARP Iowa, said unpaid family caregiving is a top issue for Iowa voters age 50 and older.

"The fact of the matter is, these voters are the driving force behind every election," Yontz pointed out. "In Iowa, voters accounted for 54% of the total electorate in 2020 and 62% in 2022, that's voters in the 50-plus category."

AARP polling shows voters in this age group are more likely to choose candidates who have a plan to support unpaid family caregivers. In the videos, Iowa's congressional candidates have 30 seconds to describe their approach.

Seniors have said aging at home has become increasingly important to them and Yontz argued having the help and care they need to do that is critical.

"In Iowa, there are over 330,000 unpaid family caregivers that assist their loved ones with needs that allow them to remain independent in their homes," Yontz explained. "That might be medical care and finances to chores, transportation, grocery shopping, you name it."

AARP said nationwide, unpaid family members provide at least $600 billion in care and services to loved ones and others who need support.

Drawing attention to a housing option that could make it easier for older Nebraskans to "age in place" is one of the goals of an AARP Community Challenge grant-funded contest.

Omaha by Design was awarded a nearly $24,000 AARP "Demonstration Grant" for its "Duplex by Design" contest. The contest is for duplex designs which "promote health and greater autonomy" with their accessibility and affordability.

Abe Lueders, director of urban design and affordable design fellow at Omaha by Design, explained duplexes are one type of badly needed "missing middle housing."

"When we say 'missing middle,' we're talking about basically small multifamily buildings," Lueders noted. "That includes duplexes but also up to quadplexes, townhomes; things that are bigger than a house but smaller than an apartment."

AARP maintains one reason small, affordable housing is missing in many communities is too little of it has been built since the 1940s. This causes some seniors to remain in larger homes than they need.

Empty-nest Baby Boomers in the United States currently own twice the number of large single-family homes as Millennials raising children.

Todd Stubbendieck, state director for AARP Nebraska, said not only is there a need for more "accessible" senior housing but also for more housing options that allow seniors to live independently for as long as they can.

"Duplexes provide that opportunity for a little smaller space, downsized, maybe less stairs and just more of an age-friendly design option for folks," Stubbendieck outlined. "This project is going to highlight and raise awareness of duplexes and create some buildable designs that folks in Omaha can work with."

Lueders stressed in addition to being more affordable and accessible, "missing middle housing" creates more housing on a single lot. He pointed out duplexes are "the next rung up" on the housing ladder, since they are built on the same scale, use the same construction methods and are subject to the same residential building codes as single-family homes.

"It seemed like a really fruitful housing type to explore because of how low the bar for entry is," Lueders emphasized. "Because part of the goal is that you want to create a design that smaller developers can build. Maybe people that are newer to development that have a small piece of land and want to create some housing."

Contest designs must all fit a specific lot, which Lueders added ensures every designer is working with the same real-world constraints.

Registration for "Duplex by Design" closes Sept. 16, after which designs will be accepted until Oct. 18. The first, second and third place winners will receive cash awards of $2,500, $1,500 and $1,000.

A new report found Connecticut residents will benefit from Medicare's new out-of-pocket cap.

An estimated 49,000 people in the state would see prescription costs reduced because out-of-pocket costs will be limited to $2,000 per person each year. The report estimated the number of residents using the cap will hit more than 62,000 by 2029.

John Erlingheuser, senior director of advocacy and outreach for AARP Connecticut, said unaffordable prescriptions are forcing people to take matters into their own hands.

"We continually hear from folks that cut back on the number of pills they're supposed to take," Erlingheuser reported. "Maybe they're taking them every other day as opposed to every day, or they're cutting pills in half and taking a partial dose every day as opposed to taking the dose that they're required to take."

This cap stems from the health care reforms in the Inflation Reduction Act. Other reports showed more than 11,000 Connecticut Medicare enrollees using insulin can save about $590 per year. The out-of-pocket cap goes into effect on Jan. 1.

However, state lawmakers are reviewing other options to reduce prescription prices such as establishing a prescription drug affordability board, an independent body tasked with evaluating drug prices to determine if a price increase is valid.

Erlingheuser explained it can help keep prescription drug costs from getting too high.

"What it'll do is really allow the state of Connecticut to monitor the cost of prescription drugs, compare it with other states, and really put a downward pressure on those manufacturers to bring down those costs," Erlingheuser outlined.

Connecticut's most recent bill to establish a prescription drug affordability board failed to pass due to last-minute hurdles during the shortened legislative session. Public hearing testimony was mixed with many praising the idea of saving people money. However, some opposed Connecticut's bill creating a board because its members would not be representative of people who need lower drug costs.