“Live simply, so others may simply live.” – Mahatma
Gandhi
“For we have brought nothing into the world, and
neither can we carry anything out. So
having sustenance and covering, we will be content with these things.“—1 Timothy
6:7-8
“Really having not enough is horrible: persistent hunger and cold
make you unwell and stressed. Having just enough, plus a little more, is
absolutely lovely. Having even more than that, just because
it’s the cultural norm, starts to make you unwell and stressed all over again …”—Annie Raser-Rowland, co-author of The Art of
Frugal Hedonism: A Guide to Spending Less while Enjoying Everything More (Finding Pleasure in the Free Things in Life)
Seniors
on fixed income live simply, out of necessity or practicality. My clients who live in Single-Room Occupancy (SRO) housing simply lack physical space to accumulate lots of material stuff! Some tell me they wish to maintain their SRO tenancy (though their limited mobility and lack of building elevator makes them homebound) because their community of neighbors is their social safety net. To live simply, it helps to be content with what one has,
and to be resourceful by embracing permaculture:
whole-systems approach to sustainable living based on ethics (earth care, people care and fair share) and principles (observe and interact to design solutions that suit our particular situation,
integrate rather than segregate so relationships develop and support each other,
creatively use and respond to change, etc.).
Housing
Pictured
above, left to right: Steven Wallace, Margot Kushel, Cathy Davis, Cristina
Flores, Wendy Max (moderator and Director of UCSF Institute for
Health & Aging)
UCSF Institute for Health & Aging and the Dorothy P. Rice Center
- Keynote speaker Steven Wallace, Professor at UCLA Fielding
School of Public Health, provided a wealth of data showing shortcomings of
Federal Poverty Level (FPL) (failure to keep up with costs like housing
and healthcare, The Hidden Poor:
Over Three-Quarters of a Million Older Californians Overlooked by Official
Poverty Line),
and need for Elder Economic Security Standard (EESS) Index to adjust for local (county) costs of living and
actual costs of basic necessities (food, housing, transportation,
healthcare); Affordable Housing: A
Key Lever to Community Health for Older Americans. Example: 2017 FPL of $1,005 per month is not enough to cover HUD fair market rent of $2,411 per month for 1-bedroom in San Francisco! He discussed innovations like Santa Monica’s rental assistance (compare San Francisco's rental subsidy program cuts),
improving SSI/Social Security (avoid chained-CPI), and linking housing assistance
to health care funding.
- Cristina Flores, Assistant Professor at UCSF
Department of Social and Behavioral Sciences, talked about how long-term care (LTC), when one can no longer remain at home, threatens economic
security due to its cost outpacing inflation since 2013.
- Cathy Davis, Executive Director of Bayview Hunters Point Multipurpose Senior Services, talked about barriers to access affordable senior housing, based on her experience with George W. Davis Senior Residence, which opened June 2016: waiting list (pre-application process), lack of computer knowledge (SF Housing Authority required online applications), misunderstanding (offers v. information), lack of advocacy, language and cultural barriers, varying income guidelines, missing window of opportunity to apply (October 2015), complexity and bureaucracy.
- Margot Kushel, UCSF Professor of Medicine, talked
about homeless older adults age 50+ who often have geriatric
conditions usually found in people who are 20 to 30 years older, and hard to have home care when they don't have a home. Based on her research of homeless seniors in
After
retiring from federal service, including serving as Director of National Center
for Health Statistics, Dorothy Rice joined the faculty at UCSF Institute for Health & Aging. Professor Emerita Rice, now 94 years old, resides
in a senior community.
In my
work with homebound seniors, mostly low-income and marginalized in Tenderloin and South of
Market Area, some clients have experienced abrupt termination or denial of
support services that impact their ability to continue living safely in housing.
Several (now former) clients became homeless from evictions due to nonpayment
of rent after they were dropped by their representative payees (due to staff
layoffs) and were not able to pay rent on their own. For my frail clients who are dual eligible
beneficiaries and could benefit from coordinated care, I referred to On
Lok Lifeways Program of All-Inclusive Care for Elderly (PACE) only to learn that they do not qualify because they are not considered “able to
live safely in the community” due to their dual diagnoses.
Home care
Many of
my homebound clients receive home care assistance to remain safely in their
homes through In-Home Supportive Services (IHSS), which is
covered by Medicaid. Jill Nielsen,
Deputy Director of Programs at San Francisco Department of Aging and Adult
Services (DAAS), provided the following statistics at IHSS in San Francisco
- 22,000 IHSS consumers
- 19,000 IHSS providers
- 1,320 consumers in contract mode (Homebridge)
Symposium
featured following panel of agency directors:
- Megan Elliott of DAAS IHSS oversees
200 employees who receive 400+ referrals per month; IHSS social workers,
who have caseload of 350+ each, see consumers at initial application and
annually thereafter to determine services and hours needed (detailed in
“notices of action”); 90% of consumers use family and friends as
independent provider (IP mode); use IHSS Public Authority registry to find
provider; less than 5% use Homebridge homecare agency; few use combination
IP + Homebridge; Independent Provider Assistance Center (IPAC) enrolls
providers and processes their timesheets
- Kelly Dearman of SF IHSS
Public Authority provides registry of 250 screened IPs, offers health and dental benefits
- Mark Burns of Homebridge (formerly called Consortium) has about 60 program staff to train/place 400+ home
care providers for 1,350 consumers who must be referred by DAAS social
worker.
They
discussed the “crisis” of provider retention. IHSS might curtail referrals to
Homebridge, by starting waitlist. Each month, Homebridge recruits 100 providers, "lucky”
if 60 show up for training, 20-25 complete 2.5 weeks of paid training, 20
providers from prior trainings are terminated (more than 50% fired for no-show
or abandonment), so there is usually net gain of 2-5 providers. Homebridge's home care workers are paid $13/hour minimum wage (v. private agencies pay $19/hour), so Burns
advocates a career ladder to attract and retain more workers. (Burns’ talk about job abandonment reminded
me of “A Separation,” an Iranian film portraying the demands of caring work: a caregiver who places her own health at risk and temporarily abandons her job caring for a man with Alzheimer’s to visit a hospital.)
Architect
Susanne Stadler and Social Worker Donna Schempp presented Aging
at Home 360: An Interdisciplinary Approach to Aging in One’s Home. They showed a 5-minute video, “A Day in the Life,” featuring 4 older adults talking about the role of their home (affordable
senior housing, co-op, private home, and Section 8 housing). Susi said who we
are depends on our environment, which should support and adapt to our needs and abilities. We should ask: Can
my home grow with me? Can I continue to grow in my home?
We need a
home base to stay connected and engaged with community, yet the majority of
homes do not support all ages and abilities.
As a result, one can become a prisoner at home. Enter Stadler & Associates offering the
power of design with social services to re-imagine aging at home beyond the basics
of safety: food, fitness and social connections keep one going and engaged.
Their
collaborative approach has 4 elements:
- Architectural design: spaces
are functional & beautiful
- Tools/technology:
interactions are healthy, intuitive & delightful
- Health/human connection:
promote optimal health, function & support
- Mental health/emotional
perspectives: develop understanding, coping strategies & support
Some of
their findings:
- Most significant barrier to
change is one’s emotional attachment to the way one has lived for a long
time
- A participatory process
through conversations is key in overcoming emotional barriers (“telling
one’s story”)
- One of the biggest barriers
to simplifying life is getting rid of books and personal papers
- It is hard to make changes on
your own – one needs partnership of family/friends/neighbors
Their Aging
at Home 360 assessment costs $2,000, which they are working to make more
accessible by creating a DIY workbook for a workshop.
Audience
included movers and shakers of aging in place advocacy: SFPL health librarian
Janet Tom, Aging Commission President Edna James, Community Technology Network
Kami Griffiths (who recently launched Tech Allies to bring tech training to homebound seniors), Meals on Wheels social workers
Amy and Lois, DAAS Nutritionist Linda Lau, and Sutter Health social worker
Vladimir.
Caring for someone with dementia
UCSF
Memory and Aging Center Serggio Lanata , MD
Yikes, most of my homebound clients are doing this “worst thing”—except during my home visits when I ask them to at least turn down TV volume (as well as to refrain from smoking and drinking alcohol)! And many affordable senior housing and centers have activity calendars that promote a culture of TV watching, along with greed (bingo, casino trips).
Yikes, most of my homebound clients are doing this “worst thing”—except during my home visits when I ask them to at least turn down TV volume (as well as to refrain from smoking and drinking alcohol)! And many affordable senior housing and centers have activity calendars that promote a culture of TV watching, along with greed (bingo, casino trips).
Sarah Dulaney, RN, Nurse Coordinator for Care Ecosystem study, presented tips on “How to be a Caregiver” of someone with dementia:
- Structure and daily routine
to help person preserve the ability to do things—providing more time,
support and supervision as person loses ability to organize, plan and
initiate activities
- Simplify the environment by
removing clutter, organizing objects by task, using visual cues (label
objects, color contrast)
- Though Reisberg’s theory of retrogenesis suggests that the cognitive level of a
person with Alzheimer’s disease develops in reverse order of how the brain
develops from birth, don’t treat the adult with dementia as a child
- Keep instructions simple and
respectful (offer simple choices, break task down to
simpler steps, be patient and give time to be successful, etc.)
- Use DICE (Describe
context, Investigate, Create plan, Evaluate) approach to respond to challenging behaviors
- Go with the flow or try to
enter the reality of the person with dementia
- Self-care!
Listening to your favorite music is better than watching TV! Music therapist Ruth
MacGregor re-enacted the response of her elderly client, with dementia, listening
to The Platters’ song, “Remember When”: changing flat affect to engagement, tapping
feet, lifting hand to shake rattle, opening up position, etc. She explained selecting favorite music from
era of a client’s teen years to 30s seems to have the most impact.
End of Life
UC
Berkeley Extension hosted End of Life Option Act: Clinical and Legal Implications with
the legal overview presented by Sara Hooper of UCSF/UC Hastings Consortium on Law, Science & Health Policy, and the clinical perspective by Lael Duncan
of Coalition for Compassionate Care of California. Under the
Act,
aid-in-dying is not “suicide” but underlying disease is listed as cause of death. Presenters said it’s hard to predict how many
California
This
month KALW 91.7FM Host JoAnn Mar launched her 4-part The End of Life Radio Project covering
Advance Care Planning, Palliative Care, Advance Directives, and Physician-Assisted Dying. Five years ago (before I entered the
gerontology field), I executed an Advance Directive choosing no life support
treatment (preferring to keep things simple, to live/die naturally). Since then, I’ve learned from my senior clients, many who return home after hospital
discharge and adapt to their changed quality of life because they’re tethered to an oxygen tank, exhausted from dialysis
3x a week, recovering from major surgery, etc. Clients
say they are grateful for what they have, another chance to savor the gift of life … so you just never know until life happens to you, and I may be reconsidering a few life support options.
Keep it simple thoughts
53-year-old
pop artist Cary Leibowitz got his own solo exhibit at Contemporary Jewish
Museum. His works also will be on view at
Muni bus shelters—similar to last year’s poster art from Susan O’Malley’s Advice from My
80-Year-Old Self.
“if U try
reaLLy hard and stiLL faiL U deseRve aLL tHE sympathy U can get”
“U CAN’T
B Dead aLL the TimE”
“it’s not humility or humbleness it’s regret”
“HEY! I’M
NOT DEPRESSED ANYMORE"
"IT’S A
BEAUTIFUL DAY AND YOU’RE HERE HOORAY!"
These umbrellas cheered me up during this rainy January.
These umbrellas cheered me up during this rainy January.
February 9, 2017
ReplyDeleteMayor Cuts New Housing Subsidies Putting Hundreds at Risk
by Crystal Yu
Mayor Lee recently cut funding for two new Board-funded housing subsidies, affecting 175 households across the city. The funding would have provided critical rental assistance for seniors, families, and people with disabilities.
These funds were backed by the Board of Supervisors and totaled $2.5 million—125 subsidies worth $1.5 million for seniors and the disabled, and another 50 subsidies worth $1 million for families with children.
“We have to invest the resources to keep people in San Francisco,” says Brian Basinger, Director of the AIDS Housing Alliance and Q Foundation, a nonprofit organization that works to prevent homelessness for the LGBTQ and HIV communities. “The repercussions of displacement are greater.”
The two housing subsidies were part of several homeless initiatives the Mayor had funded in the summer of 2016. The plan was to support the initiatives with anticipated revenue from Proposition K, a local sales tax increase on the November 2016 ballot, which would have provided $50 million for homeless services. When Proposition K did not pass, the Mayor defunded the housing assistance programs citing budget cutbacks.
Efforts are already underway to persuade the Board to restore funding. “It is cheaper to keep people in the homes they already have than to allow them to get evicted,” says Basinger. “The cost of displacement is just too high.”
The budget cuts will affect a large majority of San Francisco’s homeless population. According to the Coalition on Homelessness, which publishes the Street Sheet, at least 4,400 homeless San Franciscans have a disabling health condition. Over 3,300 are homeless children living in in-tact families, and at least 1,700 are older adults living with HIV/AIDS. In addition, the Human Services Agency Planning Division states that at least 4,600 homeless seniors identify as LGBT and need access to permanent rental assistance to remain in their homes.
“We need to make sure that we are increasing investments across the board into all kinds of communities for whom displacement puts them at greater risk,” Basinger says. “If [people] get displaced from San Francisco, they wind up in less tolerant communities.” Often, these people are turned away for critical health services they need.
Basinger urges concerned citizens to call their Board representatives. “Right now, the focus is on the Board of Supervisors to restore the funding,” he says. “We’re asking residents to contact their Supervisor and ask for their support to replace the funding for these 175 subsidies.”
“We would like to have unanimous support from the Board because we want to make sure that the Mayor spends the money. A broad base of support for this effort will influence his approach.”
So far, the community has support from Sandra Lee Fewer from District 1, Aaron Peskin from District 3, Jane Kim from District 6, Norman Yee from District 7, Hillary Ronen from District 9 and Ahsha Safai from District 11.
Community members are in discussions with the remaining six Supervisors.
http://www.streetsheet.org/?p=2891
High Anxiety: Paying for the Costs of Care
ReplyDeleteBy Lynn Friss Feinberg
February 14, 2017
My almost 96-year-old mother is one of about half of older adults with disabilities serious enough to need long-term services and supports. She is nearly blind, has dementia and osteoporosis, and suffers from arthritis…back pain…For the past four years she has been living in an assisted living facility in New Jersey …
The high cost of long-term services and supports (LTSS) — also called long-term care — is a major worry and source of high anxiety for people with chronic care needs or disabilities and their families.
... In 2016 alone, our mother’s out-of-pocket costs of care at her assisted living facility were nearly $116,000. How does this break down?
Room and board, $45,000; medication management, $7,800; help with bathing, $7,440; personal needs account to cover expenses such as cable TV and telephone, $2,650. We also hired personal care attendants for nine hours a day on weekdays and five hours each weekend day to help our mother with self-care tasks when she gets up in the morning (such as dressing and toileting) and to provide companionship and assistance during the day. This additional paid help for two aides averaged $19 per hour or $53,000 for the year.
My mother is fortunate to have a private long-term care insurance policy that my late father had purchased for her and himself back in 1996. Today, only about 11 percent of older adults own such insurance policies, with premiums generally unaffordable to most American families. My mother’s private long-term insurance policy paid $29,760, or only about 25 percent of her cost of care, in 2016. Because she has resided in an assisted living facility for four years, and used home care services for about two years before she moved out of her home, she has nearly exhausted her lifetime maximum benefit of $146,000...
And these costs don’t even include our mother’s out-of-pocket spending for medical care (such as costs for prescription drugs, dental care and health insurance premiums) and other living expenses (such as incontinence supplies). These expenses also exclude costs incurred by me and my sisters, including monthly meal and travel costs to and from Maryland (where I live) and New Jersey. Importantly, the costs don’t reflect the time and emotional energy one of my sisters spends in checking, verifying, paying and keeping track of the monthly bills on a spreadsheet.
LTSS is unaffordable for most people over an extended period of time.
Adding to our worries is the reality that our mother’s expenses are likely to go nowhere but up. Due to her need for greater help and supervision in daily activities, she may have to move from assisted living to a skilled nursing facility where the cost of care for a private room for an individual with dementia is almost $130,000 a year. This cost excludes hiring paid help to provide one-on-one support and companionship for our mother, who is nearly blind. Who can afford this? And for how long?
Most Americans are often stunned at the high cost of LTSS, especially nursing home costs.
When most families begin their caregiving journey, they are unaware that Medicare does not pay for LTSS for people like my mother who need help with everyday activities, such as bathing, dressing or eating. And private long-term care insurance meets the needs of only a few.
Better options are critically needed by American families to help them pay for LTSS.
Recently, my colleague Howard Gleckman noted that families spend more to care for their aging parents than to raise their kids. …While most families voluntarily take personal responsibility for caring for older family members’ needs, middle-income family caregivers are unable to assume financial burdens and support on their own. Like our kids, our society, too, has a shared responsibility in caring for its older adults with complex care needs and people with disabilities. Neither family nor society can do it alone.
http://blog.aarp.org/2017/02/14/high-anxiety-paying-for-the-costs-of-care/
WEDNESDAY, MAY 3, 2017 4:00 PM EDT
ReplyDeleteBen Carson is worried that public housing is too good for poor people
Carson's "listening tour" was blasted by residents who called his visits "staged"
CHARLIE MAY
As secretary of the Department of Housing and Urban Development, Ben Carson has been traveling throughout the U.S. for a number of weeks on a listening tour, meeting with low-income citizens relying on the government for assistance. Only, to some, the tour seemed more like a photo op than a chance to have a substantial conversation with a powerful government official.
“It was staged. It was so fast,” said 87-year-old Alzene Munnerlyn, according to The New York Times. Carson paid a visit to her apartment complex in Columbus, Ohio, on the second day of his tour. After she was priced out of her apartment, Munneryln now lives in senior housing, paid for in part with a voucher.
“There needs to be a forum where you can just sit and talk with him, and he could ask you how you feel and then you could express yourself,” she said, frowning, according to the Times. Munnerlyn was upset and she felt as if she had been used, as Carson and many other local housing officials took pictures in her living room.
“She had wanted to tell Mr. Carson that President Trump’s plans to cut funding for housing vouchers might make it harder for other seniors to keep their homes,” the Times reported.
Carson, a former neurosurgeon with no prior experience in running a federal agency, has acknowledged that government-funded housing is a necessity for some Americans, but he doesn’t want them to get too comfortable. He told the Times that compassion means not making people dependent or providing them with “a comfortable setting that would make somebody want to say: ‘I’ll just stay here. They will take care of me.’”
Carson has a worldview that is typical of many conservatives — that people need to work for a living and those who work harder will achieve greater success. In January, the Times noted that Carson “embraced standard conservative views that too much government help — both in desegregating neighborhoods and in lifting people from poverty — can discourage people from working hard.”
While touring various facilities in Ohio last week, Carson said in jest that one apartment complex that houses veterans lacked “only pool tables,” according to the Times. As he continued his tour, he had nothing to say, except nod his head, to officials who described to him an overcrowded homeless shelter stacked with dozens of bunk beds where the people were purposely deprived of televisions.
“We have some people who are mentally ill. We have some elderly and disabled people,” Carson told the Times. We can’t expect in many cases those people to do a great deal to take care of themselves,” he continued. “There is another group of people who are able-bodied individuals, and I think we do those people a great disservice when we simply maintain them.”
Charlie May is a news writer at Salon. You can find him on Twitter at @charliejmay
http://www.salon.com/2017/05/03/ben-carson-is-worried-that-public-housing-is-too-good-for-poor-people/
Honor thy parents by fighting for S.F. affordable housing
ReplyDeleteBY SUSAN MOLDAW | FEBRUARY 14, 2017
As a chaplain, I counsel those sick in body or spirit and try to put myself, as the saying goes, in the other person’s shoes. But when I climb the steps to Evdokia’s third-floor walk-up in San Francisco’s Richmond District, I want to take my shoes off and rest my feet.
Evdokia has Parkinson’s disease. She’s a Russian Jewish émigré who came to this country when she was 60. Now she’s 95. She can no longer go up and down her stairs without assistance, and every step is painful.
A pianist who taught music and gave piano lessons to earn a living, Evdokia plays the piano in the Russian Center every chance she gets. Days she has to stay in her apartment without going out, she feels as if she’s in a prison. She’s already waited for years to find a new apartment. What will happen when there’s no longer anyone to help her down the stairs?
San Francisco’s social service agencies help place low-income residents in affordable housing, but there is a shortage of affordable housing for residents like Evdokia. Her plight is common in San Francisco.
San Francisco’s population age 60 and older has grown 18 percent in the last 12 years, compared with the city’s overall population growth of 4 percent during that time. Seniors currently number approximately 161,777, but that number is projected to rise to about a 250,000, when it will comprise approximately one-quarter of the city’s population by 2030.
This is hardly a wealthy population. About 38 percent of seniors live below or just above the federal poverty level. A single senior’s median annual income is about $22,000 in San Francisco.
Housing continues to be the most overarching, urgent challenge facing seniors.
Yet the cost to live in the city is staggering. The median market rate to rent a one-bedroom apartment in San Francisco is around $40,800 annually, which in other areas of the country would be enough to qualify for a mortgage and buy a house. About half of San Francisco’s seniors are renters who will face great odds finding new housing if they were to lose their current home.
There are 172,000 rent-controlled units in San Francisco, 6,300 public housing units and 16,000 affordable-housing units. There’s a shortage of 40,845 homes affordable to San Francisco County’s extremely low-income and very low-income households, according to a 2014 California Housing Partnership Corporation report. Much of the city’s housing supply is old and inaccessible to wheelchair-users or those with difficulty walking or climbing stairs.
If Evdokia can’t get down her stairs, she won’t be able to get out of her apartment. The result will be isolation and potential loneliness.
“Housing continues to be the most overarching, urgent challenge facing seniors,” according to a 2015 report prepared by San Francisco’s Department of Aging and Adult Services.
SPUR, the San Francisco Bay Area Planning and Urban Research Association, recommends several measures to increase the supply of affordable housing. Its recommendations include protecting existing rent-controlled units, reinvesting in public housing and doubling the amount of subsidized affordable housing.
Jewish law commands us to honor our parents. Evdokia could be any one of our mothers. Her lifeline is playing the piano at the Russian Center. Alone in her apartment, her world is shrinking. With nowhere to move, she will soon be trapped and it will almost certainly impact her health. We need to develop more affordable housing in San Francisco to connect seniors — and others — with life.
http://www.jweekly.com/2017/02/14/honor-thy-parents-by-fighting-for-s-f-affordable-housing/
Dorothy Rice, economist whose research paved the way for Medicare, dies at 94
ReplyDeleteBy Harrison Smith March 6
Dorothy Rice, a federal economist whose research on the financial toll of illnesses and disabilities had a profound effect on health care in the United States, leading in part to the creation of Medicare in 1965 and to a more than $200 billion settlement with the tobacco industry, died Feb. 25 at a hospital in Oakland, Calif. She was 94.
She had recently fallen and broken a hip, said a son, Ken Rice.
The daughter of Jewish immigrants from Poland, Mrs. Rice was for many years a nationally recognized health-care economist and statistician, first in government and then in academia as a professor at the University of California at San Francisco.
Mrs. Rice never attended graduate school, but she developed methods of economic analysis that are still in widespread use today — and that rely on a bevy of health data that she helped bring about.
As an analyst with the Social Security Administration, Mrs. Rice wrote a revelatory 1964 ¬report that found that about half of the U.S. elderly population, or 8.5 million people, did not have health insurance. Those 65 and older who were most in need of health insurance, she noted, were also “the least likely to have it — persons in poor health, the very old, those not employed and those with low incomes.”
“Today it is inconceivable that 50 percent of the population would be uninsured,” said Karen Davis, a health-policy professor at Johns Hopkins University. Mrs. Rice, she said, was “instrumental to the enactment of the Medicare program,” which guarantees health insurance to people 65 and older, and to its subsequent refinement through the collection of data on all aspects of health care for the elderly.
At federal health agencies including the National Center for Health Statistics, which Mrs. Rice led beginning in 1976, she established new statistical standards and spearheaded studies that provide data on health expenditures across the country.
Perhaps most significantly, Mrs. Rice was among the first ¬researchers to rigorously analyze the costs a particular illness inflicts on society, in terms of individual hospital bills and the productivity lost when a bricklayer — or homemaker — is forced to take time off work.
With a colleague, Barbara Cooper, Mrs. Rice became the first to place an economic value on the work of a homemaker, a job she knew well from having taken 11 years off work to raise her children.
“She looked at all the things a housewife did during the week and how many hours she spent doing it and looked at the market for each of those components,” said Mrs. Rice’s son Thomas Rice, a health-policy professor at the University of California at Los Angeles.
“She wasn’t just taking stuff off the shelf,” her son said. “She and Barbara Cooper were inventing solutions to problems that others hadn’t dealt with before.”
Mrs. Rice led studies on a range of ailments, including Alzheimer’s disease and AIDS — “you name a disease, I did a study on it,” she once said — and did much of her research after leaving the federal government in 1982, when she became frustrated by cuts in funding for health research under the Reagan administration.
In the late 1980s, she and Wendy Max, a colleague at UCSF, began studying the cost of smoking-related illnesses, work that was crucial to a 1998 settlement between 46 states and the tobacco industry.
…Mrs. Rice …later described her move to Madison as “the best thing that ever happened to me.” She studied labor economics under Edwin Witte, one of the fathers of Social Security, and took statistics courses under Milton Friedman, the free-market economist...
https://www.washingtonpost.com/national/health-science/dorothy-rice-economist-whose-research-paved-the-way-for-medicare-dies-at-94/2017/03/06/90dbabc4-027e-11e7-b1e9-a05d3c21f7cf_story.html
Housing help for Congress? How about for people who really need it?
ReplyDeleteDiane Yentel
July 6, 2017
Just before he departed the House last week to become a Fox News contributor, Utah Republican Jason Chaffetz proposed a housing stipend for members of Congress. “I think a $2,500 housing allowance would be appropriate and a real help to have at least a decent quality of life in Washington,” he said. “You shouldn’t have to be among the wealthiest of Americans to serve properly in Congress.”
It’s refreshing to have a prominent Republican lawmaker decry housing costs and the difficulty of making ends meet. But Chaffetz should recognize the significant housing subsidy that members of Congress and other wealthy Americans already receive, and the millions of struggling low income seniors, people with disabilities and families with children who receive none.
As a member of Congress, Chaffetz earned at least $174,000 per year, putting him in the top 8% of earners in the country…for members of Congress — their average wealth is just over $1 million. Most are homeowners and, if they have a mortgage on their home, they receive a housing subsidy in the form of the mortgage interest deduction…
Meanwhile, hundreds of thousands of people in the United States have no homes at all, and just 25% of the lowest income renters in need of assistance receive such help. Why? The main reason is our unbalanced federal housing policy: We spend more to subsidize the homes of 7 million of the highest income homeowners than to assist 55 million of the lowest income renters,…
Every year, the National Low Income Housing Coalition calculates the amount someone needs to earn an hour to be able to afford to rent a modest two-bedroom apartment in every state, metro area, and jurisdiction across the country. Nationally, this “housing wage” is $21.21 per hour, nearly $5 more per hour than the average renter earns. In many states, the gap is even higher…
Seniors or people with disabilities living on fixed incomes and families with children whose parents work at very low-wage jobs often pay more than half of their income for their home. That puts them one financial emergency away from eviction and possible homelessness.
Research shows that in no state can the average extremely low-income household, those at or below 30% of the area median income, afford to pay the national monthly rent of $892 for a one-bedroom rental home. In fact, the average extremely low-income household cannot afford to spend more than $523 per month on rent.
The 5.5 million people with disabilities who rely on Supplemental Security Income (SSI) can afford a rent of just $221 per month. In 22 states, the average fair-market one-bedroom rent is more than the entire monthly income of an SSI recipient.
While low income renters struggle to afford their homes, the federal government provides ample housing subsidies to higher income homeowners with incomes greater than $100,000. Housing tax expenditures allow homeowners to subtract the interest paid on their mortgages and real estate taxes from their federal taxable income. These two deductions combined cost the federal government nearly $100 billion annually. Low and moderate income homeowners often receive no tax benefit from holding a mortgage because they don’t earn enough to itemize their taxes.
Comprehensive tax reform offers an opportunity to rebalance federal housing policy to provide housing subsidies to those most in need: the lowest income families, seniors, veterans and other struggling households. Modest reforms to the mortgage interest deduction can provide a tax break for millions more low-income homeowners and achieve significant savings to reinvest in highly targeted rental housing solutions — such as the national Housing Trust Fund and rental assistance programs that serve people with the greatest needs…
Diane Yentel is president and CEO of the National Low Income Housing Coalition.
https://www.usatoday.com/story/opinion/2017/07/06/housing-help-for-congress-or-truly-needy-yentel-column/449935001/
A Dimming Dream Of Retirement In California
ReplyDeleteTuesday, June 19, 2018
By Amita Sharma
…California has one of the highest percentages of seniors living in poverty in the United States, behind only Washington DC, according to the Kaiser Family Foundation. One in five seniors in California live in poverty, after adjusting for spending on basic necessities.
And the UC Berkeley Labor Center predicts half of Californians currently working are on track to retire with individual incomes of about $24,000 a year, twice the federal poverty figure.
The California Dream of retirement -- having enough money to enjoy a carefree life after decades of work -- hasn’t lived up to its promise…
“It’s heartbreaking,” said Kevin Prindiville, executive director for Justice In Aging, a national advocacy group for seniors. “Seniors are the people who cared for us. They’re the people who built our communities, who taught our kids, who worked in our hospitals. They really built our cities and our state and now to see them struggling so much just to put food on the table or to have housing, it’s brutal.”
According to Prindiville, wage stagnation, high housing and health care costs and a decrease in company pensions have made it harder for people to save for retirement.
The struggle often means reliance on the goodwill of others.
…Analysis by the California Budget & Policy Center shows the median percentage of household income spent on housing by seniors was 24 percent in 2016. For senior homeowners, it was 19.5 percent. For elderly renters it was 37 percent.
The federal government recommends that people spend no more than 30 percent of their income on rent or a mortgage.
What is different about today’s seniors in California is that they did “all the right things,” said Prindiville of Justice In Aging.
“They worked,” he said. “They were in a relationship. But then something went wrong, a divorce, a death of a spouse, a lost job, a problem with a housing situation.”
Conditions are more dire for women.
“Women are twice as likely to age in poverty than men,” Prindiville said. “They were likely to spend time away from the workforce and at home doing the caregiving but not being rewarded financially for that.”
In 2016, 4.4 million senior women were impoverished in the United States, compared to 2.8 million men, according to the Kaiser Family Foundation.
Overall, more seniors are working well into their retirement.
… “California senior employment is at all time high,” said Nari Rhee, who is director of the Retirement Security Program at the UC Berkeley Labor Center.
Twenty-six percent of people in the state, between the ages of 65 and 74, work. Nineteen percent of seniors older than 75 hold a job.
…In 2019, the state will launch the CalSavers program which creates retirement savings accounts for people who work for employers who don’t offer them.
Lawmakers are also discussing whether to allow more seniors to access food stamps, make it easier to qualify for Medi-Cal and extend coverage to older immigrant adults.
“It’s the first movement we’ve seen in some time for policymakers to address this issue of senior poverty,” said Prindiville. “There’s much more that can be done and needs to be done.”
Pressure on policymakers to do more for seniors is only going to intensify.
“As we see this large wave of baby boomers that don’t have enough retirement savings move out of their working years, policymakers are going to have to think about their needs,” said Erik Bruvold, chief executive officer at the San Diego North Economic Development Council. “They’re going to be housing challenged. They’re going to be medical care challenged. It’s going to be a significant burden on taxpayers and the state.”…
http://www.kpbs.org/news/2018/jun/19/dimming-dream-retirement-california/
When older residents can’t make ends meet
ReplyDeleteJAYA PADMANABHAN
Nov. 28, 2019
…Steven P. Wallace, a professor at UCLA’s School of Public Health, has been deeply invested in studying the needs for the growing number of seniors. Presenting his findings at the Gerontological Society of America’s (GSA) Annual Scientific Conference in Austin this year, he said that the number of people, 65 and older, will double in America by 2040. The 2010 Census estimated that there were 40.2 million elderly in America, which is projected to grow to 81.2 million by 2040. Significantly, the fastest growth is among elders of color.
…Wallace presented a chart that showed many seniors having little economic bandwidth after paying rent. In 2015, one out of every two persons over the age of 65 spent more than one-third of their monthly income on rent and a good 23 percent experience a severe—over 50 percent—rent burden.
Policies like Supplemental Security Income, Social Security payments and Medicare were put in place to shield individuals from facing huge financial outlays in the twilight years of their lives. However, according to Amber Willink, a researcher from the Johns Hopkins Bloomberg School of Public Health, “one in five Medicare beneficiaries is under-insured,” and “beneficiaries are exposed to high out-of-pocket costs and premiums.”
The National Council on Aging found that over 25 million Americans aged 60 and over are economically insecure—living at or below 250 percent of the federal poverty level (FPL).
But FPL—set at $12,490—claims Wallace, is an insufficient measure of poverty and any analysis using FPL does not present an accurate portrayal of seniors in poverty. FPL does not reflect the variations in the cost of living of America’s counties and cities.
…contrast between the Housing and Urban Development (HUD) fair market rent for a single bedroom apartment in San Francisco estimated at $2,255 per month and a similar housing unit in Brownsville, Texas, which rents for $563 per month. The elderly in The City pay out four times what Brownsville residents spend on rent.
Further, the annual basic cost of living for a single older adult living in San Francisco county was $2,624 per month in 2015, about 28 percent higher than the California average, with rent accounting for 60 percent of the expenses, according to Wallace’s analysis.
A better alternative, according to Wallace, is the Elder Index, which is calculated at the county level…
In Wallace’s opinion the solutions are multi-fold. He recommends helping the elderly improve their income by modernizing SSI, raising benefit levels, protecting and improving Social Security and making pension savings available to all workers through programs such as CalSavers, recently implemented in California. He also advocates for reducing the need for income by expanding Medicare benefits and housing assistance and creating a universal program to cover long-term services and support.
…In 2018, Meals on Wheels delivered 2.1 million meals to 4,700 seniors in The City, many of whom are homebound, 68 percent who live alone and 74 percent who live on less than $900 a month.
All these numbers present a precarious picture of aging in The City and it’s only going to get worse as the numbers of elderly keep increasing. Meals on Wheels pointed out that three out of 10 San Francisco residents will turn 60 or older by 2030.
It’s clear that our existing old age policies are inadequate and insufficient. Old age should not be beset by financial complications. The elderly and infirm are vulnerable, but the elderly, infirm, lonely and poor carry a weight that’s hard to fathom in these modern times.
https://www.sfexaminer.com/news-columnists/when-older-residents-cant-make-ends-meet/