Aging in Place a Challenge for Low-Income Seniors, If They Still Have a Place

June 16, 2016

Looking back to Older Americans Month, I seized on one hardship that too many of the celebrated suffer — food insecurity and outright malnutrition.

That’s not the only reason why the so-called golden years aren’t so golden for a lot of seniors. Another that looms even larger is unaffordable (or no) housing.

Acute Affordable Housing Shortage

Last month brought us a new report from the Bipartisan Policy Center’s Senior Health and Housing Task Force. As you’d guess, it focuses on the urgent need for more affordable housing suitable for seniors and the implications for their health and our country’s healthcare system.

We know, of course, about the shortage of housing that the lowest-income renters can afford. There were about 11.3 million of them in 2013, including 2.6 million elderly singles or couples. The market lacked about 6.9 million units that were both affordable and available to rent.

But not all those units would suit the needs of seniors who’ve developed (or always had) difficulties moving around without walkers or wheelchairs.

Only 3.8% of all housing units in the country have design features to accommodate moderate mobility limitations, the task force co-chairs say. These, note, are not necessarily affordable for lower-income people or available for anybody to buy or rent.

Higher-income people can afford to have features in their homes modified, e.g., doors widened, ramps built. They can have doorknobs and turn-on faucets replaced with levers if their hands have weakened or stiffened.

Or they can move to an apartment that has such features — even, if they choose, an assisted living facility where they can age in place, with increasing services as they need them. About 70% ultimately will for even such basic daily tasks as bathing, dressing and taking prescribed medications.

But an estimated 1.8 million seniors paid more than half their income for rent two years ago — an upward trend that’s unlikely to turn around on its own.

They’re already short on money for food, transportation and their share of medical costs — an especially big bite of the budget, as we can see from how they boost the more accurate senior poverty rate.

Seems the crunch will worsen as more people live long enough to become seniors — and longer thereafter. An estimated 1.8 million more senior households — a total of 6.5 million — will have less than $15,000 a year to live on by 2024, the Harvard Joint Center on Housing Studies reports.

The Bipartisan Policy Center’s task force recommends more affordable housing for seniors, including a new, special form of supportive housing — supports here being in-home health care and help with those other daily tasks.

The only federal program specifically for this sort of housing has had no funds for grants to develop new units since 2012. And contracts that keep an estimated 41,900 affordable will have expired within the next eight years.

What the task force doesn’t address is the income side of the equation, beyond recommending state and local programs to defray senior homeowners’ costs.

There’d be fewer seniors struggling to pay for rent if they’d gotten paid enough while working to have had income left over for long-term savings.

There’d be fewer if Social Security retirement benefits for former low-wage workers were higher — a forward-looking policy change already teed up by leading Democrats (and predictably trashed on by the Washington Post, among others).

There’d be fewer if the Earned Income Tax Credit didn’t exclude most workers over 65 — and do so little for childless workers.

As things stand now, a very large number of seniors and prospective seniors who hope to age in place will have a hard time doing that without risks to their health.

And the risks they knowingly take to cut costs — skimping on meals or skipping doses of medication, for example — may not save enough for them continue paying for their own place.

Rising Tide of Homelessness

Homelessness is, of course, the end result of the affordable housing shortage for some seniors, as well as younger people. Recent months have brought us several articles on the aging of America’s homeless population.

Both The New York Times and focus on seniors living on the streets or the equivalent. Many have been homeless for a long time and suffer from serious health problems, including substance abuse.

Some, however, became homeless only after a fairly recent setback — often a job loss, but sometimes other problems, e.g., a stroke that forced a woman to leave her subsidized unit because the building had no elevator.

Long-term and newly-homeless older people have shifted the profile of our country’s homeless population. Nearly a third of those counted two years ago were at least 50 years old — a 20% increase since 2007, the Times reports.

A 2010 analysis by the National Alliance to End Homelessness concluded that senior homelessness would increase by 33% within the next 10 years, assuming no significant changes in population or poverty rates.

By 2050, more than 95,270 seniors would be homeless, according to the Alliance’s projection — unless, of course, policymakers invest significantly more in affordable housing and in cash or cash-equivalent benefits.

Even the little I’ve pulled together here shows we’ve got the tools in the toolbox. What we seemingly don’t have is the political will to make them sufficient to the needs of homeless and at-risk seniors.

Nor those who’ll have a good chance of becoming seniors, if they don’t become homeless first. So if we’re going to celebrate Older Americans Month, we ought to put more money where our mouths are.

Acute Food Needs Now Monthly Events For More Than Three Million U.S. Households

October 25, 2011

Food pantry visits are becoming “the new normal,” reports Feeding America, the country’s largest charitable food distribution organization.

The “new normal” here refers to a shift in the role food pantries play in helping low-income people feed themselves and their families.

People used to seek help from food pantries when they had what Feeding America refers to as “temporary acute food needs.”

Now, it says, a majority of clients use pantries “as part of their long-term strategies to supplement monthly food shortfalls.” In other words, “acute food needs” aren’t occasional emergencies. They’re regular, foreseeable events.

Feeding America has come to this conclusion by analyzing client responses to a survey it conducted in 2009.

According to the new analysis:

  • More than half (54%) of the clients surveyed had used a pantry for at least six months during the past year.
  • More than a third of them (36%) had used a pantry at least once a month during the past year.
  • These frequent users reported using a pantry for, on average, more than 28 consecutive months.

We learn two different, perhaps related facts about these recurrent and/or frequent pantry clients.

First, 58% of them received SNAP (food stamp) benefits — another clear indication that the benefits often don’t cover the costs of a month’s worth of food.

Second, a disproportionate number of recurrent users were seniors. One out of three of all recurrent users was 60 or older. And 56% of them were long-term recurrent users.

This too sheds some light on the food stamp program.

According to the U.S. Department of Agriculture’s latest report on SNAP participation trends, only 34% of eligible seniors, i.e., those at least 60 years old, were enrolled in Fiscal Year 2009. This is 38% lower than for the eligible population as a whole.

The low participation rate for seniors continues a long-term trend. Studies have produced a variety of explanations, summarized by the Food Research and Action Center in a broader review of research on access and access barriers to getting food stamps.

Some of the barriers deter participation by other groups as well, e.g., the stigma attached to “welfare,” complex applications processes, difficulties in getting to a food stamp office, long waiting times once there, the need to go back and wait recurrently to again prove eligibility.

But one barrier stands out for seniors in particular. They decide the hassles just aren’t worth the small amount they can get.

USDA’s recently-released report on the characteristics of SNAP households shows that, for most, the benefits are truly small.

Of the fewer than 2.9 million seniors who got food stamps in 2010, 80% lived alone. Their average monthly benefit was $119 — or about $1.30 per meal.

This might explain why some low-income seniors decide to rely on their own scarce resources, supplemented by free food from a friendly pantry rather than cope with the hassles involved in getting food stamps.

Also why seniors who do get food stamps would have to develop an anti-hunger strategy that includes regular visits to a pantry.

Young and old food pantry clients alike face greater risks of hunger in the months to come.

As Feeding America notes, food prices are rising. Food companies are adopting new efficiencies and thus have less surplus to donate.

Bad economic times have reduced charitable donations from other sources. Also triggered cutbacks in funding by some state and local governments.

And to top it all, Congress has cut funding for the Emergency Food and Shelter Program by 40%, leaving $80 million less for local homeless services programs, including food pantries.

The House of Representatives has approved a $63 million cut for TEFAP (the Emergency Food Assistance Program), which provides about 25% of the foods that Feeding America’s food bank partners distribute to emergency providers like pantries.

Maybe hope for TEFAP in the Senate, though ultimately the House would have to back down.

Still and all, “the beginning of the ‘perfect storm,'” as Feeding America says.

Why Did Food Programs For Low-Income DC Seniors Need A Last-Minute Save?

September 30, 2011

The last-minute save of the food assistance programs for low-income D.C. seniors left a question in my mind. Why, I asked, did we have a near-crisis anyway?

A followup column by Washington City Paper reporter Lydia DePillis provides a partial answer.

Seems that funding for the Greater Washington Urban League’s administrative services wasn’t identified in the Fiscal Year 2012 budget because it was awarded as a one-year grant, with options for renewal.

Unless I’m much mistaken, it wasn’t a line in the Fiscal Year 2011 budget either — perhaps for the same reason.

This explains why advocates weren’t aware that the new budget provided no local funds for administering the programs. Also why senior members of the Gray administration may not have known there might be an issue.

Responding, I assume, to a query from DePillis, a Department of Health spokesperson writes, “All subgrants are subject to funding availability. GWUL was advised last year that the previous funding .. would not be available in FY 2012.”

The Urban League’s Chief Operating Officer tells a different story. Says that they “actually found out about the disappearance of funds several months ago.” (This is an indirect quote in DePillis’s original column on the issue, but I see no reason to believe that it’s not very close to what the COO said.)

Whatever the timing, I don’t think DOH is off the hook.

Recent developments suggest that funding would have been available if the department had flagged the issue back when the Gray administration was developing its proposed budget.

The grant, after all, wasn’t to support some charitable program the Urban League had decided to initiate. It was to partially cover the costs of administering two federally-funded programs DOH is responsible for.

If the department thought the Urban League was spending more than needed, it could have laid the groundwork for a smooth transition to another third-party administrator. That also could have required some local funding.

Since DOH has just announced a new administrator, it’s fair to conclude that it had no assurance it could get the needed services for free when it decided no local funding was needed. Nor do we know at this point whether it will.*

Also fair to conclude that it saw no urgency in providing for some stop-gap measure that would allow low-income seniors to keep getting their grocery bags.

After all, the Urban League issued its notice to clients on or about September 16.

DOH clearly knew by then that the food programs wouldn’t operate unless something were done PDQ. But, so far as we know, it didn’t go directly to top-level people in the Gray administration. If it did, then they’re at fault too.

All we know for certain is that they jumped in only when alerted by DC Hunger and the grassroots messages it generated.

Or maybe only when the advocacy spun off into, among other things, a query from the director of the DC Council Committee on Human Services and negative publicity foreshadowed by the original DePillis column.

In short, it’s a fine thing that low-income seniors will continue to get their free groceries without interruption. But there never should have been a moment’s doubt about this.

* In response to a query, DOH informed me that it is still in negotiations with “the potential subgrantee” and that “until negotiations are finalized, discussions … will remain confidential.”

Quick Action Saves Food Programs For Low-Income DC Seniors

September 27, 2011

More than 6,600 seniors in the District of Columbia will benefit from two sources of food assistance in the upcoming fiscal year.

But they wouldn’t have without a timely intervention by DC Hunger Solutions and all of us who signed its petition. Because the District failed to budget a relatively small amount to keep the assistance flowing.

Here’s the story, with what seems to be a happy ending.

The main source of food assistance that just got saved comes from the federal government under the Commodity Supplemental Food Program. As its name suggests, the program provides bulk processed and packaged foods, which local agencies then distribute to low-income residents.

Here in the District, as elsewhere, most of them are seniors with incomes at or below 130% of the federal poverty line.

They get monthly bags of nutritious foods worth about $52 each — a meaningful contribution to healthy eating for seniors who have to stretch very tight budgets in our high-cost city.

The other type of food assistance that was at risk comes from the Senior Farmers’ Market Nutrition Program, also federally-funded. This program provides low-income seniors with coupons they can use to buy limited amounts of fresh produce and/or honey at local farmers’ markets.

The District limits the coupons to seniors who participate in the commodity food program and relies on the same administrative function to distribute them. Low-income seniors thus stood to lose an additional $30 per year in food assistance.

Why, you may ask, did the District have to come up with any money if the programs are federally funded?

The answer is that the federal funds don’t fully cover the District’s administrative costs.

More specifically, the U.S. Department of Agriculture provides the commodities for the grocery bags, but only a fixed amount for administrative costs, based on each state’s projected caseload.

Here in the District, administrative costs exceed what the federal government provides. This, I’m told, is generally the case for states as well.

Grants for the farmers’ market coupons are based on a formula set by USDA. Agencies must spend at least 90% of their grant funds on reimbursements to farmers, market operators and the like for coupons used.

Here again they generally have to come up with some of their own funds to cover all the administrative costs.

The DC Department of Health has formal responsibility for administering the two programs. About 18 months ago, it decided to outsource the ongoing administrative tasks, e.g., verifying eligibility, distributing the groceries and coupons.

So it issued a grant to the Greater Washington Urban League, which was already operating a number of social services programs in the District, as well as in Prince Georges County, Maryland.

As with so many of these things, the District’s budget never had a line item for the grant. But funds were somehow found to renew it last year. These, if I understand correctly, covered about half the administrative costs and federal funds the remainder.

This year, the Urban League was told it would have to find another source for the administrative costs the District had paid for. It tried, but without success. So it notified its clients and volunteers that it would end its role in the program, effective September 30.

DOH apparently had no backup plan. Hence the urgent message from DC Hunger Solutions.

Well, Mayor Gray got the word — and sent out word to his people that he wants the programs continued.

E-mail from a top-level Executive Office appointee says “short-term solution” now, to be followed by “new management,” i.e., another nonprofit service provider.

So it seems that funds will be found to ensure that both the commodity food program and the farmers’ market coupon program will survive for another year.

And a good thing too. DC Hunger Solutions tells us that the small investment the District will make translates into about $4.1 million in food for low-income seniors who might otherwise go hungry — or at the very least, have to survive on a poorly-balanced diet.

Now, can someone in DOH explain why we had a near-crisis about this?

NOTE: I’m crediting — and I think rightly the work of DC Hunger Solutions and its allies, including petition signers. But it’s no coincidence that word of a solution went out shortly after Washington City Paper columnist Lydia DePillis put the issue in the public eye.

UPDATE: A followup posting delves into the final question above. It summarizes new information that’s been unearthed, as well as what we knew when I wrote this. As you’ll see, DOH still has some explaining to do.