This post originally appeared on NLC's CitiesSpeak blog, citiesspeak.org
Cities are now five years into a demographic change that will impact nearly every family in America from now until well beyond 2030. In the face of this change, how can city leaders meet the challenge of connecting available resources to the elderly?
The so-called “silver tsunami” has become a relatively well-known form of shorthand for the demographic fact that roughly 10,000 baby boomers turn 65 years old every day. This reality began in 2011 and will continue until 2030. For key lessons from an area with a large population of senior citizens, let’s look at the area around Miami, Fla.
In the city of Miami Gardens, Navy veteran Gary Brown illustrates the need facing seniors and their communities. Brown served in the Navy during the Vietnam War as an engineer. Trained as an air-conditioning technician and electrician, he worked as a handyman and carpenter until he was forced to retire due to numerous disabilities including hip and knee problems that led to replacements, limited vision in his right eye and complete blindness is his left.
Brown’s disabilities left him unable to maintain his home, resulting in substantive safety hazards. Most notably, the home’s roof had been leaking since 1992, causing extensive interior damage. Thanks to the support and partnership of Rebuilding Together with The Home Depot Foundation and the Team Depot from a near-by store, Brown’s home received a new roof, kitchen and bathroom renovations, plumbing repairs, new flooring, doors and drywall, as well as painting and landscaping.
With many seniors facing circumstances like Brown, how can cities more systematically ensure services are delivered in a coordinated and collaborative manner?
1. Use data to identify gaps in service.
The primary funding that supports seniors comes due to the Older Americans Act through Area Agencies on Aging (AAAs). In Miami-Dade County, the AAA is the Alliance for Aging. Their work provides a “no wrong door” approach for seniors. To better understand what seniors needed, the Alliance not only held public hearings, but they surveyed front-line staff and looked at client assessments. It was recognized that a quarter of elders reported “problems” with their home, and like Brown, more than half of these seniors identified issues related to major or minor repairs, including roofing or plumbing issues.
At the core of ensuring we meet the needs of seniors is access to safe and stable housing. Cities must be able to provide seniors with the ability to not just “age in place,” but to “age in community.” The installation of wheelchair ramps, grab-bars, the lowering of counters and cabinets, widening doorways and modifying bathrooms with roll-under sinks can help seniors stay in their homes, remain as independent as possible and avoid costly long-term care facilities.
2. Build and support partnerships that reflect your community.
To most effectively meet these housing needs of seniors, the area’s leaders recognized the need to strategically cultivate relationships based on key population characteristics. For example, local leaders recognized that a significant number of veterans lived in the area, so they connected with the Veterans Affairs Medical Center around the VA’s Veteran Directed Home and Community Based Services program. In addition, it was recognized that low-income seniors were over-represented in specific geographic areas. To help reach these individuals, connections were made with community action agencies to help leverage resources such as the Low Income Home Energy Assistance Program, the Emergency Home Energy Assistance for the Elderly Program and the Supplemental Nutrition Assistance Program. Finally, the diversity of the community was reflected through partnerships with immigrant organizations and faith-based groups such as Catholic Charities and Jewish Community Services of South Florida. Through these partnerships, the AAA identified three groups to provide home modifications and/or repairs. The experience and histories of United Home Care, Little Havana Activities and Nutrition Centers, and 1st Quality Home Care uniquely reflect the area’s population.
3. Understand and document the cost-savings.
In the ever-present reality of limited resources, it is critical for communities to work together so they can document the cost implications of their service coordination. Not only can this information be used to show the fiscal implications of program investments as a means of educating state and federal officials, the data can also be used as a way of exploring the potential of innovative financing mechanisms. Through its services alone, the Alliance for Aging reports the prevention of 50,359 months of nursing home care at a savings of about $201,435,168 and a rate of nursing home use per Medicaid eligible elder that is 33 percent lower than the state average.
By working with AAAs to document these impacts, cities can better target their resources to ensure they are being as effectively used as possible. In April, the Older American Act was re-authorized. Importantly though, a key section for services has received level funding ever since overall cuts that were implemented as part of the Budget Control Act of 2011. This is particularly concerning in the face of the rising number of seniors in communities.
If funding is not administered through your city, it is essential that local leaders connect with the administrating entity so area residents can be directed to the existing systems in place to meet their needs. To learn what organization is the Area Agency on Aging for your community, visit www.eldercare.gov