Friday, May 31, 2019

Older Americans Month: Connect, Create, Contribute

This year’s Older Americans Month theme, Connect, Create, Contribute, encourages older adults and their communities to:
Older adults are empowered and communities are stronger as we connect, create and contribute to make a world in which we all want to grow older!

Joined over 1,200 advocates, mostly from Northern California, for the first-ever Disability & Aging Capitol Action (DACA) Day, co-hosted by California Alliance for Retired Americans (CARA) and Disability Action Coalition (DAC)! CARA arranged for free roundtrip bus transportation between San Francisco and Sacramento, plus brown bag lunch.
After a comfy, nearly two-hour ride on our chartered bus, our San Francisco group arrived at sunny Sacramento’s Cesar Chavez Park. 
FOB (Fresh Off Bus) photo opportunity with Senior & Disability Action (SDA) and My Diversability banners.
At check-in, we signed up to join 40 legislative teams (each team meeting 1 Senator and 2 Assembly members) and picked up our commemorative DACA Day/Unity with Diversity buttons as our lunch tokens.  CARA Director Jodi Reid said that sign-ups for San Francisco Assembly members Phil Ting (also Budget Chair and legislative sponsor of DACA Day) and David Chiu were already full, so I signed on to join team facilitated by Jessica Lehman, SDA Executive Director.  Since the legislature was in session, we ended up meeting staff rather than legislators.
Visited Resource Fair vendors like California Department of Aging, which gave out bottled water.
CARA's Nan Brasmer and DAC's Goldie T. House welcomed the crowds to educational rally. Representing close to 1 million people through 275 affiliated organizations, CARA is California’s largest, grassroots senior advocacy organization working to improve the quality of life of older adults and their families.  DAC represents people with disabilities and allies in California to protect and advance our civil rights, self-determination, and life opportunities by educating, communicating, and advocating—culminating in this 15th anniversary of Disability Capitol Action Day!
Hip hop performance by Very Special Arts The Mini Monsterz from Luther Burbank High School!
Kendra DeAnna sang “I can’t hear you on the right side, can you switch to the left, I can’t help it, together we can make a change…”
81-year-old Pauline Brooks of CARA talked about working in fashion industry for 65 years until she retired with help from moving in with her daughter and son-in-law in Oakland, reminding us that not everyone has a family safety net so it is important to support DACA Day platform:  SB 512 Long-Term Services and Supports Options, and AB 1434 Increase SSI/SSP Base Grant and Reinstate COLA. 
Special education teacher sang about universal healthcare.
After our march from Cesar Chavez Park to steps of Capitol building, SDA team (Pi, Ligia, Jessica, Betty, Theresa, Tony, Sam Alicia, C.W.) are all smiles.
During lunch, our team of six met to discuss our upcoming legislative visit.  Jessica served as facilitator (introduced CARA, DAC, team members) and nailer (make sure questions answered); I served as note taker and packet presenter; and storytellers covered bills.  At minimum, we covered these two priority bills:
·       Californians have a unique opportunity to pass legislation that would begin to chart a path to provide long-term supports and services (LTSS) to all Californians, beginning with a feasibility study and assessment.  We must pass SB 512 and pave the way for providing LTSS for all! (We ask $1 million to conduct an actuarial study to determine the cost of providing additional options for LTSS: how many people will need these services, what they will cost, and how California may pay for them.)
·       It is time for California to increase the State portion of SSI/SSP so that we can move seniors and people with disabilities out of poverty.  Last year, we increased the state COLA slightly and made CalFresh available to SSI recipients.  Now we are urging passage of AB 1434 in order to restore recession-era cuts to SSI/SSP, bring payments to at least 100% of 2019 poverty level, and reinstate the annual COLA.  (To make this happen, we ask $1 billion.  Note:  More than $11 billion has been taken from 1.3 million SSI/SSP recipients who have had to live at sub-poverty level for the past decade after Governor Schwarzenegger made cuts to balance the state budget in 2008.) 
Team members also chose to present on following DAC policy platform bills
·       AB 715 Increase Medi-Cal Aged and Disabled Program Income Level to 138% of Federal Poverty Level ($1,396/month for individuals, and $1,892/month for couples).
·       SB 338 Senior and Disability Justice Act to strengthen law enforcement response to abuse of elders and adults with disabilities, with training and detailed policies and procedures based on model San Diego County Elder and Dependent Adult Abuse Blueprint.
·       SB 10 Establish state certification process for peer providers of mental health services and require Department of Health Care Services to submit Medicaid State Plan Amendment to add peer support specialist services as reimbursable Medi-Cal benefit.
After more than 30 minutes of waiting in line to enter State Capitol building, passing security check, and then waiting for an available elevator… we met with Israel Landa, Legislative Director for Assembly member Monique Limon (Democrat, 37th Assembly District representing Santa Barbara and Ventura counties).  Though we could not get commitments from this office, we picked up cool blue tote bags with yellow letters reading, “Everything is Better #con LIMON!” 
Squeezed into reception area to meet with Gianna Rogers, aide to Assembly member Jordan Cunningham (Republican, 35th Assembly District representing San Luis Obispo and portions of Santa Barbara counties).  He said he would deliver our messages to Cunningham, who authored legislation to increase access to health care and strengthen public safety.
Assembly member Cunningham’s father showed up during our visit!
Nora Lynn, Legislative Director for Senator Hannah-Beth Jackson (Democrat, 19th Senate District, representing Santa Barbara and western Ventura counties), made our day when she (they) said Senator was committed to supporting our priority bills! She (they) wore DACA Day button and posed with our team of happy campers.  (As Chair of the Senate Judiciary Committee, Senator Jackson introduced gender-neutral language.) 

During the March to State Capitol building, chants included “Seniors and Disabled, need a seat at the table” and “Our homes, not nursing homes!” 


“Live in your home, not a nursing home” is the motto of Center for Elders’ Independence (CEI), which celebrated grand opening of its Downtown Oakland Day Center, sharing this historic 1922 building with administrative offices upstairs.  Modeled after San Francisco's On Lok, CEI is a Program of All-Inclusive Care for the Elderly (PACE) organization that supports East Bay seniors age 55+ with multiple health challenges to live safely at home.


CEI CEO Linda Trowbridge thanked regulators who allowed CEI to separate the day center from PACE clinic about 5 miles away.  The former dark, dance club was renovated to this bright space that features a lounge area that opens into an activity center, 1,200 square foot fitness gym staffed with physical and occupational therapists for individual therapy and group exercise, computer lab, “tranquility room” for participants who want peace and quiet, outdoor courtyard with shaded seating and landscaping, etc.


Hors d’oeuvres at open demonstration kitchen, designed for participants to make their own snacks with dietitians during activity time.


Participant performs Korean dance to live piano.


Ribbon-cutting.
San Francisco Supervisors introduced a November ballot measure, Mental Health SF, which would build a new Mental Health Service Center to facilitate universal mental health care for anyone to access psychiatrists and other providers of mental health/substance use treatment, and establish a new Office of Coordinated Care to bring the City’s mental health systems under one network.  This initiative would be funded by a surcharge on local companies whose CEOs make more than 100 times the median income of their workers. 

Given the history of stigmatizing and institutionalizing people with mental illness, many older adults do not actively seek out stand-alone mental health care services and thus are underserved. For many older adults, primary care remains the entry point so I would prefer to see integrated behavioral health clinics to meet people where they are.  Further, as noted in Dr. Marc Agronin’s Therapy with Older Clients: Key Strategies for Success (2010), common medical conditions can impact mental illness; for example, joint pain and immobility of arthritis can lead to social isolation, insomnia, increased anxiety over falling; steroids used to treat rheumatoid arthritis can lead to confusion, anxiety, and depression.  Therefore, treat the whole person=mind+body!
Psychological First-Aid for Neighborhood Emergency Response Team with Elizabeth McMahon, PhD, who provided these tips to mentally prepare for an emergency to reduce stress and trauma reactions:
·       Adapt interactions based on diversity in community: Observe (cues), Ask (what is appropriate), Respect (differences)
·       In stressful situations: Stop (take “4 for Calm” belly breaths), Slow (for moment), Think (about situation—our role, what’s needed, possible reasons for someone’s actions/emotions, what’s best action available), Act (in most calm, caring and competent way you can).
·       If stress reactions begin to impact judgment/interactions: say “Time to Take Five” (cue to step away and practice self-care: eat, hydrate, do “4 for Calm”)
·       During emergency, connect with others: Set Tone Nonverbally (calm, caring, competent) and Verbally (soothing tone, lower pitch, adjust volume as needed, slower pace, short and simple phrasing); See the Need, Say the Need (“You can’t find your pet. You’re worried. You want your pet found”); Get a “Yes” (agreement to cooperate; e.g., “I’m here to help.  Are you willing to let me?”)
·       Assess needs (medical, practical, social, psychological) and know what resources are available
·       Direct: state simply what to do and why (“I need you to stay here because someone is coming to help you”)
·       Self-care after disaster: allow time to deal with reactions, use stress management tools, maintain social connections-talk with others who understand, create positive environment, limit media viewing, write about what learned from experience; always get support for suicidal thoughts, substance overuse, or violent activities
Historical trauma: As part of Asian Pacific Heritage Month and this year’s 70th anniversary of China’s Communist Revolution, Helen Zia discussed her new book, Last Boat Out of Shanghai: The Epic Story of the Chinese Who Fled Mao’s Revolution, with journalist Sherry Hu at SF Main Library.  Helen’s latest book was 12 years in the making, involving interviews with over 100 people, after her mother in her 70s finally shared her story of abandonment by her parents and exodus from Shanghai. Helen explained that her book is the only one in the English language about the exodus from Shanghai because people who survive trauma are not willing to share their experience right away, and many of her interviewees were talking to Helen, a stranger, for the first time sharing their whole stories.  Helen advised to keep asking because at some point people might be ready to tell their story, like her own mother who finally “felt strong enough” and then sensed a release of shame in the process.  Helen believes the World War II generation have post-traumatic stress syndrome.  
During her book tour, Helen said the Chinese government would not allow distribution of her book, but e-book available online; in Shanghai, Helen’s talk title was changed to “Four Young Shanghai People Leave and Go to America.” 
At Civic Center Plaza, Lest We Forget Holocaust Remembrance Project, by German-Italian photographer and filmmaker Luigi Toscano, included huge portrait of Gloria Lyon, who survived seven concentration camps, was rescued by the Swedish Red Cross and immigrated to the United States in 1947.  SF resident Gloria has shared her World War II experience in documentary, book, and Yom HaShoah service.  

2 comments:

  1. A silver wave? California braces for elderly boom that could overburden state
    BY MILA JASPER AND PHILLIP REESE
    JUNE 14, 2019
    …Figuring out ways to get around without a car, affording housing in a city where rents are rising rapidly, living on a fixed income and finding affordable healthcare are about to be major problems for a large group of people in California.
    The Golden State is about to get a lot older.
    By 2030, the 60-and-over population will be 40 percent larger than it is now, according to the California Department of Aging. Seniors will be a larger share of the population than kids under the age of 18 by 2036, the state projects.
    The number of Californians 80 and older will grow by about 65 percent, or about 960,000, in the next 10 years, a growth rate more than 10 times faster than the projected rate for the rest of the state, according to the Department of Finance. There will be twice as many Californians 80 and older in 2033 as there are today and three times as many in 2043, the state projects.
    It’s the same story around the world. Last week, finance ministers from the G20 group of nations met and discussed for the first time how to deal with the shrinking workforce and health care problems globally. Worldwide, the number of people over 60 years old is expected to reach 2 billion by 2050, more than double the number now.
    In Sacramento and around the state, public officials and other groups that work with seniors said California must make some significant changes if it’s going to age gracefully. Understanding baby boomers, the generation driving the state’s median age upward, is just the beginning of the challenge, they said.
    The state will face shortages in the health care workforce as well as a fragmented system of services. It will also have to confront the biases that cause older adults to be treated as though they are “decrepit,” as Kidd described it.
    Will Tift, assistant director of the Agency on Aging Area 4, which covers seven counties including Sacramento, said he is trying to make sure that officials understand how an aging population will change life in California.
    “What has happened is that we increasingly move toward a state of triage where the people with the most extreme, immediate need are served and everybody else is just in line,” Tift said.
    Now, Gov. Gavin Newsom has announced he is officially making aging a priority. On Monday, the Democratic governor signed an executive order that calls for a “Master Plan for Aging” to be created by Oct. 1, 2020…
    Boomers are not doing enough to prepare for aging, Tift said. They don’t want to feel old, so they avoid understanding what getting older means financially and legally, he said.
    …But seniors are living significantly longer than they did when the boomer generation was born in 1946, and it has become more common for seniors to live into their 80s and 90s.
    Older adults also now tend to have more chronic health conditions than before. So a lack of preparation leaves some boomers doubly vulnerable: They have a longer time span during which they need to support themselves, and they often have more conditions for which they’ll need to pay for medicine, physical therapy or doctor’s visits.
    Already, 16.3 percent of California adults over age 60 live below the poverty line, and 20.7 percent live poor or near poor, according to the California Department of Aging. Inequality among the senior population will increase over time.
    …baby boomers are “more likely to be single or childless, live alone, and live in poverty,” according to an analysis of census data by the California Future Health Workforce Commission.
    With fewer family members available to help with caregiving and less money to pay for the broad range of services that help seniors and the disabled live independently, seniors have few options for aging in place comfortably…
    “Your choice is to impoverish yourself, enroll in Medi-Cal, then we’ll take care of you.”…
    https://www.sacbee.com/news/state/california/article231449458.html

    ReplyDelete
  2. California’s Budget Includes Strong Investments for Older Adults
    Justice in Aging
    July 3, 2019
    …this year’s budget finally eliminated the senior penalty in the Medi-Cal program. Beginning no sooner than January 1, 2020, California will increase the Aged and Disabled Medi-Cal income eligibility limit to 138% FPL to match that of other Medi-Cal programs. This change will mean approximately 27,000 more seniors and people with disabilities will be eligible for free Medi-Cal. The budget contains $124.9 million in ongoing funding, including $62.4 million in the General Fund as well as trailer bill language to enact the expansion.
    …the budget failed to restore recession era cuts to the State Supplementary Program (SSP), which is the state-funded supplement to the federal SSI benefit. This cut dropped many older Californians into poverty, where they have remained. Justice in Aging will continue pushing to finally restore the SSP and lift all seniors in California out of poverty.
    Health Care and Long-Term Services and Supports
    • Restores the 7% IHSS Reduction through December 31, 2021—The budget restores the 7% IHSS cuts enacted several years ago during the recession. Although we are encouraged that there is funding for the next two and a half years, we will continue to work for a permanent restoration of these harmful cuts.
    • Temporarily Restores Optional Medi-Cal Benefits for Two Years—Beginning January 1, 2020, optical, audiology, podiatry, speech therapy, and incontinence creams and washes will be covered Medi-Cal benefits for the first time since 2009.These services will be suspended on December 31, 2021.
    • Increases provider payment rates for the Multipurpose Senior Services Program—The budget allocates $14.8 million for supplemental rate payments to MSSP providers over a three year period.
    • Increases reimbursement rates for the Community-Based Adult Services Program—The budget allocates $13.7 million ongoing to increase CBAS reimbursement rates.
    • Increases funding for the Caregiver Resource Centers ($30 million); Senior Nutrition Programs ($17.5 million); Long-Term Care Ombudsman ($5.2 million); Adult Protective Services ($5.75 million over three years); and Alzheimer’s Research and the Alzheimer’s Prevention and Preparedness Task Force ($3 million).
    • Provides funding to conduct an actuarial study on long-term care insurance options ($1 million).
    Economic Security
    • SSI Cash-Out—The budget makes permanent the "hold harmless" programs created as part of last year’s repeal of SSI cash-out, which was the policy that barred SSI recipients from receiving CalFresh food assistance.
    • SSI Advocacy—The budget provides $25 million in ongoing funding for the Housing and Disability Advocacy Program (HDAP), which provides matching funds to counties for comprehensive services including housing support to people who are likely eligible for SSI while they apply for disability benefits.
    • Equal Access Fund—The budget provides an additional $20 million for the Equal Access Fund to assist tenants with evictions and related housing needs, including people with disabilities and older adults.
    • Homelessness—The budget provides $650 million in one-time funds to counties and Continuums of Care. The funding can be used for services including rental assistance, rental subsidies, rapid rehousing, and navigation centers and shelters.
    …additional housing and mental health funding connected to the Whole Person Care pilot will benefit all Medi-Cal beneficiaries with mental health conditions and those experiencing or at risk of homelessness.
    The 2019-20 budget takes much-needed steps to reduce poverty in California, and provides momentum for a Master Plan for Aging that will address the pressing challenges that aging Californians face in trying to meet their basic needs…

    ReplyDelete