Justice, not just us

In The Boston Globe's June 20 op-ed piece, “Aging isn’t the challenge; building an equitable society is," gerontologists Laura L. Carstensen and John W. Rowe wrote: 

“Aging too often plays out much differently among less advantaged people. Instead of deepening expertise and well-being, the cumulative effects of poverty, harsh working conditions, and persistent stress leave an alarming proportion of people with little in the way of personal resources. A fifth of married couples and half of unmarried people rely on Social Security alone for at least 90 percent of their income.”

The New York Times today published its last article, “Inequality Is Not Inevitable,” in The Great Divide series, moderated by American economist Joseph E. Stiglitz, who wrote:

“Justice has become a commodity, affordable to only a few. . . .More than a half-century ago, America led the way in advocating for the Universal Declaration of Human Rights, adopted by the United Nations in 1948. Today, access to health care is among the most universally accepted rights, at least in the advanced countries. America, despite the implementation of the Affordable Care Act, is the exception. It has become a country with great divides in access to health care, life expectancy and health status.” 

Americans make up 5% of the world’s population yet consume 25% of its resources, and comprise 25% of the world’s prisoners.  And 99% of Americans are subject to the wealthiest 1%, who control more than 40% of the nation's wealth.

STOP BEING POOR (The Art Show) at Incline Gallery in San Francisco's Mission District: “. . . inspired by the sentiment that many politicians and media correspondents have reverberated: If you’re poor, stop being poor.  . . . With skyrocketing rents and massive neighborhood takeovers, our home, the Bay Area, has become a difficult place in which to live. We invite everyone to come see, but also, purchase art. Can you help us? We need to stop being poor.”

According to the Brookings Institution, the gap between the rich and poor in San Francisco is growing faster than any other city in the nation, and San Francisco’s income inequality is on par with developing countries in Central America and sub-Saharan Africa.  San Francisco risks losing its diversity, especially seniors and persons with disabilities who can no longer afford to live in an increasingly expensive city.

While there is much work to overcome rising inequality and barriers to justice, let's remember people power with this summer’s commemoration of the 15^th anniversary of Olmstead case (June 22, 1999 U.S. Supreme Court ruling that under the Americans with Disabilities Act, individuals with mental disabilities have a right to live in the community rather than institutions) and 50^th anniversary of Civil Rights Act (CRA enacted July 2, 1964 outlawed discrimination based on race, color, religion, sex, or national origin). Knowledge of existing rights and resources can help identify gaps or areas for improvement; for example, CRA has been supplemented with Age Discrimination in Employment Act of 1967 and Americans with Disabilities Act of 1990 (July 26).

Elder justice

 

San Francisco Department of Aging and Adult Services (DAAS) sponsored World Elder Abuse Awareness Day (WEAAD, June 15) Symposium at Born Auditorium in the Human Services Agency building. 

Jill Nielsen, Adult Protective Service (APS) Program Director at DAAS, rattled off the following statistics:

• 5 million, or 1 in 10, older adults in the U.S. are victims of elder abuse, neglect or exploitation
• For every case reported, as many as 23.5 cases go unreported (according to New York prevalence study)
• San Francisco APS received over 6,500 reports of abuse last year, and 580 reports in May 2014 alone

Elizabeth Aguilar Tarchi, San Francisco Assistant District Attorney (DA) for the past 27 years, explained her office’s no drop policy (DA can aggressively hold perpetrators accountable based on evidence, even if victim does not want to pursue action) and vertical prosecution (victim is assigned DA to follow through from charge of crime, rather than have victim re-live experience when dealing with different DAs).  The DA’s Office handles elder abuse cases involving physical and financial crimes.
Any known/suspected abuse should be reported to APS (24-hour hotline at 415.355.6700 or statewide at 800.814.0009) or the Police Department; if immediate harm, call 911.  (If abuse/neglect occurs to a resident in a long-term care facility, call Long-TermCare Ombudsman at 415.751.9788.) 

Mary Twomey, Co-Director at Center of Excellence on Elder Abuse and Neglect based in University of California at Irvine, reminded us that elder abuse is a public health and human rights issue. She performed rap with audience joining her refrain:

I am old, and I am positive

I have wisdom, I’m gonna tell it like it is

I may be disabled, but I’m not obtuse

There’s no excuse for elder abuse! 

At the federal level, Congress has appropriated nothing to implement Elder Justice Act of 2010.  At the state level, California Elder Justice Coalition requested increased funding for statewide training of APS staff and state-level coordinator for county APS.  Mary invited us to wear aqua-colored UNITED AGAINST ELDER ABUSE bracelets, speak up and get involved with her organization, Ageless Alliance. 

Shawna Reeves, Director of Elder Abuse Prevention at Institute on Aging (IOA), discussed the following trends in elder financial abuse with greater coverage: PBS Frontline program on Residential Care Facilities For the Elderly (RCFE) and Castro Valley RCFE abandonment case; California has 12 bills addressing RCFE abuse; and even a TV show dedicated to hoarding.  She described popular scams like the grandparent scam (phone call from perpetrator who claims to be grandchild requesting emergency funds), sales presentations at senior centers, tax prospecting by insurance agents, pension advance loans, etc.  IOA’s Access to Justice Project details San Francisco civil legal resources specializing in remedies for elder financial abuse.

Elder abuse screening tools at http://www.medicine.uiowa.edu/familymedicine/emscreeninginstruments/

Housing & health justice 

Third Annual Howard Grayson Elder Life Conference: Housing & Health for All! at LGBT Center opened with performance by Stonestown YMCA Senior Taiko Drummers! 

Moderator Sue Englander with housing panelists Seth Kilbourn, Openhouse Executive Director; Brian Basinger, AIDS Housing Alliance Director; and Tommi Avicolli Mecca, Housing Rights Committee Director of Counseling Programs.

Tommi presented the following facts:

• 29% of San Francisco’s homeless identify as LGBT, and 3% as transgender
• District 8 (including Castro, which he says is being “de-gayed”) has been hardest hit by evictions, with 2,000 units affected since 1997 during the first dot-com boom
• Two-thirds of seniors live in fear that their building will be sold by a speculator who will evict them and flip rentals for profit

Tommi called for the following 11-point plan of action:

1. eviction defense: demonstrate against speculators (Ellis Act evictions are elder abuse)
2. public relations to denounce evictions: organize, stand and block doors to Sheriff
3. affordable housing advocacy: Community Land Trust alternative
4. develop abandoned property: 300 buildings could be used for housing; only 150 Otis housing (for low-income homeless veterans) was developed in past 12 years
5. moratorium on market rate housing: this is unconstitutional, but so was same-sex marriage
6. rental assistance fund: LGBT Aging Task Force recommended Mayor build 30,000 units; first 8,000 to homeless to get off streets, and fill remaining with low-income
7. stronger eviction protection: relocation for no-fault, Ellis, owner move-in
8. repeal Ellis Act: Costa Hawkins Bill not allow vacancy rent control; need to extend rent control beyond pre-1979 constructed buildings 
9. anti-speculation tax: on November ballot would limit 5-year re-sale of building
10. City shelters need to be LGBT-friendly
11. campaign to reduce LGBT homeless by 50% in 5 years

During the Q&A, Tommi said they could declare a state of emergency to impose vacancy control and roll back rents because the system is broken so we need a revolution to build systems to address the problem, a PR gimmick to “make headlines like Newsom” and “bring outrage to the planet,” while adding “it’s all about theatrics.”

Brian said that activism and advocacy work: once the fringe challenges the status quo, they win because the fringe makes it safe to get what you ask for, and there is opportunity in crisis.  He proposed the following:

• resurrect last legislation that late Supervisor Harvey Milk worked on, two days prior to his murder: tax 100% profits of residential building that is bought and sold within two years, which takes away economic incentive driving evictions.  This anti-speculation tax will be on November ballot.
• introduce legislation to require developers to adopt anti-discrimination protections based on sexual/gender orientation; ask and dialogue to have impact
• organize homeless to develop policy, join budget advocacy, link arms and stand together to force issue and get fair share

He also mentioned the need to elect the right people who are willing to fight and move forward to support the poor, versus moderates who will not rock boats, like former Mayor DiFi who opposed vacancy control and anti-speculation tax.

 

Seth discussed Openhouse’s partnership with Mercy Housing to develop 55 Laguna, 110 units of affordable senior (age 55+) housing that is “LGBT-welcoming” with construction beginning this October, and the next development of additional 70 units, which he hopes to get HUD rent subsidy. Applications for 55 Laguna housing will be available in mid-2015, and then selection will be made by lottery.  He noted this new housing is just a “drop in the bucket” so it’s important to keep people in their homes.  Policy change solution is critical to dis-incentivize speculators from kicking out seniors and to strengthen anti-eviction.    

Snack table and resource fair included Openhouse, CARA, Gray Panthers, SDA and DAAS.

Host Denise D’Anne, former co-president of Harvey Milk LGBT Democratic Club, introduced health care panelists Miss Major, Transgender, Gender Variant & Intersex Justice Project (TGIJP) Director; Susan Pfeifer, Organizing for Action; Celia Chung, Transgender Law Center; and Barry Hermanson, Green Party candidate.  Panelists acknowledged Affordable Care Act (ACA) is not perfect but huge first step for universal coverage by requiring citizens to purchase insurance or face penalty (greater of $95 or 1% of income); ultimate solution is Medicare for All: “the best universal single payer health care system in the world.”  

After screening of 2005 Emmy-winning documentary for historical/cultural program, Screaming Queens:The Riot at Gene Compton’s Cafeteria, Q&A with Felicia Flames and director Victor Silverman. Three years prior to the June 28, 1969 Stonewall riots in New York, transgender community members in San Francisco’s Tenderloin District fought back to protest police harassment which resulted in improved police community relations and support services through Department of Public Health’s Center for Special Problems, including issuance of ID cards with their new gender.  Felicia, a screaming queen who said she will be 68 next month, is also a Vietnam veteran and 27-year survivor of AIDS.

Administration for Community Living (ACL) released an online learning tool, Building Respect for LGBT Older Adults, which is designed to increase awareness of issues faced by LGBT individuals living in long-term care facilities.  

Access to income

Positive Resource Center (PRC) and Senator Mark Leno sponsored Thriving in 2014: A Day Long Institute on Access to Income and Healthcare for People Living with HIV/AIDS at Milton Marks Conference Center in the State Office Building. 

Access to Income panel included:

• Amy Orgain, Staff Attorney at AIDS Legal Referral Panel: private long-term disability insurance may pay 60-70% of income, but only up to age 65 or Social Security retirement age
• Joe Ramirez-Forcier, Employment Services Managing Director at PRC: individuals with HIV may face discrimination based on age rather than HIV status because the average person with HIV in San Francisco is age 50, when there is more turnover in job market so skill refreshment needed  
• Jerry McIntyre, Directing Attorney at National Senior Citizens Law Center: last year’s Windsor decision (providing for equal treatment of same sex marriage) means Social Security spousal benefit available to same-sex married and domestic partners; however, being recognized as married couple is no advantage for SSI benefits due to combining resources and income of spouses, and SSI does not consider spouse if civil union/domestic partner
• Fernando Aguayo-Garcia, Senior Bilingual Benefits Advocate at PRC: non-citizens, who are not eligible for SSI, might be eligible for Cash Assistance Program for Immigrants (CAPI); HIV itself is not disabling, but combined with mental health or diabetes symptoms to make disability

Budget justice

Budget Justice Coalition held a press conference on the steps of San Francisco City Hall an hour before the packed budget hearing. 

San Francisco Public Defender Jeff Adachi called for increased funding for eviction legal defense because only 10% of tenants had lawyers to defend them in eviction suits brought by landlords, of which 90% had lawyers.

 

Colleen Rivecca of St. Anthony’s Foundation and San Francisco Food Security Task Force called for additional $10 million for home-delivered meals to serve vulnerable seniors and persons with disabilities (PWD) so they can remain in their homes. 

Marie Jobling, on behalf of San Francisco Long-Term Care Coordinating Council, requested additional $3 million funding for Community Living Fund, created in 2006 with initial funding of $3 million, to help re-establish Laguna Honda patients into the community. 

At budget hearing, seniors and PWD spoke first. SDA Executive Director Jessica Lehman requested funding to fix broken elevators in SRO hotels.

 

In the overflow room in City Hall’s North Light Court, Project Open Hand (POH) Operations Director Simon Pitchford and Executive Director Kevin Winge (seated second row) watch budget hearing on screen.  POH provides “meals with love” at 18 congregate meal sites for seniors and PWD in San Francisco.  In 1998, DAAS selected POH to replace The Salvation Army, which lost its senior congregate meals contract when it failed to comply with a 1997 ordinance requiring anyone who did business with the City to provide nondiscriminatory domestic partners benefits. 

 

At Potrero Hill Health Fair, POH Associate Director of Senior Services Noah Lopez (FOOD=LOVE) and Senior Sites Manager Darin Raffaelli (MEALS with LOVE) model fashion-forward POH T-shirts.  

Long-term care

Basics of Medicare and Medi-Cal presentation, hosted by On Lok Lifeways, addressed long-term care needs. 

Shibin Tharayil of San Francisco Health Insurance Counseling and Advocacy Program (HICAP) explained that after a 2-night hospital stay, the hospital should (and one should make sure the hospital does) admit one as an inpatient versus “observation” status —an important distinction because one must spend at least 3 full days in the hospital as an admitted patient to receive Medicare coverage for first 20 days in a skilled nursing facility. 

 

On Lok Medi-Cal Eligibility Specialist Daniel Sullivan covered Medi-Cal Basics.  In California, Medi-Cal Managed Care (such as On Lok Lifeways) is available to low-income, undocumented persons with PRUCOL (Permanent Residence Under Color of Law) status, or persons who are not lawfully residing in U.S., but the immigration agency does not intend to pursue deportation. 

 

On Lok Outreach and Enrollment Specialist John Lam provided an overview of Lifeways’ consolidated model of long-term care for adults age 55+ who are certified by the state as meeting the need for nursing home level of care, and funded by Medicare and Medi-Cal waivers.  John also organized Gray Pride community space (rest area, water, snacks, private ADA-accessible bathroom) for seniors at LGBT PRIDE Festival.

  

Civil rights

Born after the Civil Rights Act of 1964, I view this landmark legislation as history that comes alive when I hear older adults share their reminiscences of those dark ages when “discrimination with a smile” was the norm.  The San Francisco Federal Building hosted Celebrating & Collaborating: The 50th Anniversary of the Civil Rights Act of 1964. 

Steven Anthony Jones, Artistic Director of Lorraine Hansberry Theatre and artistic collaborator of Civil Rights at 50, asked the audience to interject “and women” whenever he said "men" as in “we hold these truths to be self-evident, that all men. . . and women!"  According to some reports, Rep. Howard Smith, a segregationist from Virginia who was against civil rights, included sex-based discrimination so the civil rights bill would be too controversial to pass, but it did pass! 

In this panel discussing the accomplishments and impact of the CRA, Senior U.S. District Judge Thelton Henderson was the token senior at 80 years old.  As a 1962 graduate of UC Berkeley’s Boalt Hall School of Law, he was the first African-American lawyer in the Justice Department’s Civil Rights Division and recalled being sent to the South to monitor local law enforcement for civil rights abuses, including investigation of the 1963 16^th Street Baptist Church bombing that killed four black girls. (Other panelists were Zoe Polk, Director of Policy & Social Justice at San Francisco Human Rights Commission, and Reuel Schiller, Professor of Law at Hastings College of Law.)

Closing digital divide 

At yesterday’s Older Women's League (OWL) meeting, Community Living Campaign (CLC) Director Marie Jobling presented on 10 Things to Love (and 5 Things to Hate) about Technology.  When technical difficulties delayed her showing of the trailer for Cyber Seniors documentary, Marie quipped, "Computers teach you patience." 

First, Marie's top 10 loves about technology:

1. connects us: skype, google, twitter, blogger, youtube, linkedin, facebook
2. facilitates lifelong learning 24/7 in every language (google translate, Duolingo), every subject
3. levels playing field to break down barriers for PWD, limited English: assistive technology, large print, more disability access built-in
4. language and disability access
5. pathway to employment & volunteer opportunities
6. convenient shopping
7. helps us take control of our health & well-being: research, connect with health providers, fitness apps
8. we can make & promote our own “news”: blogs, digital photo sharing, customize what you read (google alerts)
9. keeps mind & memory sharp: learn new things, brain fitness games, genealogy
10. fun: online entertainment

 

Then, Marie's 5 things to hate about technology:

1. discourage connections in-person: lack basic courtesies, create new class of haves & have-nots, don’t know when to put screen down
2. not available to all: limited affordable access
3. problem with p@ssW0rds: hard to remember all, complex to be secure
4. privacy: keep info secure, know how to be safe, what to share
5. things change too fast: hard to keep up, too expensive

CLC, which organized the 2012 Aging & Disability Technology Summit at City Hall, provides technology training through SF Connected program. CLC Connector LaNay Eastman demonstrated technology tools for persons with vision and/or hearing disabilities.  Independent Living Resource Center of San Francisco (ILRCSF) is the local assistive technology network, where one can "try before you buy."