Elaine Herscher

By Judith Graham | Kaiser Health News

Fran Seeley, 81, doesn’t see herself as living on the edge of a financial crisis. But she’s uncomfortably close.

Each month, Seeley, a retired teacher, gets $925 from Social Security and a $287 disbursement from an individual retirement account. To make ends meet, she’s taken out a reverse mortgage on her Portland, Maine, home that yields $400 monthly.

So far, Seeley has been able to live on this income — about $19,300 a year — by carefully monitoring her spending and drawing on limited savings. But should her excellent health worsen or she need assistance at home, Seeley doesn’t know how she’d pay for those expenses.

More than half of older women living alone — 54% — are in a similarly precarious financial situation: either poor according to federal poverty standards or with incomes too low to pay for essential expenses. For single men, the share is lower but still surprising — 45%.

That’s according to a valuable but little-known measure of the cost of living for older adults: the Elder Index, developed by researchers at the Gerontology Institute at the University of Massachusetts-Boston.

A new coalition, the Equity in Aging Collaborative, is planning to use the index to influence policies that affect older adults, such as property tax relief and expanded eligibility for programs that assist with medical expenses. Twenty-five prominent aging organizations are members of the collaborative.

The goal is to fuel a robust dialogue about “the true cost of aging in America,” which remains unappreciated, said Ramsey Alwin, president and chief executive of the National Council on Aging, an organizer of the coalition.

Nationally, and for every state and county in the U.S., the Elder Index uses various public databases to calculate the cost of health care, housing, food, transportation, and miscellaneous expenses for seniors. It represents a bare-bones budget, adjusted for whether older adults live alone or as part of a couple; whether they’re in poor, good, or excellent health; and whether they rent or own homes, with or without a mortgage.

Results from the analyses are eye-opening. In 2020, according to data supplied by Jan Mutchler, director of the Gerontology Institute, the index shows that nearly 5 million older women living alone, 2 million older men living alone, and more than 2 million older couples had incomes that made them economically insecure.

And those estimates were before inflation soared to more than 9% — a 40-year high — and older adults continued to lose jobs during the second and third years of the pandemic. “With those stressors layered on, even more people are struggling,” Mutchler said.

Nationally and in every state, the minimum cost of living for older adults calculated by the Elder Index far exceeds federal poverty thresholds, which are used to calculate official poverty statistics. (Federal poverty thresholds used by the Elder Index differ slightly from federal poverty guidelines. Data for each state can be found here.)

One national example: The Elder Index estimates that a single older adult in good health paying rent needed $27,096, on average, for basic expenses in 2021 — $14,100 more than the federal poverty threshold of $12,996. For couples, the gap between the index’s calculation of necessities and the poverty threshold was even greater.

Yet eligibility for Medicaid, food stamps, housing assistance, and other safety net programs that help older adults is based on federal poverty standards, which don’t account for geographic variations in the cost of living or medical expenses incurred by older adults, among other factors. (This isn’t an issue for older adults alone; the poverty measures have been widely critiqued across age groups.)

“The poverty rate just doesn’t cut it as a realistic look at the struggles older adults are having,” said William Arnone, chief executive officer of the National Academy of Social Insurance, one of the new coalition’s members. “The Elder Index is a reality check.”

In April, University of Massachusetts researchers showed that Social Security benefits cover only a fraction of what older adults need for basic living expenses: 68% for a senior in good health who lives alone and pays rent and 81% for an older couple in the same situation.

“There’s a myth that Social Security and Medicare miraculously take care of all of people’s needs in older age,” said Alwin, of the National Council on Aging. “The reality is they don’t, and far too many people are one crisis away from economic insecurity.”

Organizations across the country have been using the Elder Index to convince policymakers that older adults need more assistance. In New Jersey, where 54% of seniors are economically insecure according to the index, advocates used the data to protect property-tax relief programs for older adults during the pandemic. In New York, where nearly 60% of seniors are economically insecure, advocates persuaded the legislature to raise the Medicaid income eligibility threshold.

In San Diego, where as many as 40% of seniors are economically insecure, Serving Seniors, a nonprofit agency, persuaded county officials to use pandemic-related stimulus payments to expand senior nutrition programs. As a result, the agency has been able to double production of home-delivered meals, to more than 1.5 million annually.

Officials are often wary of the financial impact of expanding programs, said Paul Downey, president and CEO of Serving Seniors. But, he said, “we should be using a reliable measure of economic security and at least know how well the programs we’re offering are doing.” By law, California’s Area Agencies on Aging use the Elder Index in their planning process.

Maine is No. 5 on the list of states ranked by the share of seniors living below the Elder Index, 56%. For someone in Fran Seeley’s situation (an older adult who is in excellent health, lives alone, owns a house, and doesn’t pay a monthly mortgage), the index suggests $22,560 a year is necessary — $3,200 more than Seeley’s annual income and $9,500 above the federal poverty threshold.

A look at Seeley’s budget reveals how quickly necessary expenses accumulate: $2,041 annually for Medicare Part B (this is deducted from her Social Security check), $4,156 for property and stormwater taxes, $390 for home insurance, $320 for furnace cleaning, $1,440 for heat, $125 for water, $500 for gas and electricity, $300 for property maintenance, $1,260 for phone and internet, $150 for car registration, $640 for car insurance, $840 for gas at current prices, $300 for car maintenance, and $4,800 for food.

The total: $17,262. And that doesn’t include the cost of medications, clothing, toiletries, any kind of entertainment, or other incidentals.

Seeley’s great luxury is caring for four cats, which she describes as “the light of my life.” Their annual wellness checks cost about $400 a year, while their food costs about $1,080.

With inflation now making her budget even tighter, “it means I have to cut back in any way I can. I find myself going into stores and saying, ‘No, I don’t need that,’” Seeley said. “The biggest worry I have is not being able to afford living in my home or becoming ill. I know that medical expenses could wipe me out in no time financially.”

Original article can be found here.

LifeLong Chief Resident Justin Chin, DO, has been selected to receive an award for Excellence in Graduate Medical Education by the American Academy of Family Physicians (AAFP).

“Your performance during residency training ranks you among the top family medicine residents. The American Academy of Family Physicians and the Commission on Membership and Member Services appreciate your hard work and commitment to the ideals of family medicine,” the AAFP wrote.

The award includes a $1,000 scholarship that “recognizes outstanding family medicine residents for leadership, civic involvement, exemplary patient care, and aptitude for and interest in family medicine.”

“Amazing work, Justin,” said Dr. Becca Citron, Core Faculty of LifeLong’s Family Medicine Residency Program. “We are so proud of you and all your accomplishments and very grateful to have you as part of our program.”

This is the second award this year for Dr. Chin, who was honored last spring by the American College of Osteopathic Family Physicians (ACOFP).

Dr. Chin, in the graduating class of 2023, was awarded Resident Paper of the Year for his paper Perceptions of the Osteopathic Profession in New York City’s Korean Communities.

By Elaine Herscher| Senior Editor

When LCSW Becky Morris was hired last year, she became the first African American therapist at the East Oakland Health Center in at least 14 years. And Community Health Worker Leilani Hall was thrilled.

“Sometimes I talk to my patients and they tell me ‘I need a Black therapist. I need someone who’s relatable, who understands my needs,’” says Leilani, whose job encompasses case management for behavioral health. “And so it feels really good now to say ‘I actually have a Black therapist. Let me sign you up with her.’”

Becky calls it “a huge honor” to be that therapist. “People like being able to talk to somebody that looks like them and sounds like them. And a lot of people say ‘It’s nice not to have to code switch. It’s nice that you get what I’m saying,’” she says.

July is BIPOC (Black, Indigenous, and People of Color) Mental Health Month, created to bring awareness to the unique struggles of underrepresented groups regarding mental health. Providers say those challenges include lack of access due to transportation and childcare needs, as well as stigma in some communities associated with seeking therapy.

“The Black community historically doesn’t come to therapy. And also we have been told by family, ‘Just pray about it or talk to me about it,’” Becky says.

Leilani agrees. “One thing that happens in the Black community they tell you, ‘You’re just crazy. It’s nothing to worry about. Just talk to your family.’ And so it’s great for you to be able to talk to someone who’s unbiased who has your best interests at heart,” she says.

When LifeLong leadership talks about the advantages of providers coming from the community to serve the community it’s truly needed in behavioral health. But a general shortage of therapists of color is hampering many community health centers, including LifeLong.

From the time she was hired in February 2020 to May of 2021, Associate Clinical Social Worker Jennifer Ruiz was the only Spanish-speaking therapist at Brookside San Pablo who is also Latina. “Prior to that, there were some people who spoke Spanish, but they weren’t of the culture,” she says. A majority of behavioral health patients at Brookside speak Spanish only, and there is still a waitlist to see her.

“The patients say it’s so different when you have someone who’s the same culture as you and kind of understands and just gets it,” Jennifer says.

But for a lot of patients it’s not just that therapy is taboo; the stresses of daily living can also get in the way. Patients have more barriers if they have to catch multiple buses to drop their kids off at school, get to the health center, and pick their children back up. So sometimes the kids have to come along, which may add to the stressors.

“With the pandemic we had telehealth, but the barrier there was access to computers. They have phones, but some patients don’t know how to access a website on their phones,” Jennifer says.

Jennifer describes an elderly Spanish-speaking woman who had such high anxiety she was in clinic nearly daily. Through being in groups and one-on-one therapy, her anxiety has calmed, and she is grateful.

“And I’m grateful that she was open to it,” Jennifer says. “Because, again, coming from her background, there’s that stigma, and she just pushed that aside, and said, ‘No, I need this for me. And I need to get better.’”

For more in the July LifeLine, click here.

A new easy-to-remember number – 988 – will now connect people directly to the National Suicide Prevention Hotline.

The Substance Abuse and Mental Health Services Administration (SAMHSA) anticipates 988 will continue to grow and evolve over the years. In 2021, the Lifeline received 3.6 million calls, chats, and texts. That number is expected to at least double within the first full year after the 988 transition.

During this week’s Open Mic Monday, CEO David B. Vliet referenced the book, “The Five Languages of Appreciation in the Workplace” and emphasized that the Employee Appreciation Committee is seeking to find ways staff would like to be appreciated.

As Director of Human Resources RoseMarie Beatty explained in an email, LifeLong is celebrating staff birthdays, employment anniversaries, and retirements in newsletters, on the Intranet, and on the Open Mic Monday monthly staff calls. This brief two-question survey lets us know if you would like to be included in these organizational acknowledgments. 

Your participation will ensure that your milestone is noted in a way you prefer when your date arises.   

With this in mind, please complete the survey by July 22, 2022, so that we can keep a record of how you like to be appreciated:

Thank you for taking a moment to provide us with your preferences.