WAVE Quarterly Meeting
February 25, 2019
Hyattsville Town Hall
Outreach to and working with the LGBTQ community. Susan Messina, Deputy Director for Senior Services at IONA House and member of the board of Mt Pleasant Village.
Members of this community fear discrimination from villages that do not clearly advertise friendliness. Villages should be sure all communication materials clearly show welcoming approach, including a formal non-discrimination policy on the website, and an “other” category for gender on membership or other sign-up forms, as well as photos showing same sex couples. Race and ethnicity add to this fear. Social isolation and lack of family support is a serious issue for older LGBTQ people. While some do not want special programs, others are looking for activities geared to them. She suggested creating a task force to identify issues and opportunities and participating in gay pride events (month of June). IONA offers five peer-support groups for LGBTQ seniors, including Maryland. She provided two handouts, one on IONA peer support groups [Click here] and the other on resources, including a film [Click here].
The president suggested that WAVE consider having a table at the DC Gay Pride event.
Advocacy: Forecasting and being ready for long term care needs. Mary Proctor and Elizabeth Cabot Nash of Capitol Hill Village.
Capitol Hill Village, founded 12 years ago, has 500 members with median age of 75, 40% of whom live alone. It has a staff of 6. There are currently no senior residences or care facilities on Capitol Hill; hence the need to find new ways to care for seniors in the community.
A slide presentation, From Aging in Place To Aging in Community [Click here], was shown.
Statistics. Nationally, 52% of Americans reaching 65 will need long term care (LTC). 19% will need 1 year LTC; 8% 1-2 years; 11% 2 - 4 years; 14% 5 or more years. 48% will need none.
Sharing our advocacy experience and how we got here.
- Establish structure for discussion and decisions, e.g. advocacy committee of the Board , Housing committee, advocacy corps of community at large.
- Recognize members will need more than village can offer.
- Get to know your members
- Create settings for talking about hard issues of aging
- Encourage planning, use experts and best practices. E.g. Chevy Chase has small apartment called “The Stories” with special quality of life concierge. All units are universal design; there are community rooms.
- Assess capacity of community support; evaluate anticipated needs vs available DC services, housing and caregiving resources.
- Define goals and objectives; identify care and housing options; health care workforce needs.
- Advocate at DC council
What we have learned about gaps in DC for middle income residents.
- DC doesn’t cover people with incomes between 30% and 100% of annual median income (AMI).
- Only 850 assisted living units anywhere in DC; mostly in Ward 3 upper DC. No subsidy. Affordable for those with highest 20% of income.
- Adult day programs. Only IONA has 1 for middle income residents. There are only 200 subsidized day care slots available.
- Workforce issues: Not enough certified home health aides vs 4-5 years ago. Not keeping up with retirement of existing aides and growing demand. DC not thinking strategically about need for workforce or other support.
Working with other community stakeholders, government agencies, DC council, Metro Council of Govts. The Village will convene DC boards or advocacy groups in Spring 2019.
- The roles of villages with hospitals? How to calculate the actual contribution of villages to health outcomes.
- Promote universal design.
- How to prevent physical and mental disability? Set up one level housing including an RN so health care is within the building. VT has SASH program, 100 buildings like this.
Pazit Aviv, Montgomery County Village Coordinator: important to recognize that middle income people fall between the cracks. Need advocacy to include them, but recognize some of them have never and do not want to avail themselves of services. Montgomery County is compiling report on gaps on aging services. She will share it with villages who can call out the gaps. Identify partners for advocacy across sectors. Recommends a presentation to WAVE about long-term care (LTC) benefits. Congress may hear proposals for catastrophic LTC insurance.
Advocacy Breakout Groups Discussion Topics:
What insights and issues are most compelling? What does this make you think about; what was hard to understand? Next steps: how well is your jurisdiction doing in support of aging in community? Who are natural partners in your jurisdiction? What might we pursue together, as WAVE, clusters of villages or other?
Break outs by jurisdiction: Report Out
VA: Would like focus on LTC options for the home. What can villages do? What is AARP’s advocacy role? Need to address zoning barriers to senior housing options. Bring in new partners in VA for advocacy, including policy-oriented groups/individuals. This can be a recruiting tool for villages--pull in policy wonks.
MD: Discussed how position of Montgomery County village coordinator was created and how Prince George’s County could get one. Discussed housing, accessory dwelling units (ADUs), and zoning issues. State level approaches might work on some issues, e.g. village insurance. Talk with county and state representatives. Workforce issues--inadequate training, certification, pay. Reach out to other service communities, e.g. churches. How best to approach them; must build trust. Remember need to be inclusive; creative approaches needed. Perhaps “summit” of leaders of various communities.
DC: One level housing with health support, i.e. a concierge and an RN. Meeting in April/May with woman who began SASH in VT to work with Medicare to pay for RN in buildings with subsidies up to 140% of AMI. This meeting can be opened to others. Thinks MD is also developing something along these lines (housing + health care). Naturally Occurring Retirement Communities (NORCs) could include prevention-oriented activities to keep people out of LTC. LTC and housing are separate/related issues. Perhaps a middle level living--beyond a home that lacks one level living, but not yet LTC. Could villages play a role? Housing with care available reduces demand for LTC. Longevity with healthy living is goal--prevent or postpone disability. Co-housing for seniors --30 units for seniors on Capitol Hill; 2 units for the caregivers themselves.
Pazit Aviv: Silos of county, state, federal agencies is issue. Federal government could make greatest savings. It’s hard to prove that counties and states would actually save any money from village activities. Need “big boy numbers.” WAVE should demonstrate cost savings for CMS.
Miriam Kelty: Transportation is important, especially where there’s a mix of rural and urban space.
Wrap up. Members were asked to send ideas to Pat Clark or Gail Kutner.